Sectioned-being discharged-apply for continuing healthcare?

[Karjo]

My mum has been sectioned(section2)and has spent just over 2 weeks now trying to escape. She is terribly unhappy but is drugged to help calm her which may account for her extreme confusion.(diazepan i think though we haven't seen a doctor since she went in or had much feedback) or it may just be her deterioration.
We have asked how we go about seeing a doctor and have been told the doctor is off sick but there will probably be a ward round on Tuesday we can attend. This was quickly followed by a question on would I be available to care for her. i said it was possible in the day but I would not be able to cope at night.
This is very true as I know if my mum moved in with us and we didnt let her out or do what she demanded she would smash or climb out windows. She did this in her own house and was partly why she was sectioned. She has a terrible temper and cannot cope with being told no, and I am rubbish at telling her no, so my husband would bare the brunt of it which scares him.
WE are looking at a care home today but to be honest I dont think a care home could cope without either drugging her to death (and after reading re Fiona Phillips today the thought is unbearable) or getting the police to restrain her which is what happened at our local hospital before being sectioned. She sounds like a monster but she isn't - she is my mum and i still want what is best for her but i just cant cope.
Anyway to the point of this . She is physically fit which makes her more of a risk as she is so strong. I just dont know how I would cope with her her behaviour at home trying to escape etc and dont know if we should put the feelers out for continuing NHS healthcare. Would they lock her up forever which was her worst fear and then I will have betrayed her. I know even though she would be a priority for the behaviour domain in my opinion, this is unilkely to be granted because the money is just not in the pot. However, we like a lot of you are living a nightmare going round in circles wondering how we are going to cope with this. She would be self funding and could afford a basic care home,as she has some savings and a house but I question, like with Fionas dad, whether they could cope, and would she end up bounced around getting more and more drugged. Should we ask the hospital to do an assessment before she is discharged for continuing healthcare as even if she does not get it , it will be preparation for the future. Or is it best just to keep quiet and try and sneak her into a basic care home and keep our fingers crossed it works out. Or even take her back to her own home and keep fingers crossed she stops the wandering and fighting us. I really dont know what questions we should be asking if they turn round tomorrow and tell us she is our responsibility do what you want with her and take her away or do they act as bullies telling us what we have to do even if we think it would be a disaster. i suppose my point is she is a complex character but they dont really dont know her - all they have done is drug her to try and make her comply. Is that what would happen if she got continuing healthcare, just increasing the dose until she became a sort of zombie?
Sorry if that is a horrid word to use but it is how I feel and sorry if this all sounds very confused, but I am confused as usual as to what is best. what others have experienced?

[littlegem]

Hi Karjo,
Sorry I cannot help with the continuing care bit but I do know they cannot MAKE you care for your Mum if you feel unable to cope with her. Please do not take on more than you can easily deal with, you have your own family to think of.
Her caring needs will increase so maybe, if you think you could cope now, could you in 6/9 months?.
Personally, and this only my opinion, I would look for a care home, she sounds a difficult lady to deal with however much you love her.
Take care and keep us posted.
xx

[elaine n]

Hello

Your mum sounds very much like my husband was. He displayed a lot of the behaviour that your mum does and had to be sectioned. In our case the drugs that were tried didn't help at all, in fact they made him more ill it seemed. I think it's highly unlikely that a basic care home would accept her with these issues and you're more likely to need an EMI home. The one my husband was in was amazing, the staff had a lot of experience with challenging behaviour and didn't resort to drugs to calm him - they learned how to manage him. I think you absolutely should ask for a CHC funding assessment - we did and were awarded it, although it wasn't all plain sailing we got it in the end. Remember that if they do the assessment you have a right to be present and can have some input into it. Good luck, I hope you and your mum get what you need to have her cared for as you would wish. xxe

[Nebiroth]

My own personal opinion would be to look into care homes. When the hospital or social services ask if you would be available or cope with caring, tell them NO.

I know you want to care for your mum but reading what you have said and between the lines makes me pretty sure that you wouldn't be able to. That's not meant to belittle you - in dementia there almost always comes a point at which the problems become so severe that they can't be managed outside of a secure, professional care environment. A care home specialising in challenging behavior would be secure and it would have a sufficiency of fit young staff who are trained to deal with this sort of thing - and they would get breaks and holidays . Perhaps more importantly than that they wouldn't be emotionally involved which I think is sometimes the most mentally exhausting aspect of it all because of the distress and upset. An example of this is your mum being told no - in a care home she would have to accept it, and throwing temper tantrums or calling people names would have little effect. Quite a difference to what it would do to you. It's simply no fair that you or your husband should live in fear of your mum - which is what would happen. It also sounds as though it would be nigh impossible to keep her from escaping - you'd have to turn your or her home into a copy of a secure care home at least.

The hospital should organise a care plan before your mum is discharged. This should involve her doctors, social workers and yourself. She can't be discharged until a suitable care plan is arranged. You will have to be prepared to dig your heels in and say you can't and won't care yourself or be held responsible for it - the law is on your side, since no family member can be obliged to do this (or even help pay for it)

I don;t wish to sound harsh but I honestly think that no-one's interests would be served by your attempting to take this on - even if you did cope, what would happen if things got worse?

Regarding continuing care funding. That is one possibility. As your mum is under Section a lot depends on her discharge. She might well come under Section 117, which means that her care would be completely funded by the NHS - she would be treated like a hospital patient, even if not actually resident in one. Sadly the hospital may try to avoid this due to the cost for the NHS and also, some hospitals and local authorities are unaware of their obligations regarding patients under Section due for discharge.

Even if continuing care or 117 funding aren;t available, perhaps the time has come to consider residential care with the usual funding assessment...even if your mum turns out to be self-funding and this drains her assets, then it might just be the very best way that money could be used.

[Butter]

I entirely agree with everything Nebiroth has said. The last time my mum was sectioned (it has happened three times) we all had to make it 100% clear there was no way we could keep her safe, look after her, manage for a moment. My father even had to walk away from the hospital (literally) when the time came for her to be discharged from hospital to the CH. He refused to take responsibility for her. She could have thrown herself out of the taxi. She could have pushed him out. Eventually she was transfered in an ambulance - without my father there as that would have been an explosive mix.
You have to have the courage of your convictions but it is in your mum's best interests to get professional help all the way through this heartbreaking process.

[macsmrs]

Hi
I am in a similar situation with my mum. After struggling to support her in her own home for many years mum was admitted to community hospital following fall. Her behaviour deteriorated & finally professionals were able to see the issues I had been highlighting for a long time. We initially looked at EMI Residential homes but situation worsened with mum absconding from ward becoming more agressive until she was sectioned and transferred to a secure NHS mental health unit. We have now halted the process of going to panel for CHC funding until they have assessed her again. In anticipation we are now looking at EMI Nursing homes. We have fortunately found two excellent homes - recommended by others and impressive on visiting. This means when the time comes we are ready to move forward. The 'right' care home will definitely be able to look after your mum as they will be experienced in Dementia care and set up to cope with any problems. It sounds like you would struggle at home and would then find it much harder to get her into care. Take this opportunity to get CHC assessment and plan for the best future possible for all of you. Good luck.

[Pon]

I'm hoping someone out there can help me. My husbands 28 days under section is up on a week on MONDAY because both my sons work and one will have to travel home from London to go to the meeting I asked the staff nurse in charge today if a date for the section meeting had been decided stating that my sons would like to be present as well and because they both worked and one would have to travel home from London for the meeting. His reply was that there is no such thing as a section meeting that they just decide in the ward what will happen next. He said he'd go have a look on my husbands notes and see if there was anything mentioned on them. He came back and said that there wasn't anything on his notes and that he had put a note in there saying that the family wanted to attend a meeting.
Our Doctor told me last Thursday that we would be invited to the meeting so why is the hospital trying to pull the wool over our eyes. I know my husband is a very complex case as apart from the usual he has been diabetic for 40 years and the hospital is unable to control his sugar levels another staff nurse came to have a word with me before I left the hospital and said that my husband is still having hypos at night and they've tried reducing his novorapid but he is still having hypos and they have asked for a diabetic nurse to come and see him next week to see if she can come up with a solution for the hypos. It looks as though they have controlled his aggression at the cost of his diabetic control and mobility he can hardly walk he is so weak. Shall I wait till Tues and then ring the Social worker to get some answers as to what is going on . I don't want to go to a meeting without my sons incase I miss something Important they say or forget to ask something that is important to my husbands future
Any help would be great fully received
Thanks Pon