Crisis team coming to assess DFil, what can we expect?

[MsAdorabelleDearheartVonLipwig]

He won't take his ad's, his paranoia is rocketing, he's becoming argumentative and a bit aggressive and we're a bit worried about him living on his own. DSil - his other dil - is afraid to visit him on her own. I don't fancy it much either. The crisis team should visit either today or tomorrow. The Dr said if they deem him an emergency they might be able to help. They won't leave him on his own at home surely? If we can't convince him to take his meds he'll never get better. I don't know what to do.

Thanks guys. That's what we need, the chance for the meds to take effect and sadly the only way that will happen is if he's supervised, he's so convinced we're all trying to poison him.

I really hope he comes out of this and can see how unbelievably he's been acting. He would never be like this if he were his normal self. This behaviour has been absolutely bonkers.

Very glad he's being treated now . Hopefully he will gain insight into his behaviours and realise he needs the meds- have they given you a diagnosis yet?

Hope he starts improving soon. Do keep us updated.

He phoned dh in a panic tonight. A woman had rung to say she'd be along shortly to give him his tablets. He thought she was coming to take him away. Same old story. She was in fact the woman who came this morning but she's new and was just ringing him out of courtesy tonight to remind him she was coming back.

I don't know how quickly these new meds are supposed to take affect but he doesn't seem much better yet. He's on 30mg of the mirtazapine as well as the other two. Should we be seeing any improvement yet?

At least a week to see any change usually so don't give up hope yet. The dose may need to be increased or meds changed but they aren't likely to do that unless no improvement after 2 weeks.

So they'll try again with the meds before they ship him off to hospital?

Dh seems to think it would do him good but I think the shock would be very upsetting for him.

I haven't actually spoken to him for a few days, dh has been phoning him and he visited him today. I feel a bit guilty. I just find him very hard to deal with.

Just be warned that most psych wards are so terribly understaffed that they are merely a holding pen. People generally only see a doc once a week for 20 mins. I was in recently and there was nothing remotely therapeutic. It is a lonely and scary place to be, esp if you don't know the ropes. I had psychotic depression, but nobody spoke to me, other than to offer lorazepam. When I tried to talk to nurses about how suicidal I felt, they said they didn't have time (4 times it happened)! I still had to fight to keep myself safe--I had multiple chances to attempt.
I actually consider my psych ward to be one of the better ones. We have private rooms, for example.

Don't get my wrong---the staff were lovely and caring, but just didn't have the time to look after people properly. Just be warned. For me, psych wards are the absolute last resort (but obviously there are times when, yes, I have to be admitted.)

God, really? I'm sorry you've gone through this. I hope you're feeling better now.

He actually rang us tonight. Dh said he didn't sound too bad. The home treatment team rang today as well and they're happy with his progress and are going to drop his evening visits and ring him instead. I just hope he doesn't go back to his old trick of not taking his meds.

Thank you for sharing that.

The decision whether to admit or home treat depends on a lot of factors eg patient and family choice, risks at home, suitability of home environment and support available, patient ability to self manage and to seek help. Generally admission would be a last resort. The first medication not working would not really be a reason to admit (it would have just the same chance of working in hospital as long as it's actually being taken).

The main advantages of being admitted are that it should be a lower risk, meds changes can be made faster as the person is observed and has access to physical investigations, no day to day chores eg meals, laundry, shopping.

I must admit that I see my inpatients a maximum of twice a week and probably is about 20mins. I am mainly seeing other patients in clinics and at home (not doing nothing or paperwork!) the rest of the time. People believe it would help to see a Dr more often but I am not sure how it really would in fact. Psychiatric drugs take 1-2 weeks work and there is no point changing them before they've had a chance to work so if I saw my patients every day most of it would be me telling them to be patient and wait for the drugs to work. Once a week is about right to see an effect.

Just to be clearer--the biggest problem is that it's possible to be in hosptial and have nobody able to talk to you. I had the most lovely named nurse on the last admission. You're supposed to have a 1-2-1 meetings three times a week. He said to my face he would love to be able to talk to me, but he didnt have time due to all the form-filling required.

Anyway, I'm glad things are improving a bit for dfil

Well he's here for tea tonight and he's all doom and gloom again. He looks better in himself and he's not shaking or crying or anything but my god he hasn't stopped moaning. He's also talking about his neighbours plotting against him again and he's convinced that he's going to be locked away when dh takes him for his hospital check up on Thursday. Give me strength.

Your poor FIL and poor you. Can you have him to stay for a week, or even 48 hours?

I don't think I could stand it.

Right. Could your DH stay with him? Just until the meds kick in and FIL is ok about taking them.

Someone sees him every day and the HT team go in every morning. Hadn't thought about someone staying with him. Don't know if dh would be very keen but I can always suggest it.

How are things now, OP?

Well things seem to have settled down a bit. He's been on the new dose for a couple of weeks and he seems a bit better. He's not quite so nervy and tearful as he was. He still thinks he's got cameras watching him and that the police are after him but he's not quite as obsessed about it as he was. He doesn't go on about it and look shocked when you point out that it's not true.

He went for his assessment at the hospital last week, dh took him. The lady rang me the next day to let me know what she thought. She said she got the impression he was telling her what he thought she wanted to hear. She asked him to sign a form to give her permission to talk to us and he took twenty minutes to sign it. He thought it was to take him away. I told her he is the classic narcissist and told her a bit about his background, how difficult he's always been and how hard it is for us to be able to support him.

She said when he lost his job he lost all interest in life. I said that's true. Because all he's got left is his family but he's never been a family man.

Sounds like the medication and home treatment is helping him stabilise his mental health. He is still delusional though which is likely to be the psychosis still, but that may reduce still.
His underlying personality will still be the same however OP, sorry that's not changed by any of this!
Glad to hear that things are moving in the right direction; thanks for the update.

Ha, no he won't change. Far too set in his ways.

He's here for dinner tonight. He's still moaning away. Not once has he asked how we are or even spoken to his granddaughters much, except to tell the youngest to wash her hands and be quiet. I'm currently hiding in the bedroom.

Thanks for asking. It's nice to be able to talk to someone that understands.

No worries. Hope you continue to see improvement.