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Lorisauntie
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Default Apr 16, 2008 at 03:32 PM
  #1
I am caring for my 27 year old niece. (dx; schizoaffective disorder) I have signed her up her also, but cannot get her to participate. Actually, I can't get her to do anything that does not involve shopping/spending. This seems to be the only thing she enjoys. I have only recently taken over the task of being her cartaker as her mother is no longer able or willing. I know my niece has some problems, but I have a problem beliveing they are as severe as we've been led to believe after observing her 24/7 for the past few weeks. She is completely unmotivated to do anything, I believe due to her pattern of manipulating those around her to get her own way. She has no reason to want to get better as she gets anything she wants and does anything she wants. When she does not get her way she makes threats to harm herself. I have safe gaurded the house against this as much as humanly possible and watch her continuously so I 'm not overly concerned that she will actually hurt herself. I'm concerned that I can not motivate her to try.
Any suggestions welcome

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Lorisauntie
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Default Apr 18, 2008 at 01:58 PM
  #2
I should have written that last sentence better, What I meant to say is I can't motivate her to try to do anything that might help her get better. She is afraid to get better for fear of giving up her "safe" way of life. Even though she is aware that it is unhealthy, she has verbalized to me that she is afraid she will loose her income, afraid that she will have to work and not be able to spend her money how she wants to spend it. As I said, spending money is her only enjoyment. Her room and our storage bin are full of brand new items, some never even opened. She just buys it and leaves it lay. I really need some imput. I have practiced a very minimilist lifestyle and I just don't understand. How do I teach her the difference beween a "need" and a "want"?

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Default Apr 18, 2008 at 04:30 PM
  #3
Can you give us more info on her background? What were her parents like? What was her childhood like? How long has she been behaving like this? When was she diagnosed? What is her source of income? Does she get SSI payments? Has she harmed herself or attempted suicide in the past or do you think she might be bluffing? What kind of treatments has she tried? Therapies or medications? Do you think she would hurt herself if you gave her an ultimatum?

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Default Apr 18, 2008 at 06:02 PM
  #4
I think you should try to get her into a day program with others around her age who have her dx. Working one-on-one with her as you are trying to do is very hard, like pushing a rock up a hill; there isn't enough stimulus in her environment to give her reason to change. She needs to talk to others like herself who are changing and growing, doing other things, etc. It sounds like her world is very small.

It might help if you had "family" therapy together to help work out a plan the two of you could agree on together to get her moving forward? Getting more people involved with her (and you also) could break some of the isolation it sounds like she was able to practice her behaviors in before. One-on-one is never good odds for will struggles :-)

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Default Apr 20, 2008 at 12:52 AM
  #5
Thank you for your reply, this should help:
copied from my post @ Clydes
Hi Clyde and thank you. I had a great reply but lost it as I was over posting limit as a newbie. I'll try to reconstruct it.
My niece began her life as a perfectly normal, happy, loved, beutiful and extremly intelligent baby, toddler and adolescent. At some point during her earlier teens, she began accusing her stepfather of molesting her. From what I've been able to piece together, it took several years and lots of frustration for her to be heard. When she was finally heard, it was blown out of proportion and a big, 'Oh my poor baby' episode ensued.
Somehow, my niece managed to get her HS diploma, being 'home schooled' which basically means that she did her classes on line, by herself. My sister is no teacher, believe me. My niece also managed to successfully complete Basic Training for the Air Force. Something happened then, but I've gotten so many stories that I really don't know what happened. She ended up being discharged d/t claims of hallucinations.
Once she got back home, the "my poor baby" behavior continued from her Mom.
Lori admitted to me that her first violent 'episode ' was a direct result of her 'copy-catting' from a movie. She ended up stabbing her pillow one night, of course her mom walked in and witnessed it and paniced, understandably. This began a series of hospitalizations, placements in group homes, stays in the state mental facility and even nursing homes, as well as more drugs than anyone should use in a lifetime and approx. 60 ECT's. During this time, Lori was exposed to a veritable plethera of abnormal behaviors, given all the literature she needed to educate herself and learned about the magic world of Cutting. Eventually, she implemented this into her repetoire. She has cut herself, usually very minor superficial scratches, which she immeadiatley calls attention to by the closest caregiver. Every 'suicide' attempt has been extremely controlled, and immeaditely seeks treatment.
She developed a way to control her enviornment and to get her way.
When she dosen't get her way, or what she thinks she wants at any given time, she has a pattern. First she will begin talking about subjects that she knows will upset her mom. Usually this is enough to get mom to do whatever she wants. If it is unsuccessful, she will then begin to talk about harming herself. This is a surefire way to get moms attention. Typically at the first mention of this, Mom will throw her hands in the air and take Lori to the Hosp. Within 3 days, but usually before her mom even gets home Lori will start calling her, complaining of being mistreated or whatever it takes to get mom to rescue her. She goes back home with Mom, has a few days to a few weeks of 'honeymoon' until Lori has another demand that is not met and then the cycle continues.
Lori has a good psychiatrist, who seems to genuinely care for her and her well being, but when treatment plans are not followed, (Mom won't make her stick with therapy or counseling), the doctor is limited as to what he can do. Basically he has the meds, which Mom will change at will.
Now she is with me, and I'm making sure meds are taken as directed and seeing through the behaviors, realizing that though her mom loves her very much, it is a very un-healthy, co-dependent relationship that they have. I recently found out that she is also considered to have BP and takes some of the same meds as Lori does.
Lori's defence mechanisims are breaking down. I don't rush her to the hosp when she makes threats. Instead, I hold her and tell her I love her, that I will not allow her to hurt herself and that I will not give up on her.
This has been very effective, but only after an episode where she basically bottoms out and has no choice but to accept the comfort.
She is DX'ed with Schizoaffective Disorder, however the criteria for the DX is not met. It requires a period of physchosis with no mood swings for 2 weeks. She cannot go more than 2 hours without major mood swings, and that is stretching it.
If I could/would let Lori shop and spend 7days a week, we could probably go a month without an episode. But then she would just come up with some other unreasonabe request that she knows I won't grant and here we go again.
Does this help? I really need some ideas. Even if she is Schzoaffective, she is not living a productive or even happy life. She is miserable. This disorder is supposedly treatable, then why have none of the treatments been effective. She gets steadily worse. Any step forward is immeadiatly followed by 6 steps back.
(SSI) and that she would have to work and use her money to pay bills instead of what she wanted.
Today she said the most distrubing thing I've heard to date. She said,
'Wouldn't it be great if someday my mom and me were at the same facility? " Oh my God!!!!!!
What do I do? Her Mom wants me to give her whatever she wants to keep her happy, I just don't see that as a healthy option. That seems more like enabling to me.

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Default Apr 20, 2008 at 01:12 AM
  #6
Thank you,
I do have her in an art therapy day program 2 days a week. Monday will be her second day. Already she wants to increase her days, which I am trying to discourage d/t pattern of setting herself up for failure; I want her to do 2 days successfully for a while and build slowly, to increase her chances of sticking with it,(anything)
The other thing is, though it is a wonderful service it is not perfect and there seems to be a lot of inappropriate behavior going on between the clients. She is already enamored with a boy (man?) from there. She told me he hugged her really close and repeatedly touched her inappropriately. She said that one of the counslers talked to her about it and that she agreed with her that is probably wasn't a good idea. Even so, she came home with his phone number and is now talking about dating him!! I asked her moms opinion of all of this and she said "Well, if Lori wants him to Its ok"
I don't feel she is remotely ready or capable of an adult relationship at this time, much less one that has personal tradgedy written all over it. But for Her, tragedies and crisis, whether real or imagined, personal or irrelevant are like money in the bank, to be drawn from when she needs something different than the norm. It's uncanny her ability to have almost total recall regarding anything that she thinks she can use to her advantage, yet incapable of remembering embarassing herself or others by making a scene in public.
We had a bad day today...she saw her psychiatrist and was not successfull at her attempts to manipulate him. She is trashing me to anyone who will listen trying to get away from me. She's never been in an environment where she does not get her way, her caregiver is smarter than she is, and is her aunt who loves her. I do expect an escalation and have been correct in that. But she is always talked out of her threats of cutting and pleas for the hospital by simply holding her,( sometimes restraining through the guise of a hug) and telling her that I love her, will not give up on her and that I will not let her hurt herself because I love her and her mom too much. She fights me, cusses me, cries like an abandoned baby and eventually calms down, tells me how much she loves me and that she knows this is the best place for her....on and on and on. But...within 5 minutes, without fail (unless she falls to sleep) she is demanding and retesting and repeating the incident. If she falls asleep while I am comforting her, she has a pretty good day the next day, at least until she decides to ask for something she knows I will say no to or until she has an outing with her mom or a conversation with her on the phone. Then the cycle begins anew.
Sorry to go on and on, I'm boggled by her behavior.

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Default Apr 20, 2008 at 01:20 AM
  #7
I did try the family therapy, she pulled her I'm suicidal trick, they insisted on the hosp. inspite of mine and her moms pleas to not give in to her behavour, and she succeded in making them think I should not be taking care of her. They decided that because I drive a 1968 VW van(resoring her) that I must "some kind of Hippie" must not be giving her her meds and was probably giving her pot or worse. They actually wrote this in there report and faxed it to the Hospital and Dr.!
The hosp released her back to my care within 24 hours, when she realizied she wasn't being 'rescued' by mom, the behavors began almost immeadiatley

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Default Apr 20, 2008 at 03:21 AM
  #8
I don't see how, at this late date, she can be rescued against her will. I don't know how you have the time, money, and energy to devote to her; I would have to find a good inpatient program and "abandon" her there for awhile where her mother was not a factor at all. Her mother still being in the equation/her thoughts and attempts doesn't bode well. I think there are still too many "people" she can play against each other.

I guess I would try to do things as one would with a child, give her 2-3 choices in situations; one "pleasant" and a couple not so pleasant and "train" her to choose the pleasant one. If she chooses hospital and situations like that I would make her stay when she starts to complain; make her choices all have consequences.

If she could be moved to a new environment; well away from her mom and people she has played before; I think I would still try to find a residential treatment center of some sort, not too comfortable but not one she could get out of easily.

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