Psychiatric Care for the Elderly

Hello,

I have posted about my Mum several times before. I feel I am totally stuck with her current situation, and nothing I do makes any difference.

My Mum has been a revolving door patient, in and out of hospital since February and though care packages at home have been tried multiple times, none have worked.

For a long time my Mum was seen as being difficult, until she was put into a hub bed, and her symptoms escalated. The hub is really for physical rehabilitation, but my Mum’s diagnosis is severe psychotic depression, and the staff there are not mental health trained.

Mum was put into a hub out of her own geographical area, but within the same county, to be nearer to me. She was recommended in-patient psychiatric treatment in April, May, June and July, by psychiatric consultants. She is meant to be under the care of the community mental health team, but because she is still assigned to the team that covers her home address, they are only visiting her once a fortnight. This means, her reality is that she sits alone in her room, in extreme distress most of the time. I asked repeatedly if she could transfer to the team in this area for more support, but was told they might not take her on.

The community mental health team say she should in an in patient setting, but despite recommending this, she hasn’t been taken into hospital. We were offered out of area beds 200 miles away, which we declined. When a local bed became available, my mother wasn’t given it became 'it was too hot to move her. ’

I am the only person attempting any kind of social engagement with my mother. I try all kind of mindfulness activities with her, colouring, reading, finding 5 things we like out of the window etc. I know she would benefit from a different setting, and the hub team agree, but the mental health team just change her medication based on my notes and delay more and more.

I asked, if Mum were in a mental health ward, how it would look different in practice. I was told she would have more OT support and access to mental health trained staff, which is exactly what she needs.

I don’t understand why recommendations are made, yet never followed through. I have complained through PALS, (60 days ago!) and to the CQC, and am still waiting for responses.

This situation has left me feeling broken. I have had to get signed off work to be able to constantly liaise and keep teams accountable, as they do not communicate with each other.

I feel that if consultant recommendations had been followed back in April, my mother might be on a path to an outcome, and I could be actively working towards something. Instead, we are in limbo, where no decisions can be made, or actions taken. I have a six week summer break from teaching, and hoped to use this to sort out Mum’s house and possessions, and to pursue a care home placement. Due to delays, this cannot happen and the pressures on me continue.

The consultant keeps telling me they will assess Mum for sectioning, and that a medical recommendation for this has been made, then nothing happens.

I think they will leave her in the hub, tweaking her medications based on my notes. She will have no real support, other than from me.

What can I do?

I am an only child, have three children of primary school age, and my in-laws are both elderly and unwell too. I have been my Mum’s only visitor all year.

This is having a profound negative impact on my own health, and I don’t know how to resolve things.

Try non empty threats.

There’s been a national problem with mental health bed availability for some years, and Covid made it a lot worse. It’s not unusual to be “offered” a bed over a hundred miles away, directly in contravention of medical advice that placements should be local so that family visits are possible. When my carers centre had an advocacy service it was not unusual for staff to travel up to 250 miles each way for review meetings or other issues.

It’s very possible that your area mental health service has a patient from the 200 mile away placement. But they never seem to organise relocation to offer local care to both patients. Might be worth pushing for a placement, and if you have a good MP, getting them involved. They can open doors other people can’t.

Be pushy. Good luck.

Thank you. I am being really pushy, and I cannot seem to make any difference. It now I wish I could afford private care for her :sleepy:

Goodness, what an awful situation. I can imagine how frustrating and exhausting it is and I salute you for keeping a cool head.

PALS should definitely have come back to you by now - what have they said so far?

I think if you’ve got the ear of the consultant that’s a good thing and he should be explaining why what he has recommended hasn’t been achieved - does he need to make a phone call right now while you are there or who can he advise you to speak to right now to move this along? It’s the right now but that I would hope would make a difference as you’re not walking away having him tell you he has done this or that and is waiting.

Failing that, yes to the MP. You might be lucky and get someone who is actually working for their constituents.

It shouldn’t have to be this hard to get the right care, especially when everyone seems to know what that care actually is!