911 to Hospital to Inpatient psych eval

jacdev4l

I had to call 911 due to my 70 year old husband's aggressive and threatening behavior. It’s been steadily increasing over the last several months. Original diagnosis of mild cognitive impairment was 8 1/2 years ago. An infection and 24 day hospital stay 4 years ago started the downhill slide.

He’s been declining physically as well. Not eating much and drinking only a little water the last couple of weeks.

Bruce has been in the hospital for just over 24 hours and has been accepted to an inpatient mental health facility on a 1013 for evaluation.

I’m scared. I don’t know what to expect, information from hospital staff is spotty at best. I’ve asked for contact info at the facility they are taking him to for someone who can tell me what happens next. I know hospital staff mostly do the best they can but I won’t be able to check in on my DH but once a day due to the type of facility it is.

I'm not sure what my rights are and I’m concerned about how he will be treated.

Jo C.

This is certainly a very stressful time and I am sorry for all that is happening and can well understand your concerns. You are doing the best you can for him under the circumstances. No guilt; maybe feeling a bit of regret, but there is no reason for feeling guilt. You are doing something for him, not to him.

It seems from what you have written, that Bruce is being transferred to a facility that has a Geriatric Psych Unit; or GeroPsych in short. My Loved One (LO) was admitted to GeroPsych and I too had no experience and was very concerned.

What you will want to do is have the name, address and phone number of the facility as well as the contact number for the phone on his unit. You will also want the name of the Psychiatrist who will be his primary MD while on the unit as well as getting the phone number and address of his/her office.

Once your Loved One has arrived and been admitted, it would be a good idea to contact two people asap. First; it is a good idea to make friends with the unit's Psychiatric Social Worker asap; they follow the patients and it is the person who will assist in making discharge plans and usually will know what is happening with the patients as they attend most all meetings re patients; do speak to this person early. They can be very supportive. You can also contact the Nursing Supervisor for the Unit and ask her/him about your husband, how he is doing, what room he is in, and of course getting his Psychiatrists name and contact information. You can also express your concerns re his food and fluid intake and any other dynamics that would need to be followed and become part of his plan of care.

Do let the supervising nurse know how deeply concerned you are feeling and let her/him know that you wish to be in contact with someone regarding his care and progress and who should that person be? In our case, it was the Psychiatric Social Worker.

If you are not contacted by the Psychiatrist, you can request for him/her to contact you after making rounds on your husband; this will probably be best done on the following day after admission when the Psychiatrist will know more. The Supervising RN can leave a message for the doctor to contact you.

As for visiting hours; yes, that is difficult having only one time during a day to visit by only one person, but it is understandable. The patient is having ongoing assessment on the 24 hour continuum watching behaviors, responses to daily dynamics as well as responsiveness to meds and if any side effects, etc.

Also; they do not want disruption of the therapeutic milieu for any and all of the patients, and also, they do not want existing "triggers" to complicate the therapeutics.

You will be kept informed, but do make your presence known to those mentioned. If the visits go well; that will be good; but if Bruce begins to act out and become triggered and upset by visits, you may want to talk to the RN or the Psychiatrist to see if it is best not to visit for a few days or so.

After the first 72 hours, the staff usually meets together to discuss need for extending the length of stay and that usually will happen at a specific time. Sometimes they will inform the primary family member of the meeting and permit attendance. I would go as there is a lot of information at such meetings. These meetings take place at intervals if the person continues on as a patient as legalities for holding a patient on an involuntary basis must be managed according to strict laws.

Keep close watch on what the discharge planning may entail. If he is to go home, that is one option but be sure he is stable for your ability to handle matters. If he is still not stable and you are not able to manage, you cannot be forced to take him home. If he is not to return home right away or even have permanent placement, you will want to be on top of that so you are not caught short and have to make plans under time constraints and more stress.

You are going to do well; and with great hope, this may be the care that will lead to good outcome.

Please let us know how everything is going and how you are doing; we will be thinking of you

J.

jfkoc

Please contact and visit with the Dr who diagnosed the MCI as well as the current PCP.

You want to know that a diagnosis is being made following current proper protocol and that you husband is not just being given drugs.

jacdev4l

Jo C. So very helpful and informative. I only thought of half the things you listed. Now I am more prepared when the nurse calls this evening after he is settled. I only know she will because I called the facility right after transport picked him up.

Thank you also for your encouraging words, they are much needed right now.

Joydean

Jacdev41 I personally have no experience but Jo C was very informative. I just wanted to send you a hug and say I’m praying for you and your dh!

M1

Jacdev i also had to go this route with my partner in march 2021 because of threatening behavior, at the time there was no visitation because of covid which made things even more difficult. She went from the hospital to memory care and has been there ever since. One of the most important people for you to be in contact with at the hospital is the social worker. He/she will help you make discharge plans, and probably the most important thing to be thinking about is whether you will be able to care for him at home, or not. No shame if you can't, i couldn't either, and there are many ous here who have traveled this roaf. Keep us posted. I am very sorry, i know how hard this is.

Jo C.

Hello jacdev, I have been thinking of you and hope things are beginning to settle with information coming your way.

J.

LilySue

If there was one thing I would have done differently in my 11-year journey with my DH who had Vascular Dementia and Lewy Bodies Dementia, it would have been to refuse the ER doctor's suggestion to place him in a psych unit for his agitation. Little did I know that those 11 days would change him forever. Looking back, he never should have been there (he had a UTI for goodness sake), but I was a beginner in our joutney, and I didn’t know. I listened to the ER docs, and did what they said. I finally had to insist that he be discharged against the doctor's advice, and it took two days for all the drugs they gave him to wear off. He never fed himself again after that. We live and learn, but if I had a do-over, it would have been very different.