My husband's mother is in the hospital, on the psych ward. She was in assisted living, was Baker Acted due to hearing voices and being paranoid and delusional. The hospital has just given her meds, none of which have helped and someone called and left a message with my husband that she's being discharged back to her ALF TODAY. No warning, no nothing. As of last night, she was lying in bed, drooling, could barely talk and could not stop crying. She was convinced she was going to be sent to an awful place, but there was a good place she could go to but she overslept and missed her chance. This is who they want to send back to Assisted Living where basically the workers give her medicine and not much else. Last Thursday, she was convinced an actress was going to interview her son (who lives over 1000 miles away) for TV. The same actress drove her (mother-in-law) granddaughter to visit. The granddaughter hasn't been anywhere near here, neither has her other son, or, as far as I know, the famous actress hasn't seen her, either. So, I've got a call in to an attorney and am waiting to hear back. Can the Council on Aging help in a case like this? The news media? My husband is going to take a camera with him if she is discharged and do whatever he can to let people know that this is who they think needs to be released. She might be hearing fewer voices or she might have just stopped talking about it because she was angry that we didn't believe her. Other than the fact that she MIGHT not be hearing as many voices, she's worse than when she went in. Please, if anyone has advice, please let me know.
Depriving someone of their rights by committing them to a medical facility is taken very, very seriously here. Very specific criteria must be met for it to be used. A pysch facility can keep the patient for up to 72 hours. One of the criteria for holding the person is that they are likely to hurt themselves or other in the immediate future.
We don't know what happened for the AL to Baker Act your MIL. Being paranoid and delusional is not the same as being in imminent danger of harming others or oneself. Did the voices tell her to kill herself? Did she threaten to get back at certain people she was paranoid about? We don't know. Do you or your husband? Was this explained in the first call?
Trying medications is pretty much what psych wards do. This is a relatively safe environment for the necessary experimentation, under constant medical supervision. How do you know that none of them helped? Was she discharged with any additions or changes to her medications?
Not being able to stop crying is very distressing, but it is not grounds for holding someone against their will. Having delusions about interacting with an actress is also not grounds for holding someone.
It sounds like the psych ward tried things during the 72 hours they could hold her but had no authority to keep her longer. What kind of psychiatric help has your poor MIL had before this incident? Has she been diagnosed with dementia? Has she been seen by a geriatric psychiatrist?
She's been given a tentative diagnosis of schizoaffective disorder. That is something to start with as you seek further treatment for her.
Memory care units, as the name implies, are designed to care for people with memory problems -- mostly dementia. Schizoaffective disorder is not a memory disorder. Whether the memory care unit associated with her AL can deal with it needs to be determined. She may need more specialized care.
I guess what I would do is have her seen by a geriatric psychiatrist as soon as possible. I'd put any legal action on the back burner, simply because of the time and attention it will take to get MIL's residence decisions made.
Med mal attorneys would first order the medical records of both hospital and AL, then have them reviewed by a doctor or nurse practitioner in the related fields, and rely on those professional opinions as to whether or not abuse existed and there's a potential case.
This is not a criticism, but a lot of people feel that they can just file a malpractice suit if they believe that abuse or malpractice occurred.
It's not that easy. Attorneys aren't going to spend time and advance funds for document procurement if there isn't a violation of care standard and damages and a likelihood of recovery, let alone success at a trial.
It's been some time since I did an med mal work, but if I remember correctly, one of the legislative motivations for tightening malpractice suit restrictions was the proliferation of suits alleging abuse, and the astronomical costs to the medical profession to defend unfounded allegations.
I do think the AL isn't very reliable or responsible in handling the situation, but I'm not sure it rises to the level of malpractice. That doesn't justify it though, however, be aware as you've written that your husband essentially "told them to handle it because he couldn't do anything long distance. " The AL facility will use that to assert that your husband literally "washed his hands" of the immediate situation and that they acted in what THEY thought was your MIL's best interest.
Be prepared for some "blowback" if they're put on the spot. They may NOT take her back.
Please discuss this with a med mal attorney, not an elder law attorney, before you make any conclusions on how to proceed.
I think that would be a good appropriate step, not only for the assessment but to determine if any medication might help.
It also doesn't sound as if the hospital or AL is able to care for her, or perhaps neither are interested in determining further what the situation is before taking action.
From your description, it sounds as if your MIL is undergoing some terrifying experiences. Has anyone considered memory care?
BTW, who initiated the Baker Act proceeding? Was it the AL staff? Also, BTW, what do you see as elder abuse? From your description, it seems as though better solutions could have been identified and addressed, but I'm not sure that Baker Acting someone or releasing that person while still confused is necessarily elder abuse.
It might be a form of "passing the buck" though, but psychiatric units of hospitals, or institutions and other facilities have guidelines on who and what kinds of medical issues can be handled and treated at the specific facility.
Your post "tugged at my heartstrings." I feel so badly for this woman, and hope that a good and safe solution for placement can be identified.
Others here have more experience with memory care and probably will offer more succinct suggestions as to whether or not that's an option even temporarily while you determine what is the best solution under the circumstances.
Best of success in finding a placement for your MIL.
Perhaps her delusions are reflecting a deep fear for herself, in this stage of her life. And I suspect also that there's a lot of anxiety due to this fear. Perhaps any meds recommended by a geri psych could address this fear, anxiety and paranoia (as you mentioned).
It wouldn't surprise me if she's terrified of what's going to happen to her as she deteriorates mentally and physically, but isn't able to direct her fears other than in the methods she's displayed.
I really do feel sorry for someone who's this terrified of being injured and is lashing out in anticipation, if that's what's happening.
Thanks Evermore for your answer.
The ALF is who had her Baker Acted. Hubby was out of town for a (different) family emergency and he basically told them to handle it because he couldn't do anything long distance.
When I talked to my husband last, he said he'd call the ALF and see what they say. He hasn't called me back.
One of the doctors told my husband his mother has schizophrenia, she hasn't been having this episode for 6 months or longer so it's more likely schizo-affective disorder. Regardless, she needs to be somewhere that she can have more supervision.
My concern is a hospital discharging a patient who was absolutely not cognizant enough to sign her own discharge papers and my husband with POA wasn't even consulted, just informed, via a voicemail that she was being discharged back to the ALF.
I sure hope that you can get this sorted quickly, as it is so incredibly stressful for all involved! Good Luck, and please let us know how this turns out for you, as we all learn from others experiences!
See All Answers