My mother is in her mid 70s and now lives with us. She has pain (arthritis) and medicated bipolar disorder. Sometimes she retreats to her bed, staying there for 36+ hours. Sometimes she attributes it to a cold, other times to a migraine... she has always done this, and she doesn't seem to want to discuss it - for her, it's just the way it is.

But now that she lives with me, I find myself wondering what I ought to do. Should I respect her preference to be left alone, or should I probe for causes? Should I try to monitor whether she is taking her meds and drinking enough water?(she curtly says she is, but can I just accept that?)

I am home now, but soon will be back at work full time. I won't be able to personally check on her, and in this state she does not respond to texts.

Mbfoster; Hello Good question I often wonder If I should check on Auntie more often an assisted living I beleive they lawfully have to check the residents every 2 hours , but at home whats the protocall ? For us I make Auntie come out for 3 meals a day and have a chair in the liveing room for her to sit in , although Auntie argues we convince her to come out she has dementia so you never know what shes going to do thats why I keep her close to us I always say well these are the rules if you do not follow them youll end up getting hurt then maybe even a nurseing home...she does what we say then .But when I worked in a AL sometimes residents refused to come out or get out of bed its usually in the Winter its very hard for a person with bipolar disorder to stay on a level emotional place the seasons change causeing depression of course thats when they stop takeing meds this is a cruel cycle. I think 2 hours during daytime at home and before you go to sleep and when you wake up., if I get up to pee I check on Auntie and I get up EVERY night to pee about 3 times .maybe you have a neighbor or family that will check while you are at work,just an idea maybe you should take control of her meds to make sure shes takeing them.GOOD LUCK you are a good daughter !!
Helpful Answer (1)
Reply to Lorraine12

I would take her to her doctor and explain this odd behavior. Sleeping that long deprives her of proper nutrution, liquids, and medicine intake.
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Reply to Llamalover47

I would not take her word for it that she is taking her meds and drinking enough water. I suggest you do two things to help you truly monitor:
1. Get a 7-day pill box and fill it at the beginning of each week for her. Then you can track what is really taken, and bring it to her at the end of the day if she has not.
2. Fill a large water bottle at the beginning of each day. If she likes it cold, she may also drink more if you make it ice-water. If you can get her in the habit of that being her go-to place to drink water, you now have something you can monitor.
Good luck!
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Reply to shedwells

It is possible your mom is what is called involuntary confinement, and is not aware that she is separating herself from daily life activities that can lead to depression. Have you informed her PCP of her new behavior? When you return to work, maybe someone who have senior care experience, and medication training / management stop by for a hour or so to ensure her medication is taken, and morning care, and meals has been completed and eaten. Having companionship that is not family attached sometimes help with the new living arrangements. I offer consultations, other informative information and services.
I hope the adjustment period passes, and your mom gets back to enjoying her elder years.

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Reply to MyCalling

Yes you need to check on her. She could get bedsores. If her hygiene goes then she could get a UTI and that would require Doctor visits, medication, worst case scenario hospitalization. she needs to be taken care of whether she wants it or not. Respect is key. one small thing at a time. Explain and be gentle and consistent. Try not to talk if that helps. I had a client that we often did things in silence because she really didn’t want it done, actually despised it, but she knew it had to be done. some people think Constant positive talk is the right thing to do To keep the clients spirits up, but that is not always the case. (I have wanted to tell other caregivers to shut up sometimes). Another alternative is to give them Service in silence because that’s the only space they can retain their dignity. Often, I was more successful with giving her detailed, well explained, logical reasons why she had to do something, with respect, talking to her like she was an adult, then any cajoling Could do. You know your mother. I am not against cheery talk. I think it helps us keep our spirits up sometimes more than them. it’s a dance. And sometimes you just have to do it and that can be in silence too. Get into a face to face support group for yourself. You sound very kind, but you will need support.
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Reply to Lizhappens

Would she consider you managing her medications for anything serious -like her bi-polar, blood pressure, meds, etc. She could still be in charge of her vitamins, baby aspirin (if she takes those) and any other non critical meds. You are in a tough spot. I would definitely get her to a geriatric doctor. Does she have a doctor monitoring her bi-polar medications. It sounds like they aren't being taken properly or it needs to be adjusted. Getting the right combination is a challenge and may need adjusting every now and then. Just a thought to kick around.
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Reply to montanacmm

I can completely understand where you are coming from with your concerns.
In my opinion your mom is living under your roof now and she should probably start sharing her life with you however that said when I took care of my mom whom had a terrible form of Demita I sat her down and talked to her. She finally agreed to let me in. When someone you love has bipolar there’s a lot of give and take. Meaning they dish it out while you sit back and take the hit ( per say) so it’s extremely important that your mom take ALL her medicine on time every day. If she misses her meds she may have an episode that could be ugly. You need to sit down with your mom and tell her how you feel. She’s living with you so in my opinion you have every right to make sure she’s okay. I mean give her space but just politely knock on her door and she if she needs anything. This is what I did and it worked.
As for when you have to go back to work I would try to get Homecare started. She may qualify for assistance. Call her insurance company and find out if you can get a Homecare aide to come in to assist her with her needs. Homecare aides can do so much for her. They can help her with bathing/ toileting (if needed) or just anything that involves the general actives of daily living ( ADL). This also involves medication reminders. The aides can’t touch the meds but can remind your mom too take them and write down the time she did. Aides can also provide companionship to your mom so she won’t feel lonely. They can also cook, clean do your mom’s laundry and so many other things. If your mom qualifies this will help you while you are at work. You have enough on your plate right now. If it were me I would look into this. Your mom may not want anyone at first but ask her to give it a trial run. These Homecare agencies are there to help but you need to do some homework before you just pick anybody. Ask the department of aging for a referral for your area. Pick a aqency that has good ratings and ask around. You can even ask her insurance company.
Bipolor disorder is nothing to mess with. It’s a terrible diagnosis to have. It’s very manageable with medication but when one starts to miss thier doses this disease can show its ulgy head. I really hope you can come to an agreement with your mom. I hope she will let you into her life. It’s going to be a struggle I believe. However don’t give up keep pushing it will pay off in the long run. The bond between a mother and daughter is priceless. These are the days now that matter the most. Try to make the best of each day given. It’s really all you can do now. She needs you more than she thinks she does.
I wish you well and keep the Homecare in mind. Going this route may ease your mind somewhat. 🙏🏻💕
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Reply to Caringangel
GraceLPC Jan 7, 2019
Excellent answer. Also have your Mom write down how things go with caregiver. At first there are often different people till you get on a schedule.
Even with a respected agency I had one person storm out after 8 minutes and another threaten to leave 5 times. Agencies appreciate instant feedback. Sometimes it was 😀😀😀😀😀, with new worker, after long email about bad worker.
You can audit the responses based on her emotional state, but this will give her a better feeling of Control over her care & life! That her input is sought and respected.
Mom is now residing with you. New Rules with her living under your Rule of Thumb, hun. Yes, Make sure she is safe and sound, check on her, get her to a doctor when she needs it to make sure she is on the meds as needed. Get her a Life Alert, My dad just got one. If you are going back to work, make sure it works and that Mom abides things that will work for her to make her safe while she is alone at your home on her own.
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Reply to Parise

Hi, all --
Mom popped out of her room and was 'right as rain' today -- the same as she did the last time (the day after Christmas). We talked it over, as she was in a fairly good state of mind. She said that she had been getting up to take her tiny dog out when the dog needed to go. She indicated that this is just what she does sometimes, and there's no cause for alarm. She also agreed that we need to have a way to tell when she is in distress vs when she's just resting.

I guess there may come a time when leaving her alone to rest will have been the wrong thing to do -- but until then, it seems like the right thing to do.
I will talk to her about how I can monitor her medications, which she keeps in a pill-box with am/pm compartments. And I'll take her some coffee in the morning if she hasn't gotten up, and some tea and broth in the afternoon and evening, so she stays hydrated and knows she hasn't been forgotten. She seems happy with that.
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Reply to MBFoster
SusanW56 Jan 6, 2019
It sounds like you have a good plan. I was concerned when you mentioned she was not seen for up to 36 hours at times. I am very much a loner and prefer not to deal with people or much activity so I understand where she's coming from but under the circumstances touching base with her at least once or twice a day sounds good...keep strong!
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Good morning!

What precipitated moving in with you? Was she not taking care of herself? The 36 hour sleep fest would concern me too. My mother also suffers from arthritis and Bipolar disorder along with other ailments. Just from the information that you gave us, I would get her an appointment with a geriatric physician and psychiatrist. Whatever medication she is taking is not working very well. Her doctors need to be informed of this behavior.

The biggest issue is her medication. If she is sleeping or non functioning for 36 hours at a stetch she is probably not taking her medicine as she should, nor eating or drinking properly. Bipolar disorder is one of those conditions that convinces the sufferer that they don’t have a problem, so they stop taking the medicine. My mother suffered one hospital stay after another when I was growing up due to this. As my siblings and I had to take over more and more of her daily care, we made ourselves responsible for her medication. Although she still had hospitalizations for other physical issues, her emergency trips to the psychiatric ward were geatly diminished.

She sounds as if she is in the depressive side of the disorder now which could lead to the manic. If you have never experienced a full blown Bipolar episode, just picture a behavior-affecting UTI times 10! You want to avoid this for her and for your household.

Of course you want to give your mother respect and autonomy, but I suspect she moved in with you because she needed help. Her medication and food and water intake are the help she needs. After her geriatric doctor appointments you could blame it on them. “The doctor says I need to monitor your medicine (cwillie’s suggestion of daily pill boxes will help you keep up). The doctor says you have to drink lots of water with this medicine. The doctor says this medicine needs to be taken on a full stomach, etc.” Most of these medications are given in the morning and in late afternoon, so you would probably be available to administer them.
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Reply to Treeartist
GraceLPC Jan 6, 2019
Well said. I know one medical alert company was working on a pill box with alerts at time to take medication, and a call to family member if dose not taken within a given timeframe. Not sure if it is out yet.
Yes, she is not aware of how her Bi- Polar really effects her. She has always had it, thus the "it has always been this way" explaination. The only thing it can't monitor is if she swallows them.

I suggest bottles of water & small juice boxes in a cooler bedside. I get large bear shaped container of Animal Crackers, and stock Protien & breakfast bars to eat so I have something starchy on my stomach before taking meds that should be taken on a full stomach.
Instant oatmeal, mashed potatoes are also great "full stomach foods".

I too get migraines. Wish I had someone to assist when I get one, because they can be debilitating.
36 hours in bed is extreme depression. Then suddenly Right as Rain, is low level manic episode. She needs to have her medication levels closely monitored.
It appears you are aware that dehydration can cause terrible headaches, so you need to stay ahead of it. Your MIL knows nothing different. You might need to hire a helper to come in to help with meals and medication monitoring. Get someone with a gentle touch and familiar/experienced with her ailments!
At 30 the body is more resilient to periods without food or enough water. Age compounds these effects. Feeling too sick to move, or get up and cook, prepare food, clear your dishes, get to the matter the ailments... having someone keep you fed and hydrated, and on schedule with your meds makes your health and quality of life much better.
I do not have bipolar, but have been very restricted by other health issues. I am also a retired Mental Health Counselor, so I have seen the negative effect if pandering to the belief system of the person with this illness can have.
She may still isolate, but she has a fighting chance to have a better quality of life if she is monitored and given assistance she needs.
I like willies idea for blister pks and Ahmijoy's for a nanny cam.

At 70 you are not going to change Mom. Just let her do her thing. She is safe in your home. If she sleeps 36hrs and always has, let her. This is how she deals with life. You can't enjoy a person if you are constantly trying to manage them. Try to enjoy what time you have with her. Dementia will eventually rob her of her memories.
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Reply to JoAnn29

This has to be a very difficult dynamic to live with, I think I would do a simple check in to see if she would like anything at meal times and bed time and call it good. One way to monitor the meds is to have them put into daily pill containers or pharmacy blister packs.
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Reply to cwillie

My #1 concern with this situation is that your mother is bi-polar, you are not certain if she is taking her medications and she will soon be left alone.

If she has always taken refuge in her bed, there isn’t much you can do to change her now. You cannot pour water down her throat or force feed her. She’s survived this long this way. Her bed is obviously a safe haven and to try to change her now would only cause much stress for everyone. She is living in your home now,for whatever reason, but she is still living HER life and will most likely not offer any confessions or reasons why she’s like this if she hasn’t already done so and has avoided the issue.

As for leaving her alone, perhaps an available sibling could look in on her each day? If she’s in her bed and not responding to texts, someone will need to do an in-person check on her. Chances are she will also not get out of bed to let a hired caregiver in. A “nanny cam” might work better in this situation.

You need to find someway to monitor her medications. Mom may just have to realize that this is the way it is now, and as far as the meds go, you will be supervising her.
Helpful Answer (2)
Reply to Ahmijoy
JoAnn29 Jan 3, 2019
She is now an only child
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