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Topic Title: How to get a mental diagnosis
Created On Wednesday July 21, 2010 7:36 PM
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SWMD

Posts: 67
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Wednesday July 21, 2010 7:36 PM
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MIL has shown some mental deterioration since she had the stroke. Short term memory loss, lack of judgement and self-control (yes, I know those two could just be personality). Also saying off the wall things and believing crazy things. Lately it seems to be worse though.

Today she was taking a shower and when I went in the bathroom to help her get out she was pushing the stopper up and down and then pushing down on it really hard. She seemed frustrated and I told her she'd gotten it all the way down, it was fine, and she said "I was trying to turn the water off!". This startled me, the stopper doesn't turn the water off at all, the knobs do. She's been able to turn the water off by herself before for the past year.

She's also been forgetting things lately, more than usual. The other day I went to check the mail, I told her right before I walked out the door that I was going to take the boys and go to the mail box. We came home and about an hour later she says to me "so y'all decided not to check the mail?".

Those two things are examples of what has been happening more and more lately. I'd gotten used to them happening a couple of times a week but now its almost every day.

In the past when we've talked to her regular Doctor she just says "I have no idea what to tell you, I'm not that kind of Doctor". Who is the right kind of Doctor??? Who do we talk to? How do we know what decisions should be left to her and which ones should be made for her? We already do make some for her. So far she has given no argument (most of the time) but I can't help but wonder if there will come a time.

Has anyone else gone down this road? Any advice? She's getting her Medicare next month and I'm starting to try and figure out what all we need to have taken care of at that time.

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myonly

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Wednesday July 21, 2010 10:10 PM
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Dear Jessica,
I wonder if a neuropsychiatrist would be helpful. I had an eval for DH a few months ago, and it helped me to get a handle on his deteriorating judgment and behaviors. The doctor did recommend further evaluation, however DH will not consent to that. He has a definite prejudice against counseling/medical and/or therapeutic intervention where mental health issues are concerned. He thinks if he agrees to any of the above that he is "officially crazy". His family are all cut from the same cloth, so no help there!

If you can't find a neuropsych doc, perhaps starting with a neurologist would help (or does she already see a neurologist?). If so, maybe that doc could steer you in the right direction. Sometimes you find a lot more specialty docs in and around university medical centers or teaching hospitals. Good luck in your search.

Hope you are taking good care of yourself, too. You've got your hands full!

Hugs,
Gaby


 
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SWMD

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Wednesday July 21, 2010 11:20 PM
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she has obviously had mental problems long before this stroke, but don't tell her that! Its everyone else that's crazy. I'm not even sure how to discuss with her the need for this type of evaluation. I'm just in the gathering info stage. She does not see a neurologist at this time. Right now she's only seeing a Dr. of Internal Medicine and a GYN. I know things are going to change when she gets Medicare though. The Dr of Internal Med already has made notes of the specialists she wants to send MIL to as soon as the Medicare comes in.

Her older sister told me that when MIL was a teenager their mom was beside herself as to what to do with her because of the crazy way she thought about things. MIL has been through a lot in her life. When she was only 4 years old her dad committed suicide, she's been married and divorced 5 times and gone through a lot of drama besides. I don't want to disparage her, I'm just saying that she has never thought straight about things and its worse now.

Thanks Gaby, I will try and take care of myself. I know if I don't I won't be able to take good care of my family.

Jessica

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TechieSidhe

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Friday July 23, 2010 10:01 AM
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Originally posted by: myonly He has a definite prejudice against counseling/medical and/or therapeutic intervention where mental health issues are concerned. He thinks if he agrees to any of the above that he is "officially crazy".


That's our problem with MIL. We can't get her to go to the psych doc to get evaluated and diagnosed because she doesn't believe there's anything wrong with her. It's everyone else's fault that she acts like this, according to her.

Recently, she misplaced her food stamp card. DH and I used it to go shopping, since she didn't want to go. We gave her back the card WITH the receipts she wanted. Two weeks later, she blamed us for not giving her the card back. She swears that we still have it, even though we both emptied our purse and wallets on the table to prove it. But she won't go through her room looking for it, it's automatically someone else's fault.

We're having a huge problem getting her a diagnosis, since if she even thinks we're trying to get her a psych eval, she won't go. The only way to get her any evaluation is to wait for her to really lose it and Baker Act her. The doc tried to get home health to come in and do it, but they want a professional eval first. We're right there between the rock and the hard place.

We've thought about giving her an ultimatum, but what are we going to threaten her with? Kicking her out? We can't do that. Putting her in a home, we can't afford that either. We did consider telling her that unless she goes for an eval, we'll have the doc look into pulling her drivers license, since if she's this forgetful at the house, she should not be driving either.
 
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SWMD

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Friday July 23, 2010 10:33 AM
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TechieSidhe, I fear we may have similar problems when we try to take MIL for an evaluation. I just don't know yet since we haven't tried yet. On the other hand, she may protest but agree to go since Dh is her favorite child and the light of her eyes lol.

I almost wonder if it would be even better to go with just telling her we are going to see a Doctor to follow up from her stroke and see how she's doing rather than telling her its a psych evaluation. I just don't know.

We don't know much about her history in this regard but she did supposedly have a mental break down when she was in 3rd grade. She saw counselors for a while back then. We don't know what the results of that were.

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TiredDave

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Friday July 23, 2010 1:38 PM
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Ladies,

You also might want to have their doctors look into things and have a talk with your older parents. They may not realize that things have changed greatly as far as mental health goes. In their day you were pretty much locked up in a mental institution. Most of the mental health drugs didn't really start until the 60's. A famous early patient was Jonathon Winters. Today there is a huge variety of drugs that can be prescribed to help people and a visit to a psychiatrist is much like visiting any medical specialist. Also any doctor can prescribe the drugs needed you could talk to your GP and see if they will help.

Dave
 
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rzxq2y

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Friday July 23, 2010 8:08 PM
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Hi, Jessica,

It seems to me that you are more concerned about her recent behavior changes since her stroke than her past history. My suggestion is like Gabriele's, find a neuropsychiatrist to get an evaluation. If you cannot find a neuropsychiatrist, a neurologist might help, or the neurologist might refer her to a psychiatrist. After the evaluation, there are medications that may help alleviate some of her behavior problems.

People with behavior problems typically think that they are fine. So I would suggest that the not to let the decision to see a specialist be up to her. I think that it is a good idea to simply tell her that it is a follow up to her stroke, which is.

Best Regards,

Min-Shih
 
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colette

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Friday July 23, 2010 8:45 PM
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Jessica,

Had I told my SIL she was going to see a psychiatrist last year, the woman would never have gotten into the car. SIL was talking to pictures; carrying on conversations & rages with herself (2 different voices); packing up clothing in Walmart bags b/c she thought she was going to live w/her niece a short distance away (short distance = 1300 mi). These are just a few of the odd behaviors she was exhibiting.

SIL was told she was seeing a dr for problems I was concerned about. SIL is 77 yrs old and would probably never have gone if I had mentioned "psychiatrist." Today SIL is on a med that has her on an even keel. She no longer carries on conversations w/herself, and it has been sometime since she packed up to go to the niece's house.

Please write down everything you see and what the family has said about her teen years. It is possible all of this is connected.

I am with Min-Shih. The less said about "why" the dr's appt, the better off you are.
Quote

People with behavior problems typically think that they are fine. So I would suggest that the not to let the decision to see a specialist be up to her. I think that it is a good idea to simply tell her that it is a follow up to her stroke, which is.


Whenever MIL does something "odd" or forgetful (out of the ordinary), please pull up a new email and document the situation, then send it back to you. This gives a time and date stamp. Also, if MIL is getting aggressive (You did not give my FS card back to me!) have your cell phone, if you own one, ready to record the conversation. The cell phone was my savior when it came to making the case that SIL had a problem.

I hope some of what I posted is a help to you.
Take care & keep us posted.
Colette
xoxoxo

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Family Caregivers are not paid because they are worthless; Family Caregivers are PRICELESS!
(paraphrased & source unknown)

Edited: Friday July 23, 2010 at 8:52 PM by colette
 
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SWMD

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Saturday July 24, 2010 9:07 AM
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Thanks.

I talked to my sister yesterday, she was a caregiver for several years of my Grandparents. My Grandfather had dementia. She suggested recording everything and that will help us see if there is a pattern. She said that to her a lot of what MIL is doing sounds like "normal" confusion and forgetfulness, but that a couple of the things sounded exactly like what she dealt with with my Grandfather.

I'm going to keep recording things for now and bring things up the next time we see her regular Doctor and see if we can get a referral.

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