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She throws tantrums, screams non-stop, wets herself and refuses to go into a Behavioral Rehab. 5 different Doctors have said these actions are all her choice. She's been seeing a Therapist for over a year but refuses to change. She has been in a Behavioral Hospital 4 times this year because she was violent and repeatedly hit my sisters/father. How do we care for her? An in-house nurse is not an option because she has bankrupted my family.


She has been on several different medications but nothing seems to work. She never calms down. Her screams have caused neighbors to call the cops. What do I do?

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I agree with other people who have suggested Alzheimer's as a possibility. One thing about Alzheimer's is that it can't be 100% definitively diagnosed or ruled out until after death, with an examination of the brain. With the behavior and symptoms you've described, I don't think any physician should say, "It's not Alzheimer's" unless that physician can say, "It is X." And so far, no one has done so.
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You know, this sounds like Alzheimer's. It doesn't show up on tests at first. It seems she is not in control of her behavior so to suggest she is being willful seems odd. Screaming at night is a symptom I have seen in Alzheimer's patients. In early stages not all the usual symptoms appear. If she has it, in time other symptoms may appear. Each person is different. The screamers sometimes don't seem to know they are doing it. She is a problem and has not had a proper diagnosis. She should be in a care facility. Something is wrong with her. I hope it can be found soon.
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Apply for Medicaid as she has no money left. Why do the Behavioral Hospitals release her if she is no better?
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This will seem cruel, but your mom seems resistant to changing her behavior. She is risky to have at home since she harms others. Apply for Medicaid. Get her into a locked psych/rehab unit that will take Medicaid.

This is my weird thought. Have folks pray for her, you, and the family. Prayer does seem to help people... even folks that don't believe.
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NeedHelpWithMom Aug 2019
That’s not weird. Can’t hurt to pray. We still have to do our part along with prayer.

I think of the nuns at my school who always instructed us to turn to God but not be lazy and expect God to do everything. We were told to pray to do well in school but it was our responsibility to study and work hard for our grades.
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Is there anything or anybody (including you) that seems to trigger this behavior? If she won't change, you may have to change the people and environment around her. The staff at the Behavioral Hospital may have some insights about this.
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This doesn’t sound like normal stubborn behavior to me. How do you lock someone out daily and just allow them to enter a home to sleep? That seems cruel.

Can you video tape her and show her psychiatrists the tapes? If she is bankrupt can she apply for Medicaid to receive free mental health help? I hope all of you, including your mom finds peace soon.
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Has a physical cause, like a brain tumor, been ruled out?
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Frances19 Aug 2019
She has had all neurological testing done. She has been thoroughly examined at according to my father and her records. No brain tumor.
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The comments from your mother’s therapist ("lock her outside the house during the day and only allow her to come into the house to sleep at night"), from the Behavioural Health Care facility (isolate her and ignore the screaming), and from 5 different doctors (these actions are all her choice), all suggest that your local Health Professionals really think she is choosing to behave badly – have lost patience and are at their wits’ end. It seems an unlikely choice for your mother, unless you can think of any ‘rewards’ she gets from acting this way. It seems more likely that something bizarre has gone wrong in her brain. Reading Oliver Sacks’ books is an eye-opener about just how bizarre and unusual things can be, as a result of a brain malfunction (eg The Man Who Mistook His Wife For A Hat). The sudden onset (a year ago) would be in line with this. Barb’s good suggestion is to go up the ladder as far as you can, to get the possibilities assessed by neurologists and psychiatrists. Is seems like everyone local is out of their depth. I wish your family the best of luck.
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Frances19 Aug 2019
She has been thoroughly examined and any neurological issues have been ruled out. It is a behavioral choice because when the cops have shown up in the past, she acts completely normal (very meek and calmly answering questions).
The therapist says this is her way of punishing my family for moving on with our lives while she is still miserable. Though she did choose to move with us she has not wanted to actively participate in her life.
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Hi Frances. Very sorry for your Mom and your entire family. It sounds like it’s been an awful year for all involved. I agree your Mom needs a full neuro work up with mri to rule out a few things. Will she allow a family member to be medical POA on her behalf so that someone can speak freely with medical staff to fully understand what is going on?
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Frances19 Aug 2019
She has been tested to rule out tumors or any neurological issues. She has been through many different medications to try to control her behavior. Her last Doctor simply said it was her "stubborn will" that wasn't allowing the medicines to calm her down. And she has been on high doses.

She does not care about the consequences of her screaming out loud constantly during the day. Even the mentions of the police coming back doesn't phase her at all. I just don't know how to control the screaming... punishment means nothing and she doesn't care for rewards.
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Has she seen a neurologist?
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What sorts of doctors have worked her up?

Behavioral issues are sometimes caused by physical issues. Brain tumors, Wilson's disease, demyelinating diseases spring to mind.

Get her to a Board certified neurologist or psychiatrist at a university hospital for a complete diagnostic workup. I'm glad to hear that she doesnt have dementia.

ALL of the physical possibilities need to be ruled out before someone says that these behaviors are " her choice".
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Frances19 Aug 2019
I will make this suggestion to my family. I know she has had certain testing done in our local hospital and even an out-of-state hospital but I'm not sure which tests. Will do a follow up on that!
Thank you for your suggestion. I do appreciate it.
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If this is new behavior, there is obviously something seriously wrong.

I would push for getting to the root of the problem, especially since the meds are not working. Are you sure she takes the meds? Not to be mean, but until her problems are resolved, I don't think she really gets a vote in refusing to get help and/or change (which I don't think she really has much if any control over). With her violence and over-the-top behavior, she is certainly a danger to herself but mostly to others. It is not a safe place for the rest of you. I would get her back to her doc ASAP and nicely but firmly demand that SOMETHING be done.

Personally, I could not live with someone like that. She needs professional assistance, much more than you and your family can even consider giving her.

If it's ever in a really really bad place, you could always call 911 to have her taken to the ER and then let them know how bad her behavior is and refuse to take her back home. At this point, it is NOT her choice. She does not appear to have the capacity to make choices of this importance at this time.
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worriedinCali Aug 2019
You can call 911, yes, but your mother can refuse to go and unless they think she’s a danger to herself, they won’t be able to force her to go.
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If your mother has been diagnosed with Alzheimer's (per your profile) it's hardly fair to say that these behaviors are her "choice". Did she have mental health issues before her dementia diagnosis?

What level of care do her psychiatrists recommend ?
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Frances19 Aug 2019
I didn't realize that I had put she was diagnosed with Alzheimer's. She does NOT have Alzheimers nor does she have Dementia. I included those in my research for how other Caregivers cope with family member diagnosed with those conditions.
She is only diagnosed with Depression and Anxiety. She has never had issues with any mental health conditions up until this time last year.
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Has she had a full neurological work up. MRI scans and checked for tumors or other brain issues.?
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Frances19 Aug 2019
I'm not sure but I will certainly check up on that.
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