When the drugs don't work...

Sal the caker

Registered User
Dec 14, 2010
19
0
Huddersfield
:confused:Mum is 63, on a mental health ward waiting for funding to go through (for the 3rd time, but that's another story), for EMI continuing care plus a top up, lost track of all the Jargon now, have had enough.Found her a place at a nice home, keeping bed for her depending of funding confirmation, which is one weight off the trauma. I havent seen her since weds, the amount of time i can spend with her is slowly decreasing as it is breaking my heart. She's in a constant state of personnel torment, angry, aggressive, words sometimes come out right, mostly wrong, swearing like a trooper, as if she's got a form of Turretts syndrome. Can't feed herself, needs 2 nurses to walk her to bathroom, doesn't know who I am anymore. She never stops shouting out, ALL DAY, the only positive thing she's doing is sleeping for moderate chunks throughout the night. She's been on lots of drugs, diazepam, lorazepam when required, aricept, risperidone, quitiepine, which they are slowly increasing, but nothing gives her any rest/peace. When i go to visit, she is now sat on her own in a lounge, food down the clothes and round the mouth, losing weight, and some days looks so dehydrated. The consultant mentioned the addition of Rivastigmine? Helps with agitation, although not licensed for use in moderate to severe stages. Just 4 weeks ago I was managing to get her in the bath by myself, I haven't seen her actually walking for over a week. I feel sooo helpless and frustrated. They all keep telling me she's so complex, a Square Peg. They have tried other things, like the snoozelen room etc, but nothing helps her. I feel like they are slowly letting her die, with so much suffering, can't bear it. What can I do? Had numerous meetings with the consultant, he says there are other option such as anti-epilepsy medications, has anyone heard of that? I'm a general nurse, but this is way beyond my comprehension....
 

Sandy

Registered User
Mar 23, 2005
6,847
0
Hi Sal,

The fact that you mentioned swearing and your mother's young age made me think that it might be worth looking at the factsheet for Frontotemporal dementia - it is one of the most common forms of dementia affecting people under the age of 65:

http://www.alzheimers.org.uk/site/scripts/documents_info.php?documentID=167

If that seems to ring some bells in your mum's case, you might want to look at this website from the Medical School of the University of California at San Francisco:

http://memory.ucsf.edu/ftd/

I don't know if the consultants have ever mentioned a drug called Ebixa (memantine) which can have quite positive results for younger people with dementia.

Take care,
 

Sal the caker

Registered User
Dec 14, 2010
19
0
Huddersfield
Thank you Sandy and Sue,
Have looked at your links, I'm gonna go and visit mum tomorrow and assess the situation, dad can't face going at the moment as she is soooo angry! I will keep you posted.
Sally.
 

Sal the caker

Registered User
Dec 14, 2010
19
0
Huddersfield
First day back at worked ruined.....

It was my first day back at work today after 6mths off, helping my dad with mum. Was actually looking forward to it up until 5 o clock yest eve, dad rang me to say the ward had phoned to say the 3rd funding panel, i repeat, 3rd panel, had declined mums continuing care funding, the social services are now saying mum needs to go into a challenging behaviour unit. I am just gobsmacked. She doesnt even get up out of the chair now, unless with help of 2 nurses. Ye, she lashes out occasionally, but can easily be managed by competent professionals. The nearest one to us is in Todmerdon, over half an hours drive away, not just that, what other sort of patients will there be there? Will mum be just sooo vulnerable. SHE IS NOT GOING, we will appeal. Dad was trying to get hold of the social worker today, don't know if he's tracked him down. I am so p----d off, what will happen now, more funding meetings, ARGHHHHHHHHHH!!!!!!!!!!
 

TinaT

Registered User
Sep 27, 2006
7,097
0
Costa Blanca Spain
! was told that my husband would probably remain on the 'assessment' ward for the rest of his life as no care home (even specialising in dementia) would cope with his behaviour. If you see the early threads of mine around 2007 you will be able to read my posts as I was actually living through this nightmare.

I went to the care home where he had spent a few days on respite. The manager remembered Ken. I put all my cards on the table, telling him what the consultant and ward staff had said and what I thought which was that his behaviour would never settle down whilst he was on this particular ward (many problems which I won't go into now)

The CH manager felt he would like to 'have a go' at allowing Ken to have a trial period at the home. The home also had close links with the consultant and the CPN who knew Ken when he lived at home with me. Both of these professionals were regular visitors to the home to review someof the residents.

I arranged a 'review' meeting with staff and the consultant(had to wait a month for this). My son had a day off work and my brother in law came along, both for moral support and the manager of the CH came too.

The consultant threw all kinds of behavioural problems at the CH manager and each time he responded with, 'I think we can manage that' (God bless him!!!). Finally the consultant agreed and Ken moved into the CH for a trial period.

The trial period was the most nervewracking of my life. I was on pins but the staff at the care home worked in close cooperation with myself and each time Ken had a serious behaviour 'episode' they phoned me and I rushed up to the home. Between myself and the staff we always managed to calm him down.

During that time he had one of the care workers in a headlock trying to strangle her as he thought she had kidnapped him off the street. He smashed his bedroom window on another occasion but both the staff and management worked very hard with me and between us we had a wonderful success story as Ken's behaviour eased over time and now his is no more unrully than any other resident at the CH.

After a year the consultant admitted that she had made a mistake and that Ken's placement in the CH had been a 'tremendous success'.

It would be doubtful that your mother's consultant would allow her with behavioural problems to be placed in an ordinary care home so I would take a look at all the specialist dementia homes in your area and chose one which might suit your mother's needs. Don't be frightened by the word dementia unit and please don't think your mum will be upset to be placed there. At least you will know that the staff are experienced and hopefully trained in dementia related bahviour difficulties and will be best placed to cope.

Don't be panic stricken. Sit down with your dad and work out a plan of action but being realistic about mum's behaviour problems. Then find out just where you would get the most help from any of the specialist care homes in your area. Ken's care home is a specialised dementia home as I knew that the consultant would never, ever have allowed him to be moved to an ordinary CH.


Good luck and wishing you all the strength you can muster to get what you know your mum will be best suited with.
xxTinaT
 
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Sal the caker

Registered User
Dec 14, 2010
19
0
Huddersfield
Thanks Tina,
Dad spoke to social worker at tea-time. The Panel were basing their decision on how my mum was 2 weeks ago! She was really difficult to manage then, over the last week she has been a little bit calmer, not as "vocal" and will sit in the chair for prolonged periods, instead of wanting to be up and off continuosly. She's still angry, rambling, but having quiet periods in between, she actually sat with me on Mon and fell asleep for the first time in weeks.
She's had another fair day today and had a good tea the nurses say, although she still fights them a bit when they are attending to personal cares.
We have found a nice dementia unit, (I've had to do the "home run" twice, as they first assessed her for EMI Residential, then it changed to EMI nursing, then Continuing Care.) I felt very comfortable there, patients looked well looked after, all at differing stages of the disease, very local too. They actually assessed mum about 4wks ago, when she was at her worst, and they said they would save a bed, dependant on funding (mum was needing 1 to 1 nursing at that point, hence them applying for Continuing Care) They are known for taking difficult to manage patients, has a good reputation, and the nurse in charge gave me lots of advice when I thought mum was on too much medication.
The Social Worker and nurses on the ward think that, if our chosen home would take mum on a trial basis, like your "plan", keeping her bed available on the ward in case of, that would be a good plan. As she's not needing 1 to 1 care now, she might not need the continuing care funding anyway, so, hopefully, the home would have no reservations about taking my mum. They are going to put this to the consultant tomorrow.
All we want is mum to be settled and well, looked after, and be able to visit with children, everything is STILL up in the air.
WHY is it sooo hard?
 

TinaT

Registered User
Sep 27, 2006
7,097
0
Costa Blanca Spain
That is great News Sal!! I'm so pleased to read that you have found somewhere you & dad think will be right for your mum.

I would still go full steam for continuous care. They can only say 'no' once again and may even say 'yes'! Your mum sounds as though she needs both nursing care and dementia care.

xxTinaT
 

sue38

Registered User
Mar 6, 2007
10,849
0
55
Wigan, Lancs
That sounds better news Sal.

My dad originally went from the assessment unit to the Care Home 'on leave', so if it didn't work out he could go back to hospital without going through the admission procedure again. It did work out, and I hope it works out for your mum too.
 

Lauren

Registered User
Oct 13, 2006
33
0
Dorset
I so sorry to here your story, My mum is in the same stages accept we have her at home with carers that come in the day! She has completely lost the ability to walk so we use a wheel chair and hoist!!
I Know what you mean about the medications, we could run a pharmacy with the about of meds mum is on!!! Id say to be honest none of them really have an effect and that her decline still continues!!
The best thing you can do is to think that although you are now not caring for you mum directly you still can by going to see her as often as you can when your not at work and even if u just sit with her your still there!
Your already missing someone that hasnt gone, i very much understand this, its horrible seeing your mum slip through your hands so quicky!!
Our mums are only a few years appart in age and im a midwife so you feel helpless because unfortunatly the world still goes around with all of us secretly strugling!!
Keep your chin up, dont go it alone, visit with company and make sure that the home is caring enough for her and tell them to make sure she does not have food down her mouth, because at the end of the day that is NOT good care!!

Take care of yourself
Love Lauren:)