A tricky topic - sectioning

Discussion in 'ARCHIVE FORUM: Support discussions' started by Kate P, Oct 29, 2007.

  1. Kate P

    Kate P Registered User

    Jul 6, 2007
    565
    Merseyside
    #1 Kate P, Oct 29, 2007
    Last edited: Oct 29, 2007
    Hi there TPers,

    It's a sensitive subject but one that has hit us this weekend.

    Dad had a terrible week with mum - they went away with our church rambling group for a few days (the cost of hotel and everything was paid for by the group as an anniversary gift for mum and dad otherwise I don't think they'd have gone).

    Well, it was disastrous. On one walk mum cried the whole way round, on another she kept hitting dad, she had tantrums in the hotel and was slamming doors. I think they were all so shocked that none of them actually did anything to help dad, which I was initially annoyed at but as they only see her for a couple of hours a week in a church setting I think they were shocked about how bad she really is.

    Anyway, they came home on Friday and much of the same ensued.

    Come Saturday he just couldn't calm her at all - he brought her to my house to see if that would help which it did for about ten minutes. Eventually she demanded to leave and he took her back home. About 30 minutes later he called me again to say would I go round as he didn't know what to do and was going to take her to the hospital.

    We ended up not doing as we didn't know what to do or if we should? We couldn't calm her down or control her but weren't sure what would happen if we took her to the hospital - would they section her, would they send us away? Do we even want that to happen?

    I'd really appreciate it if anyone could help me as we don't know what to do if it happens again.

    Mum is still only on a mild antidepressant which seems to be having no effect at all and again she seems to have taken a real nose dive in the last week. One day dad said she stripped off completely in the kitchen and put all her clothes in the washing machine and yestetday my poor hubby was mortified as he found her on the toilet with the door wide open and she didn't react to it at all.
     
  2. Brucie

    Brucie Registered User

    Jan 31, 2004
    12,413
    near London
    Hi Kate

    This is a sad, but not infrequent problem.

    I think it means that the condition has moved up a notch and you need to bring in the GP and consultant again to assess what needs to be done to help manage this development.

    I don't believe that applying a section is appropriate at the moment and indeed it may never ever be - that is such a drastic step to take, one which our own medical people always declined to do even when Jan was at her most agitated. Even when I suggested the step myself. :eek: .

    I think you need have an assessment made of medications that may help calm her.
     
  3. Grannie G

    Grannie G Volunteer Moderator

    Apr 3, 2006
    68,732
    Kent
    Oh Dear Kate, how upsetting.

    Firstly, your mother`s behaviour on her few days away most probably was due to confusion. She was in unfamiliar surroundings with a group of people and it was just too much for her.

    Secondly, it seems as if she`s losing her inhibitions, which is embarrassing for those who witness it. You are embarrassed for her, but she is unaware of the upset she`s causing.

    The nose dive she seems to have taken, could be caused by the change in routine and the change in environment. But she could be deteriorating.

    It`s one for the doctor to address, but please don`t worry she may be ready for sectioning. I`m certainly no medic, but I`m sure she has a way to go yet.

    These are the behaviours my mother demonstrated. She would open the door in her glass porch, in bra and pants. Would strip off in front of anyone, my husband or son for example. She was never sectioned. She went into a NH on a voluntary basis as she was frightened of being alone and wanted care.

    Give your mother time to recover, take her to the doctor and see if there`s any need for her medication to be adjusted.

    It must be so frightening for you all to see your mother like this.

    Take care

    Love xx
     
  4. Kate P

    Kate P Registered User

    Jul 6, 2007
    565
    Merseyside
    #4 Kate P, Oct 29, 2007
    Last edited: Oct 29, 2007
    Thanks Brucie and Sylvia.

    I think we can all live with the lessened inhibitions - it's something we kind of knew would happen eventually, although it seems a little sooner than we had expected.

    It's the hours of crying and hitting and shouting that we just don't know how to deal with.

    When it's our kids we just sit them in the corner or put them in their room until they calm down - plus you can reason with them! - but mum is just utterly out of control.

    Plus we have the added problem of her not being able to speak which I think makes these episodes worse, plus her understanding of what we are saying to her has gone out of the window as well.

    I'm trying to get an urgent appointment to see the consultant as something needs to be done. Is it "normal" at this point for her to be on nothing more than a mild antidepressant?
     
  5. Skye

    Skye Registered User

    Aug 29, 2006
    17,000
    SW Scotland
    Dear Kate, it must be so frightening for you, seeing your mum in such a state.

    I'm sure that being away from home, in unfamiliar surroundings, will have made her more agitated. I had the same with John yesterday. We took him out to lunch, which he has always enjoyed, but it was totally confusing for him, a complete disaster. And as you say, the lack of language mekes it worse. There's no way to reassure them, apart rom by touch, and if they're really agitated they won't even let you touch them.

    Believe me, I do sympathise.

    I do think you're right to get an urgent appointment with your consultant. It does sound as if your mum has gone beyond 'early stages', and should qualify for AD medication. There's no guarantee that it will work for your mum, but at least you should be given the chance to try it. She may alternatively be prescribed some calming medication, which may help to settle her. But you certainly need to demand some support, you can't carry on like that.

    Let us know how you get on,

    Love,
     
  6. Kate P

    Kate P Registered User

    Jul 6, 2007
    565
    Merseyside
    Thanks Hazel. I think being away did make her worse - as I said I think they only went because the group had paid for it and dad felt a bit obliged.

    I've been trying to get an appointment with our consultant and her secretary has said she's passed on the message and they'll ring me if they want to see her but she's very busy.

    !!!****??????***** !!!! :mad: :mad: :mad:

    I needed to get that out or a bad word would have come out instead!

    I'm not holding out much hope for medication really - mum has FTD and so far we've been told there is no medication they can give her.

    I was wondering whether a tranquilliser is more appropriate now than antidepressants but we were slightly concerned that if she is in more of a stupor other things will start to go such as her toileting etc.

    It's hard to know which would be worse - the crying, shouting and hitting or her losing more dignity?
     
  7. Skye

    Skye Registered User

    Aug 29, 2006
    17,000
    SW Scotland
    Kate, regarding medication, I know AD is not usually prescribed for FTD, but John had it from say one (because he was mistakenly diagnosed as AD), and it certainly helped him. I think it can work because it slows down the progression of the disease to the rest of the brain, though in some cases it can have devastating side-effects, and has to be discontinued.

    I think tranquillisers may work better, and your GP would be able to prescribe them, since your consultant is so unhelpful.:( Anti-psychotics are another possibility. John has recently been prescribed a small dose, and they've helped immensely.

    It should be possible to monitor the dosage so that your mum is calmed, without being knocked out.

    I'm not an expert on drugs, though, I can only speak from experience. But if you don't get an appointment with your consultant, I'd definitely try the GP. He might also be able to get you an emergency appointment with the consultant.

    Love,
     
  8. Grannie G

    Grannie G Volunteer Moderator

    Apr 3, 2006
    68,732
    Kent
    Dear Kate.

    My husband is on anti-depressants. They also act as a sedative. Because he was so agitated during the day, his dose was increased slightly and split, so a small dose is taken every morning and a larger dose at night-time.

    He does not have FTD, as far as I know, but his agitation has certainly been reduced by the morning dose.

    Next time you phone the Consultant, tell her your mother`s behaviour is unmanageable and you are seriously concerned for your father`s health.

    Love xx
     
  9. Kate P

    Kate P Registered User

    Jul 6, 2007
    565
    Merseyside
    Will do. I've spoken to dad and he's going to ring the GP to see if he'll see us straightaway.

    I'm so concerned for both their healths - dad is so stressed out and mum is having full blown panic attacks.

    I thought I'd turned a real corner with my own dealings with it but it threw me this weekend.

    However, I can't deny I did get a small giggle from the expression on my poor hubby's face - bless him, he's easily embarrassed at the best of times!!!!

    Thanks for the support - I'm feeling much calmer now.:)
     
  10. Grannie G

    Grannie G Volunteer Moderator

    Apr 3, 2006
    68,732
    Kent
    Please let us know how it goes.
    Love xx
     
  11. laura92

    laura92 Registered User

    Aug 28, 2007
    47
    Bucks
    hi i don't overly have any advice i can give u but i send u my love and and support.
    my dad was sectioned about 6 months ago after some violent outbursts. the final one being, that he chased his daughters friend around the garden with a knife because he believed she was there to kill him.
    on alot of my dads wild out bursts after hitting some one he'd walk out generally not fully clothed, he always took his torusers off, my sisters husband if home would generally follow him in the car. Any way the police stopped him one day, as he was only half dressed and the truely angry man, melted to a tiny child at the sign of the police and got straight i the police car, after that as the only lived in a small town the police would keep an eye out for him. and as my sister had a friend who was apolice officer she'd call him if dad had an angry spurt, and the minute the police showed up he'd calm down. evey one believed it was because he thought he was still a teenager.
    it might sound nasty but if u have a friend whos a police officer and your mum gets angry get them to come round as it might calm your mum down. its just a thought though. my dad got to out of control and that is why he was eventually sectioned.
    all my love and support
    laura
    x
     
  12. cariad

    cariad Registered User

    Sep 29, 2007
    89
    Hi Kate, the medics think my Mam has FTD and she is on anti psychotics (they really calm her but were prescribed due to delusions/hallucinations). If it's any consolation my hubby bumped into my mam on the landing (she was stark naked and had soiled herself). She was totally unphased by the whole thing. I had to explain to her that it was best to put her dressing gown on.

    I too have had difficulty getting past secretaries. They always want to know what I want first and sometimes I just want to speak directly to the person who can help. Be firm with them Kate, tell them you need to speak to the Doctor and it's confidential and urgent. If they refuse, ring every half an hour and repeat the whole thing. You shouldn't have to do this but 'the squeaky wheel gets the most oil'.
    Has your mam got a CPN? That may be a useful port of call during distressing times. My Mam's G.P called out the 'crisis team' for mental health before now. They didn't section her (thankfully) but they put a whole lot more support in place for my Dad (social worker etc).
    From the sounds of it your mam needs medication to deal with her symptoms. Speak to her Dr or specialist about drugs to reduce anxiety/ tranquilizers. Even a mild dose may be beneficial. If that causes other problems (incontinence), cross that bridge when you come to it. I felt guilty when my mam was put on medication (cos it zonked her for a while) but it's the whole family you have to think of. Your Dad's health and your are paramount!! I hope you don't think I'm preaching to you, I just want to offer support. Let us know how things go, good luck, Berni x
     
  13. Kate P

    Kate P Registered User

    Jul 6, 2007
    565
    Merseyside
    Not at all Bernie - I take any and all advice I can get as it makes me feel slightly less like I'm stumbling around blindfolded!!:) Not to mention my hubby will be so pleased to know that others have suffered worse visions of thier mother in laws!!;)

    Well the consultant's secretary has just phoned to say she will squeeze us in next Tuesday seeing as it's urgent - personally that's not an urgent response to me but I guess they have lots of patients and only so much time.

    Hopefully the GP will be more forthcoming - he usually is.

    In terms of a CPN I'm not sure what that is? I've referred mum to social services because our GP and consultant both said it was for the other to do and I got sick of waiting for them. However, I've never heard anything back from them. Is the CPN from SS?
     
  14. scarlett

    scarlett Registered User

    May 31, 2007
    22
    Derby
    Dear Kate,
    it could be possibly due to change in environment etc or "moved up a notch" but have you any reason to think your mum might have an infection at all as if something physical is happening this can 'cloud the mind'
    anything physical that my mum has had has compromised her mental ability and caused increased confusion etc.
    for instance does she have any sign of a urine infection......burning, cloudy or smelly urine or is she going more frequently for example? or could she be constipated? or anaemic? enlist GP to help

    re sectioning..... this is awful for you all to contemplate but if GP feels your mum needs thoroughly assessing and she refuses, this option allows for this. if you reach a crisis at any time get GP or out of hours service...
    in order to be sectioned 2 professionals need to order it eg doctor and social worker or 2 doctors so, as relatives, i'm afraid you are unable to act without this... you could of course go via Accident and Emergency which will ensure prompt assessment/ referral
    A benefit to sectioning is that if mum then needs to go into a care home fees may be paid by NHS... which I know because my mum was sectioned... and she was also referred on to other specialists and started on Aricept which really benefitted both of us!!!
    I hope this helps a little,
    Scarlett
     
  15. Skye

    Skye Registered User

    Aug 29, 2006
    17,000
    SW Scotland
    Hi Kate

    A CPN is a community psychiatric nurse. In some areas one is assigned immediately on diagnosis, and I believe they are very supportive. In our area, we only get them if there is challenging behaviour. We never had one -- by the time the challenging behaviour started, it was too late. I'm not happy about that. Ask your GP for a referral when you see him. Failing that, your SW can refer you.

    I hope you get a good response from your GP, let us know how it goes.

    Love,
     
  16. cariad

    cariad Registered User

    Sep 29, 2007
    89
    Hi Kate! We had exactly the same difficulty with my Mam. The GP said SS should be responsible etc etc. Went round in circles. A CPN is a community psychiatric nurse (who you could ring for advice whenever your mam is agitated/out of control etc). I was told by my mam's SW that she doesn't need one as the SW is responsible for co-ordinating her care. The SW is 'case accountable' but I only learned that when I started to kick up a fuss as we were getting zero support from anyone. I rang SS and insisted on speaking to someone who could do a care assessment on mam and a carers assessment on me. Only after I got other SW's involved did it become apparent that the initial SW was the one who SHOULD have been sorting this out anyway! I have now requested a continuing care assessment (even though mam still lives at home) because I feel strongly that her needs are health and not social and the NHS should be footing the bill for supervision. Guess what? Since requesting this assessment The SW has said that mam actually needs a CPN before the assessment can be made so she is now sorting this out. It seems to me that you have to research what help/support should be in place rather than it being automatic/ It makes me want to scream!!!!!!!!But at least I am getting somewhere now. Your mam either needs a SW or A CPN or both. You as a family need that support too.
     
  17. cariad

    cariad Registered User

    Sep 29, 2007
    89
    I just read the bit about social services not having got back to you Kate. Granted it took 14 phone calls and many tears of frustration but find out which team you are under (different geographical areas have different teams) and ring them direct and insist on an assessment. Ask people for their full names, this seems to buck people up. It's too bad that you have to do this but personally I feel that life became more bearable once the SW pulled her finger out and got us some support. The SW is in the process of chasing up the OT (occupational therapist) to do an assessment too. I wouldn't have known about this facility. Now that I realise the SW is 'case accountable' we are getting somewhere!1 Hope you do too, Berni x
     
  18. sue38

    sue38 Registered User

    Mar 6, 2007
    10,856
    Wigan, Lancs
    Hi Kate,

    Sorry I am only just catching up with this thread.

    We had a similar incident to you the Saturday before last (why do these things always happen at the weekend when there is no one to help?) when my Dad was shouting, kicking the furniture, threatening to go somewhere, do himself in...

    My Mum and I were trying to cope with him and we too considered just taking him to A & E but were worried he would be sectioned and things would just deteriorate.

    In the end my Mum rang the surgery and got the number for the out of hours service. She spoke firstly with a nurse and then a doctor rang her back. He prescribed diazepam over the phone and faxed the prescription through to the pharmacy at the nearest supermarket. The prescription was ready within 10 minutes of the call. We told my Dad she had forgotten to give him one of his tablets at lunchtime and he took it without a wimper. He calmed down - not sure if it was the diazepam or the fact that we became less stressed having had some advice.

    My mum saw the GP the following week (not the regular GP) who spoke with the consutant's team and he prescribed amisulpride. When we read the leaflet it said it was not recommended for people with irregular heart beat (which my Dad has) so we have not given it to him and the regular GP today advised that this was right and to have it on 'stand by' if there is another incident.

    My Dad is not due to see the Consultant again until July 2008! :eek:

    I think it depends on the GP, but we are finding that this is the best route for help, as you can, if the worst comes to the worst, just go and sit there until you are seen!

    We do not have a CPN either but are considering raising this with the GP as none of us are trained psycholgists and when my Dad is having one of his 'turns' we don't know how to handle it or what to say. Are we making things worse? It would be good to have someone on the other end of the phone for advice, but are they there at weekends?

    Hope things settle down for you soon (they have settled down for us, for how long we don't know).

    Take care
     
  19. TinaT

    TinaT Registered User

    Sep 27, 2006
    7,095
    Bolton
    Hi Kate,

    I am so sorry that you are having to stumble your way blindly through the maize of organisations, procedures and strangely titled people. It is so horrible that, on top of having to cope with the unbearable experience of dealing with dementia, you are left feeling alone and abandoned by the professionals. I think so many of us have the same experience. And as the disease progresses, just as you feel firmness under your feet and begin to understand the procedures, a new and frightening aspect of the disease rears up which turns the firm land into quicksand again.

    My darling husband is sectioned and is in a Long Stay Mental Health ward at the local hospital. He was sectioned under the section 2 for 28 days and now, under section 3, for 6 months. I have to say that if I had known all the implications of sectioning, I would have fought hard to prevent this happening, although it does seem that sectioning can be done entirely without a nearest relative’s permission. I was informed, not asked to give permission.

    One major implication of the section is that I am not allowed to take my husband off the ward, even along the corridor to the café unless I have a permission order signed by the Consultant. This has to be signed and renewed every few weeks. I am not allowed to take him out of the hospital grounds. I have spent the last month trying to get permission to take him out in the car to visit my housebound mother. I had one visit allowed then the form did not get signed the next week before the Consultant went away on holiday, with the consequence that I cannot take him out of hospital grounds yet again until the holiday is over.

    I have had to threaten to take my husband home and throw hysterics to get the ward manager to arrange an appointment with the Consultant now she is back from holiday. As you say, the Consultant has so very many patients and so very little time to spare. But I have reached a point where I have waited long enough and I want to be utterly selfish and demand that mine and my husband’s needs are met, not in two weeks time but NOW.

    Your family needs help. Throw fits, cry, scream – do what it takes but demand the help that you urgently need.

    Xx TinaT
     
  20. connie

    connie Registered User

    Mar 7, 2004
    9,519
    Frinton-on-Sea
    Tina, so very sorry that you are still trying to get some results re outside visits.

    Do hope that you get something resolved soon. You NEED results NOW.
    Thinking of you,
     

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