Sorry, it's a long one!?

87 year old lady liveswith 90 year old lady.  Some agitation and
wandering reported by next door neighbour.

Seen by GP - probably somke dementia, ? depressed. coping not too bad -
husband fit physically and pretty good mentally.

Domiciliary psychogeriatric ( ? politically correct term) opinion sought
- admission arranged.  Treated with Dothiepin and then thioridazine and
discharged home with attendance planned for Day Hospital.

Taxi (not ambulance) arrives to take to day hosp - patient refuses go -
taxi leaves - happens 3 times a week for 2 weeks -until we are alerted
by neighbour ( not hospital).  CPN arranged by hosp -given injection of
Depixol.  CPN v active and realises respite needed and sorts out nursing
home for 1 week.

On discharge from nursing home is "Off Legs" (?Depixol contributing -
who knows? - legs worked well before) - Social Services arrange half an
hour of Home Care in the evening!!

Neighbour alerts us - whien I visit huasband is desperately trying to do
some gentle physio of his own design to get her back on her feet ( I
nearly cried!).

He has picked both of them up off the floor twice following his attempts
to help her get to the loo.

Mentally she is unchanged.

After long chat she agress to hospital admission - to me same
psychgeriatric team and unit makes sense -she knows them  they know her
etc

I phone psychogeriatrician who I am first told is there and then is
not.

I am told by his secretary that if the patient is not mobile then she
cannot have a bed on the psychogeriatric ward!!  Even thoough discharge
home is realistic and we are prepared for high level of input to acheive
this.


I GUESS THE WARD IS LESS ABLE TO COPE/CARE FOR THIS ELDERLY LADY THAN
HER 90 YEAR OLD HUSBAND AT HOME WITH NO EQUIPMENT WITH HIS WIFE POSSIBLY
SUFFERING SIDE EFFECTS FROM THE DRUG THAT THE SAME HOSPITAL DOCTORS GAVE
HER.

Result - admission to acute medical ward.

Do we all suffer this sh1t?  Not to mention our patients suffering.

All comments gratefully received - do all psychogeriatric units have
this policy of not taking anyone that cant walk?

What if the younger psychiatric units had same policy?

What if....

Jelly Bean


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