They want to section my Mom to start her on new drug

[Daisy pie]

I care for my Mom, I posted on here a few weeks ago about feeling drained looking after her as she was sundowning all day, things havn't changed much I added some more care hours to give me a break, went to the doctors and he gave her some IBS tablets which did seem to help Mom when I can get her to take them. She has been physically aggressive with me for about 14 months now so they physical aggression isn't new but had got worse lately.
I contacted her CPN thinking perhaps they could change her medication to help deal with this, to cut a long story short they turned up at our house a few days ago saw the scratches and bruises on me said this couldn't go on so they arranged a meeting to talk about Mom.

I was then told they want her to go into the hospital where they would section her and take her off the drug she is on at the moment and then start her on Risperidone.

To be honest I really don't want this to happen, I am frightened that this will worsen my Moms dementia ( my Mom has mixed Alzeheimers and vascular dementia) it will be very confusing and distressing for her, also I am also concerned that they will try push to put her into a home and we won't have much say in it, I want to care for her at home as long as possible.
She was bad enough when she was in hospital this time last year after her operation and that was my brother & SIL and myself with her for the day/nights she was in there, so I think she will be really distressed being kept in there for weeks while they do this.
She is already on a antisycotic drug which has never really calmed her down so they are just replacing current one with another one, I'm wishing now I had never contacted them.
I am just wondering if this was a normal thing for them to do also does anyone have advice who have gone though a similar situation with sectioning?

Thanks

 

[jenniferpa]

I'm sure people who have been in your place will respond tomorrow but I didn't want to read and run.

I understand why you are disturbed by this proposed course of action, but while there are no certainties, I do think that this is probably the best, most responsible choice. It's clear that the anti-psychotic your mother is currently on isn't working, it wouldn't be safe to simply take her off this and try others without the sort of backup you can only get in a psychiatric ward.

You really should not have to live in an environment where you have to suffer physical abuse, and I'm sure if your mother was well she would say that too.

 

[Swoozy]

Hello. I’m in your position that mom is aggressive towards me and my daughter.

My moms psychiatrist reported our situation to the safe guarding team and I panicked thinking that they would take her away.

Social services said because my daughter and I are adults and aren’t vulnerable then it wasn’t a matter for them as mom was safe and looked after.

She has tried a few drugs to calm her down and started risperidone last week. Her mental health team know I want to keep her home as long as possible and have always offered hospital as an option for me but they have given her the pill on prescription for me to administer on the basis that I would report all symptoms.

Remind them that you don’t want her hospitalised and that you will happily start the risperidone at home with any adverse affects reported and will have her admitted if you can’t cope.

They can’t force you to put her in a home. My own moms team are trying to encourage me to put mom in a home at the moment and I’m struggling with that decision too x

FYI the risperidone hasn’t worked for my own mom. I wish you luck. Stay strong. Xx x

 

[Shedrech]

hello @Daisy pie
life for you and your mum sounds pretty challenging right now
I appreciate that ideally you want your mum at home - the 'medics', however, don't suggest this course of action lightly, indeed it's rare not normal at all, so please do listen to them - they are weighing up what is in your mum's best interest and also looking to your welfare - to be blunt, no-one should be accepting 14 months of aggression; not good for your mum or you
sadly her dementia is moving on, rather than any intervention making it worse; we just can't stop that however and whatever we try - maybe it is time to let them have a go at getting the right medication to help settle your mum

 

[Bunpoots]

My friend's father was sectioned after an episode of extreme and catastrophic violence. Sadly too late for his wife. He was eventually allowed home to live with his daughter with night time carers, which they didn't have to pay for, after his medication was sorted out.

I know you want to care for your mum at home but if sectioning has been recommended it needs to be given serious consideration.

 

[love.dad.but..]

It seems to me that a lot of dementia care medication is trial and error and what works for one does not necessarily work for another because no one person with dementia is exactly the same but everything should be tried in case it works. Sectioning is not taken lightly...give it a chance...your mum's illness will continue to decline but if they in a secure monitored environment can find medication to help calm her that can only be a good thing. In an ideal dementia world we would all want our loved one to stay at home to end of life but for many different reasons that may not be in the pwd or carers best interests. Physical aggression is surely one of the top reasons.

 

[love.dad.but..]

My dad whilst presenting many challenges including verbal aggression as he was so frightened of any care or medical intervention...was fortunate as was I that he wasn't physically aggressive but in his Dementia NH I saw those that were and no matter how experienced the carers are with using well proven strategies to diffuse aggressive situations sometimes something else has to be tried...I am all against a chemical cosh prescribed without care for the patient...but often the pwd who is aggressive is very tormented and medication with care for that person should be tried if all else has failed. If families or attorneys are involved then the professionals are questioned and asked to justify their medication reasoning.Dementia Patients aren't mostly blameless...they are completely blameless...but a way has to be found to help them and some medication with tweaking to get it right is very successful during a particular stage until or if the physicsl aggression subsides. You will see many heartbreaking posts on TP detailing extreme challenging behaviour. I agree diagnosis and care can be a lottery...it shouldn't be...there is still a long way to go with dementia awareness training and expertise amongst all professions that need to provide a joined up care experience for a pwd and their families

 

[Wheelan Kumaghen]

My dad whilst presenting many challenges including verbal aggression as he was so frightened of any care or medical intervention...was fortunate as was I that he wasn't physically aggressive but in his Dementia NH I saw those that were and no matter how experienced the carers are with using well proven strategies to diffuse aggressive situations sometimes something else has to be tried...I am all against a chemical cosh prescribed without care for the patient...but often the pwd who is aggressive is very tormented and medication with care for that person should be tried if all else has failed. If families or attorneys are involved then the professionals are questioned and asked to justify their medication reasoning.Dementia Patients aren't mostly blameless...they are completely blameless...but a way has to be found to help them and some medication with tweaking to get it right is very successful during a particular stage until or if the physicsl aggression subsides. You will see many heartbreaking posts on TP detailing extreme challenging behaviour. I agree diagnosis and care can be a lottery...it shouldn't be...there is still a long way to go with dementia awareness training and expertise amongst all professions that need to provide a joined up care experience for a pwd and their families

My dad was middle weight boxing champ of the whole allied forces in 1950 so the potential to be aggressive is undoubtably there. So many of the issues sufferers face are routed in fear. I have heard so many stories of people who decline from loneliness, bad diet, lack of stimulus, bad care, bad policy but here in the UK the problems start at government level.

50 years of tax and NI have brought him nothing. His extra pensions help fund only those who created the situation and all of the plans he made to support the 3 generations who follow him stand in tatters as they disregard what is best for him in the fight to make him pay for what he already paid for in National Insurance. Are you surprised dementia sufferers get anxious?

 

[love.dad.but..]

However the illness decline itself can also cause those anxieties and fear to start or escalate as understanding and mental capacity disappears. In moderate or advanced stages many if not most pwd would not be able to understand or reason the points you make about their contributions during pre dementia years so anxious obviously but not necessarily due to that

 

[Wheelan Kumaghen]

The last thing I want to do is question the reality of your situation or your assessment of it. I am not yet in your situation and only wish to offer 2 small pieces of advice. Your dad could have had the demeamour of the Dalai Lama until his condition was diagnosed but in my experience dementia amplifies what is already there.

If a person feels loved, occupied, fed and secure they are less inclined to anxiety. Secondly if those who are tasked to deal with the condition are only worried with containment and the financial implications of continued care, I choose to question any treatment offered.

My dad spent his whole life trying to do the best for his family. It is his nature, and anything that would suggest that all he worked for was at risk, will make him anxious.

I sincerely hope any course of action you take is successful and can only offer my father's experience as reference.

Thank you for your post, forewarned is forearmed. I wish you only the best

 

[love.dad.but..]

The last thing I want to do is question the reality of your situation or your assessment of it. I am not yet in your situation and only wish to offer 2 small pieces of advice. Your dad could have had the demeamour of the Dalai Lama until his condition was diagnosed but in my experience dementia amplifies what is already there.

If a person feels loved, occupied, fed and secure they are less inclined to anxiety. Secondly if those who are tasked to deal with the condition are only worried with containment and the financial implications of continued care, I choose to question any treatment offered.

My dad spent his whole life trying to do the best for his family. It is his nature, and anything that would suggest that all he worked for was at risk, will make him anxious.

I sincerely hope any course of action you take is successful and can only offer my father's experience as reference.

Thank you for your post, forewarned is forearmed. I wish you only the best

My dad died last March so he is now at peace from his dementia thankfully for him. Dementia can I agree amplify or exacerbate the personality pre dementia but in my dad's case he was pre dementia a very gentle quietly spoken man who I had never heard swear and so to see his rage contorted face and voice that sounded like he was in the Exorcist film at 2am was not pleasant to say the least. Best wishes to you and your father

 

[Georgina63]

Hi @Daisy pie, so sorry to hear about the situation with your Mum. Different circumstances, but my Dad was prescribed risperidone after some violent outbursts in his CH. I did think at the time he might be sectioned if his behaviour became too difficult to manage and if he continued to be a threat to the safety of others and himself. Fortunately, with the right combination of care and medication, he is much more content, though it did take time for things to settle. When I posted at the time, there were a number of responses that suggested sectioning might be a positive thing as it would enable the right solution to be found, but I don't have personal experience of this. As other posters have mentioned, this would not be a move taken lightly and I'm sure the health professionals would continue to support you and your mum remaining at home if safe and possible. From what you've said, it does sound like you could both be at risk because of your mums violent behaviour and that can't be a good thing for either of you. Take care. Georgina x

 

[Daisy pie]

Thank you to you all for your replies I appreciate your advice, I know that things can't go on as they are at the moment but I supose I just thought they would start her on another drug at home. She is on a waiting list at the moment as they have no beds so we shall see what happens.

The verbal and physical aggression started when my Mom started thinking I was not her daughter but a stranger who shouldnt be living with her, because she thinks of me as a stranger she thinks I have no right to as she sees it 'tell her what to do' or to be living in her house. It's so sad my Mom was never like this before she was a lovely caring Mom, now she spends most of her time hating me this is what dementia has done to her

 

[love.dad.but..]

Dementia is destructive to the pwd and all those around them. In her mind the aggression towards you is not to you as her daughter but to some strange person who seems to always be in her house and she can't make sense of it. If you sense she is starting to get upset take yourself into another room...perhaps go and make a cup of tea...try and phrase things so it doesn't sound like an order and if it isn't something important maybe leave it unsaid. Nothing you say or do will make any difference so giving her a bit of space may help diffuse her mood before explosion point is reached. Dad wasn't physically aggressive but arms would fling around a lot and he was very verbal so I used to give him his space quite often. He still knew me not as a daughter but if I moved from the chair or went out of the room he would ask where has he gone...meaning me...he couldn't retain or compute the person that was there and me were the same person just in a different place.. yes it is very sad when the lovely person disappears replaced by someone else but in the same body.....I hope a bed comes up soon.

 

[Ludlow]

You have my sympathy - I know I would hate to see my mum sectioned and taken away from me. I am fortunate in that although my mum suffered from paranoid delusions and was very distressed, she has never been violent so all her treatment has been at home. It is worth trying a different anti-psychotic though. My mum was tried on 2 others which did absolutely nothing before Risperidone worked miracles for her.

 

[Daisy pie]

Dementia is destructive to the pwd and all those around them. In her mind the aggression towards you is not to you as her daughter but to some strange person who seems to always be in her house and she can't make sense of it. If you sense she is starting to get upset take yourself into another room...perhaps go and make a cup of tea...try and phrase things so it doesn't sound like an order and if it isn't something important maybe leave it unsaid. Nothing you say or do will make any difference so giving her a bit of space may help diffuse her mood before explosion point is reached. Dad wasn't physically aggressive but arms would fling around a lot and he was very verbal so I used to give him his space quite often. He still knew me not as a daughter but if I moved from the chair or went out of the room he would ask where has he gone...meaning me...he couldn't retain or compute the person that was there and me were the same person just in a different place.. yes it is very sad when the lovely person disappears replaced by someone else but in the same body.....I hope a bed comes up soon.

Thank you @love.dad.but.. I know it must be horrible for her she just can't understand why I am involved in her life at all and will say "why are you doing this to me why are trying to control my life?" she would like me to just disapear and let her get back to living her life as it was before.
Mom has trouble grasping things like that, she will think that I am leaving her if I just go into another room or go to sleep, sometimes she will call out "Mom where have you gone Mom" but she is calling to find me, it really is so sad isn't it
I had a update message today saying they are still waiting for a bed.

 

[Daisy pie]

You have my sympathy - I know I would hate to see my mum sectioned and taken away from me. I am fortunate in that although my mum suffered from paranoid delusions and was very distressed, she has never been violent so all her treatment has been at home. It is worth trying a different anti-psychotic though. My mum was tried on 2 others which did absolutely nothing before Risperidone worked miracles for her.

Thank you @Ludlow, yes it the sectioning part I am dreading, the other drug my Mom was on did nothing to help apart from make her sleep better which was good but didn't address any of the other problems she was having, I'm glad that Risperidone has helped your Mom, hopefully it will help my Mom to.

 

[Lavender45]

My mum was sectioned and whilst it wasn't what I'd have said I ever wanted it truly wasn't that bad.

Mum had to go into a general hospital and was sectioned from there so I appreciate starting this process from home is more stressful, but I'd honestly say don't fear it. At every stage I was fully involved. The decisions were medical ones, but I was included.

Mum was transferred from the general hospital to the secure unit via passenger transport. I was asked to go with her as she was violent and unpredictable which was a bit cheeky, but the ambulance staff could not have been nicer. Mum had a spell back in the general hospital around the start of October. On her return to her nursing home (where she now resides) it happened to be the same two ambulance staff. I didn't recognise them, but they knew us, they remembered mum, given that her first ride with them was the start of the year and that despite fears she might "kick off" on that first journey mum was fine I thought that pretty amazing. The police who were involved in getting mum into hospital were brilliant too by the way.

I've digressed somewhat, sorry. The two units mum was in whilst under section were dementia specific. In the first in particular I suspect there were more staff than patients. Mum's medication was adjusted, new things tried and to be honest for mum nothing much worked. She proved extremely drug resistant. I could not have coped with things at home. If something was wrong the staff had a doctor to her immediately. At home we'd have had to wait days if not weeks to get someone to see her. The care she got could not be equalled in it's responsiveness.

If I had ever given a thought to sectioning and secure units I'd have imagined cold and sterile environments. It wasn't. I've just tried to upload a couple of pictures and failed. If i manage it I'll pm them to you. The unit looked like a nursing home complete with garden and more staff than I've ever seen in mum's nursing home.

I guess I'm saying don't fear sectioning. It's not what we would want for our loved ones, but sometimes it is needed. Whilst mum was in the unit I saw patients come arrive and leave both to go home and into care. Being sectioned isn't automatically a step towards a care home, but it is a step towards getting medication right in the shortest possible time, that has to be a good thing.

 

[love.dad.but..]

Thank you @love.dad.but.. I know it must be horrible for her she just can't understand why I am involved in her life at all and will say "why are you doing this to me why are trying to control my life?" she would like me to just disapear and let her get back to living her life as it was before.
Mom has trouble grasping things like that, she will think that I am leaving her if I just go into another room or go to sleep, sometimes she will call out "Mom where have you gone Mom" but she is calling to find me, it really is so sad isn't it
I had a update message today saying they are still waiting for a bed.

Yes it is...dad went through a phase when very definately he thought I was his wife...my mum. There was a noticeable change in how he spoke and looked at me.... then he didn't know who I was but still I could tell he realised most of the time I was someone important in his life but that could have been a carer...activities lady...anyone else other than a daughter

 

[Daisy pie]

My mum was sectioned and whilst it wasn't what I'd have said I ever wanted it truly wasn't that bad.

Mum had to go into a general hospital and was sectioned from there so I appreciate starting this process from home is more stressful, but I'd honestly say don't fear it. At every stage I was fully involved. The decisions were medical ones, but I was included.

Mum was transferred from the general hospital to the secure unit via passenger transport. I was asked to go with her as she was violent and unpredictable which was a bit cheeky, but the ambulance staff could not have been nicer. Mum had a spell back in the general hospital around the start of October. On her return to her nursing home (where she now resides) it happened to be the same two ambulance staff. I didn't recognise them, but they knew us, they remembered mum, given that her first ride with them was the start of the year and that despite fears she might "kick off" on that first journey mum was fine I thought that pretty amazing. The police who were involved in getting mum into hospital were brilliant too by the way.

I've digressed somewhat, sorry. The two units mum was in whilst under section were dementia specific. In the first in particular I suspect there were more staff than patients. Mum's medication was adjusted, new things tried and to be honest for mum nothing much worked. She proved extremely drug resistant. I could not have coped with things at home. If something was wrong the staff had a doctor to her immediately. At home we'd have had to wait days if not weeks to get someone to see her. The care she got could not be equalled in it's responsiveness.

If I had ever given a thought to sectioning and secure units I'd have imagined cold and sterile environments. It wasn't. I've just tried to upload a couple of pictures and failed. If i manage it I'll pm them to you. The unit looked like a nursing home complete with garden and more staff than I've ever seen in mum's nursing home.

I guess I'm saying don't fear sectioning. It's not what we would want for our loved ones, but sometimes it is needed. Whilst mum was in the unit I saw patients come arrive and leave both to go home and into care. Being sectioned isn't automatically a step towards a care home, but it is a step towards getting medication right in the shortest possible time, that has to be a good thing.

Hi @Lavender45, sorry about the delay in replying things have been very bad so haven't had much chance to get on here, thank you for sharing what happened to your Mom and thanks for the photos also for your reassurances it has really helped. The unit your mom was in looked really nice, the CPN said that my Mom would have a ensuite room, the place she would be in is part of the memory clinic which is modern and part of a hospital for elderly people. They said that I could take Mom in as if she was going in for a normal appointent and they would take over from there, rather than them having to come into our home with a social worker to take her away which would be more distressing for her. It's just hard to give over the care of your mom to other people.