My Mum, aibu at the hospital's care Trigger Warning: attempted suicide

[turnaroundbrighteyes]

Name changed for this as it's really identifying to the few people irl that know what's going on...

Not really sure what I want from the this thread partly somewhere to just get it all out without being careful who I say what to, but also aibu to think the Hospital have messed up (or just easier to focus on that), can't face aibu on this.

So... around 1am Sunday night / Monday morning my mum attempted to commit suicide... She wrote me an short email (love you, but can't carry on), transferred some money, appears to have cancelled her phone line (and ???) took a shed load of pills with a large glass of vodka, unlocked front and back doors and tucked herself in bed. At around 10am I picked her message up, rang her and she answered! I said something like thank god, you scared me, are you okay and she said sorry, she was okay, just "needed to sleep for a couple of hours". I then rang her doctor, the receptionist made me a phone apt for 12:00, GP was great, made her an appointment for the same day and rang her straight away - he rang me the next day to say she'd answered, agreed to see him in evening surgery, seemed ok, just tired, didnt turn up, but thought she'd fallen asleep and how was she "today"?

Drove over after work to see her expecting her to be tearful, but okay, arrived at the house to find lights off, window's shut, bedroom curtain drawn, not answering door or phone and thought fuck, she did it, "need to sleep for a couple of hours" became clearer and I realised that no text or anything in circumstances wasn't right and that my assumption that not hearing back from GP = everything okay was a big one.

Wimped out on using my key to enter thinking 18 hrs later she was either, hopefully, out or I was going to find her body in god know's what state, so went to police station, broke down and asked them to come with me. They were great, came with me, realised doors were unlocked and found her in bed, alive, but unresponsive.

Paramedics brought her round took her to a&e.

She seemed strangely fine cognitively, understood, answered questions except those she chose not to "no I didnt take any paracetamol", but wouldnt say what she had take (boxes were out). She was pleasant, complicit, smiled loads at me. Initially they thought 6 hours and she'd be home! They thought I'd got the timescales wrong as "no way could she have spoken to you at 10am if she'd taken all that" until her blood results came back and blood pressure stayed very low and confirmed just how long it had been.

Went up to ICU, critical, but not life threatening, bp coming up very slowly responding to treatment. Still smiling at me, complying, understanding and responding appropriately.

Tuesday night we talked for a few hours, she said her mind was clearer, we discussed everything but the elephant in the room, she agreed to visitors "when transferred to a ward" which was due to happen the next day, she understood who had the full story and who part, talked about GC, discussed her coming to stay with us when released at least until physical injuries healed, sorted details of that, she got me to agree not to come over the next day, etc. I assumed all was going to be well and she regretted it.

Wednesday I called ICU as normal to receive the devastating news that she'd withdrawn her consent for any treatment or monitoring. Then when ignored had pulled her wires out and taken her oxygen mask off. They said they couldnt treat her without her consent, but were trying to change her mind and had only stopped putting her mask back on her against her will when she told them it was common assault. They asked what I thought they should do. I asked what would happen without treatment - they didn't know, but thought past the worst and maybe ok with out and def not in imminent danger so I told them to back off, stop trying to force her, give her some space, then talk to her with respect and she's more likely to change her mind or accept some treatment. Also briefly spoke to her and she seemed cognitive, but refused to discuss it then hung up on me! Awful feeling, going from thinking everything was going well to waiting to see if she'd live or die without oxygen, saline and meds. Wanting to rush over, but knowing that she was sure in her own mind, had made her decision and would upset everyone a whole lot more me being there.

Then spoke to a psychiatrist about her mood before - seemed fine, she'd had some health probs, but improving and she was happy about that. He asked about mood swings, I said yes, but only since the OD she'd seemed happy, pleased to still be here, etc.

Hung up then gradually realised, I was wrong, she'd not said a damn thing to indicate she'd changed her mind or regretted it, but plenty to the opposite, had waited til after I'd visited, made sure I and her DB knew she was pleased to see us, made sure no more visitors were coming "until on ward". Then stopped treatment.

Hardest thing I've ever done in my life, but rang back in floods of tears and said much as I disagree with her, I was wrong before, as far as I was concerned she was consistent and clear of mind and to tell her that I loved her and didnt agree, but respected her decision and wouldnt stand in her way. The nurse said she respected me for saying it, thought it was the right thing and would pass the message on.

Then, around 6 hours after treatment ceased they assessed her mental competence, found it to be lacking (oxygen levels down to 60% by that point so yeah, defy anyone to not be confused) and restarted treatment against her will.

I believe they were very wrong to do that - that they should either have assessed her competence at the time she withdrew consent (not 6 hours later) or let her go with dignity.

Since then they have assessed her every day with the intent of either sectioning her (every day concluded too confused / sleepy to asses - she was clear of mind before) or using DOLS to keep her against her will (not done it as waiting for her to become cognitive enough to section).

Thing is though, and I'm desparately trying to think of another explaination, but it looks like when they eventually decided to treat her against her will they brought her body back, but not her mind - sleeping lots and when awake me, her DB, and SIL have all independently come to the conclusion that she presents like someone in advanced stages of Alzheimers who's no longer making any sense - some total nonsense, some just not her, unable to answer simple questions other than a vague sounds right but isnt type reply.

Ironically, today, the hospital have just declared her sane, in no need of a section and complicit with treatment. When I expressed my concerns they'd "not noticed anything wrong".

Sorry for the essay, okay if no one replies, just nice to get it all out!

[keeptheheid]

I don't have anything particularly constructive to offer you but I read your post & you sound like a very loving & caring daughter. All the best to you & your mum, sounds like a very difficult time for everyone

[Penfold007]

Just want to say how brave I think you have been. You have been empathetic in realising and acknowledging that your DM may well have made the decision to end her life and indeed be ready to go. Like you I'm far from sure that forcibly treating someone against their will is the correct thing to do. Sadly your DM is likely to get little support from the NHS, it just isn't available. Your mum maybe disappointed and even angry that her attempt to take her own life was unsuccessful on both occasions that you know about. I really do hope you all get some support.

[Myusernameismyusername]

I'm sorry you are going through this.
It must be heartbreaking
As for the hospital I sincerely would like to believe they are all trained professionals and used their judgement at that moment in time for her best interests if she lacked capacity, which is such a hard thing to determine. They equally do not want a legal battle on their hands over doing the wrong thing (accepting withdrawal of treatment if there is any doubt over mental capacity) so have to cover their bases. BUT if you do want clearer answers then contact their Patient Advice Liaison service for advice. They may also be able to offer you support for how you are feeling right now?
Stay in touch with her psych and try to stay positive, it may be that she is confused and needs time to get well. Dementia doesn't usually present so suddenly like that but some mental and physical health conditions can have similar symptoms.
I hope you are ok. I don't know what else to post x

[Lanaorana1]

How strange for you. I take it that DM has a long history of failed suicide attempts. How old is she?

Medics don't choose which bits of a person come back when they save a life. They don't have the medical capability to do and anyway, the NHS brings a person back to a beating heart, not necessarily life or a life, let alone that person's life.

Yes, the NHS do have to save someone when the person isn't fit enough to decide for themselves. It's the law.

A lot of people in long-stay homes and some types of care home end up there because of botched suicides. Your DM may well have given herself brain damage.

Or DM may be faking - admittedly a banana could pass the NHS competence test, but if she can get through that she can't really have advanced dementia.

Either way, you can't blame the NHS for not finishing your DM off.

[turnaroundbrighteyes]

Thanks all, especially Keep and Penfold and MyUser

Lana - No, I know her mental health was bad many years ago when she was in an awful situation, but no other attempts in 40 years - she 60's now. I dont blame the nhs for "not finishing my mother off", but finding it hard not to blame them for waiting 4-6hrs before assessing her competence during which time, I'm struggling to find any other rational reason for her new symptoms but that the lack of oxygen treatment gave her brain damage. I believe they should either have immediately deemed her competent and let her go with dignity or deemed her incompetent and continued treatment.

I dont beleive she's faking she's genuinely saying some very strange things 99% of the time yet bizarrely hospital have gone from weds eve - Sun saying they want to section her, but cant assess as shes too confused + concurrently they want a dols order to detain her, but delaying incase she regains enough competence for section to now saying shes competent and complicit so don't need either. Just to be clear since they brought her back a second time on weds shes been "confused", then "very sleepy" and complied with treatment.

Trying to find straws to clutch at for reasons for her current state that mean it will recover...

[Myusernameismyusername]

Are they sedating her?

[louisatwo]

Wow Lanaorana - if you're a medic you certainly missed out on the compassion training

OP - so sorry that you're going through this - it sounds to be such a difficult situation. I have some personal experience of a 'right to die' issue and know from bitter experience that many doctors and the system are (unsurprisingly) ill equipped to deal with this.
How are you coping?

[Lanaorana1]

It's early days yet. Don't despair. There's no reason why she won't make a full recovery by the sounds of things. I'm so sorry if I sounded unsympathetic, I was simply trying to be clear about the law, which can sound very cold at times.

[Myusernameismyusername]

They really are not equipped for this right to withdraw, it's a really cloudy subject because of the UK laws. Do not resuscitate is very different to withdrawing treatment, especially when mental health issues are involved.

It might help OP to get some further advice on this and I wonder if PALs can put you in touch with anyone

[turnaroundbrighteyes]

MyUser, no, my first thought was that it was medication affecting her. Thought maybe a strong anti-depressant as they'd said she was complying with all treatment now, but, no, all shes prescribed is vitamins and oxygen and they dont seem concerned when the nasal oxygen falls out....

lana its ok, winced a bit, but good to get different opinions.

Interesting points about right to die shes always been pro-choice and very different to me, but also very supportive of others having the death of their choice when terminally ill (obviously different to this, but for background).

Louis - suddenly very tearful tonight, thanks

[Myusernameismyusername]

We don't have a clear right to die pathway in the UK. The Liverpool care pathway I think wasn't working either, and that was for end of life care but there are end of life protocols and laws, but no so much with this issue - it's one thing believing in it but another in practice.

[louisatwo]

OP - it's a gruelling experience watching someone you love decide they no longer wish to continue living. I have no wise words but, depending on what happens there are people and organisations with some experience who could be of support. Wishing you well.