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She has been Baker acted twice and taken to mental health hospital. Once she’s discharged, she refuses to continue medication. Situation has been ongoing for over 2 years. Lives at home with husband.

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Advice regarding what exactly ?

As far as I know she cannot be forced to take medications. Unfortunately instead of reform of psychiatric institutions , most closed decades ago leaving families to deal with the chronically mentally ill who cannot function out in the world .

Is her husband in danger ? Is he able to go to work ? Can his wife be left alone at all ?

Has her husband gone to a social worker or eldercare lawyer to see what help may be available ? A lawyer could also help her husband protect some assets for his own retirement years .

Unfortunately , there are increasing number of homeless elderly people with mental health issues , because there are simply nowhere for them to live .
The pendulum swung too far the other way , reform rather than abolishing psychiatric institutions would have been better . Some people young and old with some psychiatric problems can not function in the outside world. They end up homeless or in jail .

Families have alot of difficulties trying to live with the mentally ill . Some are murdered like Rob Reiner and his wife .

I’d advise her husband see a lawyer to see what his options are including possibly divorce . I know it sounds cruel , but maybe divorcing her , could get his wife in some sort of long term facility.
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Reply to waytomisery
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It may take the husband getting your SIL declared incompetent so he can get guardianship and have her placed in a care home that will get her medicated. My mom was given a psych eval twice via IVC. I spoke with two therapists about this and learned there just are not good facilities for mentally ill people. I spoke with a nurse/social worker/elder care worker, PA, and a police officer and all were pretty much clear that it is very, very hard to get real help for mentally ill people. We need institutions that can house seriously mentally ill people. I would rather them be private run. My mom is still in denial that she has schizophrenia. She probably has no idea she is taking psych meds, even though two years ago she was informed of that. The meds are working really, really well. Since she is in her 80s we got her placed in a dementia care facility where they make sure she takes her meds, sees a therapist and has activities that she can enjoy. She is still delusional, but is having fewer hallucinations. She said the voices outside her window have stopped. She is much calmer and life is better for her now. She is on at least 2 psych meds along with antidepressants.
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Reply to JustAnon
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If the husband hasn't been able to bring about any change it is because he's not willing to do the one thing that may: divorce her, not live with her and allow her to become a ward of a court-assigned guardian. Someone I know just had to do this to his wife because nothing else worked. APS can force them to get the help they need.

Her husband needs to care about his boundaries.
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Reply to Geaton777
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LakeErie Feb 7, 2026
Just so you know, only a court can force anyone to be hospitalized against their will or take injectable medication.

Mentally ill people do not have the capacity to survive on their own. They are not compliant with a guardian and end up on the street living under bridges, as I'm sure you have seen in your own community.

Yes, the husband needs boundaries. Suggesting someone get a divorce just to cast aside a very ill person is frankly very cruel.
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I know of nobody with schizophrenia or bipolar disorder who are willing to take meds. It's part of the mental illness. This woman's husband needs to look out for himself now, imo, because after awhile, these conditions unmedicated are way way too much to handle. I've seen both of them (and others) up close and personal and all I want to do is run the other way, to be blunt.

Good luck to you.
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Reply to lealonnie1
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puptrnr Feb 5, 2026
There are many people with those conditions that do take their medications consistently, however. The poster asked for guidance, not asking what you or others would do, as in run the other way-although that's tempting, that's not helpful either.
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She might have anosognosia which means she doesn’t know she is sick because that is part of her illness.

Unfortunately, there isn’t much you can do with that. My sister has it.
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Reply to southernwave
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First, I'm sorry for what you are going through as this is a very difficult situation. Unless youyr sister in law is a threat to herself or others, there's nothing to force her or others who desparately need care to get it.

However, there's a great book called I'm Not Sick, I Don't Need Help" by Dr. Amador. He outlines how to work to get people to agree to treatment and it's an exdtremely helpful resource.

Additionally, finding great team of therapists, psychiatrist and general practiftioner, to work as a team along with family/friends, can make a huge difference. The medications are slowly becoming more effective with fewer side effects as well, but the challenge, as you mentioned, is getting the patient to take it and take it consistently.

Depending on where you live, there are several accredited inpatient facilities that use evidenced based methods to treat patients and do have comprehensive care to get people stabilized. They do cost a lot and are (perhaps) partially covered by insurance. Below is a list from a basic search, but getting a referral from a mental health provider is ideal:

Highly Rated Inpatient Psychiatric Facilities 
McLean Hospital (Belmont, MA): Consistently ranked as the top psychiatric facility in the U.S. by U.S. News & World Report, part of Mass General Brigham and a Harvard Medical School affiliate.
Johns Hopkins Hospital (Baltimore, MD): Recognized for high-quality care, particularly in psychiatric research and specialized treatment.
NewYork-Presbyterian Hospital-Columbia and Cornell (New York, NY): Top-ranked for comprehensive inpatient psychiatric care and research.
Resnick Neuropsychiatric Hospital at UCLA (Los Angeles, CA): Premier facility in the Western U.S. for intensive psychiatric treatment.
Sheppard Pratt Hospital (Towson, MD): A renowned, private, non-profit institution offering extensive inpatient services.
Menninger Clinic (Houston, TX): Known for specialized, research-driven treatment for complex psychiatric disorders.
Massachusetts General Hospital (Boston, MA): A top-tier academic medical center known for specialized psychiatry programs.
Boston Medical Center (Boston, MA): Offers specialized care, including a large behavioral health center and community-focused treatment.
Penn Medicine Princeton Medical Center (Princeton, NJ): Offers comprehensive acute, sub-acute, and outpatient psychiatric care. 

Wishing you all the best.
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Reply to puptrnr
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I would think she is her husband's responsibility.
He may not want to, or know how to deal with her.
He may be afraid of her.
A very sad situation.
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Reply to Dawn88
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Most mentally ill people have a condition call anosognosia, which means lack of insight. Their brain does not allow them to be aware of their illness and then why would they take medication if they are not ill? Sometimes a patient will agree to monthly injections, and that is really the best solution, until they decide they don't need them and won't cooperate. In some cases, injections are court-ordered and a nurse comes to the house.

Unless she is a danger to herself or others she cannot be hospitalized against her will. The lack of short- or long-term care for the mentally ill in this country is shameful. If you need to be seen by a psychiatrist or psychologist, you can expect to wait 6 months for a 15 minute appointment that accomplishes exactly nothing. No one cares about crazy people.

The husband could apply for guardianship, and this is easiest done when she is in the hospital. If not, it is easy to download the forms from your county probate court and file them yourself. I did this for my daughter and have written about it in other posts. It is easy and very inexpensive. He should also apply for SSDI and other state and local programs.

The National Alliance for the Mentally Ill (NAMI) has chapters in many cities and offers online resources and support groups. The National Shattering Silence Coalition (NSSC) has many guides and resources.

As people age, dementia mimics many of the symptoms. A person who has both illnesses will need to be in an SNF or memory care. If the mental illness symptoms cause out of control behaviors, the person can and will be kicked out. Often, with age, behaviors decrease.

Unfortunate there is no easy answer or solution. I read a lot of books about schizophrenia, and one of them noted "if there is a worse illness than schizophrenia, it has yet to be discovered."
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Reply to LakeErie
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97yroldmom Feb 7, 2026
LakeErie
Different states have different laws on many things. Access to guardianship being one.
I was never so aware of just how different rules and regs could be until I started reading posts here on the AgingCare forum.
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