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Psychiatric Hospital

Psychiatric Hospital

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Today the head nurse and general manager of Ashford court called to say they could no longer keep My husband. He's started beating up other patients, and really hurting the nurses. She suggested sending him to the psych. hospital for an eval. Am waiting to hear from his doctor to get an order to take him. What a nightmare. If they can't bring him down someway, what do we do with him. He's just out of control. Am watching the reports on elec. shock with interest maybe a last ditch hope for My husband.

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Your experience with My husband is a real deja vu for me. This is just about exactly what Mom & I went through 18 months ago. Mom's connection to reality got very tenuous soon after she moved to the assisted living facility. She had hit a couple of the staff, and while they were waiting to contact me about it she left the facility (at night) and began trying to flag down cars on the highway. (There was a pretty well-developed delusional system that made this make sense to her, but I won't go into that.)

We did hospitalize her for about 6 weeks and, while the hospital stay didn't fully resolve the problems, it did get them under control for awhile.

I'm no expert, but there are some things I think I did right and some things I learned from the experience. I'm sharing them in case they might help you.

I was able to be present during part of the admission interview with the nurse practitioner. I was amazed at how well Mom was "covering" her delusions during this interview, and I was afraid she might come off as a totally sane person being persecuted by the staff of a care facility. At one point I finally broke into the interview and asked Mom directly what made her so afraid that she felt she had to leave the facility on foot at night. Her answer to that one "opened the floodgates" and the whole delusional system came out, much to the surprise of the nurse.

In general, admission was a demoralizing experience for Mom. They took all items that could be considered dangerous. This included nail clippers and cosmetics in glass containers. It was also a locked ward, and they insisted that Mom keep the side rails up on her bed and ask for help when she wanted to get up. I thought the nurse did an excellent job of explaining that this was because meds were being adjusted and some dizzyness was to be expected, and that dizzyness causes falls and falls break bones, etc.... It was still demoralizing.

The hospital was several hundred miles from me, so I was only able to visit on weekends after the first week. I was able to arrange for friends living locally to visit, however.

One thing that a friend and I did was to get acquainted with the staff and try to "humanize" Mom. I talked about her experience with PD, how it had affected her career, how she had been able to maintain her professional licensure and how hard she'd worked at that, etc. The friend (a friend of the family) talked about Mom's relationship with her family, etc. Maybe unnecessary, but the idea was to make sure Mom was seen as a person, not just a patient.

The experience WAS difficult for me. The increased antipsychotic meds sedated Mom to the point where she couldn't stay awake for an entire meal. She had to be fed, and fell asleep with a bite of food in her mouth at least once. At various times there was also major agitation, extreme soft voice and big mood swings. It was about a 6 week stay, with a couple of medication changes and ECT was considered as well (see yesterday's note).

Of course I read up on every new drug, etc.

When we left the hospital, Mom's PD was somewhat worse -- she needed more help with standing & walking -- but she wasn't actively hallucinating anymore. She had memories of the delusions and remained real for some time. She still "remembers" a war and an evacuation that supposedly took place during that time, and I think the memory is still real for her, but she's able to "reality check" it now (there's no mention of the war in any newspapers/magazines -- must not have happened). Some things she's not able to reality check, and we just have to agree to disagree on those. Since then, we're back to "almost as good" as Mom was before the break.

I'm really not writing just to share horror stories -- I AM trying to be helpful. I just remember how unprepared I was for the experience (and I had worked on an inpatient psych unit for 2 years!), and I'm hoping to at least reduce the surprises for you. It seems like I could be more help than this.

If there's ANYTHING I can help with, PLEASE let me know.

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