Woman evicted from NHS hospital ward after being stuck for 18 months

[SerendipityJane]

https://www.bbc.co.uk/news/articles/c897ew0ekp4o

I suggested an institution of some type earlier. We don’t have enough places for people like this.

Who can deal with her? It’s not a job I’d want. I did work in Care for a short time (younger people of a similar age to this woman). My job was unpleasant and I had my hair ripped out a few times, faeces smeared on me, and was bitten. I left, but some of the people I worked with could cope with the job. The money was totally rubbish for the work they did. Getting people who can do this job and paying them a proper wage would help.

Forgot to add, I notice you refer to women like this

Men like this would be more likely to be dealt with under a forensic pathway and arrested/criminalised (not saying its right or wrong, just the difference in how men like this are seen)

You can open institutions for people who cannot cope in community settings, for a start. While there were horrible cases of people who should never have been put into hospitals for their lifetimes, there are others who honestly cannot cope without that level of care.

And yes - you are right about the difference between men and women - if she was male she may well have a diagnosis of antisocial personality disorder rather than EUPD as those two do seem to split between men and women. There are a lot of men in prison who probably would not be there if they had access to a long term place to live like the old mental hospitals.

We also need to stop awarding healthcare contracts on the basis of what is cheapest, which is edging out the NHS from a lot of contracts - and look at quality services where continuity of care is a priority.

In fairness @oakleaffy it tends to be quite rare, in the most intractable and difficult situations such as this one, it's not an open offer! Sometimes though it is the only way, a temporary solution while something is worked out.

Plus giving them protective clothing akin to Kevlar
This is undoubtedly why straight jackets were used in the distant past, to keep everyone “safe” from self harm and attacking others.

There are some old padded rooms on you tube where Urban Explorers have been to now defunct mental homes - where would be impossible for anyone to hurt themselves.
But very depressing that these rooms were ever needed.

Quite but she should not be allowed-to inflict herself and her behaviours on other patients and staff in an acute hospital ward for almost 2 years- refusing to co-operate, and behaving appallingly. The medical specialist should be able to restrain, sedate and move her to somewhere appropriate. Do you disagree- what do you think should have happened?

There was an old ( 1960’s?) public health poster warning of LSD

“ LSD can take you to places you never dreamed of” showing a young woman in a straight jacket in a padded room.

Designed to scare.

Can I just say that I don’t see you as attention seeking (it’s a bloody stupid phrase anyway). People need support, and aren’t getting it. 💐

Sounds like she was too complex in terms of care after discharge. No place would take her.

I have a diagnose of EUPD, and some of the people I have been in therapy with have been difficult to be around. One lady was proud of the fact she was abusive to staff in A&E. One time came in and said she punched a nurse, and was telling us like it was an achievement. A few others found it funny. None of them lasted beyond a few sessions. None of them finished the full course of group therapy.
NICE guidelines say about hospital not being suitable for those with EUPD as it can create a reliance on services. I was limited to 3 day crisis admissions (although sometimes they went on longer). The other people with EUPD that I was inpatient with were all pleasant, and were nice to staff. I think the ones that were not would not have been admitted to start with.

I don’t disagree that an acute ward is completely inappropriate and unsafe for both her, the staff and - most importantly - the other potentially very vulnerable patients.

She should have been told she had to accept the supported living placement identified with a view to alternative accommodation being considered once she was discharged. It’s not uncommon in social care for people to live in non preferred placements / areas to allow more time for a better long term option.

I do believe there need to be stricter laws for facilitating discharge from NHS acute beds. I believe we should use the legal system much earlier. I am absolutely categorically against sedating capacious adults against their will. It is a slippery slope. Someone within the hospital should have worked quicker with their legal team to serve an eviction notice. That is the most humane option.

She was told and refused to move. It took months to reach court snd she refused and behaved appallingly throughout. What do you think should have happened- did they just have to tolerate that?

I was taken aback by that post. Whatever happened to patient confidentiality? I'm a nurse and would never discuss my patients with anyone other than colleagues on the same ward. I hope the SIL doesn't get into trouble for sharing information, because I'm pretty sure she could be identified.

As I said, I think there needs to be a better legal framework for people who refuse to leave care settings. It needs to be quicker. It is currently far too slow.

Once she has been evicted, the police can remove her to the alternative accommodation identified by adult social care.

The legal case cost the NHS over £50,000. You want them to do more of these while they are forced to indulge these people? Why do you think the demands of these patients come before the well-being and safety of other patients on the ward and staff?

It will have cost way more than that

Had she not left the original care home to go into hospital, I bet that they wouldn't have said that they could no longer meet her needs. My guess is that she was hard work so they refused to have her back. They should have been supported to have her back until the flat became available. It's such a sickening waste of money too. Unbelievable that it has to go to the High Court too.

Not necessarily, just like children, adults with challenging behaviour are often given notice on placements and bounce around care placements with no one offering a placement

Its hard because providers have to often deal with staff refusing to work with a particular person, being off sick due to being injured from assaults or being suspended because the client makes an allegation, particularly if the person has needed emergency restraint, which is quite often for some people.

What makes you think that? My mum was massively less difficult than that woman, yet she still came very close to being evicted from her care home because of her behaviours. In the end her money ran out first (she was self-funding) so that cleared the decks for them, as the council moved her somewhere cheaper.

EUPD and BPD are often diagnoses given to women who are actually autistic. It's interesting how women (and it's always women) with this diagnosis get treated. Like trouble. These are increasingly controversial diagnoses
in the fields of psychiatry and psychotherapy.

www.bacp.co.uk/bacp-journals/therapy-today/2024/articles-december/the-big-issue/

You should always be grateful for those who assist you, even if they are paid. Teachers, nurses, the emergency services all get paid and have to do some of the worst jobs out there. I will always be grateful to them, just as I am the checkout assistant at the supermarket. You don't have to look someone in the eye or even thank them necessarily. But you can still be grateful and understanding of the job that they do.
That said, I do think that you're getting a bit of a hard time on here.

Yes, but it would have been considerably more difficult to evict her if she was still living there and had no where to go. I think that they saw their chance and took it.

Perhaps. Perhaps those diagnoses of ASD are actually incorrect and the correct diagnosis is EUPD, theories and practices change, it wont be the same in 10, 20 50 years time

If she is ASD then she shouldnt be in hospital, there are big drives in clinical practice to prevent and avoid ND clients being admitted, so if she is then even more of an argument to be discharged much sooner than she was

However, whatever the diagnosis, the issue is the same, she didnt need to be in hospital, caused disruption and distress to other vulnerable patients and so yes she was 'trouble', theres no other word for it when others are on the recieving end

And if you come across a man acting in the way she did, he would be seen as more than 'trouble', the descriptors for a man like that would be abusive, controlling, NPD, anti social PD, sociopathic, violent and he would be arressted.

It wouldnt at all. Providers give notice all the time, it isnt their business or concern if the person has no where to go, the day they need to leave they need to leave. They call the police if necessary.

Yes, a lot of people I know with EUPD are now diagnosed autistic. Some are still both.
But they have been what has been seen as the "quiet" type of EUPD.
The really loud ones, the ones that are seen as "manipulative"... have not been diagnosed as autistic. Anecdata, I know. They were all proud about how abusive they were with people.
Sadly, we all get tarred with the same brush. I broke my foot, and because there was a 'Patient Alert' in my notes about a PD, I was treated like shit. Straight away, the triage nurse told me I was faking it and she saw me walk fine (I was not walking fine). Said I made up a story to get attention.
I "walked" out of A&E with crutches, a boot, and an appointment for fracture clinic a few weeks later.