Friends, Family & Carers Forum

[mygoodspirit]

Hello,

I am a first timer here. I am worried about my brother. He has paranoid delusions (psychotic) that has been controlled by meds for about 3 years during which time he has lived a relatively normal life.

Lately he has been acting paranoid and irrational again and making rash life changing moves. I suspect he has lowered his dose. He has absolutely no insight to his condition.  I am worried sick as he has two children whose mother died from cancer a year ago and now they only have him. I am closer to him than anyone.  Should I ask him straight out about the meds and try to convince him to take them ? what is the best approach ??

Any advice appreciated.

[Baboo]

Hello My good spirit,

In my opinion- if you have a good relationship with any one honestly is the best polices.

If he reacts negatively perhaps ask him if he thinks there has been any changes.

I would say " hey there- wondering how your going today, I've noticed you have been a little different- are you still on your meds?"

Baboo

[mygoodspirit]

thanks for your response baboo. i will try.

[NikNik]

Hi @mygoodspirit

@Baboo has some great suggestions there. 

I know many of the carers here have to have difficult conversations like the one you might have.

People can become defensive when they genuinely don't have insight. To add to Baboo's suggestions around language, the advice I have seen other carers give in this community, talk about what you have observed, 'I have noticed xyz, have you noticed this too?' and finishing the conversation with assuring them of your support is a great way to wrap up.

 @Shaz51  - have you in the past had difficult conversations like this with your husband?

You might not get the response you want right away, but you might give him something to think about.

Keep us updated on how you go - as I said, it's a conversation many of us struggle with.

Nik

[Shaz51]

Hi @NikNik,

Yes I know when he takes his  whole medication or half of his medication ==  because I wil tell him so if he has only taken half .

I just could not beleive the medical team not even trying to change his mind about therapy

[mygoodspirit]

Thanks for your advice. Invaluable to get your knowledgeable advice.

[Shaz51]

Hi @mygoodspirit

how are you today ??

how is everything going

[Attahua]

In my experience with my partner either reducing his meds or not taking them at all it has been an ongoing battle. Fortunately he is on a Community Treatment Order so he has to have his fortnightly depot as at least he is getting something in him as he refuses the oral she is supposed to have. He and I have had conversations when he has been well regarding his care plan and it clearly states that if I suspect he is becoming unwell then he will go to the doctor, all well and good in writing but when push comes to shove it is a struggle. My partner has very little insight and the sicker he becomes the more unlikely he is to take meds when just on orals as 'he feels fine!!!' I feel for you I really do as it is so difficult trying to tell someone you think they may be becoming unwell and it must be so very hard for the unwell person hearing that when in their mind all is well!! Would your brother be open to going to his GP with you? Or his pyschiatrist... even if it were on the pretext of just a three monthly catch up to see how he is travelling? Does he have a case worker? Like I said I feel for you as I have been through this scenario many times with my partner and like your brother my partner, when well and on correct meds dose, leads a normal, working life. But when unwell, like mine is now....well it is just hard and even the hospital are struggling to get orals into him!!!All the best !!

[mygoodspirit]

Thanks Attahua for your story and advice.  I think he is seeing his psych bimonthly or something- but I don't even know how much insight the psych has.  My brother is unusual in that he appears completely normal - you wouldn't know what is going on with him unless you spend a lot of time with him and see the subtle signs.  I doubt if he is telling the psych really what is going on (i..e the paranoid delusions).  It's the toughest thing in the world trying to help him and the ultimate test of patience and goodwill (I'm sure you will agree with that !).

Anyway I wrote a nice considered letter to him about my concerns re. the meds and his increasingly psychotic behaviour. I tried verbally first then I though writing it down might help it to penetrate his wall of resistance better.  I can only wait and see what happens next. I find all the worrying and fear so, so draining.

[Attahua]

Yep it is definitely draining!!!! My partner( in the early stages of becoming unwell) can appear totally normal as well which is so very frustrating when you know it's a front !!!! Mine is still in hospital refusing his orals and I just want to shake him and yell at him and say 'don't you want to come home???!!' But of course that would be ineffective as he is so unwell and thinks the nurses are trying to poison him , that's his reality at the moment and a genuine fear for him!!!! Can you go with your brother to the pyschiatrist??? My partner doesn't really like me going and I am usually okay with that up until now... from now on, when my partner is well again I think it is important to go as his pysch was telling me some things my partner had been saying six months ago at his last visit when I thought he was well but clearly he was starting to unravel ever so slightly! Is your brother open to you going???