On losing one’s mind.

I would never describe my mother as level-headed. My relationship with her is complicated and dysfunctional in the way only a relationship with a parent who has struggled with mental illness can be. Sometimes, she appears completely normal. Sometimes her affect is off. I have learned to recognize her manic periods by her tone of voice and the names she calls me. She has spent her life struggling with depression, and has made several suicide attempts over the years. She has done her fair share of manic shopping. She is horribly manipulative, and rarely honest — with herself, or anyone else. She hoardes dogs, and things that she buys from the Goodwill, carefully stacking other people’s cast-offs into piles and pathways through her home. Mom has health issues, too. She is a diabetic, and takes medicine for high cholesterol as well as depression. Occasionally, she will have a period of enlightenment when she is lucid, mostly logical, takes her medicine, and appears to be in good spirits. Sometimes these times last hours or days, sometimes months.

I live about 1700 miles away from my mother. I have all sorts of guilt about that, especially because it left my sister with greater responsibility for her, largely because of geography. On the other hand, I am nearly certain that distancing myself from my family was one of the smartest decisions I have made as an adult, even more now that I have a daughter of my own. I talk to my mother about once a week on the phone, in which she chatters on about her dogs or the weather. It’s not a real conversation, but I don’t know that I have ever had a real conversation with my mom. I check in to see if she’s lucid, if she is able to walk around, if she’s alive — that’s pretty much all these calls tell me. Lately, I thought she was doing fairly well. She was able to converse mostly normally (though still about very little), and she had recently told me she was getting rid of some of the things in her house and cleaning it, she is trying to eat healthy, she is taking walks with her dogs, and doing well. She clearly was lying.

She was admitted to the emergency room about a week and a half ago. She had chronic diarrhea due to severe colitis, was delusional, spouting nonsense, was at the lowest weight she has likely been in her life, and had a blood alcohol concentration of 200ml. After leaving against the request of the hospital and being readmitted to the ER a few hours later, she ended up in intensive care for several days. They did a full body scan, and discovered deep dementia fissures in her brain as well as encephalitis. My sister was there with her for nearly a week, trying to piece together my mother’s true health condition along with the doctors, and dealing with mom’s hostility toward her and her delusional speech the whole time.

During my mom’s stay at the hospital my sister went to mom’s house, where mom hadn’t been staying for several days since she had been house-sitting for her friend. When she got there, my sister found doors and windows left standing open, the key in the lock of the front door, piles of things everywhere, and medications that had not been taken, or had been taken incorrectly. (Too many or two few pills left in bottles.) She did not find unusual amounts of alcohol or empty alcohol bottles, so that is still a bit of a mystery, but clearly she has a problem which is strange and unexpected — I can count on one hand the number of times I’ve seen my mom drink even a half a glass of wine in my life. There are other mysteries which we are still trying to get to the bottom of, as well. The neighbors told my sister that they were concerned for mom, who often stood in her driveway for extended periods of time, doing nothing. A social worker visited mom in the hospital, and arranged for a mental health nurse to visit her once she returned home. It was pretty much agreed that if left in her home instead of assisted living, they would be expecting to see mom in the emergency room again, and likely soon, if mom was very lucky to avoid the alternative.

The state nurse came and evaluated mom a couple of days after she returned home, and mom convinced her that she’s just fine. Because she can access outpatient services, they will not place her in an inpatient facility. Because she can answer yes and no questions and sign her name, we can not legally force guardianship and move her to somewhere that she will be supervised and safe. And so now we wait for her to either die, or end up back in the emergency room, at which point she will only be released into assisted living. My sister is frustrated and angry. I am struggling with what the most humane course of action is, and with the ideas of free will, and motherhood, and obligation, and preservation of the generations. My mom told me she went to the hospital for “a couple of days” because she had the flu. And that she is perfectly fine. Legally our hands are tied, and there is a looming dread about all of this which I am still unable to put into words efficently.

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