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AIBU?

Share your dilemmas and get honest opinions from other Mumsnetters.

Original poster

AIBU - The Dr should do something?? Mum, dementia, crisis!

29 replies

birdybirdbird · 14/12/2016 18:28

Have lurked a lot in AIBU but first time posting - really need the traffic and the advice! This is probably very outing if anyone I know in RL sees it but oh well...

My Mum has dementia and also other mental health issues (bi polar), epilepsy and a long list of other issues. Her memory has really deteriorated recently and currently desperately trying to get social services to step up - she still lives by herself, hundreds of miles away from me, not even a daily carer, run up huge debts, not really caring for herself etc etc.

Anyway, over past couple of weeks she's been increasingly aggressive to neighbour - going round, shouting and swearing at them. Today she did the same and actually grabbed their very young child - hurting and scaring them. Nighbour rang me - I got onto 111. They basically told me that I couldn't report my concern about her as I wasn't actually there to witness it (neighbour couldn't report as Mum was was round there again, although this time was calm!). Told me to ring GP. Which I did and they said they would send on call Dr out to her and I should call back for an update. Except, when I called back actually "No - he isn't going round. He will phone her first as she's been aggressive and then determine whether or not he needs to go round. Oh and our phone lines close now so..." And that was the end of the conversation.

Now I totally get he needs to make sure he will be safe from harm BUT, AIBU that I expect them to do something?? That she really needs some medical investigation (sectioning??) to investigate the cause of her sudden personality change and aggression? And for me to able to speak to someone and find out what is happening? Or do I have rely on the word of my Mum who can't even remember going round to neighbours in the first place?!

Any advice gladly received!

OP posts:
december10th · 14/12/2016 18:37

I would ring social services

Original poster
birdybirdbird · 14/12/2016 18:46

Have just called the emergency social services team - will hopefully get a call back soon.

Hopeful bump for anyone other advice!

OP posts:
junebirthdaygirl · 14/12/2016 18:49

Is there a nursing home she could go to that caters for people with a mental illness in old age. Maybe this episode will bring everything to a head. Sounds like she meets full time care.

PlayOnWurtz · 14/12/2016 18:52

Call the police or get the neighbour to ring them. They can convey her to hospital under section if she's a risk to herself or others but tbh she needs to be under the care of a geriatricIan or mental health team

Verticalvenetianblinds · 14/12/2016 18:53

We have a service where I live that kind of assesses and reports to ss and is accessed through the ambulance service. Police also do welfare checks for them. Flag it with as many people as you can, more people that know more chance you have of getting help! Good luck x

Doyouthinktheysaurus · 14/12/2016 18:53

Does you area have anything like a mental health rapid response service? The trust I work for has and they can be contacted by carers or professionals etc, if there are concerns about an individuals mental health and their risk to themselves or others. They do urgent referrals and can give advice.

It would be worth a Google of your local mental health trust and what urgent response services there are.

Didiplanthis · 14/12/2016 19:01

You can ask police to do a welfare check and if neighbour will ring police too if they deem her at immediate risk to herself or others they can take her to a place of safety for a mental health assessment - they have something called a section 136. Ss can I think request a section 2 as can gp but gp will not be able to actually do the section as that needs a psychiatrist and social worker.

PlayOnWurtz · 14/12/2016 19:02

Police can section a person whereas a normal section requires two qualified professionals

Original poster
birdybirdbird · 14/12/2016 19:45

Thank you for all the posts and advice - I disappeared as had phone calls to answer.

Dr did actually go around in the end but obviously by this point she was calm and fairly coherent so there was nothing he could (would?!) do. I stressed the risk to the child and he agreed but said she wouldn't be admitted. I really don't understand the thinking behind this - how is she not deemed a risk to others?! Is that not enough to be admitted under mental health act? Have also spoken to the emergency social workers - they also recognised a clear risk but passed buck back to Dr.

It's increasingly clear (to me anyway) that she needs to go into a nursing home, which takes time and I just seem to go round and round in circle from GP to social services to mental health and back again. I'm just very worried that something very big and very bad is going to happen before they actually place her somewhere...

OP posts:
Snoopysimaginaryfriend · 14/12/2016 19:45

Please be aware that the police cannot place some under S136 when they are in private premises. They will have to call an ambulance and if you start mentioning that she has grabbed a child and been aggressive then police may have no choice but to get involved in criminal investigations.

Northernlurker · 14/12/2016 20:31

Obviously there are agencies which can be involved but bottom line is she's not their mother. She's yours. You are always going to struggle to finesse the situation from a distance because you know more than anybody else possibly can. You need to be on the spot if you want things to drastically change. It's not reasonable to expect the GP or social services to pick up the pieces of a situation you've heard about second hand.
Can you make arrangements for your other responsibilities so that you can visit your mum for a few days?

DecaffCoffeeAndRollupsPlease · 14/12/2016 21:55

Are you your mum's only family?

WW0nderland2016 · 14/12/2016 22:06

Can you go to visit or can you collect your Mum to come and stay with you ?

It is difficult if you live a long distance away

Also it will be Christmas soon, so there will be an extra strain on all services

jacks11 · 14/12/2016 22:18

It's hard to say, I think it sounds like a difficult situation all round TBH.

For a start, there are very specific circumstances under which someone can be detained under the mental health act. Acting on hearsay (i.e. 2nd hand information) which does not match the presentation of the patient at the time they are assessed is a potential minefield and could be very difficult to justify (and rightly so). I understand your concerns but your GP has to abide by the rules. So if your mum was calm, reasonably rational and so on when the GP went to see her, there really isn't a lot they could do.

They also can't force your mum to undergo investigations that she won't agree to, unless she is deemed to be lacking capacity. Similar rules apply to social services, they will be unable to force her to have carers or go into nursing home if she has refused (no idea if she has, just speculation) unless or until she has been deemed to lack capacity.

I'm assuming you don't have Power of Attorney? If not and if your mum were deemed to lack capacity, then an application for guardianship would be required. This can be both time consuming and expensive, unfortunately.

I'm not dismissing what you are saying, it does sound like things are tough but it's not as simple as GP swanning in and detaining her under section on your/her neighbours say so.

creampie · 14/12/2016 22:40

You need to ask the GP to make a referral to the older persons community mental health team or memory clinic. You can then ring that team and express your concerns which should get her seen fairly urgently.

They will take you seriously. Although it's "hearsay" it's given a lot of weight in dementia services because the patient themselves often can't give an accurate history.

Hairyfairy01 · 14/12/2016 22:46

Has your mum got a diagnosis of dementia or bipolar? Does she have a social worker? Does any family live nearby?

PacificDogwod · 14/12/2016 22:47

The mental health act can not usually be used to admit somebody against their will unless they have a 'treatable' mental illness.
Has your mother's capacity ever formally been assessed?
Does she have a psychiatrist/old age psychiatrist? Is there a diagnosis of dementia?

It is a horribly difficult situation for you - being so far away and so helpless is difficult Thanks
I think her neighbour needs to call the police if she is threatening/aggressive to anybody.
Yes, contact SS in the morning, describe the situation and ask for an urgent care assessment - SS departments usually have an older people's team who have access to all sorts of other services.
Her GP may be able to help to rule out other causes for confusion such as a urine infection or pain or new medication or whatever.

Admission to an acute medical or psychiatric bed is very rarely appropriate nor in the best interest of a confused older person (whatever the reason for the confusion) and can make disorientation and distress worse.

Etak15 · 14/12/2016 22:53

Would it be possible for you to visit/stay for a while? If not You could arrange a respite stay with a nursing home Privately - if you think your mum would agree to this? If so at least whilst there they would be able to witness any incidents and act accordingly. It would be good if the gp could do some simple urine/blood tests to rule out any infections which could explain her rapid deterioration - of course your mum would have to consent to this.
Did the gp do a formal capacity assessment of your mum or just left it that he thought she was calm and amenable? I think although hard for gp to go on 2nd hand info there is more he could have done here - referral to mental health services - does your mum already have a mental health worker due to her bi-polar diagnosis? Has she been formally diagnosed with dementia - if so then she must have some history with mental health services, GP should follow this up and refer on.

Bettyspants · 14/12/2016 23:02

This is just awful and you must feel dreadful. Does your mother have a confirmed diagnosis ? If she's taken a sudden turn for the worse an organic source of the aggression needs to be excluded. From what you've said I would expect the GP to run baseline tests such as a urinalysis and 'confusion screening' on bloods. She may have other underlying medical conditions contributing to her behaviour, in a manic episode from bi polar or not being compliant with any meds. If you are not registered as her next of kin with GP things can be a bit tricky but if you are I would ring the again for a telephone appointment with yourself and follow it up with an email. The dr is in a bit of a corner if your mum was 'as normal ' when he saw her and if he's going purely by your word. Once medical concerns have been addressed ss need to be involved....dementia and mental health resources can be crap or good depending on your area.

MsJamieFraser · 14/12/2016 23:03

Doctor can't do anything it's social services you need to call.

december10th · 15/12/2016 01:39

You are legally entitled to get an assessment by social services so long as your mum is agreeable to it.Remeber like all public sector workers they will be very overstretched so the squeakiest wheel , and all that.

december10th · 15/12/2016 01:47

How much money/ capital does your mother have? As I am sure you know, If she has more than capital limit (which in this area is £23.5k- I don't know if its the same everywhere) then she would usually be expected to pay for her care, so there is no point waiting about for a SS assessment, you might as well approach private care homes directly.They will usually do an assessment themselves to see if they can meet her needs and you could get her admitted temporarily to begin with to get over this crisis and give you all a bit of breathing space.

NurseRosie · 15/12/2016 01:50

I would have thought to drs need to rule out an acute medical reason for the behaviour change such as a urinary tract infection.

Will they refer to the community mental health team for assessment?

The emergency duty team at social services should step in to give help or find respite for your mum. Maybe if she is a danger to herself or others a safeguarding alerter needs raising with social services, they would have to intervene then. It's difficult because all areas and local authorities work differently but it sounds like things are reaching a crisis point and they need to step up.

It must be hard being so far away, I hope you get sorted.

AcrossthePond55 · 15/12/2016 02:47

My mum has dementia, my brother lived with her and was her carer. When we saw that she was starting to get suspicious of us and began having horrible delusions about my brother we started visiting care homes and making plans so that by the time she really wasn't able to be at home anymore even with my brother (she started calling 911 on him and wandering outside at night) we had selected a care home, figured her finances, and filled out the needed pre-admission paperwork and put her on their list. Luckily they had space available when the time came.

I think you need to do the same. Try to get POA and find out her finances. Speak to a solicitor who specializes in elder law. Speak to your other siblings (if there are any) and get a plan together.

You may not want to get the police involved, but if your mother becomes violent or abusive again, it may well be taken out of your hands because a neighbour will call the police on her. There have been threads on MN before regarding older neighbours who are either abusive or a nuisance and the posters have been advised to call the police even with the knowledge that the person may face criminal charges.

Scooby20 · 15/12/2016 06:41

It's very very difficult. We have just been through similar with my grandad. We actually only got help when a neighbour called the police because he was in his underwear screaming in the street and trying to get into on of the neighbours cars.

We couldn't even get a diagnosis before that. The police came and called an ambulance. I don't know the ins and outs as I wasn't present. But he was taken to a hospital where he was kept until they could find a place in a home for him. Only at this point was he disgnosed.

We had all been trying to get help for ages.