I Want Him to be Sedated
October 24, 2007 9:12 AM   Subscribe

Still crazy after all these years filter - what can be done about my dad? (long post following)

My dad is in his early 80s, mom is 77. They've been married since 1958. We kids often thought privately that Dad was nuts when we were growing up - for example, he was prone to insane bursts of temper. He never, ever hit us, but he'd yell and scream until his voice went soprano. You could never predict what would set him off; perhaps there were (what he thought) too many glasses in the dishwasher. Then he'd go off on a tirade - we kids drank too much, there must be something wrong with us, we're probably diabetic, it's not normal, etc. He was obsessive about certain things, including the grass (couldn't play on it, might ruin it), long hair (if any of the household drains started running slow, it was my fault because of my G-- damned long hair [I'm a female, and Marcia Brady-style hair was the fashion at the time]), black people (he had a fit one time because I was watching the Flip Wilson Show on TV, and he said that I was just encouraging the networks to have more n***** programming)....I think you get the drift.

He'd often told us and Mom that the reason he'd never been in the service was because he was the youngest son of 10 children (that part was true, and his six older brothers had all been drafted or had volunteered). However, just a few years ago, my Mom was cleaning out a big box of old papers from Dad's older sister's house after she passed away. In it she found a report from a military doctor - apparently Dad *had* been summoned for military service, but after his physical/interview, was diagnosed as having either psychotic neurosis, or neurotic psychosis (she can't remember what order the words were in, nor can she find the paper now). But to this layperson, that sounds like an official diagnosis of "n need of mental help." Am I right? Is there a significant difference between the two diagnoses?

Meanwhile, it's just Mom and Dad at home now, and he hasn't gotten any easier to live with. She's mentioned Dad's behavior and foibles and such to his doctor (she accompanies him to his appointments), but the doctor seems to be of the Old School, and chuckles and tells her that *she's* suffering from anxiety, and offers to give her medications. I think that Dad should be on some sort of anti-psychotic meds. Is there any way to successfully communicate that to the doctor without having to find that old military diagnosis? And can the doctor legally prescribe such meds to Dad without telling him what they're for? (Because Dad will not take anything like Valium or anti-depressants...he'll immediately assert "There's nothing wrong with me!!")
posted by anonymous to Health & Fitness (14 answers total) 2 users marked this as a favorite
IANAD, but there is absolutely no way any doctor with any ethics will conceal the purpose of a prescription from an adult, never mind the legal aspect.
posted by Tomorrowful at 9:28 AM on October 24, 2007

The diagnosis you talk about is, basically, from a very different time in mental health treatment. It makes no sense in today's diagnostic system, and in any case, without the accompanying notes, doesn't really provide much of a sense of what's going on with your father. It is certainly not sufficient cause for you or anyone else to assume that your father should be medicated against his will.

It sounds like your father could be difficult to live with for all kinds of reasons. What he doesn't really sound like is "a danger to himself or others" in the sense that that phrase is used to compel mental health treatment in most parts of the US with which I'm familiar. Has he been physically violent to your mother? Does he threaten physical violence? What about to people in the community? Is he able to dress himself, wash himself, feed himself, keep himself generally together? If he can't do the reasons have to do with physical infirmity or mental infirmity?

If your mother feels unsafe, she can and should contact a domestic violence hot-line in her area, or perhaps adult protective services for her jurisdiction.

It's clear from the tenor of your question that you're justifiably upset about your father's behavior and are worried for your mother. He may well be mentally ill, although there is no way to diagnose that from your question. The way you've presented the question, however, you've chosen to assume responsibility for your father's behavior and not your own. I don't mean that to be harsh, but just to point out that there are options available to your family that do not include tricking your father absent evidence that he's a physical danger to anyone. Your mother can leave, she can confront your father, you can all confront your father, someone can move into the house with them, you can plead with your father to get help, etc, etc. Some, or all, of these things may not work, but being difficult to live with is not a crime, and neither is being an asshole. Tricking someone into taking medications is.
posted by OmieWise at 9:42 AM on October 24, 2007 [1 favorite]

How long has he been having these bursts of temper? It's a cliche, but he has to want to change, and if he's been behaving like this for 20 odd years (just a guess, based on my own assumptions of the average age of a mefite), then he's probably not going to be open to changing.

Could you perhaps take your father to a different doctor, to get a second opinion?
posted by Rabulah at 9:48 AM on October 24, 2007

No, you cannot medicate your father without him knowing about it, and certainly not on the basis of a decades old diagnosis.
posted by happyturtle at 9:56 AM on October 24, 2007

as the above have said, you can't medicate your dad without his consent unless he is unconscious or unable to make decisions.

i think you need to figure out why you want your dad to take medication. is it because he is violent or abusive to your mother? or just because you can't stand him anymore?

it would be great if he could stop being a pain in the ass and finally become the loving dad you never had. it might also be nice to catch him in his lie and prove to him that something's wrong with him, and that maybe you really were right about some things all those years ago.

if your mom is in danger, you might have more leeway. you might be able to have him declared mentally incompetent or get him committed involuntarily for a diagnosis. otherwise, there's not much you can do. your mom has been making her own decisions about this man for a long time now--the best thing you can do is promise to give her all the support she needs if she feels she has to leave him.
posted by thinkingwoman at 10:00 AM on October 24, 2007

Look, the doctor is useless if that's his attitude; I don't know why you're trying so hard to communicate it to him. Your mom needs to (1) go to a psychiatrist about this and talk to them, and (2) bring your dad to talk to the psychiatrist as well.

At some point, this might involve confessing that she found the paper. It might only mean her telling your dad that he's hard to live with, that it's hard on him too, and that she wants to help him. In any case, it will involve confronting him.

The other option, of course, is living with it. In which case, again, talking to a psychiatrist is the best-- perhaps the only-- thing to do.

As an option, you might consider going to the psychiatrist yourself to spare your mother the trouble. I'm certain they can give you more help than the old-school doctor or anybody else can.
posted by koeselitz at 11:31 AM on October 24, 2007

Anonymous, are you my husband's cousin?

My husband's dad (now deceased) was very much like what you describe, but he went further in that he was pretty abusive as well.

Your main priority is the happiness and safety of your mama.

As to meds, they aren't a panacea for this sort of thing even if he would take them, and at his age they would definitely work differently (older people process medication differently.)

At this point unless Dad sees a problem himself (not likely) it is best if someone can keep checking on Mom, and see that she gets some respite from him. Living with this crap is very tiring.
posted by konolia at 12:42 PM on October 24, 2007

Psychosis, in 21st century parlance, is a symptom rather than a diagnosis.

But whatever he was in 195x, it's pretty irrelevant to what he is in 2007. My judgement from what you've said -- based on caring for family members on anti-psychotics -- is that he's just difficult, not destructive or dangerous. Anti-psychotics are some pow'ful juju and generally won't be prescribed unless absolutely necessary. They aren't anti-anxiety drugs like Valium or its modern-day equivalent in the pharmaceutical chart, Xanax. Those would be tried first, along with anti-depressant SSRIs like Paxil or Zoloft. Both of these types are much safer and have fewer serious side-effects than anti-psychotics.

But it really sounds like your mother is not in danger and he's just "difficult". Well, welcome to this stage of life. They are probably used to each other but patience is something you seem to have less of at that age. My suggestion is to think in terms of couples counseling.

Good luck. I'm dealing with a parent with early signs of dementia and related irritability and who doesn't want to accept this as a disability. It's an uphill battle.
posted by dhartung at 12:43 PM on October 24, 2007

Sounds a lot like my old man, who in my view suffers from Borderline Personality Disorder. Hard to diagnose and treat, and hard on bystanders. Look it up. There's at least one quite recent thread on it here, that I know of offhand.

The "splitting" behavior, characteristic of the BPD sufferer, means they will likely not reveal their difficult side to a respected authority figure like their family doctor. As others have suggested you might do better to focus on supporting your mother and other carers. Good luck.
posted by Coaticass at 3:53 PM on October 24, 2007 [1 favorite]

OmieWise has it. Nothing from your question suggests that your father is psychotic, or actually clearly suggests any mental illness. Having had an army recruitment doctor tell him he might be either psychotic, or neurotic, or both, more than 50 years ago doesn't amount to anything. He does sound like a curmudgeonly old git, and maybe he would benefit from the advice of a psychiatrist or perhaps a geriatrician. He also sounds as is if he's competent to refuse any medication, and therefore it would be illegal to try and covertly medicate him. There's some relevant background in this recent article about covert medication in UK nursing homes.
posted by roofus at 3:54 PM on October 24, 2007

How's his blood pressure?

I ask because my father in law was, according to my wife's family, not too far off what you're describing for some years. The racist angle was lacking to be sure, but certainly the sudden rages over nothing and obsessions with weird household policies.

They eventually got him on blood pressure medication and it apparently chilled him right out. He's still recognizably himself, but not as prone to just losing control and freaking everyone out.

Other commenters notwithstanding, I have a strong suspicion that that's really why he was prescribed the BP meds in the first place.
posted by Naberius at 5:07 PM on October 24, 2007

Follow-up from the OP:

No, Dad is definitely not physically abusive towards Mom or anyone else. IANAD, but I'm pretty sure he suffers from OCD, which is one of the main things that is driving Mom nuts the past few years. He's obssessed with the temperature; he'll check the thermostat in the living room, then go check the outside thermometer, then back to the thermostat, then another indoor thermometer, etc. Then he'll pace and fret that the air conditioning/heater is working too hard, that one of the temperatures must be wrong (even if they're the same). He does the same with clocks - pace the house comparing one clock to another, and fretting (and re-setting) if any is off by a minute. (He has a wall clock in almost every room, and he compares them against each other plus the digital clock on the VCR, his wristwatch, etc.) When the news story about the lead paint from China causing toy recalls, he spent the next two days looking at all the appliances, shoes, Tupperware, etc, in the house to see if any was made in China. His foot ached (he was diagnosed with gout a few years ago), and he was positive it was because his shoes were made in China, so he threw them away. I've heard that anti-depressive meds can help with OCD, but I know that if the doctor told Dad he was suffering from like that, Dad's reaction would be "Bull****! There's nothing wrong with me!" That's his constant mantra - nothing is wrong with him, it's the rest of the world that's crazy. Anyway, I guess he's not a danger to himself or anyone else, but my Mom is stuck in the house with him and I know this is affecting her quality of life. (She's told me more than once she'd leave him except for the fact that he couldn't possibly survive on his own, and then she'd feel guilty if something happened to him.) This may be a no-win situation, but any opinions are appreciated.
posted by jessamyn at 6:27 PM on October 24, 2007

Yeah...this all sounds a lot like my own father, only he has been, like konolia's husband's father, very abusive, and he actually did manage to serve in the Marines. (Was drafted; later was court-martialed; later still won an honorable discharge; has been on disability the entire time I've been alive.) I've guessed it's some variant on Borderline Personality Disorder.

Your mother sounds like she's been put in much the same position mine was—my parents finally divorced in April, after 29 years of this shit from my dad, and my mother still has to drive him around to appointments, 'cause he's legally blind and can't drive.

As for a solution or diagnosis...your guess is as good as mine!
posted by limeonaire at 8:46 PM on October 24, 2007

poster: "Anyway, I guess he's not a danger to himself or anyone else, but my Mom is stuck in the house with him and I know this is affecting her quality of life. (She's told me more than once she'd leave him except for the fact that he couldn't possibly survive on his own, and then she'd feel guilty if something happened to him.) This may be a no-win situation, but any opinions are appreciated."

Again, she should really, really talk to a psychiatrist, more for her own happiness and sanity in the situation than for his sake. Even if they decide together that it would be foolish to confront him, it'd probably help her a great deal. I'm not a pro, but I do know that she's going to have to have strategies for dealing with him. That's the best way to go about it.

Good luck.
posted by koeselitz at 12:01 PM on October 25, 2007

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