I am looking for the right care situation for my brother-in-law who has significant mental health problems and struggles to cooperate with treatment. We are at our limit trying provide him with care since the death of my sister, his wife of 50 years; but recently he has become delusional and aggressive.......medications help some, but he normally begins to refuse medication and his symptoms, paranoia, depression, isolation, poor appetite, and insomnia worsen. If anyone has suggestions about strategies or facilities that might be appropriate for him, I would greatly appreciate any help you could offer.
Bernard
If so is he now living alone?
I will say right off I do not think someone with dementia should be living alone.
He is grieving now and with grief can come with all the things you mention. But so do mental illness, dementia and depression.
Getting an accurate diagnosis as to what is happening is important.
It is also very possible that your sister was helping to cover many aspects of his dementia, /mental illness, and now it has come to a head.
I should also ask ... who is his POA for Health and Finances? Does he have family that will step in and either help or take over his care?
Looking for Memory Care if he has dementia is a first step. But moving him while he is dealing with his grief can cause more problems.
Has he been seeing a doctor or therapist? If so are they aware of the death of his wife? If not they should be informed and also informed of his decline.
But without POA or his signature on HIPAA forms this might be difficult.
He needs to be placed in a memory care facility, but if you are not his POA, there's really not much you can do, other than report him to APS as a vulnerable adult living by themselves and they will come out and do an assessment.
Or if no one else is his POA you can file with the courts for guardianship, but that costs a lot of money and takes a while to get.
You are very kind to look out for your BIL. I hope you get things worked out for him soon.
You cannot get the mentally ill person to continue meds and in many instances they "like" their delusional states and stop their meds.
If this is mental illness and not dementia you deal with now I can only wish you the very very best of luck. I do have a book to suggest and that is a memoir titled Never Simple by Liz Scheier. She tried to help her mentally challenged mother for decades, even with the able assistance of the city and state of New York and their social workers. Pretty much all to no avail.
You have a terrific challenge on your hands, but you will learn so much and have much to contribute here. Again, wishing you the very best of luck.
Sorry about your BIL's struggles. You mentioned dangerous conditions: diabetes and heart disease. How is he managing his diabetes with mental problems?
Had she discussed your BIL's mental health difficulties with you before, or was she the sort of person who would go soldiering on regardless?
I think if your BIL is aggressive along with everything else he will have to go into a managed care facility.
You can try homecare and see how it works out, but I don't think it will. From what you're saying here your BIL's health issues, aggression, and aversion to treatment for his mental illness make a situation that a single homecare worker or live-in caregiver cannot handle. He needs to be cared for by a full staff in a secure facility.
Who has his POA? Or conservatorship? You may have to send him to the hospital and they will find placement for him.
Good luck. It's so hard and I'm so sorry for the situation you and your family find yourself in.
I am sorry for the loss of your sister. How long ago did she pass?
Unfortunately BIL is not likely to cooperate the more his symptoms surface w/o the aid of his medications to control them. It’s a no win situation for his caregivers and for himself. Your posts indicates you are familiar with the cycle.
And often, he will have to do something “Wrong” in order for authorities to intervene and the intervention may not be gentle. please do not put yourself in danger.
Does he have a diagnosis of dementia or is he someone who has long suffered from mental illness? Perhaps it is both?
Does he live on his own since his wife passed or is he living with you? He will be easier to find placement for if he is living on his own as the need is greater. Do not move him in with you. Do treat this as an emergency to find him placement as he is vulnerable alone.
I would try calling his doctors office and leave information with them re his current status and that you are looking for recommendations for someone in his condition. If you aren’t on his HIPPA release, they probably won’t give you personal information, but will take information from you and possibly make recommendations. Most likely they will want to see him.
I just looked up Baker Act in Indiana. A 72 hr hold request in Indiana must be signed by a doctor. In some states a request can be made by anyone who reports the person is a threat to themself or others. So, his doctor or a hospital would be where I would start. The other local resources might be the Area Agency on Aging, APS, or the local police. Check with the police as in some areas, the sheriff’s department is who deals with the mentally ill.
Unless you want the state to assume his care, you will need to have him sign a POA giving you authority and even with that, he can refuse treatment/placement. If he has dementia, he may not be able to sign the POA (legally). If it is mental illness, he possibly could. If he won’t sign or is deemed incompetent, the next step would be seeking guardianship. This is expensive and time consuming. His funds would pay the attorney’s fees.
A good elder care attorney would be able to advise you on these steps. There are emergency guardianships that a judge can allow as needed.
Did your sister make it possible for you to access their bank accounts, etc? Do you pay his bills? You may already have some of this worked out.
Give us more information so we can give better suggestions.
Be careful and best of luck finding him a safe place.
It is not easy being a caregiver and more so when there is a mental illness.
Edit. This came up on Google. It might be helpful.
https://www.oflaherty-law.com/learn-about-law/involuntary-commitment-to-a-mental-health-facility-in-indiana
Ideas:
https://bewellindiana.com/mental-health-resources/
Call 911 when he is agitated and let the hospital evaluate for placement.
PNP Center Texas: https://www.pnpcenter.com/
Psychiatric Clinic, Neurology, 2600 Highway Ave, Highland, IN · (219) 972-0131. I am sorry for the loss of your sister and send condolences.
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