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Name: thekitty
[ Original Post ]
I hardly know where to start. I am the adoptive mother of an adult with a dual diagnosis of schizophrenia and a mild intellectual disability. My husband and I adopted him as an older teenager and have been fortunate to have him in our lives for about nine years now. He has a history of physical abuse and abandonment and suffers from flashbacks of his frightening childhood. He is currently living in a supported living environment with two roommates and has round-the-clock staff.

Over the past 7 weeks, he has had five inpatient mental health hospitalizations that were primarily related to behaviors rather than actual psychosis. I am getting very frustrated and tired from the constant drama and upheaval. I truly do not know what to do at this point. In general he receives above average direct care from from kind and patient staff members. I have daily contact with my son either by phone or in person. He is unhappy with his current roommates and wants to move, so he is having major behavioral issues every weekend. I understand that there are emotional factors that cause the behaviors, but I have to find a way to help him express them more appropriately. They cannot be an excuse for misbehavior any longer.

Tonight's crisis was ingesting about 3 oz. of mouthwash. He is at the emergency room with staff while I sit in my den because I do not want to reward his behavior with attention. I feel pretty cold and callous right now having my son at the hospital and staying home, but I really don't know what else to do.

He began individual counseling last week and sees a psychiatrist at a large community facility. He does not seem to be exhibiting any of the warning signs of psychosis that we occasionally see. His medication seems to be controlling the hallucinations and paranoia. The real issue is just behaviors. Because he lives in housing provided by an agency and governed by state regulations, there is very little that can be done in terms of consequences for negative behavior. I have a few options including removing a couple of privileges such as attending church unescorted and going to a restaurant for a weekly dinner, but little more.

I live about 45 minutes from his home, and I am in moderately poor health at this time although I am recovering. These issues make it difficult to parent at a distance. My son's cognitive and emotional functioning is approximately 7 years old. He is basically having tantrums over not getting his way. The problem is that he is 7 in a grown man's body and tends to be aggressive toward others at this point and engages in typically insignificant self-harm gestures such as eating coffee grounds or flour as a "suicide" attempt.

He receives behavior services from the state, but the plan cannot be implemented because he is spending more time at the hospital than at home. So, now what? How can I help him? What can I do to keep him safe, healthy, AND generally happy? Moving him to another agency is really not a good option for a variety of reasons including quality of care from other agencies. He is just stuck with the roommate he dislikes at least for now. I cannot bring him home because I cannot physically care for him properly while I am ill.

If I attempt to set parameters for acceptable behavior and implement consequences and rewards, the immediate result is increased negative behaviors because he thinks I am "mad" at him. If I try to deescalate a situation over the phone with simple reassurances, it reinforces his behavior. Calling foul over the behavior escalates to a crisis.

As I sat here typing this, I got the call that he is fine and returning home. I know it sounds mean, but I hope he has enough of a bellyache from drinking the mouthwash to NEVER do it again. I hate that he got the attention he wanted from the behavior. Honestly I wish I could just ground him for a day or two and take away privileges like any mother would do after a child's tantrum. I don't want to do some horrible injustice to him, but the Human Rights Commission won't even let the agency take away TV time.

So what do you do with a 24 year old man who thinks and behaves like a 7 year old and can be give such limited consequences?
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