When can caregiving become overzealous and or abuse?

The decisions are just plain tough at this point. The hardest part is that nothing will make your mom "better". All you can do is make thins better . . . My mom is in a Memory Care Unit. She started striking out physically at people who were trying to help her and running away (once she got out the her own door she didn't know where she was) when we kept her at home. She was also isolating herself because she was so confused by going out. Now she has a contained social world and she gets an opportunity to do things and see people without feeling lost. She also has breathing issues (COPD) and sometimes has to be on oxygen and a nebulizer. She doesn't fight it nearly so much when she thinks a nurse is administering it. She responds better to the structure of an Assisted Living environment than she did to us (it's tough to be told what to do by your kids when you are used to being in charge). I visit often and she is happy and at peace. She was recently put on one of those black box anti psychotics (she was going through a rough patch) and I understand your concern. Be sure they start with a really low dose and adjust up if you need to. Be sure she is not being sedated and look for opportunities to wean her off once she is over the Pneumonia and he life evens out. It is a constant process. I know we believe it is always better to keep someone in their home, but I have learned that is not always true. Of course you really have to find a good place if you make that choice. There are plenty of "bad" places. We were lucky.

All I can say is that SSRIs are first choice for anxiety and OCD as well as depression, they do vary somewhat in side effects, and if the Celexa was not the culprit in the headaches and was helpful, there is no reason not to resume using it. In really dicey side effect situations, changing one drug or dose at a time and giving each thing a few days to be sure often makes sense. Nothing is a sure thing for everyone! Some side effect patterns seem to run true in families, other times one person can take a med that mom or kids can't tolerate at all. Except for more severe reactions, for myself I usually try things a second time before I put them on my list of stuff I won't try to take again, as I've seen mistakes made in both directions. I would personally fire a physician who did not want to work carefully with me around side effects.

If you talk this one into trying buspirone - it's been a good choice for us in an acute rehab practice for anxiety and agitation, relatively few people too sedated on it and very rare to have antipsychotic-like motor effects, OR if you decide to try the Depakote after all - see if you can get a small supply to try first and see how it goes. Wish it was easier. Maybe someday they will have better pharmacogenetic testing that covers more common side effects of more common drugs, right now its more out there for stuff that can kill you rather than stuff that will make you miserable...

Oh - and the hand-print shaped bruising - especially if you got a photo, that could potentially be called in as potential abuse. They should not be pretending nothing is there or nothing happened,thinking they can just claim you overreacted because you are anxious have panic attacks. You would need to be pretty objective about what you saw and come across as such in communicating about it, and trying to react when you need to and let things go when you need to, while staying calm and objective, is a real challenge in a very emotional situation. I hope you have good help for yourself med-wise!

holycow, There are SSRI's and SNRI's and let me explain the difference. SSRI's can actually trigger manic behavior because they only affect serotonin.
SNRI's affect both serotonin and norepinephrine (the panic hormone) so they tend to level out behavior. I would try an SNRI for six weeks before jumping to the antipsychotics. Talk it over with the MD, but in the long run, trust his judgment and inform him you cannot take care of her, nor can she return home alone in her current state. She will need a longer course of treatment or referral to a secure facility. You have done all you could, God keep you safe.

Just a quick thought on the bruise. What is her platelet count? If it is low, she will bruise very easily. Remeron and many other drugs can induce thrombocytopenia ( low platelets/long clotting time). If it is normal, then I am going to guess she really fought them on the blood draw.

Gracious, I feel for you. My father didn't get quite that bad before going on Namenda and Aricept which seem to be working for him. He used to be combative verbally. He takes inhaler meds now, but compliance to use it correctly is an issue. I like the nebulizer answer but bet there would still be a fight, so having another party administer who may be able to gain her trust might work. Daddy always loved someone doting on him, so any home nursing visits or doctor visits where the nurses just make a big to do all over him made him calm and quiet. If she has pneumonia maybe she needs hospitalization for a few days (enough to qualify for home health visits which would be Medicare covered), and then her recovery might come along a little smoother. In the hospital if she is combative they may need to have sitter stay with her in the room, (also Medicare covered). Good luck!

I was so dreading Mom's doctors appointment yesterday as her doctor has not been kind or on the same wave length about her care lately. I have to say I have been doing a lot of praying about this and asking for guidance. When we got there we had Mom taken to one room while my sister and I met with the doctor. When we arrived in his office a second doctor was there as well, I believe her being there changed everything.

The doctor had already removed Mom from the Celexa and he decided to remove her from the Remeron as well to see if the headaches she had been experiencing ceased. I would be lying to say that did not frighten me as without medication she was not sleeping at night, upset, angry and flipping on our lights during the night, keeping us all awake until we were losing our minds.

Today Mom was fine, we had no problems at all. I realized everything has to be kept quiet, low key, played her favorite music, let her sit in the garden. The problem began between dinner and bedtime with last minute details, locking up, everyone being home, take dog for a walk etc. These she must do over and over anyway but without meds it was a bit worse.

The doctor now feels that if the headaches are not related to the Remeron and Celexa, he may put her back on them rather than the Anti-psychotics. I hope we can stay on lesser drugs for the time being. Today made me wonder how much she actually needs them at all but I know her condition is like a roller coaster and as soon as we think she is fine, she will get worse. I just know that I cannot take care of her if she is obstinate and angry, screaming and yelling. Mentally and physically I just cannot handle this all alone when she is in a bad condition.

My sister who is of no help in caring for Mom and actually stays at work 4 hours after quitting time so she does not have to be around the "situation" left to go to her doctor to have a CT scan done of her brain. I think she believes she is developing dementia or Alzheimer's as well. I refuse to take care of her, she has made my life miserable and continues to do so. She also filed a FALSE report with APS against me, saying I beat her and caused bruises and scratches on her arms. She did this to herself in an attempt to have me jailed and removed as Mom's POA. My 16 year old niece was here and saw everything and was my witness which is all that saved me. I have felt that I was losing my mind caring for my mother with zero compensation for the last 8 years, I will not care for my sister. I know that sounds horrible, but I just cannot.

HC, sounds like you had a good doc visit today! I hope the med changes work for everyone.

And you sure as heck will not find me caring for sisters if the ever develop this wretched disease! No help from them, only additional stress and also a false report on me to APS. They will have to wing it .

With my husband, as with your mom, I just wanted to keep him clean and dressed; leaving him in wet smelly clothes, unwashed, with long nails, Moses-like beard, bad breath......all of these seemed like abuse. However, he would fight me terribly to get these things accomplished and I would get frustrated and angry at times and probably looked like I was abusing him, pushing him down on the bed and forcibly pulling off his wet clothes (often getting hurt myself in the process). It was hard to "surrender" and accept that I am not God, and just walk away, again and again, until the medication calmed him better, or until a change in the brain made it possible to help him.

holy cow your mother has dementia. The truth is what she believes at that moment so trying to convince her otherwise is a waste of breath. decide which is most important. To me taking the antibiotics is more vital than the nebulize. having that in her mouth may make her feel claustrophobic so as suggested try holding it under her nose or let her hold it if she will. next time it is due present it as a new treatment with luck she will have forgotten. Having it forced and becoming agitated will not be effected. keeping the air in her room adequately humidified will also help and changing to the nebulizer.
i would definitely agree to the antipsychotics. in my view having a calm demeanor far out weights any black box warning. it means she is at increased risk not that she will have a stroke. priorites are the way to go and if a nursing home is going to be the only way she gets proper care that's the way to go and do it without guilt you have done your best and that is always good enough

HC I'm sitting here with my mouth fallen open. Refusing to entertain the idea of caring for your *sister* if she gets dementia "sounds horrible"? Are you crazy?

What sounds horrible - in fact you've just introduced a notion that will have me waking in cold sweats all night long - is the very idea that you MIGHT feel obliged to care for your demented sister (hypothetically, I mean - spit spit, God forbid that she ever gets the disease at all).

Mind you I think if there is one person in the world who would be more aghast at that idea than me… it'd be my sister, at the thought of my looking after her.

So please! Caring for our sisters next? That idea ends RIGHT here.

ValerieHecht: As far as my family members go you are completely right in what you say, everyone could do something to help. Neither of them choose to help and I hear the same thing over and over about siblings who do the same thing. My younger sister does have it hard with working 12 hour days to keep her home, the loss of her husband to MD and having two children to care for. She actually told me this week that she would work less on one day a week and care for Mom so I could attend a caregiver support group. The other sister who lives with us continues to get off work at 2:30 and show up at home between 5-7pm so she does not have to help. She may sit with my mother and watch TV for an hour or so then go to her room and she believe she has done her job. When I asked her to be home to watch Mom so I could attend the group and not make our younger sister lose work and money, she spouted off that she did not give a D--m that my sister would lose work or that she needed it to pay the mortgage on her home.

jw: Brought up the fact that we need to take care of ourselves if we are to be any good to anyone else. I have a therapist that comes to my home to talk with me every Monday morning and see how the week has gone. She continually tells me that I MUST leave the house on the weekend at least or I will go crazy. I was trying to go out for a while each weekend and then it went down to every other weekend and now live in sister who cares only about herself has had a meltdown that I EVER LEAVE THE HOUSE! Her real problem is that I leave the house with my daughter and my younger sister and her daughter. The 4 of us enjoy each others company so we may go out to eat or a movie or a swap meet. Older sister does not like this and has now informed me that I CAN NO LONGER LEAVE THE HOUSE ON THE WEEKENDS WITHOUT HER PERMISSION BECAUSE SHE MAY HAVE THINGS SHE NEEDS TO DO. Now I am 61, use your imagination as to what words I told her off with! What she has now resorted to doing is watching me to see if I am getting ready to go somewhere. She gets up in the morning and dresses, hair and makeup as well then basically waits to see if I am going to get ready to leave, then she dashes out the door first. Or if I am leaving she wants to know when I will be home because she has numerous places to go. To that I have just told her that she has 5 days a week where she refuses to come and help, therefore in that extra 4 hours each day she better make sure she has completed all of her tasks because come the weekend, she will be the care giver while I do what has to be done for myself! She yells and screams and throws a fit and pushed me out of her bedroom the other day and slammed the door in my face.....she is 66.

She is very rude to my mother as well. I believe she does this so I will not leave her in charge of our mother. You know how some men with fake incompetence so their wives will not ask them for help, well I think she does the same thing where most everything is concerned any more. The other night the sprinklers came on outside and it was suppose to rain the following day, so she comes to my door and says "the sprinklers are on." I was speaking with my daughter so I looked at her and said, "Would you like to go turn them off?" She replied, "No." and walked to the bathroom.....I let them run.

This particular sister does the things she does because she has had a problem with me since my birth, that she failed to ever get over. She further makes my life miserable with Mom because it is my punishment for taking Mom's MDPOA and financial. She will make me suffer no matter what because I put a stop to her taking Moms money to pay her bills.

Countrymouse: She tells me that she is having a brain scan done as a baseline for her doctors to go by. I am sure she believes she has the beginning of dementia or Alzheimer's as it does run in our family. My mother's mother had 3 sisters and I believe 4 brothers although I never knew the brothers. All of these siblings had children that have had Alzheimer's. My mother is the only one in her siblings to have dementia.

I know my sister has a mental problem and has had it her entire life...it is called being a B--ch! She has alienated both of her children who are in their 40's and either do not claim her as their mother or will only speak to her, "when hell freezes over." By the way this lovely woman is an elementary school teacher!

Countrymouse: Do not worry I have braced myself for saying NO to giving her any care. I have enlisted the help of my younger sister and her children as well as my daughter to knock me in the head and drag me off if it even looks like I may fall prey to caring for her. Since she has filed a FALSE report against me to APS I would be a fool to touch her with a 10 foot pole....actually I can't touch her, APS told me that "I cannot ever lay a finger on her!" I hope she does not need me to save her life some day!

I am sorry that I sound so horrible but you can only take abuse for so long until you stand up and have to fight back. When my mother is gone, I honestly hope I never see this sister again. She offers nothing but pain and misery to my life.

jw: just a fast answer about the Tylenol, Mom is currently using the strongest or highest potency of Tylenol that they make and it does nothing to stop the headaches. Advil, Tramadol, nothing she can take with stop the headaches when they hit. She is on blood thinner so there is no asprin she can take and we have not found anything to stop the headache yet. A slight headache would be manageable but hers became all day long every single day to the point she had to lay on the bed with ice or heat and nothing worked. Celexa can upset the sodium in your blood and cause headaches but even off the meds she is continuing to have them. She did not have them prior to beginning the meds.

I so want to respond to all of you who have made such valid points and I greatly appreciate you all!

Time to trick your sister. Pack a little bag the night beforewith your clothes makeup bath stuff etc for the day on Friday night. About an hour before she wakes up creep out of the house with your stuff - no don't evern use the bathroom - hold it till you get to your daughters. Get yourself leisurily bathed and dressed and enjoy breakfast with the family and set out for the day. Or get ready fast and get the hell out of there before sis showes up. Stick a note on the fridge with instructions for the day before you leave. If you find she leaves mom alone file charges.. call during the day to make sure she is home with Mom.

Holy Cow - all I can say is Holy Cow. Your older sis has some major problems. Are there any community resources or paid caregivers that could give you some respite? You may have covered this already. I apologise if you have. You do need regular breaks - without question. You do not sound horrible at all. I plan to not seeing or communicating with my sis except possibly through lawyers while the estate is settled, after our mother dies. Why would you want to have her be any part of your life? I am so sorry about these dreadful headaches your mum has.

Veronica - nice plan in some ways but it would only work once, if that. The idea appeals...

Emjo it might only work once, but if it was me, that memory would last me a L-O-O-O-N-G time, LOL!! And it would make older sis awfully jumpy every weekend as to whether it would happen again.

HC why does your sister live with you and your mom? Sounds like you'd be better off if she wasn't there. Does she contribute to the household expenses?