Tell me what to say to a consultant who has wrongly diagnosed my dad

[Borntorunfast]

I've got a meeting with the discharge team and consultant tomorrow. Dad was sectioned 2 weeks ago. He went in with a working diagnosis of degenerative cognitive decline caused by Alzheimer's and has been on anti-psychotics. The meds are working, but because he's now calm and compliant the Consultant - who says she can only diagnose on the basis of "what's in front of her eyes" (her words) - proposes to discharge him with a diagnosis of anxiety and depression.

This is harmful as it means he wont take the meds as soon as he's out (he disputes there's anything wrong with him, and has a history of refusing to take them).

It's also harmful to my mum, as when she then has to call for help (ie when he stops taking the meds), no one will prioritise her as he 'just' has depression. Rather than the Alzeihmer's with psychosis.

Consultant has point blank refused to take into account previous medical history, testimony of other colleagues who assessed him while he was having his crisis, or any testimony from the family.

Dad can put on a good show. He 'presents' well. It has been a long, long battle to get anyone to take us seriously and now this consultant will set us back to square one if her diagnosis stands.

I have a meeting with SIX doctors tomorrow apparently and fear they will bully me into accepting their diagnosis and allowing him home.

Where he will terrorise my mother, who was having panic attacks due to his abusive behaviour.

How can I get this consultant to change her mind? To listen? To consider the evidence we have that all is NOT well, and he's not the nice cute man he appears to be because he's currently drugged up to the eyeballs? That a diagnosis based only on 'what she can see' is batshit?

I'm so worried about the meeting, it's so intimidating having to be sat there in front of a hostile, interview-style panel. I don't stand a chance, do I?

Why do they discount everyone else like this? It's breathtaking in its arrogance.

Endemic in doctors, I am afraid, especially if you dare to suggest what the problem may be - never met a lot with such fragile egos.

I've pm you x@Borntorunfast

Refuse to allow him back. If, as the Consultant says, there's nothing wrong with him cognitively, he's an abusive man your mother is under no obligation to let back in (unless the hospital want to get involved in getting a court order, which they won't, they won't be able to force the matter even if it gets to the point that she's changed the locks and isn't answering the door when they try and drop him off).

And if his abuse isn't his fault, that means he isn't able to control his behaviour and is therefore clinically unfit for discharge.

Whatever way they argue it, you're telling them that he is not getting let back into the house and they'll have to find an alternative.

This is correct. A diagnosis of dementia is made through completion of an ACE III assessment and the type is determined by symptoms and scans. Quite often a person with dementia doesn't know they have dementia, so input from family members often helps.

The issue is he's been sectioned but no longer meets the criteria for the section as he is stable. Keeping him in would breech his human rights. You need an urgent referral to cmht or the crisis team. You need the gp on board as well. Anxiety and depression won't prevent him getting support from cmht.

Can you say that the family do not feel they can manage him and you feel unsafe.

From the sound of it, regardless of your dad’s diagnosis he will go home and not comply with his medication. Your mum should simply tell them all in the meeting that she cannot have him back home as it isn’t safe for either of them.

So he's calm due to taking medication and Dr says it's anxiety. Maybe a week off meds for her to monitor his "anxiety" would show her what he will be like once home and non compliant with meds. I've looked after people like your father in a Dementia nursing home. They can wash and dress and then they can slam you up against the wall refuse medications, throw furniture and put other residents in danger.
We used to have a lovely Older persons mental health team (headed by an psychiatrist who only looked after older people) who would come and visit and also do meetings by phone with us to try and get the resident into a place where they could live calmly without being sedated too much, it was an on going balance.

They won’t section for longer than needed, so when they r in crisis, its down to the family to sort out suitable care for him, especially as yr mum can’t cope.

This. Let him be one of their bed blockers if they're going to play this game. If they say he's "just depressed" then he can bloody well be 'just depressed AND their sodding problem!!!"

Arrogant doctors (who decide for themselves what type of person you are before you've even sat down), wind me right up. Been there.

I don't think OP is suggesting they keep him in, just that they discharge him with the correct diagnosis (Alzheimer's with Psychosis) as this unlocks support for her Mum.

@Skybluepinky OP is not suggesting they keep him in, just that they discharge him with the correct diagnosis (Alzheimer's with Psychosis) as this unlocks support for her Mum.

This is why I was asking about the dementia diagnosis. I couldn't tell from the wording of the OP whether the 'working diagnosis of psychosis caused by his dementia' meant that the dementia was clinically confirmed, but it was the working assumption that it was now causing psychosis. Or is it that a working assumption has been made on both counts based on behaviour.

I probably sound pedantic but it makes a difference because once you have an official clinical dementia diagnosis, that can be the basis for arguing that your dad needs certain support, including potentially in patient treatment. It also looks bad if this consultant is denying that he has dementia (or psychosis) and claiming it is 'just' depression instead. Medics listen to other medics and what they say. Rather than emphasising your own disagreement with them, I'd be asking why they don't agree with the existing diagnosis of dementia (if there is one) and / or why they disagree with their colleague who diagnosed him as psychotic. References back to what's in his medical history and records will help you.