Suicidal thoughts from dementia sufferer...any ideas?

[wazza]

First post.


Mum was eventually diagnosed with mixed dementia (severe) vascular and alzheimers, Nov 2016. The family had protected her (me included) for quite a while before I had to do something to get her "on the radar", so I got her doctor to refer her to memory clinic, tests and diagnosis.
Since then, she has a social worker and a CPN, assessed at home by OT, .
She has really deteriorated this year, turned against the family, (accusations of stealing her money, trying to poison her, no understanding of her personal safety, not eating or drinking properly. Heading off on the bus to sometimes at least 14 miles away from where she lived. Telling family members to go away and never come back. Tidy in habits, but unable to look after herself. Things came to a head when I was on holiday in June. She went to her bank (again) and accused me of stealing her money, sister had to go and try and take her home. She wouldn't get in the car. Sister got a call hours later from the police, saying she was 14 miles away, in a church, in the area she was born in.
Days later she became shaky, sick and confused. No doctor available so sis, quite rightly took her to local hospital on recommendation of our emergency services. Mam was kept in, but was delirious, fiddling with drips (other patients) hallucinating, trying to escape.
They only kept her there 4 nights. Then she was transferred to an emergency room in EMI care home.
She's still there. Any home care wouldn't be enough. After a review meeting, it was decided she needs 24/7 care.
Bad start, however about 2 months down the line she showed signs of beginning to settle.
No chance.
She won't have a shower or bath because she'll do it when she's HOME. One week since the last one, and she used to have a shower every day when she was living at home.
She has been talking about killing herself, (to be honest, she was saying the same when she was living at home)
We visited today and she showed us her left hand, very bruised,, she said she'd been trying to kill herself. Told staff, and they found her with a biro top, which she'd tried to sharpen and stab her hand with, needless to say, they've taken it away.
I've reported it to the nurse, who is new, and has 40 residents to look after.
Any ideas? I'll l'll take on board anything that comes this way.

 

[AlsoConfused]

Welcome to TP. I'm sorry you and your Mum are having such a hard time.

I'm appalled by the staffing ratio - one nurse to 40 patients in a specialised EMI unit!!! That doesn't seem right and can't be safe. Is the unit more of an ordinary nursing home than a specialist unit please?

If it is a specialised unit caring only for the more demanding and needy of mentally frail patients those low staffing levels might be worth taking up with whoever runs the unit. The Care Quality Commission might intervene if it's a specialist unit to urgently demand an increase in staffing levels.

I think you ought to be speaking to the doctor / psychiatrist in charge of your Mum's care to see whether tweaking her medication might improve her quality of life. She may be clinically depressed as well as suicidal. My Mum's paranoia was significantly reduced when her psychiatrist altered her medication so this avenue is worth exploring.

I don't think you should worry too much about your Mum only showering once a week, providing she remains reasonably clean and isn't suffering from incontinence. A Care Assistant ought to have the skills to persuade your Mum over time to accept showering and personal care as often as her health and well-being requires.

 

[wazza]

Thanks Also confused

Thanks for your reply. Yes, this is an EMI unit. I think the nurse is new, and doesn't know any of her patients. The family had review meeting at least 3 weeks ago, when we raised our concerns that mum was not being offered any medication to help ease her anxiety. Obviously, nothing has been done or passed on, because when I talked to the nurse today, she was unaware of any concerns we may have....
I'm beginning to see that we need to take control here, not be fobbed off, but must press for something to be done to help our mother. Would you say that's what we should do?

 

[cragmaid]

Urgent Action.......Get in touch with her GP, her Mental Health Team,her Social Worker, The CH Management, the CQC and if necessary, her MP and the Media. Use all the key words especially to the Social Services ie "Vulnerable Adult", "Duty of Care"," At Risk" and certainly" Entertaining Suicidal Thoughts".
The staffing levels do concern me, unless there are Non Nursing carers on duty as well as the Nursing Carer.
Sadly, unless you make a song and dance, things will get worse.

 

[Tin]

Thanks for your reply. Yes, this is an EMI unit. I think the nurse is new, and doesn't know any of her patients. The family had review meeting at least 3 weeks ago, when we raised our concerns that mum was not being offered any medication to help ease her anxiety. Obviously, nothing has been done or passed on, because when I talked to the nurse today, she was unaware of any concerns we may have....
I'm beginning to see that we need to take control here, not be fobbed off, but must press for something to be done to help our mother. Would you say that's what we should do?

Yes you should start pushing hard and if no medication available or they are unwilling to prescribe then find out why.

 

[wazza]

Thank you Tin

Yes you should start pushing hard and if no medication available or they are unwilling to prescribe then find out why.

Thank you Tin. I think the whole situation has knocked us for six, and we really need to get a grip on it. There are so many residents here, and some of them are lovely, but only one of them is our mum. I don't think staff are able to keep track of everyone, but I think that if our mum has ben barricading herself in her room, to the point that furniture has had to be attached to the walls, and that she's been shaking in her bed, terrified that someone's out to kill her, and it's all written off as part of dementia, we need to act as a family, and at least try to make things easier for her......somehow...

 

[wazza]

Thank you Cragmaid

Urgent Action.......Get in touch with her GP, her Mental Health Team,her Social Worker, The CH Management, the CQC and if necessary, her MP and the Media. Use all the key words especially to the Social Services ie "Vulnerable Adult", "Duty of Care"," At Risk" and certainly" Entertaining Suicidal Thoughts".
The staffing levels do concern me, unless there are Non Nursing carers on duty as well as the Nursing Carer.
Sadly, unless you make a song and dance, things will get worse.

Thank you Cragmaid. I will do everything that you suggest. To date, I have not met the manager of this care home, as she deals with several homes in this area. We even postponed a date for the last review to include her in the discussion, but "due to an emergency" she was not available(again)

 

[AlsoConfused]

This all sounds appalling. Nobody should be left unsupported in a state of prolonged fear, whatever its cause.

Have you seen your Mum's care plan and the daily notes on how she's been? Have you seen the CQC report on the unit?

It's late now but can you document everything you and others have seen of the defects in your Mum's care and speak to the unit manager ASAP (like tomorrow)? If you're not happy with what you hear please convey your concerns to the SS manager responsible for elder care.

My Mum was in a (good) assessment unit. When there were incidents in the unit I noticed usually at least 3 or 4 staff members would quickly and quietly go immediately to sort it out. There were always enough specialist nurses, occupational therapists and well trained, kind care staff to nurture and monitor the patients. Your Mum's care should at least be similar to that.

 

[wazza]

AlsoConfused thanks

This all sounds appalling. Nobody should be left unsupported in a state of prolonged fear, whatever its cause.

Have you seen your Mum's care plan and the daily notes on how she's been? Have you seen the CQC report on the unit?

It's late now but can you document everything you and others have seen of the defects in your Mum's care and speak to the unit manager ASAP (like tomorrow)? If you're not happy with what you hear please convey your concerns to the SS manager responsible for elder care.

My Mum was in a (good) assessment unit. When there were incidents in the unit I noticed usually at least 3 or 4 staff members would quickly and quietly go immediately to sort it out. There were always enough specialist nurses, occupational therapists and well trained, kind care staff to nurture and monitor the patients. Your Mum's care should at least be similar to that.

Thanks Also Confused for your reply. I kept a daily diary when mum was at home, but haven't done the same when she was put into care. However, me and the family have a FB message link that does document her care on a day to day basis. However think I need to again keep a daily record, and act upon it if some concern is not resolved asap. That's a very useful tip. It's so tough, knowing that our mum's suicidal, in a place that is going to cost her nearly £500 a week. As she said to us, " I wasn't born to be here at the end" I don't know how to deal with this....