No continuity from RITT whilst Mum is left to suffer

[DougFlo]

Mum's dementia has deteriorated quite a lot in recent months. She is in a care home, who are very good.

We called in the RITT Rapid Intervention Team (they have seen Mum from time to time in the past) as she has been getting very sever hallucinations which distress her and she becomes very vocal and will lash out physically sometimes. Other times she is much better, but her mood can switch from one minute to the next.

The first person who came from RITT said that she thought they should look at prescribing something for the hallucinations and she would refer it back to the doctor, who may want to come out or may prescribe based on her recommendation.

The doctor came out and said he wanted to switch her memantine dose to liquid and see how she was within a week before prescribing anything new. We had been fighting for Mum to change from tablet to liquid memantine, as the liquid is easier to get down, but apparently nobody was prepared to prescribe as it is expensive!

After the week on memantine, the doctor did not return. (We never get notice of their appearance). Instead an occupational therapist turned up and spent some time with Mum and said that she wanted to come back to do more extensive tests to establish where here cognitive function is.

She was supposed to come back the following Friday, but turned up on Wednesday. Did no more test with Mum and suggested giving her paracetamol and a doll.

I rang and spoke to the OT and said I was unhappy about the continuity of care and the decision making process for Mum and when I summarised it (Bearing in mind we are 4 weeks down the line, with Mum still severely distressed) she agreed the care had been poor. She tried to shift blame onto the GP and then say she thought Mum was in pain and not having hallucinations.

I insisted on a care plan for Mum, that showed the care so far and the decision making process and why the drugs for the hallucinations had not been mentioned again. This was promised for the following day.

One week later it has arrived and it is the most dreadful few pieces of paper. It is a Pool Activity Level Report. not a care plan and no reference to previous visits. They have got Mum's name wrong, her life history wring and is plainly just constructed from a template that bears not relation to Mum's abilities. In the report, they have not even bothered to change "him" to "her" or "he" to "she" on some parts of the report.

The summary has suggested making a fruit salad with Mum, or exercises, music, dancing, sweeping and polishing. I am lost for words! Nothing about these dreadful hallucinations and mood swings.

I am at a loss as to where to turn for help.

Sorry for the long post, but would really appreciate advice or opinions.

 

[Grannie G]

I am at a loss as to where to turn for help.

All I can suggest @DougFlo is to ask the care home to pursue this.

I doubt much can be done to ease the mood swings. They seem to be a symptom of many with dementia and rarely can be pinpointed by trigger points which set them off.

The hallucinations are a different matter and if they are causing distress to your mother can be helped with medication. Perhaps if the care home concentrates on the hallucinations, the mood swings may ease once they are reduced.

My husband hallucinated but he accepted them and wasn`t afraid of them. he just thought they were part of his life. Because of this I accepted them too.

If he had been afraid and hitting out was the only way he could express himself I would have wanted help for him as you do for your mother.

I didn`t worry about having care plans etc in writing. I was more concerned with on the spot help. Once the problem was alleviated the paperwork could then be completed.

Quite frankly, I never asked for care plans. Seeing my husband well cared for and contented was enough. My husband`s home never got glowing reports because they spent more time on the residents then paperwork. He entered the home taking antipsychotics but it wasn`t long before he was able to be weaned off them.

 

[canary]

I would be inclined to chase up the doctor who said he would come back after a week.
I agree with Granny G - its the hallucinations, or rather, his reactions to the hallucinations that is the problem.

Once that is sorted, everything else will fall into place.
I never had a copy of mums care plan either. Im not entirely sure why you wanted one.

 

[Jaded'n'faded]

I agree with the others. It seems clear from the hopeless 'plan' you've got that it is all about OT. Which may or may not help your mum but really doesn't address her medical problems.

I would talk to the RI team and/or the GP again.

 

[Sirena]

I there a reason the care home is not taking more of a role here, surely they have a lot of experience of this and know who they need to speak to resolve the issue? But it sounds as if you need to involve the GP again, and failing that RIT.