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My 70-year-old mother is bipolar and routinely suffers from insomnia. She's been having trouble sleeping on and off for over a week and now seems paranoid (anxious?) and fearful to the point she's mistrusting the food. Her situation may have been compounded by a recent epidural steroid injection in her back and recently starting Crestor, both of which can sometimes cause insomnia.



Her psychiatrist said to use lorazepam to help solve sleep situation and her PCP said to pause Crestor. She's taking her meds as usual, including the lorazepam but she seems so exhausted/weakened and I'm even more concerned now that she's refusing food. I want to take her to the hospital for an evaluation but she refuses (she had negative experiences at hospitals last year). She also says she's not ready "yet" to see her PCP (who I hope could facilitate a psych eval).



She experienced this last year and had to forcibly be taken by ambulance to the ER. I really don't want that for her again, considering that she's still there mentally, just a little frayed. But it's looking like we have to wait for her to be convinced to go voluntarily, or for things to get so bad that an ambulance has to forcibly take her. I don't know what other options we have in NJ?

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NancyNJ, I noticed you wrote that your Mom just started taking Crestor, which is a drug used to lower cholesterol.

Not long ago my primary doctor gave me a statin drug to lower cholesterol and I noticed I was having short term memory loss. So I quickly stopped take that drug. Now I try to control my cholesterol with diet. Now I wonder if a side effect of Crestor, for your Mom, is the feeling paranoid. Some people just cannot take those types of statin drugs. Glad her doctor paused the drug.

Also, have your Mom checked for an Urinary Tract Infection [UTI] as such an infection can cause all types of different behavioral issues in an older person [not that 70 is old by today's standards]. I remember when my Dad had an UTI he didn't want to eat because he was seeing ants in his food and on the wall.
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I am afraid that this last paragraph says it all. I am afraid that the EMS is the only option when things are this bad. It may require a 5150 which I would imagine you are familiar with.

Nancy, I never pay much attention to our OP's individual names, nor the numbers of their posts here. I plead being 80. So forgive me if I mentioned this before. But in the case of adult children attempting to deal with mentally ill parents I always recommend a book, a memoir by Liz Scheier called Never Simple. You will feel less alone after reading it though be forewarned that despite decades of trying, along with the good auspices of the city and state of New York, Ms. S. never found an answer to help, and she sadly sacrificed a whole lot of her own life to no avail.

I wish you the very best and I am so very sorry.
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NancyNJ Mar 2023
Thank you so much.
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It appears that you’ll have to wait for things to get so bad that the ambulance forcibly takes her. On the other hand, she’s mentally ill and clearly unable to make good decisions. Do you have the Baker Act in NJ? In Florida this act is invoked so that someone can be held involuntarily for 72 hours for a psych evaluation. Maybe that would work for your mom.
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NancyNJ Mar 2023
Thank you for responding.
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I can only see the choices of:
- Someone voluntarily seeking medical advice (their Doctor or go to ER).
- Volunteering to seek medical advice *for another reason* & once there, their Advocate can initiate the mental health topic.
- Involuntarily being forced to present for medical advice/treatment. This is usually for severe cases (eg harm to self or others) & can be distressing (as you already know).

While becoming more paranoid & refusing food is certainly concerning, it probably does not fit as 'severe' enough.. yet.

Dehydration will be a risk.
Is she still drinking water or other drinks?

I think I would try for a telehealth appointment with her primary Doctor. If not an option or Mom is not willing, I would make an appointment for ME. For advice & discuss an action plan - a little like an Asthma Plan: what symptoms to look for, when to seek help, who to call.

Prevention is better than a cure so the saying goes. Yet it is so hard to help those who refuse help.
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