What to do about bipolar brother?

[chayamalka]

My 78 yr old brother only has me and my sister. We are his half sisters by our mother. My mom made me promise to watch over him after she died. A few weeks ago he threw away all his medicines, both medical and psychiatric. I don't know why because he wasn't talking to neither me nor my sister. Either he let the answering machine pick up or shut it all together and didn't answer the phone. That's what he did the day before we had to admit him to the psych ward. His medical doctor called ahead and got a psychiatrist he had seen before in the hospital to admit him quickly. He signed himself in. But the volunteer ambulance had to call the police to make him get dressed and agree to sign himself in. That hospital only takes sign ins. He got very submissive when the police came. All this was traumatic for me and I can imagine how it was for my brother. He was mad at us. I waited in the ER waiting room until he got admitted. He wandered in there looking for a room, maybe to leave or go to the bathroom. I asked him where he was going. He asked why I was there. I said to make sure he was ok. He said,"Go away, Both you and your sister are crazy just like your father and started to rant. I didn't want to hear anymore per chance my heart condition might act up(in the right place)and I didn't want to upset him anymore so I left. A few days later I called him and he didn't want to talk to me. He was mad that me and my sis  for putting him in the psych ward. But his private psychiatrist insisted we not leave him alone without meds for the weekend and gave us a note to admit him. She said we were doing the right thing. Last week he did talk to me a little. I quickly asked if he needed anything. He said no who is this? I didn't tell him and just asked how he was. He said ok. I asked if he wanted me to visit him. He said no so I said goodbye. He was heavily sedated. Today, before the holiday weekend, he was discharged! Without homecare and we couldn't bring him home. I spoke to the social worker to send him home Monday when the case worker can re-evaluate him for homecare eligibility. But she said the insurance has to send him home so she will send him home Friday afternoon. She wanted to know: how is he going to fill his prescriptions? I said there is a 24hr drugstore 4 blocks away from him. My brother is capable of doing that himself as long as he wants to take his meds. She said he will take them. My problem after all these details is: Will he talk to me and cooperate with me after being mad we put him in the hospital? He has homecare 3 times a week now and I feel he needs more. Simply because he forgets sometimes. I think he is showing slight signs of senial dementia or Alzheimer's. His father had that in his old age. So he needs homecare all week. but he goes out to eat sometimes and goes to the drugstore and the grocery, all on his own. I had asked the hospital psychiatrist to test for Alzheimer's but he kind of shrugged it off. And he didn't want to get in the middle of family situations. I asked him if my brother would talk to us. He just said to call him and try to establish a good relationship with him. What do I do? do I call him at home to see if he filled his meds. He got mad before the hospital when I asked him why he threw them away. So do I even bring it up. Do I just call to see how he is feeling? I dont't want to antagonize him. I want to stay on good terms with him. So any suggestions on what to do? My sister is away for the weekend and is leaving it all up to me to watch over him for now. I get anxiety pains thinking of what to do....I woke up 4:30am thinking about this problem....please help.

[ILADVOCATE]

People often do better living in the community and nursing homes can very often be abusive and will worsen their situation. For more information on eligibility for home health care you can look up your local independent living center:
http://www.ilru.org/html/publications/directory/index.html
He obviously needs medication but psychiatrists have found (it states this on the medication advertisements itself) that antipsychotics are to be used with caution in elderly people with dementia. Have him see a neurologist to rule this out first and any other related condition and one medication that has been helpful in family members that were elderly was Namenda.

[Venora Moonwind]

I know this is very difficult for you. We went through much of the same with with my grandfather when he had to be admited to the nursing home.

My mom was taking care of him at home after having a stroke. Now mind you my grandpa was very hardheaded efore the stroke. When you wnated him to do something you always had to make him think it was his idea. 2 weeks of arguing with my mom was taking a toll on her as well. ( I often think the caregivers have more stress than the one with illness)

Any way mom was hurt by the things my grandpa would say to her. When se talked to me about it I told mom he is sick its not really him talking any more. you cant take what he says personally it is really just  frustration at his situation.

I am no doc I only have my expereience to go on. We bi polars have a tendancy to say what ever is on our minds an d it pops out before we even know we are going to say it.
I know when I am cycling I just want to shut the world out

It may be time to consider a nursing home for  him. It is a difficult decision to make.Talk it over with your family and decide what what be the best for him.

Prayers for you and yours
Venora