My mother is bipolar (manic-depressive). I just found out that she has not seen a psychiatrist to check on her medications in at least 10 years -- despite the fact that in the intervening time she has had multiple traumas (including the suicide of her only other child, my brother, a few years ago).

I don't know who to blame - I guess she just told her GPs that she was fine.

But recently she told my son that she thinks we will "kick her out", and the thought makes her suicidal.

Now, with coronavirus, the chance of getting her to see ANYONE in person for a medication evaluation seem pretty minimal.

Today she did something she does from time to time: she spent the whole day in bed, not even getting out of bed to take her dog outside.

Not getting up to get coffee or anything to eat.

I don't track her meds. I don't want to hover over her like that. But I think it is possible that she misses doses when she takes to her bed.

In fact, I have gradually come to see that she is an 'unreliable narrator' on a number of counts.

In short, I don't know how able she actually is to care for herself, but I am reluctant to step in and do more because she is very happy to do nothing at all to help herself. (This has always been her way, since before I can remember.)

Any words of advice? Anyone??

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Good evening,

I am reposting my answer (see below)to a similar question you asked in January of last year. I’m sorry your mother’s medication issues have still not been resolved. My mother’s psychiatrist recently told me that as a patient ages the episodes become fewer and fewer. At issue here is that your mother is still fairly young. At 78, my mother was still capable of manic/depressive episodes that were beyond belief! You say you don’t want to track her meds or hover over her, but what kind of life is she leading now?

My mother’s mental and physical health improved greatly after we took control of her medicine, but this didn’t happen until she was about 65. Prior to this, those times in which she stopped taking her medication and went into full blown episodes took a tremendous toll on her body and mind. She is now 88 and lives in a nursing home due to moderate dementia and many other physical issues, but she is not suffering the torture of untreated bipolar disorder. She is able to interact with others and family to the best of her capabilities and find joy in small things. Today I prayed with her through the window of her room at the nursing home (no visitors allowed now). We are still vigilant about her mental health. We know the signs when her medicine has to be adjusted. Nurses see so many quirky behaviors from dementia patients that they are not as quick to realize when our mother needs help. A UTI can wreak havoc with her medicine levels.

Good morning! (from January, 2019)

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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My question is, who "is" prescribing her meds. In my state, you have to see a doctor every six months to get refills especially if a DEA controlled drugs. And a prescription is needed monthly for a DEA drug. I doubt if a
psychiatrist is still prescribing her meds after 10 yrs of not seeing him.

Medications have changed for BiPolar in the last few years. Mom needs to have a good physical and go from there.
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I think the OP has hinted at her mom not being as transparent as she should be. She is not telling her doctor everything. Sad, because her meds may need adjusting and she is pretending everything is okay.
There is nothing wrong with medication reminders.
Bipolar and Schizophrenia can be greatly helped with medication.
However, non-compliance with meds is part of the condition.

Is she showering? Can she keep her own room clean?

I am wondering how she comes to confide her suicidal thoughts to her grandson, and if you feel this is appropriate for him to carry this burden? If you are not involved with your mother's illness, (for whatever reasons, it is understandable), can you hire a caregiver who could do medication reminders? She might just need some encouragement, a schedule, socialization with peers, meals prepared and attended in a board & care environment geared towards the treatment of her condition.

It does not appear that you are hovering at all.
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You have given us quite a bit of background on your mom and that is helpful. So your mom is seeing a GP for her meds and since she is exhibiting depression at the current time and is suicidal you are thinking she needs to see a psychiatrist for an evaluation of her meds? Seems reasonable. Since she is older it might be helpful for her to see a geriatric psychiatrist. Does her idea that you might “kick her out” have any basis? Have their been arguments etc?
Medicare will pay for Telehealth services and that has been increased due to the coronavirus. You might ask her GP for a referral for a Geriatric psychiatrist or look online for one who might be willing to visit with her via telemedicine. Many people will be and are stressed with this pandemic. Meanwhile her doctor should be consulted due to her suicidal ideation. I would be more concerned with that than the occasional day in bed. How long has she been living with your family?
Why did she move in? Since you are worried about her behavior does it seem appropriate to you that you might need to become more involved with helping her manage her medication? It might be time to increase your involvement to support her through this time. I’m sorry about your brother. It might really be helpful for her to see a therapist as well as the psychiatrist so that she can work on those traumas you mentioned. She must have had some hard times dealing with so many loses. She is lucky to have you in her life.
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She has bipolar disorder. Age isn’t the most relevant issue here. Bipolar disorder is treatable with medication. No matter what her age is. she needs to see her psychiatrist.

How often does she go to her doctor? Do you go in with her? How do you know what she is saying if you aren’t involved? She is living in your home. You are not ‘interfering’ in her life. Your concern is valid.

If she is sleeping then she isn’t taking her meds unless she is setting an alarm. Is there a reason that you are reluctant to discuss this with her? She is the one who has the answers, not us.

How involved do you want to be I. Her care? Think about it and be honest with yourself. Do you feel she should set an alarm and take her own meds? Do you want to be responsible for waking her up and giving her the necessary daily meds?

Things are hanging in limbo at the moment. Settle this and you will feel more secure and at peace.

Best wishes to you and your family.
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