Mum so upset in Hospital

Discussion in 'I care for a person with dementia' started by middlemiss, Dec 17, 2015.

  1. middlemiss

    middlemiss Registered User

    Apr 27, 2014
    24
    Hi All, my mum has been in hospital for two weeks now after having a fall at home and breaking a bone in her neck. She was on 24 hour 1 - 1 supervision because the fracture was unstable and she refused to wear a collar.
    Mum hasn't settled well, she was moved to 5 different wards in a week, she's now been in a room on her own for a week. She swings from being a very nice lady to being very negative, everything is 'no', she begs and begs me to take her home, she is extremely argumentative, takes my belongings and stuffs them anywhere on herself and refuses to give them back, she cries, she loses her temper and throws things, shoves the overbed tray across the room, sits on other patients beds, tries to take their belongings, grabs me, scratches, pulls and shoves me till my shoulders and back are sore, - and the hospital telephone me to visit and see if I can calm her down! No - the only thing that will calm her is for her to go back to her own home and that is not possible. Whilst she is not at high risk of falls, the neck injury will always be a weak area and another fall could be fatal. What a nightmare, she is fit for discharge but to a nursing assessment bed in a care home 20 miles away from where I live and I have a visual impairment that makes driving in the dark too difficult for me. I was so upset today for the first time, nothing I do helps her. What an awful time for everyone. How do people manage emotionally? My heart feels like it will break into pieces.
     
  2. Bod

    Bod Registered User

    Aug 30, 2013
    1,157
    I think you will have to "hand her over" to the assessment care home, then stand back, letting them handle her.
    This will mean not visiting for the first two weeks, at least.
    The home should be experienced in dealing with this type of behaviour, and will advise you on when best to visit.

    Bod
     
  3. marionq

    marionq Registered User

    Apr 24, 2013
    5,848
    Female
    Scotland
    I am really surprised that the hospital have not prescribed a medication to calm her down in light of her injury.
     
  4. fizzie

    fizzie Registered User

    Jul 20, 2011
    2,739
    I would ask to see the consultant and say to him that they put her on some calming medication. Of course you want to be able to visit and that is a big part of her recovery. She is probably frustrated, angry and simply doesn't understand why she has to be there. It sounds as though they are not looking at her holistically (how often does that happen) and they are expecting her to behave like other patients. I would insist that the consultant who deals with dementia at the hospital comes to see her and prescribes

    Will music or the radio help at all?
    I'm so sorry, you must be so stressed. xx
     
  5. Amy in the US

    Amy in the US Registered User

    Feb 28, 2015
    4,623
    USA
    I'm sorry, this sounds terribly stressful for you. It must be awful feeling that you can't help your mother.

    You've gotten some good advice above. As awful as it sounds, I agree with Bod and would suggest you consider visiting less.

    About the only other thing I can think of, is to ensure she is getting adequate pain control. If she is in pain, on top of everything else, it will only make the situation worse.

    I would point out that by being her advocate, you ARE helping your mother. Even though you can't fix the physical problems, making sure she gets the care she needs and is in the right place, is doing quite a lot.
     
  6. fizzie

    fizzie Registered User

    Jul 20, 2011
    2,739
    I do agree that you are absolutely helping your Mum - you may not feel that you are but you are the person who knows her best and cares about her most so you are best placed to be her advocate - but if it is causing you extreme distress then you mustn't damage yourself in the process. It is a very stressful time.

    I don't agree that you visiting less is a good idea but that's because I don't understand the thinking behind it. If we left a distressed child in hospital we would be accused of all sorts. People with memory loss need the people they are closest too around them in the same way that a child would - remove those people and you take away their anchor - in the same way as was proved many years ago by Bowlby and others of his ilk if the person or child quietens down that is because they are defeated and abandoned - perhaps not the reason that we wish them to quieten down. That is why children's hospitals have such a lot of facilities for families - because children don't understand the processes of the hospital - in the same way that our loved ones don't understand the hustle and bustle and strangers wanting to poke them around or move them to a different unfamiliar place.

    I think she needs you to be close, as long as it isn't making you unwell xxxxxxxxxxxxxxx
     
  7. Kitten71

    Kitten71 Registered User

    Jul 22, 2013
    157
    East Yorkshire
    I tend to agree with Fizzie. Visit as much as you feel you can without making yourself ill. I would also ask the hospital about some medication to calm her down. Maybe her neck is painful and all her agitation is maybe making the pain worse. If she was calmer then it would give her injury time to heal. If you believe she is in the right place in her hospital room, you can insist she stays there. Don't let the hospital rush you into a decision about moving her somewhere else until you feel you are both ready. My dad had very violent episodes in hospital. His favourite thing was grabbing an arm and giving it a Chinese burn and not letting go so you got dragged onto the bed or squeezing a hand until you felt your bones crunching. He threw the furniture and ripped the curtains down, got his wife in a headlock and pulled her hair to name but a few things, it was all pretty traumatic and he ended up with 24 hour security guarding him. However, as he has recovered from his illness, his violent tendencies did decrease so please don't feel your mum will be like this forever, it's likely she won't be. At the moment she's probably confused, in pain and frightened and the only way to communicate this is through challenging behaviour. Has she had all the assessments from social services and have the hospital done a CHC checklist? Maybe the falls team need to assess her too. Your nightmare will get better and you are helping her. It's a huge emotional challenge for you, but I'm sure you will find an inner strength that makes you fight tooth and nail for your lovely mum. Sending you a big hug and a chunk of strength xxxx
     
  8. copsham

    copsham Registered User

    Oct 11, 2012
    592
    Oxfordshire
    Things can get better!

    Hi middlemiss,

    My mother was in hospital in a terrible state about three years ago. With lots of physical problems as well as severe dementia. I visited every day because I was so concerned about the neglect. Cutting a long story short, she went in to a nursing home and after a few weeks began to thrive. She has been there for nearly three years, is up and down but mostly settled.

    The hospital setting is hard for anyone let alone anyone with dementia - imagine your mother being moved five times!

    If the assessment unit "knows their stuff" you might be pleasantly surprised. I really hope so as it is very taxing on you at times of change like this.

    I am strongly of the opinion that, providing it does not "crack you up", visiting is very important. I could not visit my mother for 4 weeks when I had surgery. When I visited again she said "Oh I am so glad you found me. See I am not dead" So although she could never remember whether I had visited yesterday, she was able to feel the distress when I did not visit.

    I wish you well for the next few weeks - it certainly is not easy. Keep posting.
     
  9. copsham

    copsham Registered User

    Oct 11, 2012
    592
    Oxfordshire
    Rereading your post

    I just reread your post and the glaring thing to me is how "toddler like" a person with dementia and who is unsettled, can become. It still surprises me. Yesterday when I took my mother to an outpatient appointment my mother was saying "you will stay with me, won't you?' and wanting to hold my hand. Your mother hiding your things in the hope you will not be able to leave. Not easy!
     
  10. middlemiss

    middlemiss Registered User

    Apr 27, 2014
    24
    Hi All,
    Thank you for your advice and reassurance, it really helps with the feelings of guilt. Mum was moved to an assessment unit on the hospital site last Thursday, I visited her for the first time in this unit today. My brother has been visiting about 4 times a week, my sister visits almost daily. I am main carer for mum and provide lemonade (she won't drink water) and clean clothing, and snacks. Mum is constantly pleading with me to take her home, and gets quite cross at times, accusing me of leaving her there on her own, calling me a liar and lots of other nasty things. Mum remembers vaguely that last September she was in hospital it was me who arranged her discharge and took her home, I think this is why she is getting cross with me because I have to tell her I'm not taking her home today. We've tried to explain that she had a fall, is in hospital and has to stay until her neck is better, we never tell her she can eventually go home because that might not be possible. Most times she doesn't believe me - hence being called a liar. I have to visit again tomorrow to go through the CHC checklist as the ward thinks she may meet the DST criteria for assessment for nursing care. Such a shame, all she want's is to go home - she's not half as confused at home, but her neck injury will always put her at serious risk of harm if she had another fall, having said that, she could just as easily fall in 24 hour care (I work in social care). Thanks again for all your support - I've placed many older people with dementia in care and supported families, and I thought I knew it all until it hit my family, all the training and experience in the world couldn't prepare me for this.
     
  11. Bessieb

    Bessieb Registered User

    Jun 2, 2014
    108
    Hi middlemiss,
    Just wanted to say that I really feel for you as I had a similar situation with my Dad in June. He was in hospital with a UTI, terribly confused and distressed. My visits calmed him but in between my visits he would get distressed, the nurses couldn't cope and they would call me to either talk to him on the phone or ask me to visit. It was unbelievably stressful and I remember the dread of the phone ringing.
    Eventually I agreed a plan with the hospital social worker and you might want to find out who this person is in your Mum's hospital so that you can agree a plan and some groundrules with them.
    My Dad had a 1:1 nurse assigned to him so that this nurse could be on hand to reassure him if he got agitated. They also put a Dols on to ensure he didn't leave. I agreed the ward that I would phone twice a day every day at specific times...and the nurse would remind him of this during the day so he knew he could always speak to me and that I hadn't forgotten him.
    It's just my experience anyway but it's not OK for the nurses to be constantly ringing you asking you to sort things out - there needs to be support in the hospital and there are resources for this. I would get the hospital Social Worker on the case asap if she / he isn't already.
    So sorry it's tough for you - can completely empathise. My Dad couldn't go home either - but 6 months down the line is fairly settled in a lovely CH.
     
  12. Amy in the US

    Amy in the US Registered User

    Feb 28, 2015
    4,623
    USA
    Hi, middlemiss, sorry to hear about the situation with your mother.

    I do know what you mean about the "why am I here? I don't believe you, you're lying" conversation. This happened to me with my mother when she was in hospital earlier this year. She'd been found outside in very cold weather, no coat, wandering, confused and suffering hallucinations, and injured, and taken to A&E and then sectioned.

    In A&E she didn't know why she was there and kept trying to leave. In the secure unit, after she'd been sectioned, she didn't know why she was there and spent the first week repeatedly asking me why she was there and wanting to know when she could go home. After fruitless efforts to explain (you hurt yourself and you are in hospital to get checked out and find out what is wrong), and mind you, this was before they told me she had dementia so I had no idea what I was dealing with, I finally realized that she didn't remember what had happened and nothing I could tell her was going to help. So I would say, I don't know when you can go home (by this point she'd confabulated a story about how she was in hospital because she had surgery and was waiting to find out when she would be discharged), we will have to ask the doctors/nurses. This would satisfy her for five seconds or five minutes, and then we'd do it all over again. I am guessing this sounds familiar to you!

    Eventually I accepted that she couldn't remember falling or wandering or being in A&E (or now, being sectioned and in hospital for two weeks) and ten months later, she is reasonably settled in her care home and I no longer get the questions, but it wasn't easy getting here. (My least favourite conversations were the ones where I had "kidnapped" her and "dumped" her in the hospital or care home. Sometimes I wanted to steal her money, other times I was just evil and a bad daughter and wanted her to be miserable, and there was nothing wrong with her, so she didn't need to be here. Sigh.) Because my mother had such a strong negative reaction to me (thank you, limbic system), after we moved her into the care home, I did not visit her at all for almost two months.

    I think you shouldn't sell yourself short. You clearly are doing the best you can and want your mother to be well cared for and as safe as possible. And your training and experience are helpful, just maybe not right this second.
     
  13. middlemiss

    middlemiss Registered User

    Apr 27, 2014
    24
    Hi All, a quick update, last night my sister arrived at the assessment unit and it took 3 attempts to wake up mums 1-1 carer who was supposed to be keeping an eye on her! Then tonight, she arrived to find mum had locked herself in her room, couldn't understand instructions to unlock it, no spare or skeleton key and a carer had to climb in through the window to unlock the door! Imagine how frightened mum would have been!!! Thank goodness her room is on the ground floor. Mums CHC assessment is tomorrow morning, to be honest I don't think the care she is receiving now is any better than care at home. She previously lived alone with a large care package of 14 hours personal care, 6 hours companionship, family visits every day, reduced tablets as she'd started refusing them, shopping, laundry, cleaning, gardening done by family, outings 2 - 3 times per week. We'll see what the assessment tomorrow brings!
     
  14. copsham

    copsham Registered User

    Oct 11, 2012
    592
    Oxfordshire
    Just catching up with your thread. Everything is so predictable but unpredicatable at the same time. When my mother had very poor care in hospital she went really down hill partly because of her condition and partly because of her "care". It is so disheartening. When I read your post it brought back those memories.

    How can an assessment happen in the context she is in? 1-1 carer sleeping what help is that. Climbing in the window - how scary for your mother. It is ridiculous. At least she will not be in an assessment unit for ever.

    I hope plans have moved on. I also hope she is assessed properly. My mother went from 8 weeks in hospital to a good nursing home and she improved greatly. Now 3 yrs later she is going down hill but at least I know that it is her condition not the quality of care.

    Hope you are okay. It is a tall order being a relative and also working in social care - very different hats.

    Well after all that - Happy New Year to you!
     

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