Hi everyone

carolr

Registered User
Jul 12, 2007
33
0
bradford
This is my first post, my Dad has recently been sectioned under section 3 he has been cared for by my mum for over seven years in his own home but we are now being told that he cannot come home and must be placed in an emi nursing home, how can he have have worsened so quickly and can we appeal against this.:(
 

jenniferpa

Registered User
Jun 27, 2006
39,442
0
Hello, and welcome to TP.

Whenever anyone brings up sectioning I normally end up looking at the Mind site. This is what they say about Section 3

Admission for treatment (section 3)

Duration of detention: up to six months, renewable for a further six months, then for one year at a time.

Application for admission: by nearest relative, or ASW in cases where the nearest relative does not object, or is displaced by County Court, or it is not 'reasonably practicable' to consult her or him.

Procedure: two doctors must confirm that

(a) the patient is suffering from one of the four specified categories of mental disorder (see above) of a nature or degree that makes it appropriate for her or him to receive medical treatment in hospital; and

(b) if the patient is suffering from a psychopathic disorder or mental impairment, such treatment is likely to 'alleviate or prevent a deterioration' of her or his condition; and

(c) it is necessary for her or his own health or safety, or for the protection of others that she or he receives such treatment and it cannot be provided unless she or he is detained under this section.

Renewal: under section 20, the RMO can renew a section 3 detention if the original criteria still apply and treatment is likely to 'alleviate or prevent a deterioration' of the patient's condition. In cases where the patient is suffering from mental illness or severe mental impairment, but treatment is not likely to alleviate or prevent a deterioration of her or his condition, detention may still be renewed, if she or he is unlikely to be able to care for her or himself, to obtain the care she or he needs or to guard her or himself against serious exploitation.

Discharge: by any of the following

RMO
hospital managers
the nearest relative, who must give 72 hours notice. If the RMO prevents the nearest relative discharging the patient, by making a report to the hospital managers, the nearest relative can apply to a MHRT within 28 days
MHRT. A patient can apply to a tribunal once during the first six months of his detention, once during the second six months and then once during each period of one year. If the patient does not apply in the first six months of detention, her or his case will be referred, automatically, to the MHRT. After that, the case
is automatically referred when a period of three years has passed since a tribunal last considered it (one year, if the patient is under 16).

The relevant point for you is Discharge. You will see that it is possible for the nearest relative to request discharge, but it is also possibly for the RMO to prevent discharge in which case you can appeal.

The thing I would be wondering about, though, is WHY they wouldn't release him to your mother. Section 3 is normally used because the person is a clear danger to themselves or others, and isn't, from what I have seen, used lightly.

Can you perhaps tell us more about how your father came to be sectioned?

Jennifer
 

Grannie G

Volunteer Moderator
Apr 3, 2006
81,444
0
Kent
Hello Carol. Welcome to TP.

If you don`t mind me asking, why was your dad sectioned? My understanding of sectioning, is it`s for those at risk, either to themselves or others.

I also believe sectioning is not necessarily permanent. If the condition can be helped by medication, the section can be lifted.

Are you being advised to place your dad in an EMI home or instructed.

I do know things can deteriorate very quickly with some people, but I am unable to explain or even understand why it happens with some and not others.

Would it help if you asked for an appointment with your dad`s consultant, so he could explain the situation in full, to you and your mother.

I wish I could be of more help to you. Hopefully, someone else may be.
 

carolr

Registered User
Jul 12, 2007
33
0
bradford
Thanks for your replies, my Dad struck my Mum and in the heat of the moment she asked me to remove him from the home. He was placed in a hospital for assessment, three days later the hospital social worker rang and said that they had sectioned dad there was no discussion and we were not present at the time. We were led to believe that this was for a temporary period of only 1 month however the social worker now tells us that that a section three is very rarely if ever removed.

Dad cant go home as Mum is just not well enough to look after him, and is scared that he may hurt her again. Dad is very strong and fit my Mum is tiny and not in the best of health. I offered to take Dad but my Mum will not agree to that as she says that I have to look after my children and partner first and that Dad would be too much for us all.

I just dont understand the assessment of Dad they describe actions and behaviour then we have never seen, its like they are talking about another person. He has developed infections and swollen legs since he was admitted and for the first time in the illness he does not remember his grandchildren.

Dad has been on Aricept since he was diagnosed 5 years ago they will not give him the drug any more as they say he is too for gone. Aricept has been our hope to hold on to Dad for as long as possible and now his treatment seems to be out of our control.

We have found a wonderfull EMI residential home the people are lovely and we felt very happy with Dad going there, however the hospital will not allow him to go and say that we need an EMI Nursing home. This is a man who up to three weeks ago was in the sole care of a frail 73 years old lady. It seems so logical to me that his behaviour has deteriorated due to the change in his medication and that if that was corrected he would revert back to the man that he was.

Its so hard to accept that he must live away from home but to have your choice so limited is cruel to say the least.
 

Skye

Registered User
Aug 29, 2006
17,000
0
SW Scotland
Dear Carol

I can understand how upsetting this must be for you. It does seem strange that your dad should be sectioned for one act of aggression. I can see that they perhaps wouldn't trust him to care for your mum again, but a section seems a bit heavy-handed. Has he perhaps ben aggressive since he has been in the assessment unit?

All I can suggest is that you ask for a meeting with your dad's consultant and social worker, and try to find out exactly what's going on.

I'm sorry I can't be of more help, but this is outside my experience. I hope some other members who have experience of aggression and sectioning will be able to give you some advice.

Love,
 

jenniferpa

Registered User
Jun 27, 2006
39,442
0
Oh good grief: I typed a really long reply and then accidentally deleted it, so I'll try again...

Dear Carol

First off I need to apologise in advance in case I'm reading too much into your post, so If I make any unwarranted assumptions I'm sorry.

From what I've read on these boards, it is (as Hazel said) unsusal for sectioning to occur as the result of one episode of violence. Add to that the fact that often parents will protect their children, even adults, from the worst aspects of dementia and I do wonder whether this really was one episode. It is also quite unsusal for the paranoia which can produce these violent outburst to come all at once: it seems more of a gradual process. It may not have involved physical violence, but even verbal abuse can be scary if the abuser is much bigger than you are. You say your mother is scared that she will be attacked again, and I do think she is right to be concerned. Also, she seems to feel that you should not take your father into your home, and I have to say I agree with her: caring for a possible aggressive dementia sufferer (or, in fact, ANY dementia sufferer) is not normally something that can be fitted in around other family responsibilities.

I also assume from what you say that since he has been in hospital they have withdrawn his medication, but you feel that this is what has caused his deterioration? Is that correct? It is normal for the meds to be withdrawn and then added back to see which mix works best: I'm not sure if this is what is happeneing. I have to say though, that the violence came BEFORE the meds were withdrawn (I assume): I'm not sure why you would believe that his condition (or behaviour) would improve should he be remedicated. Obviously that's the hope, but I'm not sure it always works that way.

I would be trying to find out, in your position, what an EMI nursing home would offer that an EMI residential unit would not. Is it possible the former would be more secure, and would be more able to cope with his challenging behaviour? It is after all the homes responsibility to not only ensure your father's saftey but the safety of other residents: perhaps a EMI residential unit could not do that? The secure residential homes that I have seen only seem to be geared up to prevent wandering - not aggression.

Best wishes

Jennifer
 

Taffy

Registered User
Apr 15, 2007
1,314
0
Dear carol
Sorry that I have no advise to offer you, as I live in Australia.I do sympathize and hope that things are sorted for you real soon. Best Wishes to you and your mum. Taffy.
 

carolr

Registered User
Jul 12, 2007
33
0
bradford
How right your were I had a really good chat with my mum last night and she admitted that there have been other incidents which she has chosen to keep to herself. Whilst dad has never hurt her before he has frightened her on a number of occasions. We are told that dad needs and EMI nursing home as they are the only people apparently who can administer the muscle injections which the assessment unit have been giving him when he gets angry. Mum & I visited one of these homes last night and whilst the staff were very nice I hated the place from the moment I got through the doors. We are told that there are only 6 such places in Bradford I just hope & pray that we find one that we like. I am so glad that I found this forum reading the posts from you all makes me realise that we are not the only ones going through this. Sometimes we feel so alone as if we are fighting a lossing battle with doctors & social workers the descisions we make are so vital for my Dad and also for my Mum so that they can be as happy as possible with this horrible situation. My Mum is such a wonderful person I am admire her so much for the care that she has taken of my Dad. The hardest thing to bear is that we have taken all the decisions for Dad for 5 years right down to the clothes he was wearing for the day and now we feel that we are not involved, we have to constantly badger the staff for information even when Dad had a fall in the unit (he has never fallen before) we had to ask what had happened and only found out when I took Dads jumper off to shave him and found the dressings.
 

Amy

Registered User
Jan 4, 2006
3,454
0
Hiya carol,
So understand your feeling of not being allowed to be involved - before going into the NH I bathed and toileted mum, now I have to leave the room when they want to change her pad. Though I understand why - privacy - and all that, it makes you feel pushed out and almost irrelevant.
Love Helen
 

Grannie G

Volunteer Moderator
Apr 3, 2006
81,444
0
Kent
carolr said:
. Mum & I visited one of these homes last night and whilst the staff were very nice I hated the place from the moment I got through the doors. .

Hi Carol,

If your dad will have to be admitted to an EMI unit, I understand how upsetting you found your visit. They are not the most pleasant of places.

You found the staff very nice, so can I presume you found the other residents and the whole environment upsetting?

What helped me, when my mother was in such a unit, was to look at all the other residents, and know they are parents of others like myself, were once pillars of the community, held responsible jobs, brought up families and had the same struggles we all have.

So many families affected by the tragedy of dementia.

I hope you find a home for your dad you feel happier about.

love xx
 

connie

Registered User
Mar 7, 2004
9,519
0
Frinton-on-Sea
Jumping in here to reply to Amy's post:
So understand your feeling of not being allowed to be involved - before going into the NH I bathed and toileted mum, now I have to leave the room when they want to change her pad. Though I understand why - privacy - and all that, it makes you feel pushed out and almost irrelevant.
Love Helen

From day one I have always insisted on being involved in whatever they did to Lionel. Propably helped that by the time he went into the care home he needed at least two people to change pads etc, so I am welcomed as a willing pair of hands. Think it would kill me not to be involved.

Perhaps I am lucky in our choice of home.
 

carolr

Registered User
Jul 12, 2007
33
0
bradford
In reply
GrannieG I have no problem at all with the other residents it was the ambience of the place that upset me, the front rooms ie office and visitors lounge was plush and fresh the rear of the house was dark dingy and less than fresh, the bedrooms were dark with no carpeting found down a warren of corridors all of which were locked. All the residents were in nightwear at 6.00pm! However having said all that they were all chatting away and spoke to the member of staff who was showing us around.

Connie I want to help however my Mum does not want to upset the staff in anyway she says we have to leave Dad when we go home and she doesnt want to rock the boat.
 

Skye

Registered User
Aug 29, 2006
17,000
0
SW Scotland
Carol, I'm so glad you've got to the bottom of what has been happening. Your mum must feel so relieved that it is all out in the open now.

Don't worry about not liking the unit you vivited, you'll find another. I think first impressions are so important, and you'll know when you've found the right one. The thought of your dad being there is upsetting, but he will be well looked after, and your mum will be able to relax.

Let us know how you get on.

Love,
 

Brucie

Registered User
Jan 31, 2004
12,413
0
near London
Hi Carol
the front rooms ie office and visitors lounge was plush and fresh
They have to be as the running of the place needs to be clean and meeting employment standards. That is not to say they should be better than resident's areas though.
the rear of the house was dark dingy
during the daytime, homes usually leave lights off around the bedrooms since residents will not be there. Also, I reckon that the darkness may be thought to be a deterrent to residents wandering too far.
and less than fresh
decoration, or cleanliness? No excuse for the latter.
the bedrooms were dark
dark - unlit? or dark miserable?
with no carpeting found down a warren of corridors all of which were locked.
often areas are not carpeted due to 'accidents' with residents... it can take a good few hours to dry out an area of carpet and longer to get rid of smells on a carpet. In my Jan's home there was one resident who would wander into all bathrooms and turn on all the taps, resulting in flooding of corridors. It took ages to dry the place out each time - though they do have carpets at her home.
All the residents were in nightwear at 6.00pm!
It takes an age to get all residents fed and watered and changed - often the process may be a couple of hours all in. Often residents are up early and the normal thing may be for early start/early to bed for them.
However having said all that they were all chatting away and spoke to the member of staff who was showing us around.
That is a key point, very important that they seem communicative.

Carol, no-one in other circumstances would ever want to be using a care home, but we don't always have a choice. I wept the first time I saw an assessment ward - the smell was horrific, but that was an NHS assessment unit, a secure one, and they had many challenges.

Homes vary, but I am sure that the home I find so acceptable now [it is indeed an excellent one] might not have felt so acceptable when Jan lived at home and I was trying to find somewhere for her.

Time and experience moulds us.
 

jenniferpa

Registered User
Jun 27, 2006
39,442
0
Dear Carol, it is so difficult.

I realise this isn't much comfort but I'm quite surprised that Bradford has as many as 6 emi nursing homes: most places seem to have only one or two.

I understand you mum's concerns about rocking the boat, but perhaps you could present it in this way: if she really feels that any issues she raises will cause them to "take it out" on your father, there is a vanishingly small possibility that NOT complaining will protect him in some way. A somewhat depressing thought, I realise, but if the unit did have the lack of professionalism that the first scenario conjures up, there is a liklihood that whatever you do, the care will not be up to standard. Also, there have been posters on the board who have had loved ones in similar situations and putting the staff "on notice" as it were has produced rather more care than less.

If you can get over your mum's reluctance (not an easy thing I realise) you could be pushing to see if they have tried appropriate medications to reduce the aggression, rather than just tranquilizing him (I assume) when the aggression gets too much.

I'm so sorry that you found the EMI unit so depressing. Hopefully, one of the others will be be better, but I'm afraid that locked doors and no carpet are probably going to be a fairly standard feature due to the requirements of security and cleanliness.

Best wishes

Jennifer
 

Grannie G

Volunteer Moderator
Apr 3, 2006
81,444
0
Kent
Dear Carole,
I`m sorry I got hold of the wrong end of the stick, re your first impression of the NH.

The first EMI unit my mother was in was beautiful. Chintz curtains, blowing in the breeze, fresh air from the open, safety locked windows, lovely bright decor, modern furniture, chairs arranged in groups, friendly chatty staff.

It was all show. Once she was resident, I realized how much was window dressing.

Quote:
However having said all that they were all chatting away and spoke to the member of staff who was showing us around.

Bruce identified the importance of this point and I second him. I wish you luck in your search.

Love xx
 

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