Waiting for the trainwreck: What do you do when your LO refuses to trust family or doctors

pq · August 31

Hi! I was on the boards here 7+ years ago for my dad, and now I'm back for my cousin.

My younger cousin, 56, probably has early onset Alzheimer's and it's being exacerbated by self-medicating. She had an MRI in January and a PET scan in April that showed elevated amyloid in three of four lobes and borderline in the fourth. Since May she has been manic, paranoid, delusional, projecting her own mental symptoms onto her husband. She's also physically unwell, having had urine and bowel incontinence for months, and an ongoing yeast infection. She is an unreliable reporter of her own health and actions, and she has threatened herself and her husband at times.

Her husband and mother tried to have her involuntarily hospitalized to get help, but Cousin is a former social worker and was able to showtime enough to get the magistrate to dismiss the motion. Several days later, she actually took herself to an ER, where her mental symptoms were bad enough that they sent her to a mental hospital. She was there for two weeks, and admits that she played compliant and "better" in order to get released. So now she's home, no better, and we're all in the same nightmare we were before, only Cousin trusts her family and doctors even less than before.

So what can we do? If a person is unable to see that they are sick, how can you get them the treatment they need? Ironically, she said of her husband that "They [dementia patients] become paranoid and see the person who they love and who loves them the most, as the enemy," but this is actually a description of her right now. We all feel so helpless.

terei · August 31

Sometimes you do have to wait for a crisis before someone can take control. In the meantime the family should try their best toNOT provide ‘scaffolding’ to enable her behaviors. Try to get video of any bizarre confrontations + do not hesitate call EMS to have her transported to an ER if she becomes threatening. Then on to a Geri psych ward for assessment + medication. She is also with it enough to see through manipulation so it’s going to be tough. Sometimes early onset progresses very fast+ she may deteriorate quickly which actually may make make helping her easier sooner than you think.

This is probably the most challenging type of behaviors for the family because they are handcuffed by the whole system to prevent them from keeping their LO safe from their own actions. Her medical issues may keep her within the orbit of MDs who should, sooner or later, with progression, see that she is incompetent to make her own (illogical) decisions.

I would quietly + gradually make sure she has less and less access to anything that could threaten the welfare of the whole family(credit cards, savings, retirement accounts etc) Mail addresses can be changed (PO box) so that accounts are not even being seen by her. Banks + brokerages can be made aware of the situation in case she tries to access funds. Passwords can be changed, etc. Cars made less accessible or unavailable at all. Good luck

SDianeL · September 1

Welcome. Sorry about your cousin. Your cousin does not have the ability to realize she has a problem. She has Anosognosia which is a neurological condition that prevents people from recognizing or acknowledging their mental health or neurological deficits. The term comes from Greek and means "to not know a disease". People with anosognosia may be unaware of their illness or the extent of it. Does her husband have a DPOA? If not the only option may be to petition the court for guardianship. The court should get access to all her medical records.the next time she goes to the hospital her husband should tell them that she needs to be medicated and that it’s not safe for her to return home until her meds are working. It takes time for the meds to work and for them to find the right combo. Her behaviors are consistent with Alzheimer’s. As someone posted here that hit home for me was “you can’t reason with someone whose reasoner is broken” Learn all you can about the disease. Read the book “The 36 Hour Day” and have her husband read it. Google for dementia caregiving videos. Tam Cummings and Teepa Snow have good ones.

Waiting for the trainwreck: What do you do when your LO refuses to trust family or doctors

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