Section 2 elderly brother what to expect from in patient experience

Hi @limetrees32 , just saw this. So sorry that things are so rough.

So yes, as @JennieTheZebra said, they can do ECT without consent but IIRC they need a second opinion approved doctor (SOAD) in order to do that.

Your posts are very well thought out and articulate- may I suggest that you copy them separately into bullet points and have a discussion with his RC and named nurse so that you get a satisfactory answer?

I would encourage you to consider contacting the MIND legal line and get an Advocate involved ASAP. You may wish to consider specifically alluding to your relatives baseline presentation. Happy to be corrected but it sounds as though this perhaps has not been fully acknowledged by the staff.

https://www.mind.org.uk/information-support/helplines/

You are right about the ECT and side effects. Would I have it again? Absolutely. Was I told that my memory would still be impaired 10 years on.? Nope. You are right to consider these things.

You are doing great, keep asking any queasiness you need to!

I was told I was to be given ECT against my will when I was sectioned in the 1990s. I completely freaked out as I didn’t want it and they did change their minds, Apparently, it was taken as a positive sign that I cared about what was done to me.
No idea if that is typical but it can’t harm to make sure they are aware of his objection and that of his partner and you.

Yes, that is correct. ECT can be given without consent under section 62 of the Mental Health Act to alleviate ‘great suffering’ or prevent acute deterioration (this is known as “emergency use”) or under section 58a as long as another doctor agrees it’s necessary. Why are you worried? ECT sounds scary but is the gold standard for depression and can do absolute wonders, especially if medication isn’t really working.

Possibly, but I think very unlikely. I would be very concerned about the clothing and lack of communication. And the name used. And the section he is on.

He should have a full nursing assessment done which would include this. And be oriented to the ward.

None of these things sound like they were done and he should have a named nurse whom you KNOW to be the named nurse. Not just a senior one.

You may wish to consider requesting a meeting and highlighting all of these points because there are some red flags there in terms of care.

You may also wish to consider specifically requesting a MH Advocate and the goal of the section.

If you have any more questions just ask, I will do my best to answer them.

Hi OP. I'm so sorry to hear about this difficult situation.

Have the staff talked to you about a MH Advocate? There should be posters up on how to contact them and usually they introduce themselves as well.

Are they being seen specifically by an old age psychiatrist? Your relatives situation sounds especially complex.

As a PP said, check out if you are his nearest relative. This is not the same term as next of kin, it's a legal term and important.

Finally, bear in mind that hospitals differ. I've been in multiple MH units where no activities or OT input had been offered or available. And I include private hospitals in that. Care simply consisted of bed, board, medication and a weekly ward round. That is across at least 6 hospitals in the last 9 years.

Best wishes.

It can vary a bit from place to place. Most places do have an older people's mental health ward but sometimes they are mixed (general mental health and dementia) and some places have separate wards for each.

The wards are in many ways nicer than a general hospital, you usually have your own bedroom, many places ensuite, there will be a day room, dining room and often an activity room. Some places have secure garden spaces too so people can safely get a bit or fresh air.

There are usually activities, some will have a specific staff member to arrange these, access to an OT as well as the nurses and support workers. There should be a meeting "ward round" at least once a week which you can probably join remotely (on teams etc.).

The nurses will observe and record any behaviour changes and report this back to his named psychiatrist, they will make sure he has any medication he needs, they try to avoid over sedating people (but sometimes starting a new medication can make someone more tired). They should be able to update you if you're worried.

If you search for the hospital some websites have a bit of a guided tour of their wards so you know what to expect.

@limetrees32 I know that psychiatric hospitals seem terrifying but that’s because we’re unknown to you. The best way of dispelling that is to build a relationship with the ward. Wards are staffed 24 hours a day by nurses and there will pretty much always be a nurse available to talk you by phone. You can arrange regular phone calls for updates, as often as is necessary for you to feel safe. I know you’re a little way away, but most mental health hospitals don’t really have visiting hours either-we’re happy to accept family up to about 10 pm and family leave is usually given early and freely. Please come when you can. If you want to attend ward rounds you can usually do so by video call or in person and doctors/consultants are usually able to give regular updates by phone. I work very closely with the doctors in my unit and am always happy to pass on the need for a phone call from the medical team.
Speaking as a nurse, we do really care for our patients and their families too, many of whom I have got to know really well. Please don’t be put off by other people’s negative experiences. Our aim is to help people to build the best life they can.

Try not to worry. Once we got over that hump they were quite cooperative. They'll work out what's going on and then come up with a plan.

He's in the right place, for now. Polydipsia (compulsion to drink water) is linked to mental health issues, but they will need to make sure he doesn't have, for example, diabetes insipidus. Polydipsia is serious because if you drink too much water it dilutes your electrolytes and can cause the brain to swell.

It's really worrying when your loved one is in hospital. It took us almost a week to find out anything about my DM and I had to make an official complaint before we were given any information. But tbh, the hospital she was in was dire and once the head of the organisation knew what was going on, he was phenomenal. One day, they wouldn't let us see DM because she couldn't dress and walk to see us off the ward (she had lost all self-care ability). We had driven 20 miles to see her. She was sitting at a table, arms outstretched, calling for us. We weren't allowed on the ward, and she couldn't walk to the visitors room. They said she clearly didn't want to see us because she'd get dressed if she did. The head of the service was walking down a corridor and heard me getting cross, so came to investigate. When I told him what was happening, he marched onto the ward, a door shut, I heard very raised voices, then he marched back up the ward and said "Lougle, this way. Come and dress your Mum." From that day on, we were allowed into the ward to visit until she was well enough to come out to the visitors room.

Ah see this may be a little more complicated. At 78, I would imagine that he’s been admitted to an older adults mental health ward. Treating the initial agitation with lorazepam was the standard thing to do. The next steps are to rule out mental health or neurological/physical disorders that are not anxiety and depression. As this has been going on for a while he will likely have brain scans to rule out brain damage and dementia and blood tests-itching and thirstiness may indicate difficulties with liver or kidneys, or diabetes. He may also be prescribed medications that are not anti depressants, including anti psychotics, depending on the strength of his compulsions. It can take a little while to work out exactly what is wrong and what will help before people start to get better.
Does he have any children? If not, you’re his nearest relative, legally. I would again suggest ringing the unit and, as long as he’s given consent to share, the nurses there will be happy to talk you through the plan. I hope this helps a little x

Sorry for the dumb question but what is an SCA?