leaving a section 3

[Lavender45]

I know this is quite a specific question, but here goes.

Mum has been in a secure unit for around 3 months now. She is on a section 3. Mum was sectioned due to her violent behaviour. She is still displaying verbal aggression quite regularly, but apart from an incident last week when she kicked a doctor she hasn't shown any physical aggression the I am aware of since sectioning.

Mum is currently on respiridone, trazodone and diazepam and the unit have said she is ready for a care home placement, but have advised that her behaviours are such that I would not be able to have her home.

Whilst it's sad that she can no longer live with me I am resigned to this and am looking for a care home for her. The unit are still trying to find the optimum balance of medication for mum and have indicated that this "tweaking" of medication including a reduction of respiridone hopefully with a view to taking her off this medication will continue "in the community". This worries me. In my head I expected mum to be on a stable set of medications before she left the unit. Am I expecting too much? My worry is that adjusting her medication in a care home setting could bring a resurgence of her physical aggresion which could jeopardise her place in a care home. Am I over thinking this (probably yes). Am I expecting too much of the secure unit in wanting them to have finished sorting her medication whilst still under their carer?

I know it may come across like I never want mum to leave the unit. I promise that isn't the case. I don't feel its a good place for mum at all, but it is the place with the ability to change medication quickly if any of their "tweaking" goes wrong.

 

[Tin]

I have no experience in this area, but can see why you are worried. I should think it depends on the kind of care home she goes to and they have appropriately trained people to tweak her medication down to an acceptable level and not up. Any chance you can insist on her staying where she is, till all tweaking down?

 

[jaymor]

Ask those who are treating your Mother in what type of care home they expect her to be cared for. There are nursing homes that can care for challenging behaviour very well.

You need to be very clear about the level of care your Mum needs then there should be no need for moves should she have problems whilst the medication is tweaked.

It is the responsibility of the unit to point you in the right direction to start looking at care/nursing homes. It's hard enough to find the right home when you have the information, trying without is practically impossible.

My husband was in an assessment unit and they guided me as to where to look and the level of care that was needed.

 

[Lavender45]

Thanks Tin and Jaymor

The type of home mum needs is under debate. Mum has had 2 consultants since being sectioned. The first Dr S was also mum's consultant in the community and has known her for around 2 years. The second Dr P has known her for 6 weeks and by week 2 decided mum needs residential not nursing care. I pointed out Dr S said she needed a nursing home and was told by Dr P that she was very experienced knew best. I have looked at 14 homes (some dual registered) who have all said they would be unable to meet her needs in a residential setting yet the consultant as of Wednesday still thought I could magically produce a residential home for mum.

As far as the medication is concerned last week they increased her diazapam, this week they have reduced her trazodone. They want to hold off on changing tho dosage of respiridone until she is in a care home setting. Last week one nurse told me mum was constipated causing falls, another said she wasn't. The notes for one night said mum slept through one particular night yet a nurse on duty in the daytime said mum looked tired and when he'd asked her she said she slept badly. He said he believed mum rather than the staff notes.

I know I am stressed and over focusing, but to me it is shambolic. I really want mum out of there, but I really want to feel that I'd done what I could to ensure that her leaving the unit does not fail. Mum hates being in there. If tweaking medication in a care home setting failed and mum got violent enough to have to return to the unit I don't think she would cope.

 

[jaymor]

This is why it is so important that those in charge of your Mum!s care are both singing from the same hymn sheet. When we were looking for a nursing home for my husband it was difficult to find one that said they were equiped to deal with challenging behaviour.
If your mum's medication will still need tweaking then surely a nursing home, with nursing staff on duty all day is a necessity.

Tell the consultant who says residential care is wanted to find you one that will look after your Mum because you can't and I wish them luck in finding one.

 

[Pete R]

I know this is quite a specific question, but here goes.

Mum has been in a secure unit for around 3 months now. She is on a section 3. Mum was sectioned due to her violent behaviour. She is still displaying verbal aggression quite regularly, but apart from an incident last week when she kicked a doctor she hasn't shown any physical aggression the I am aware of since sectioning.

Mum is currently on respiridone, trazodone and diazepam and the unit have said she is ready for a care home placement, but have advised that her behaviours are such that I would not be able to have her home.

Whilst it's sad that she can no longer live with me I am resigned to this and am looking for a care home for her. The unit are still trying to find the optimum balance of medication for mum and have indicated that this "tweaking" of medication including a reduction of respiridone hopefully with a view to taking her off this medication will continue "in the community". This worries me. In my head I expected mum to be on a stable set of medications before she left the unit. Am I expecting too much? My worry is that adjusting her medication in a care home setting could bring a resurgence of her physical aggresion which could jeopardise her place in a care home. Am I over thinking this (probably yes). Am I expecting too much of the secure unit in wanting them to have finished sorting her medication whilst still under their carer?

I know it may come across like I never want mum to leave the unit. I promise that isn't the case. I don't feel its a good place for mum at all, but it is the place with the ability to change medication quickly if any of their "tweaking" goes wrong.

Where is your Mum's Social Worker in all of this this? Your Local Authority should be responsible for finding the correct placement for someone that has been sectioned not you.

 

[Lavender45]

Where is your Mum's Social Worker in all of this this? Your Local Authority should be responsible for finding the correct placement for someone that has been sectioned not you.

Hello Pete

No one has ever told me that it is for the L.A. to find a placement for mum. Very interesting!

Mum was allocated a social worker 3 weeks ago. She promptly went on 2 weeks leave. On her return this week we had a MDT meeting. The meeting started an hour late initially due to the ward, but by the time the ward were ready the social worker had disappeared off to do some other stuff within the hospital. Cannot blame her for that, but still frustrating. In the MDT meeting it was very much left to me to find a home to take mum. The most the social worker was willing to do was to call brokerage and let me know of homes with vacancies. She hasn't contacted me. The meeting was Wednesday and I'm not really expecting a call now.

I have no direct line for the social worker. Have to go through the L.A. contact centre which inevitably has a message due to the high volume of calls...... I listened to their music and how my call was important to them for a bit and gave up. The powers that be are definitely the powers who don't when it comes to my mum. One positive is that the social worker has told me I could go out of borough to find a home. I looked at one yesterday which may be a posibility for mum. They still said they nursing not residential, I've been told that everywhere I've been. They are going to assess mum next week and they have vacanies so we will see.

 

[Lavender45]

Tell the consultant who says residential care is wanted to find you one that will look after your Mum because you can't and I wish them luck in finding one.

I would dearly love to!

 

[Beate]

Can't comment on the medication issue but just wanted to say that if she is discharged under section 3, she should be receiving section 117 aftercare, so do mention that as it makes all the difference to the funding!

http://mind.org.uk/information-supp...-hospital/section-117-aftercare/#.WOiiMYGkqrU

 

[LadyA]

Lavender, I've been "following" you on other threads, and tbh, at this stage, I wouldn't be so polite to those in the Unit! I would give them a complete list of all the homes you have tried, and which say they could not cope with your mum, and ask what "residential" setting exactly they had in mind, and where is it, because you have been unable to find it, and that at this stage, you are left with the distinct impression that they insisting on a care home rather than a nursing home for your mum is a money saving exercise, which will inevitably lead to a failed discharge, and be detrimental to your mum's well being.

 

[Onlyme]

I thought residential meant that there weren't nurses able to give medication; with the list of drugs your Mum is on then she would need nursing, possible EMI due to behaviour and 117 discussion due to Section 3.