Well there I was, adapting nicely and starting to write pieces for the Parrot has Landed of a light-hearted nature when it all went very tits up again.
This last week, beyond appalling, is one I’ll be glad not to have to live through again. As you’re aware, the previous week’s visit to my mother was a disaster that featured her hitting me with a stick, throwing out the carers, threatening aggression and suicide and generally exhibiting many types of behaviour that come under the general umbrella term, as used by the healthcare professionals of ‘Kicking off’. The Doc was summoned, a strong water infection was diagnosed and antibiotics were prescribed.
Get her outside of a few of those and you could be forgiven for thinking that the troubles were at an end. I wish.
On Saturday morning’s phone call, nine antibiotic pills into a week’s course, I gently asked if she recalled hitting me and was told I deserved it and that the china cupboard was in a dangerous state and that heads would roll because of it and so on and so forth.
Sunday morning early the phone went.
Oh how I dread early morning phone calls!
She had thrown the carer out again, the manageress of the agency was in attendance and the agency were doubting their ability to continue care of my mother in the face of her aggression and planned to summon doctors to assess her ability to stay in her own home.
Have you ever spent a Sunday at home reading the Mental Health Act 1983 to see how it applies to your mother? It is a very successful way of ruining what might have been a nice day; it’s also a great way of ensuring a sleepless night. As always with making the decision to care for your relative in their own home the upside is the downside in that you will be involved in every decision and you will be taking responsibility. The problem in this case is that, under the terms of the Act, if two doctors and a health professional deem that a patient is a danger to themselves or others then the patient can be removed to a safe place and the nearest relative (me) cannot overrule the decision. This is the practice commonly referred to as ‘sectioning’ because only a section of the Act is used to detain the patient. When I say detain, I mean that the patient is taken to a secure mental hospital to be assessed and, if they are deemed dangerous, locked up until they are not dangerous.
It is two years since my mother put all her clothes in a pillowcase and ran around a hospital ward hitting sick patients with the result. She reacts very badly indeed to institutions. I cannot imagine that it would take very long after her arrival in a mental hospital for her to be in a little quilted room hurling herself against the walls, at the least. It is three weeks to her 90th birthday, can you imagine how it would be for family members ringing the house to wish her happy birthday to be told she was throwing herself round the walls of a padded cell? Can you imagine what it would do to her 100 year old sister?
By Monday morning I was worrying so much I spread my woes outwards by inadvertently scraping alongside a badly parked car in a car park. I left my contact details and ploughed on with the day, in discussion with the care agency, whose contact with the County mental health unit resulted in a doctor arriving to assess my mother in the afternoon. Well, she was still there in the evening, despite the presence during the day of the manageress and the strong arm lady being required.
So I determined to carry on as normally as possible, including a visit of the usual duration on the usual day, during which I would attempt to persuade my insane mother to stop hurting people for her own sake. No one should have to do this.
To say I was distracted over the intervening day was an understatement. I’m amazed I didn’t walk into the walls. I primed the OT not to leave me at the dinner table to be harangued by my mother but instead to stay as a witness. I rang the agency and told them what I was planning to do and the muscle lady kindly volunteered to be standing by in case the attempt put me in physical danger. I learned the Mental Health Act by heart and printed it off to take with me in case my mother needed proof.
The task was tricky, I had to convince her of the need to moderate her behaviour while remaining calm myself but not being patronising, not bearing grudges or using the opportunity to settle old scores and above all things to do it from her point of view without being self righteous or obnoxious in any way at all. Not even with a Captain Kirk sneer or flinging my hair back or getting triumphant if I succeeded. In short, like a grown up.
Well we got in the tumbril and went and at lunch I coughed all the way through every mouthful of food that I wished I wasn’t eating. And then I told her. I told her that she had pushed five carers backwards out of the door and was lucky they hadn’t broken. She replied, as fast as you like, that she had no memory and couldn’t possible remember those things. I asked if she remembered hitting me and she replied: I’ve just told you I have no memory. Looking back on it, it was an aide memoire to the David Frost Interview of Richard Nixon.
I reminded my mother that I knew her better than anyone and that I had told her at the beginning of her illness that you catch more flies with honey than vinegar and that all the tactics she had used throughout her life to get people to do what she wanted, namely running them the length of her tongue, tearing them off a strip and berating them were unsuccessful now. If it became impossible to care for her in her own home because she was so aggressive then it couldn’t be done. I quoted from the mental health act and explained that the doctor yesterday who she was wondering about and demanding angrily to know who sent for him when it wasn’t her, had come as the first person to assess her and that it wasn’t in my power to override his assessment.
She was, of course, aggressive and argumentative and said it was her illness making her do things. I replied that if there were problems because of her illness we would let the doctors look after those, and that all I was asking her to change was the behaviour that was making her impossible to nurse in her own home. And that was it.
I stopped after about eleven minutes, or thereabouts.
I went in the study where the carers, who had been briefed, were hiding. After a short while, when there were no screams from the dining room, I went in and said we were going shopping, I’d make a list and suggested she go into the lounge. So she did, the new shift carer settled her down and off we went.
We didn’t stay away long in case she took it out on the carer. When we returned we had quiet tea and cake and left but she called me back, wanting to give me pocket money! Amazing.
And since then she has been as nice as ninepence.
We have been utterly drained, sleeping late and getting up slowly.
How much was due to the infection and how much was due to her just ‘Kicking off’? My guess is as good as yours, but knowing my mother she may have taken advantage of a tricky situation to get away with what she could. Dementia is undoubtedly frustrating but she isn’t in pain at all. She is continent, mobile, and very, very verbal. Will this patch on affairs hold until her birthday, so that her relatives and the few friends she still has, can wish her a happy one in her own home?
She is still constantly threatening suicide, but as the OT remarked, she probably hasn’t got the courage to do it. I have reminded her how difficult life would be if she bungled it and that the pills will not do the trick but the carers are on the alert that she has made the threat, through she has been doing that for the last two years. Beside which, who can you boss about and run the length of your tongue in the afterlife? I have never heard a report that suggests this is a possibility.
The only good thing about the continuing situation is that when it finally ends, I am highly unlikely to be utterly distraught.
When I refer to the Mental Health Act, I am invoking UK law. If you are reading this elsewhere in the world, you might want to do an online search for the law as it pertains to your part of the planet.
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JaneLaverick colour me knackered.com