my mothers blood pressure has been 230/110 for a week.  She went to the ER and they got her systolic down to 180 and sent her home.  It is back to 230 again.  she also has slow speech and sharp headaches.  I think she should be back in the ER.  My father is not acting fast enough.
Hi! Welcome to Chat Doctor! Age of your mother not mentioned.Anyhow, I have gone through the problems discussed in your question. I am of the opinion that your mothers BP is not controlled, the fact that she is having severe sharp headaches and slow speech is highly suggestive of impending Hypertensive emergency. She needs to be treated in ER possibly by using intravenous BP lowering Chat Doctor.  Her BP should be reduced gradually to prevent sudden fall in BP. She also needs to undergo CT scan to rule out any problem related to her slow speech and sharp headaches. If your father is not acting fast, you should take or make arrangement to take your mother to the hospital. Wishing your mother a smooth recovery from high BP, If you are convinced with my suggestion, reply with thanks.