Author Topic: Medical/mental help for a family member with mental health issues  (Read 8549 times)

SunnyDays

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Re: Medical/mental help for a family member with mental health issues
« Reply #50 on: June 14, 2020, 05:05:16 PM »
Irritability is also a symptom of depression.  He doesnít necessarily have to seem sad.  Withdrawal from family activities or anything that takes effort can also be symptoms.  However, if it was that situation specific, he maybe just didnít/doesnít value family interaction that much, sorry to say.  It probably isnít uncommon for someone of his generation (and maybe culture?) to see the manís role as being the provider and once thatís done for the day or for life, then thereís nothing else left to do.  Everything else is the womanís role.  A lot of men have trouble with retirement because then they donít know what to do with themselves.

As far as the diet goes, have the doctor or nutritionist put their evaluation and recommendations in writing for him?  If what he can eat is there in black and white, itís harder to say he canít eat anything.  He might just mean that he canít eat anything he likes, in which case, he will have to adjust his palate.  If he wonít even try to adapt, you canít do it for him and pressuring him about it will just make him more resistant.  You canít be more concerned about his health than he is.  Sometimes people play these games just for the attention and the most beneficial thing to do is to express confidence that he can do whatís best for himself, then leave it alone.

Sibley

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Re: Medical/mental help for a family member with mental health issues
« Reply #51 on: June 14, 2020, 06:07:42 PM »
Having worked in the field I agree with all of Sunnyís recommendations. I also wonder if he is developing dementia. Being paranoid is a major component.

This is what I'm wondering too - it seems like there's a component of dementia at play here but the psychiatrist didn't seem concerned about that at all. Of course, the assessment was done over Zoom which probably isn't the best thing....

In a state of depression/anxiety, and if someone is 'aware', is it common for them to manipulate their response to mask or hide the fact that something's wrong? My brother has observed that in some cases when my dad is talking to certain people, he'll act and give off the impression that he's totally fine and normal.

It's very possible with dementia I know. Particularly in the earlier stages. My dad does this actually. He can pretend that he's perfectly normal in front of people, he's capable (sometimes) of fooling the doctors who are supposed to monitor his cognitive function - except that they also know that he's capable of it. I would imagine that someone with depression may be able to do the same, at least for a while.

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Re: Medical/mental help for a family member with mental health issues
« Reply #52 on: June 14, 2020, 08:57:39 PM »
2 thoughts about getting assistance: can you set them up with a meal delivery service, possibly one recommended by the nutritionist so it's all stuff your dad "can eat"? And is there someone that your mom or dad admires and trusts who could recommend a cleaner or companion or something? Even if you have to ask the friend to fake-gush, hearing from someone their own age that "Mary is so helpful, I don't know how I did it without her, she's so trustworthy" could help with their reluctance. I just think that it's time to start some outsourcing since they have the income to afford it.

Cassie

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Re: Medical/mental help for a family member with mental health issues
« Reply #53 on: June 15, 2020, 10:30:40 AM »
Yes people can hide depression or dementia and act normal.  I hope he tries the CBT. It can be very effective.

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Re: Medical/mental help for a family member with mental health issues
« Reply #54 on: June 15, 2020, 12:40:41 PM »
I think your dad should see a good therapist. Get referrals from friends and be wary of anyone who accepts insurance. Sad to say, and apologies for generalizing but no really good therapists are in-network anywhere, especially in the bay area. If you aren't paying $200 a session at least, they probably aren't going to be experienced/smart/mature enough to be of much help.

jeromedawg

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Re: Medical/mental help for a family member with mental health issues
« Reply #55 on: June 17, 2020, 10:46:34 AM »
Update: my dad had his follow-up appt with the psychiatrist. The psychiatrist expressed concern and wants my dad to go in for a comprehensive neuropyschological screening and MRI/brain scan. The reason, he says, is that my dad is having trouble trusting my mom (who he has been married to for 50 years now) and also professionals (who he thinks are often wrong about their assessments of various matters). This is a drastic change from his initial assessment that my dad is just anxious and depressed but maybe that's how he had to 'start' things given he's a new patient? But I was calling for this months ago when I observed my dad circling back to the *same* issues repeatedly, despite having been reassured of them over and over.

So I can't help but think that the more comprehensive testing will reveal that he likely has some form of dementia. Is it common for people to 'slowly' develop this condition where small changes will occur earlier on (irritability, detachment from personal social gatherings, etc) then something traumatic like an unrelated physical health condition/issue arises and the condition devolves into a worsened state? It sounds like this might be the case as some of you have alluded to.   

Cassie

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Re: Medical/mental help for a family member with mental health issues
« Reply #56 on: June 17, 2020, 05:47:19 PM »
Yes my friend didnít get worse for a long time until she got suspicious that her husband was having a affair. He was old, sick and caring for her.

MayDay

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Re: Medical/mental help for a family member with mental health issues
« Reply #57 on: June 18, 2020, 05:58:56 AM »
Yes that is very common. People learn coping mechanisms to hide the dementia, and when something throws them off and the coping doesn't work, there is a step change.

Often this is seen with a medical procedure- someone can cope in their own home that they've lived in for 50 years but if they are admitted to the hospital for something, they fall apart and end up being unable to return home. Obviously your dad is at an earlier stage than that if he is indeed suffering from dementia/Alz/etc.

jeromedawg

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Re: Medical/mental help for a family member with mental health issues
« Reply #58 on: June 18, 2020, 09:17:17 AM »
Yes that is very common. People learn coping mechanisms to hide the dementia, and when something throws them off and the coping doesn't work, there is a step change.

Often this is seen with a medical procedure- someone can cope in their own home that they've lived in for 50 years but if they are admitted to the hospital for something, they fall apart and end up being unable to return home. Obviously your dad is at an earlier stage than that if he is indeed suffering from dementia/Alz/etc.

Yes my friend didn’t get worse for a long time until she got suspicious that her husband was having a affair. He was old, sick and caring for her.

I see - thanks for the info. Yea, hopefully the more comprehensive screening/brain scan will give more 'closure' especially for my mom who has had to deal with all this. Something just seems off because often when we do Google Hangouts with my dad he sort of just 'spaces out' with a blank stare at most points of the conversation. He just becomes totally disengaged and if you try to engage him he'll put his hands on his face or rub his eyes out of frustration because he doesn't want to hear it or be involved (earlier on before the meds he would put his hands over his ears a lot - he still actually does this but not as much. He's apparently sensitive to noise). And often he complains that everyone is going to look at him and it's going to be embarrassing. On one call he was telling my mom to quiet down because all the neighbors would be able to hear her conversation with us about him (and they have double or triple pane windows!).

jeromedawg

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Re: Medical/mental help for a family member with mental health issues
« Reply #59 on: June 29, 2020, 12:09:06 PM »
Appt for a more comprehensive battery of tests with the neuro psychologist is next week apparently. And the MRI of his brain to be scheduled within the week. In the meantime, he has been driving my mom and brother absolutely crazy. It seems like there's no light at the end of the tunnel with this. My brother says this is how my grandmother (dad's mom) also was, so I guess it was passed down... I'm scared of how I'll be when that time comes :T

ysette9

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Re: Medical/mental help for a family member with mental health issues
« Reply #60 on: July 05, 2020, 11:27:18 AM »
Iím so sorry to hear how hard this is on your family. I hope the brain scan shows something useful. Aging is scary.

jeromedawg

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Re: Medical/mental help for a family member with mental health issues
« Reply #61 on: July 10, 2020, 12:08:09 PM »
My mom gave us a quick update after meeting with the neuropsychologist - her report is that my dad is severely depressed. No signs of dementia or Alzheimers... unless he has some level of intellect that recognizes how to answer questions to the point that he is able to continue to fool two different psychologists and the psychiatrist and mask his dementia/Alzheimer's (my mom pointed out that prior to the battery of testing, he was anticipating the questions and claimed to know what the psychologist would be trying to ask/find out). So I dunno. He did have an MRI this week as well and there will be a follow-up with the psychiatrist next week to review all findings.
Anyway, I have noticed in recent calls that he seems to be slightly more willing to engage with the kids and talk with them - not much but his tone has slightly changed to be similar to what it was before. I even heard that he picked up a basketball and shot around with one of my nephews at a small 4th of July gathering they had last weekend; something I've only seen once in my life before (when I was probably in late elementary or early junior high) and he had a relatively decent shot (bricked it but his form was good LOL). Anyway, he still frustrates my mom and makes her cry - yesterday on the Hangouts call he sort of just wrote it off as "you know, it's just me again, making your mom cry" as if he were feeling sorry for himself but also that it was no big deal.

SunnyDays

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Re: Medical/mental help for a family member with mental health issues
« Reply #62 on: July 10, 2020, 03:40:14 PM »
Well, at least it's not dementia.  If he has that level of awareness of how to "con the system," then he likely doesn't have dementia.  Alzheimer's patients can be crafty at any given time, but likely not in a sustained way.

If your dad isn't responding much to meds, there is something called Transcranial Magnetic Stimulation that can provide a fair amount of relief from depression. He could discuss this possibility with his doctor.

jeromedawg

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Re: Medical/mental help for a family member with mental health issues
« Reply #63 on: November 30, 2020, 05:23:41 PM »
Quick update on things: I can't believe it's been almost a year now. Since I posted my dad has been put on Lexapro and now Wellbutrin. And his dosage of Wellbutrin increased as well. IIRC I think they bumped up his Lexapro too. He still is underweight but hovering around his lowest range (between 120-130lbs). I think he still has many of the same fears but they're just more subdued with the meds now. My mom is wanting him to get back to his 'normal self' but not sure if that'll happen or if it'll be like it was before all this. The guy is extremely unmotivated and just wants to lay around all day. He'll actually do some stuff if you get him to. We visited last week and had to force him to go out for walks, etc. Doc says sunlight and some exercise is good but he is unmotivated. He's frail and walks gingerly likely due to the weight loss. The thing is, he didn't have many interests or hobbies prior to this episode and would just sit in front of his computer or withdraw to his room and be isolated (even amidst social activities) nearly all day. The difference is that he actually had some interest in cooking food and doing docent work (sometimes) at local museums. He has lost interest in all these things.


Moonwaves

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Re: Medical/mental help for a family member with mental health issues
« Reply #64 on: December 01, 2020, 04:02:25 AM »
Sorry to hear about what a tough time your dad and your family is having. For what it's worth, I've just caught up on posts since June and everything you say really does sound like depression to me. Or at least very like my particular flavour of depression (everyone's is different). Catastrophising is something I really have to watch out for, and has and does hold me back from achieving quite a lot that I, in theory, do want to actually do. Hallmark movies? Totally understand that - what do they generally have in common? Happy endings. Usually with a hefty emotional twinge thrown in there somewhere. I have a series of historical comedy/romances that I re-read almost every year, usually around August and/or February, which seem to be my difficult times. And yes, smiling depression is definitely a thing. I don't even try to hide it during bad episodes but later find out that friends and colleagues generally have absolutely no idea that I have ever been at all depressed.

I'm glad he doesn't seem to have any serious neurological issues and hope both he (and your mum) are able to get to work with good therapists.

mozar

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Re: Medical/mental help for a family member with mental health issues
« Reply #65 on: December 02, 2020, 01:23:39 PM »
My grandmother went through something similar, where she lost interest in everything. She went on like that for years until she died. It's sad to say but in hindsight I think she was done with being alive.

jeromedawg

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Re: Medical/mental help for a family member with mental health issues
« Reply #66 on: December 03, 2020, 11:16:00 AM »
Sorry to hear about what a tough time your dad and your family is having. For what it's worth, I've just caught up on posts since June and everything you say really does sound like depression to me. Or at least very like my particular flavour of depression (everyone's is different). Catastrophising is something I really have to watch out for, and has and does hold me back from achieving quite a lot that I, in theory, do want to actually do. Hallmark movies? Totally understand that - what do they generally have in common? Happy endings. Usually with a hefty emotional twinge thrown in there somewhere. I have a series of historical comedy/romances that I re-read almost every year, usually around August and/or February, which seem to be my difficult times. And yes, smiling depression is definitely a thing. I don't even try to hide it during bad episodes but later find out that friends and colleagues generally have absolutely no idea that I have ever been at all depressed.

I'm glad he doesn't seem to have any serious neurological issues and hope both he (and your mum) are able to get to work with good therapists.

The Hallmark movie stuff he was watching prior to this episode. Now all he watches is the cooking channel and football if anything. He's generally just disinterested in everything and doesn't seem to want to do anything. When we talked to him about cooking stuff, something he was really into (even though he wasn't great at it), he kept on alluding to it as a thing of the past. I think there's a sense of guilt as well in terms of how he used his time in retirement (he retired earlier in his mid 50s IIRC) but was extremely unproductive. Always on the computer and if he did anything around the house to help my mom, etc it was always a half-a job that would fall apart half the time. I think he realizes a lot of this now and feels guilty and incompetent with many things. He tried helping my mom install a toner cartridge the other night and couldn't figure it out and ended up just being frustrated about the entire thing, which didn't help. Doc has changed up his dosage to take half the Wellbutrin in the AM and the other half after lunch - I think he did this yesterday and my mom said he was better. So I guess the full dose of the Wellbutrin makes him really tired and groggy in the morning. Already, the mornings are the challenge for him (he seems to get better as the day goes on and most 'coherent' in the mid-late afternoon through the evening).


My grandmother went through something similar, where she lost interest in everything. She went on like that for years until she died. It's sad to say but in hindsight I think she was done with being alive.


Yea, I kind of feel this way - he just seems "checked out" from life at this point.

SimpleCycle

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Re: Medical/mental help for a family member with mental health issues
« Reply #67 on: December 03, 2020, 01:18:00 PM »
Hey @jeromedawg, you're describing "anhedonia", the inability to feel pleasure (and subsequently, motivation to do pleasurable things).  It's a hallmark symptom of depression, but can also be a symptom of other mental illnesses and physical illnesses as well.

I think if it's been a year since you first sought treatment without much improvement, it's probably time to get a second opinion.  Some of this could be related to aging, but it really sounds to be like inadequately treated depression.  I'd be concerned about his weight and frailty secondary to appetite loss as well.

If I recall your parents are in the Bay Area, so I'd strongly consider booking an appointment with a psychiatrist at UCSF or Stanford.  Academic medical centers see a wider variety of patients than a private practice psychiatrist, and can offer a wider array of treatments.  They can also consult with other specialties if needed without having to refer out.

Continued thoughts for your parents and you, this stuff can be so tough.

lhamo

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Re: Medical/mental help for a family member with mental health issues
« Reply #68 on: December 03, 2020, 03:54:14 PM »
If he hasn't seen a gerontologist, you might want to go that route -- might be easier to convince him and they should be able to refer him to a psych specialist if that is really what is warranted.

My MIL has Parkinson's and early signs of it were paranoia/hypochondria and depression.  All have gotten worse as her parkinsons has progressed.

Moonwaves

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Re: Medical/mental help for a family member with mental health issues
« Reply #69 on: December 04, 2020, 12:06:29 AM »
The Hallmark movie stuff he was watching prior to this episode.
I got that. I just meant that he might indeed have been suffering from depression for a very long time, even if no-one, especially he, realised it.

jeromedawg

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Re: Medical/mental help for a family member with mental health issues
« Reply #70 on: December 08, 2020, 12:03:52 PM »
Hey @jeromedawg, you're describing "anhedonia", the inability to feel pleasure (and subsequently, motivation to do pleasurable things).  It's a hallmark symptom of depression, but can also be a symptom of other mental illnesses and physical illnesses as well.

I think if it's been a year since you first sought treatment without much improvement, it's probably time to get a second opinion.  Some of this could be related to aging, but it really sounds to be like inadequately treated depression.  I'd be concerned about his weight and frailty secondary to appetite loss as well.

If I recall your parents are in the Bay Area, so I'd strongly consider booking an appointment with a psychiatrist at UCSF or Stanford.  Academic medical centers see a wider variety of patients than a private practice psychiatrist, and can offer a wider array of treatments.  They can also consult with other specialties if needed without having to refer out.

Continued thoughts for your parents and you, this stuff can be so tough.

Thanks - good to know the term. I'll mention it to my mom and for her to bring it up in future conversations with the psychiatrist, psychologist and PCP. I remember the first round of 'research and weeding out' that I did trying to even find a psychiatric group, psychologist, etc that were covered under their plan. It was extremely difficult and felt like slim pickings all the way around. Even how he landed with the current doctor was so roundabout. It was very frustrating trying to find help at least up that way. I'll look into UCSF and Stanford though... ugh, dreading it.

If he hasn't seen a gerontologist, you might want to go that route -- might be easier to convince him and they should be able to refer him to a psych specialist if that is really what is warranted.

My MIL has Parkinson's and early signs of it were paranoia/hypochondria and depression.  All have gotten worse as her parkinsons has progressed.

Yea, we had discussed this previously but my mom is so stuck on their PCP and continuing just to see him because he's been their PCP for the past 30-40 years *rollseyes* - to me, the guy doesn't provide much help or benefit to them and wants to just defer to the psychiatrist they have. All he did was pretty much scold my dad for not eating. Then told him to go see a pulmonologist because it sounds like he thinks my dad has a case of walking bronchitis or walking pneumonia.  Part of the hassle of trying to find help up there too was my mom's insistence and pickiness of who she sees, and deferring to her PCP. On the other hand, we have multiple doctors in our extended family who she has reached out to for advice/help. I think she just wants to have a certain level of trust and assurance; a lot of it is her looking for the silver bullet too and hoping/expecting for an overnight fix (even though she'll tell you she understands it won't be). But for her I think this is a "no end in sight" type of thing so she's grasping for any shimmer of light she can find.

The Hallmark movie stuff he was watching prior to this episode.
I got that. I just meant that he might indeed have been suffering from depression for a very long time, even if no-one, especially he, realised it.

Ah ok, yea you're probably right. Prior to this 'meltdown' we noticed a certain amount of detachment and awkwardness in social situations/gatherings that sort of devolved probably within the past 5-6 years up until the point that he completely broke down. At home he just always wanted to be in front of his computer or laying own watching Hallmark. At social gatherings he kept to himself unless he found something very specific to talk about with certain people. I would describe him as mostly withdrawn though.

SimpleCycle

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Re: Medical/mental help for a family member with mental health issues
« Reply #71 on: December 08, 2020, 12:07:55 PM »
Hey @jeromedawg, you're describing "anhedonia", the inability to feel pleasure (and subsequently, motivation to do pleasurable things).  It's a hallmark symptom of depression, but can also be a symptom of other mental illnesses and physical illnesses as well.

I think if it's been a year since you first sought treatment without much improvement, it's probably time to get a second opinion.  Some of this could be related to aging, but it really sounds to be like inadequately treated depression.  I'd be concerned about his weight and frailty secondary to appetite loss as well.

If I recall your parents are in the Bay Area, so I'd strongly consider booking an appointment with a psychiatrist at UCSF or Stanford.  Academic medical centers see a wider variety of patients than a private practice psychiatrist, and can offer a wider array of treatments.  They can also consult with other specialties if needed without having to refer out.

Continued thoughts for your parents and you, this stuff can be so tough.

Thanks - good to know the term. I'll mention it to my mom and for her to bring it up in future conversations with the psychiatrist, psychologist and PCP. I remember the first round of 'research and weeding out' that I did trying to even find a psychiatric group, psychologist, etc that were covered under their plan. It was extremely difficult and felt like slim pickings all the way around. Even how he landed with the current doctor was so roundabout. It was very frustrating trying to find help at least up that way. I'll look into UCSF and Stanford though... ugh, dreading it.

The good news is academic medical centers usually take a wide variety of insurance!  The downside is there can be a long wait to be seen.  Private practice psychiatrists often don't take insurance, or only take a few plans, which is incredibly frustrating.  Sending you good vibes - I know it can all be overwhelming.

jeromedawg

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Re: Medical/mental help for a family member with mental health issues
« Reply #72 on: December 08, 2020, 12:20:55 PM »
Hey @jeromedawg, you're describing "anhedonia", the inability to feel pleasure (and subsequently, motivation to do pleasurable things).  It's a hallmark symptom of depression, but can also be a symptom of other mental illnesses and physical illnesses as well.

I think if it's been a year since you first sought treatment without much improvement, it's probably time to get a second opinion.  Some of this could be related to aging, but it really sounds to be like inadequately treated depression.  I'd be concerned about his weight and frailty secondary to appetite loss as well.

If I recall your parents are in the Bay Area, so I'd strongly consider booking an appointment with a psychiatrist at UCSF or Stanford.  Academic medical centers see a wider variety of patients than a private practice psychiatrist, and can offer a wider array of treatments.  They can also consult with other specialties if needed without having to refer out.

Continued thoughts for your parents and you, this stuff can be so tough.

Thanks - good to know the term. I'll mention it to my mom and for her to bring it up in future conversations with the psychiatrist, psychologist and PCP. I remember the first round of 'research and weeding out' that I did trying to even find a psychiatric group, psychologist, etc that were covered under their plan. It was extremely difficult and felt like slim pickings all the way around. Even how he landed with the current doctor was so roundabout. It was very frustrating trying to find help at least up that way. I'll look into UCSF and Stanford though... ugh, dreading it.

The good news is academic medical centers usually take a wide variety of insurance!  The downside is there can be a long wait to be seen.  Private practice psychiatrists often don't take insurance, or only take a few plans, which is incredibly frustrating.  Sending you good vibes - I know it can all be overwhelming.

I think the first appointment with the current psych was back in April. It's a group that utilizes Transcranial Magnetic Stimulation for treatments but so far the psych has not recommended this path. My mom says my dad was doing and getting better up until mid-late Oct (which coincidentally was his birthday). He had coughed up some blood in his mucus (due to suspected bronchitis) and to my mom's recollection and notes (she logs progress pretty much consistently), he "spiraled" since then becoming listless and negative. It seems the course of action in response was to increase Wellbutrin as well as break up his dosages to be spread throughout the day. My mom spoke with my uncle, who is a pharmacist, and he said that it may just need more time to adjust and get used to the meds. In any case, I have a feeling my mom will still want to defer to her PCP and the same psychiatrist. It's really hard for her to break-away, even if something's not helping, because she wants to believe so hard that it will help. But I'll plant the seeds in her head and at least send her the suggestion w/ phone numbers to at least make the option known.

lhamo

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Re: Medical/mental help for a family member with mental health issues
« Reply #73 on: December 08, 2020, 05:06:12 PM »
Have you read Being Mortal by Atul Gawande?  Lots of good stuff in there about how to improve quality of life for elders.  Might also find some strategies for dealing with your mom.

jeromedawg

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Re: Medical/mental help for a family member with mental health issues
« Reply #74 on: December 16, 2020, 04:59:59 PM »
Have you read Being Mortal by Atul Gawande?  Lots of good stuff in there about how to improve quality of life for elders.  Might also find some strategies for dealing with your mom.

Not yet - will have to look into it.

Currently my dad's weight is down to 120lbs, which is the lowest to date. My mom is struggling with trying to get him to eat but I think part of it is that she's stuck on this notion that he has to be severely limited with what he eats... this "notion" originally came from him demanding that he only eat certain things. Now he lacks appetite probably because he doesn't want to eat any of those things and forces himself to most of the time. He has diabetes so he does have to be careful but his PCP and multiple other doctors have told him he needs to gain weight back and eat again. They've met with at least one or two nutritionists who have given them tips/advice but I don't think they're listening. One was to eat more meals throughout the day and to stop constraining himself to a very limited set of bland foods (quinoa, chicken, any any sort of veggie with barely any salt... sounds awful to eat every meal). My mom has been slowly expanding out with things like In and Out burger, burritos, pizza (well, my brother makes it so it's not the crap pizza from most fast food joints), etc. I told them moderation is key - don't go nuts but eat what you want and do it more often.  Balance it out with healthy stuff. Talk to your nutritionist. My mom makes excuses and doesn't want to calorie count or meal plan for my dad (understandable). The problem is that he himself is not sufficient enough. Frankly, I don't think know what to do to make him gain the weight back; either the nutritionist has no idea what he/she is talking about or my parents aren't listening, and I think it's the latter.

Any "tips" or advice on how to get someone in this state of mind to start eating and gaining their weight back?

lhamo

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Re: Medical/mental help for a family member with mental health issues
« Reply #75 on: December 16, 2020, 05:20:55 PM »
My mom lost her appetite as she aged.  It is really hard to eat when you can't taste anything/nothing tastes good.  She was pretty good about drinking 1-2 high protein Ensure/day for the last year or so.

Please try to get him in to see a gerontologist.  I really think they will be in a better position to help than his old PCP or generic nutritionists. 

jeromedawg

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Re: Medical/mental help for a family member with mental health issues
« Reply #76 on: December 16, 2020, 05:37:20 PM »
My mom lost her appetite as she aged.  It is really hard to eat when you can't taste anything/nothing tastes good.  She was pretty good about drinking 1-2 high protein Ensure/day for the last year or so.

Please try to get him in to see a gerontologist.  I really think they will be in a better position to help than his old PCP or generic nutritionists.

What is crazy is that he'll demolish stuff like sushi, pizza, In and Out, etc. My mom, even though she denies it, restricts him on what he can or can't eat. So I don't think it's just him. Someone offered Ensure (they had extra) and she told my dad but he didn't want it.

It's going to be really difficult convincing him to see anyone besides his PCP... especially a gerontologist because "those are for old people" - they have a lot of shame when it comes to asking people for help

BTW: what's the diff between a geriatrician and gerontologist?
« Last Edit: December 16, 2020, 05:41:13 PM by jeromedawg »

Accrual

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Re: Medical/mental help for a family member with mental health issues
« Reply #77 on: December 16, 2020, 06:14:31 PM »
I am sorry to hear about your dad, Jeromedawg. It cannot be easy seeing a parent in that state. I empathize as I have been in your Dad's state for the past year or so. I am 29 years old. Also on Lexapro and Wellbutrin. I periodically will experience states of panic, euphoria, and the feeling like I am literally losing my mind. Mornings are also bad.

Like your dad, I focused on things I could control (since everything seemed so out of control) - finances. It got to the point where I had to ask friends and my parents to take possession of all finance-related passwords so I wouldn't do anything rash. Thankfully that has passed (for now).

Was your dad under an immense amount of stress before you noticed the symptoms you outline in the original post? I believe my symptoms are a result of acute work stress along with the lack of a formal schedule the pandemic had brought to my personal life. Perhaps these two variables could also impact your dad.

My suggestion is to try and implement a rigid schedule for you dad - i.e. every day take a walk at the same time, around the same neighborhood, or setting side specific time to watch television. A schedule is what bumpers are to a bowling lane: they keep you in the lane to knock down pins (life). A schedule may also help with any anxiety / stress he may be experiencing. A formal schedule has tremendously helped my grandmother who suffers from dementia. Something to think about.

Like others have mentioned in this thread - diet is huge. Minimize caffeine. Try to cut down nicotine (if he uses it).

I sincerely hope this helps. I normally don't get this personal on forums but fuck it.
« Last Edit: December 16, 2020, 06:19:10 PM by Accrual »

jeromedawg

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Re: Medical/mental help for a family member with mental health issues
« Reply #78 on: December 16, 2020, 07:08:00 PM »
I am sorry to hear about your dad, Jeromedawg. It cannot be easy seeing a parent in that state. I empathize as I have been in your Dad's state for the past year or so. I am 29 years old. Also on Lexapro and Wellbutrin. I periodically will experience states of panic, euphoria, and the feeling like I am literally losing my mind. Mornings are also bad.

Like your dad, I focused on things I could control (since everything seemed so out of control) - finances. It got to the point where I had to ask friends and my parents to take possession of all finance-related passwords so I wouldn't do anything rash. Thankfully that has passed (for now).

Was your dad under an immense amount of stress before you noticed the symptoms you outline in the original post? I believe my symptoms are a result of acute work stress along with the lack of a formal schedule the pandemic had brought to my personal life. Perhaps these two variables could also impact your dad.

My suggestion is to try and implement a rigid schedule for you dad - i.e. every day take a walk at the same time, around the same neighborhood, or setting side specific time to watch television. A schedule is what bumpers are to a bowling lane: they keep you in the lane to knock down pins (life). A schedule may also help with any anxiety / stress he may be experiencing. A formal schedule has tremendously helped my grandmother who suffers from dementia. Something to think about.

Like others have mentioned in this thread - diet is huge. Minimize caffeine. Try to cut down nicotine (if he uses it).

I sincerely hope this helps. I normally don't get this personal on forums but fuck it.

Thanks for going out on a limb and sharing your experience. Even though it sucks in reality, it's helpful to know directly from someone in the same boat that he's not the only one out there going through this.

In terms of stress, I don't know if it was pent-up stress or what. He said there are a lot of things he didn't tell my mom though. There were a number of things going last year leading into this year but the biggest trigger I think was my dad's physical health - he had constant recurring abdominal pains and had to go through a near full battery of examinations and tests to rule out lots of things. I think it was determined that he was diabetic (runs in the family) amidst all this. Prior to that, I don't think there were any huge traumatic instances. It may have been a serious of things that just piled up over the years. There are a lot of things he has talked about regretting/resenting like being all over the place with finances, and not being on top of other various things (they kind of hoarded a lot and he would buy tons of electronics and crap), etc. They also had multiple deferred maintenance issues with one of their rental homes, which prompted my mom to sell this year.

Good to know about the schedule - one of my brothers suggested this but it was largely ignored. However, I think he does try to go out for walks and such. The doctor actually ordered him to do that. He lays down A LOT - says it's "comfortable" for him. Psychologist says it's important to define or figure out what he really means when he says he's "comfortable" - like is he comfortable because he's not in physical pain when he lays down? Is he comfortable because he doesn't have to deal with something he knows he should be doing but doesn't want to do?

He cut out coffee and has never smoked so those aren't current factors. He's just paranoid about anything that is put on the plate that he has to think about eating... or was... he was given 'permission to eat anything' just to gain the weight back (hence the mukbang fests with In and Out, Pizza, Burritos, etc). In fact, after first getting word of the doctor's orders to eat, he went to town on an entire footlong burrito. Ate half of it w/ some soda, laid down for an hour, got back up and ate the other half w/ sparkling water, then proceeded to throw it all up...smh
The guy has no sense of moderation and never has, so I think that's something that has stuck with him... anyway, my mom wants to feed him quinoa and unsalted chicken w/ broccoli every night, so it's not a surprise that he's losing weight. I'm probably overstating the facts but I know for a fact that he doesn't like her cooking and she hates cooking (esp for him) so it kind of just doesn't work out and is forced. They're too cheap to hire a personal chef (even though they can afford it) so the next logical route is to convince them to get more takeout or delivery. My brothers and I are meeting tonight to discuss this. My brother who lives behind them has already offered to bring food over for him more frequently. And he stated that when he does my dad devours it. So there's something here that my mom is missing...

Poundwise

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Re: Medical/mental help for a family member with mental health issues
« Reply #79 on: December 16, 2020, 10:46:25 PM »
I just finished reading this thread.  My mother (late 80s) has some of these same irritating aspects. She was always an anxious, negatively oriented person, and since my dad passed a few years ago, her anxiety has gone through the roof. 

Like your dad, she seems to be able to turn the frailty on and off as convenient to her.  She also gets fixated on certain worries that are either nonsensical or easily dealt with. She's obsessed with her health, worried about getting diabetes, and watches her diet madly.

I am not her primary caregiver (she now lives in a different state, near my brother), but here are some suggestions for your dad, based on our experiences:
- Sadly, you can no longer depend on your dad or even your mom to take care of themselves. Consider them as having the ability of a couple of young teens to live by themselves... if your dad needs medications or supplements (I suggest Vitamins B12 and D3) somebody like your brother should load them up in one of those weekly pill organizers for him. Don't rely on your mom to take care of it.

-  You and your other brother should be calling him daily (or alternating) if you are not doing so already... perhaps you could practice CBT or other exercises with him at this time. We have the kids call my mother as fortunately they have a very warm relationship with her.

- Your dad is likely unable to plan or complete complex tasks (like selling his rental) or even multi step simple tasks any more.   You and your siblings will have to finish them.

- You should consider having food delivered a few times a week until your father reaches a healthy weight

- Have your doctors brought up the possibility of an eating disorder? Anorexia is surprisingly common in the elderly as a control issue, and leads to confusion and lethargy. https://www.theguardian.com/education/2001/jun/07/medicalscience.healthandwellbeing1

Good luck!! This is such a tough time.

SunnyDays

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Re: Medical/mental help for a family member with mental health issues
« Reply #80 on: December 17, 2020, 10:57:10 AM »
Well, frankly, I wouldn't eat either if I was presented with quinoa, chicken and broccoli every day!  If your dad has an appetite for other foods, that's good, he just shouldn't overdo it, because his stomach is likely the size of a walnut by now.  The question is how to get more variety of foods into the house without depending on your mom.  If your brother can help out twice a week and they can get take out once a week, that's a start.  You could look into something like Meals on Wheels if that's available in your area or stores/services that provide individual frozen meals for the rest of the time.  Is there a neighbour who would like to make a few bucks cooking for them in his/her home and bringing it over?  Maybe some smoothies?  Time to get creative. Your mom may welcome not having to cook.  Apart from the diabetes, is there some reason he can't eat most of whatever she cooks for herself? 

A schedule of activities is a good idea.  Writing it down and posting on the fridge could help, with meals/snacks scheduled in 5 or 6 times a day. When it's in writing, it seems more like an order than a suggestion.

It sounds like there are some relationship dynamics behind the food/eating issues.  From previous posts, you dad sounds extremely (pathologically) passive, and eating is the one thing he has total control over.  Maybe he's using it to express other issues. 

jeromedawg

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Re: Medical/mental help for a family member with mental health issues
« Reply #81 on: January 02, 2021, 02:47:24 PM »
Quick update: my dad went in to see the pulmonologist and had a CT scan done where they discovered a small 5cm 'lesion' which the doctor thinks may be some sort of bacterial infection - this would explain all the coughing and hacking that he's been experiencing. He has a biopsy scheduled this Monday to collect a more definitive sample so is anxious about that but my mom is saying he's doing OK so far and has been eating more (after the 'all-hands' meeting we had a couple weeks back where we were really getting on him to get back to eating). But the doctor also prescribed him antibiotics to take for whatever is in his lung and my mom says it seems to be helping and she hasn't noticed him coughing as much. I'm sure the coughing/hacking doesn't help him with his mental state as far as feeling any better but hopefully as it subsides, he'll generally feel better and gain more of his appetite back.

Anyway, my mom has been largely avoidant and resistant to any sort of meal plan/MOW as well as any sort of counseling/help from others - she believes she's in full control of the situation, which I think is some sort of coping mechanism in of itself (except when things go 180 she starts emailing more and this is perceived as "distress signals" so while it may be 'beneficial' it can easily backfire on her just as much if not more).

mozar

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Re: Medical/mental help for a family member with mental health issues
« Reply #82 on: January 03, 2021, 09:35:20 AM »
Good update!