Friend has asked me to paste what she's told me here for advice:
"My grandad had an op for kidney stones and was told he had to stay in for a few days until they could do a second op. Then when all the family left today he just walked out with tubes and catheter attached. He literally just refuses to go back in even though he has wires hanging out of him. Refuses to go back ever, would rather die or take his own life.
He's asleep now but in the morning we'll have to phone an ambulance and if they medics assess that he has no mental capacity then they can section him. He was perfectly comfortable in the hospital but is phobic because of being in an isolation ward as a kid. He was fine before the op, but they said bladder infections might be contributing to the psychosis.
He's with my grandma. She had to hide the keys because he threatened to walk out in the middle of the night and not come back. He tried to kill himself by shutting himself in his car with the ignition on. We've told her she needs to call 111 when he wakes up and they'll send a medic to him instead of sending him to the hospital. I could actually understand him wanting to be at home if he was dying and didn't have any options left but this wasn't even a serious op.... He's made it serious."
Any advice would be greatly appreciated. The family isn't sure who best to contact as the grandad in question is so phobic of hospitalisation, and due another operation. The couple are about 80; my heart breaks for them and their family, but I don't really know what to suggest despite family experience of dementia. Thanks for reading!
It doesn't sound to me as if the primary reason for his behaviour is dementia, as he has ability to plan what he does. He may well be found to have capacity, especially as in my experience they set the bar fairly low. If he can demonstrate that he understands why he should have the treatment, what could happen if the doesn't, but still says he doesn't want it, plus he is fairly oriented during the interview he will probably be found to have capacity. In that case medics usually try to use reason, reassure etc and convince the person to comply. It sounds like he does have insight, he had a bad experience when he was young, etc. maybe also he is afraid of losing independence, becoming medicalised. He may also be depressed and unable to see the point of struggling on. I would have thought the first point of contact should be the GP, then psychogeriatrician for a fuller assessment maybe. Sorry if this isn't massively helpful but maybe it's a start.