To ask to MH advice?

[Biber]

My husband is very unwell. He was in hospital yesterday, diagnosed with pneumonia, he went in very confused and very weak, unable to stand or use and of his body very well.

Several hours and lots of tests and an X-ray later he was allowed home with a box of antibiotics. He was clearer in his mind and stronger, but the Dr only allowed him home on the understanding he would return if he got any worse. He hates being in hospital, with good reason, there was a serious error in his medication that caused one of his problems.

Back story - three weeks ago he was admitted and discharged within the day with poor motor skills and confusion with hallucinations. This cleared up and last week all was well and he was back to his normal unwell self - history of bilateral clusters of Pulmonary Embolisms and pneumonia this year and previous PEs in the past couple of years.

This morning, confusion doesn't begin to describe his mental state. I've told him he needs to be back in hospital but he point blank refuses. The nurse on the ward just says bring him in or call an ambulance but if he refuses they can't make him, can they?

I know for a person to be detained under the MH act it needs for several people to approve the detention, we've been through it with another family member but my memory of that difficult time is a bit vague - I do remember a house full of psychiatrists and an approved social worker, police and all sorts. At the moment, he can pull himself together temporarily to look 'normal' so as to escape getting the help he needs.

What do I do? I can't cope. in the meantime, I'm going to keep trying to get hold of the doctor who was on duty last night.

[Mishappening]

He has to have "capacity" - i.e. he is rational enough to make decisions about his own well-being. I suspect that in this case he probably has and there would be unlikely to be any legal compulsion to go into hospital. This is assuming that any confusion has been related to his pneumonia and to fever rather than to a mental illness.

I would contact the ward where he was and talk to them. I get so fed up of hearing about people being discharged too soon to relatives who have to find some way of coping; although I guess in this case the discharge was what he wanted. But he has been in and out - it is not satisfactory.

[zebedebe]

This sounds really tough OP, sorry you’re in this situation.

Contact the ward, explain the situation. He will need a capacity assessment to determine if he has the capacity to make the decision not to go. Given how confused you said he is, he probably doesn’t. If they decide that then yes they will be able to make him go.

[Biber]

Thanks for the responses. The trouble is getting him to someone to make the assessment. Tbh, some of the time he acts quite rational, and then flips. He thought the electrodes on his chest where there for a firing squad to aim at, and he was saying random nonsensical words, and an hour later ther words made sense but were not in context. Later he was making sense, but I knew that he had NOT been out, come home and had something to eat. Someone coming to the situation afresh would have thought him quite rational.

Tomorrow morning I will phone the GP and see what to do. Finding the relevant person to speak to in the hospital has proved impossible so far. If the GP is not the right person perhaps PALS would be the right place to start, rather than going about the houses as I did earlier.