Sunday, September 09, 2007

132 involuntary committal

My mom went to a support group meeting on Thursday and talked a lot about my dad's violence. They were all appalled. They told her next time he does it, to call 911 and have the police come and have it documented. Then the police will take him to the hospital for evaluation and from there place him into an Alzheimer's care facility.
Sounds good on paper, right?
Saturday morning (yesterday) he flipped out while my mom was trying to get him to shower. He scratched her face and bruised up her arms. She called 911 and me. I was on my way to one of my favorite restaurants, about 20 miles away, for an early lunch while my husband's car had new tires put on. I told her not to let them take my father until I got there. We got off the highway and got back on going South and came back to town. When we got there, 3 or 4 cops and a couple of paramedics were taking my dad out. He didn't see me. I followed them to the ambulance but they wouldn't let me talk to him.
I had had a headache since the night before (not enough food on Friday). I was adamant about not going to the hospital without eating. My friend's husband is an EMT and they heard the call over the scanner and called me to see if everything was okay and did I need help or anything. I couldn't think of anything they could do so I said no. Her sister in law works in the emergency room where they were taking my dad so she said she'd call her and make sure my dad got good care. Will, my mom and I stopped for hot dogs. My friend called back to say her SIL wasn't working that day, but that my dad had just arrived at the ER. She said the procedure was that he'd be evaluated and sent to the hospital's Alzheimer's ward. From there, maybe a nursing home with an AD unit, or something similar. Okay, sounds doable.
The reality was far different.
My dad was in one of the little curtained off cubicles in the ER. A horrid woman who we thought was a social worker but who was the head nurse came out and asked some questions. She seemed very snotty and not at all sympathetic or supportive of the choices we had made with my dad's care so far. She questioned why we never got a nurse or aide to come in and help and seemed very supercilious. She didn't seem to understand the disease at all. She complained that my father wouldn't answer questions. "He can't," we said over and over, exasperated. "He's got Alzheimer's." "He doesn't remember what happened," the nurse said. Again, we said, "He's got Alzheimer's."
As soon as she left, my mother said, "if it's up to her, she'll send him right home and nothing will change."
Then a very nice doctor, Dr Curran, came in. He had a slight Irish or Scottish accent, a very kind-looking man. He asked real questions, he listened to the answers, and said that he was relieved. After reading the police and ambulance notes, he worried that he would have to convince us to place my dad in an Alzheimer's facility. He said most of the cases coming in fall into two categories: trying to dump an AD patient they don't want to deal with (but who doesn't really need to be placed) or one that needs to be placed but the family refuses. Very rarely does he get a family who has genuinely tried and understands that this is the end of the line. I really hope he is not the doctor my father tried to kill, but that's getting ahead of the story.
No sooner does the doctor leave when my dad gets moved into the hallway so an accident victim can have his cubicle. In the hallway we stayed, in everyone's way, for hours, ignored for the most part.
So much happened that I'm not sure of the order anymore. All this happened, but I have no idea of the sequence. I was out of it from head pain, grief and hunger.
A nurse or aide or tech of some kind came to take blood. She tried to explain to my dad and get him to cooperate. He wouldn't. She tried talking louder. (Did she think he was merely deaf? Do these hospital workers not understand AD?) He hit her and she walked away without even taking the tube off his arm.
At some point, there in the hallway, my father realized that he was being put into a home permanently and he was never going home. He started to cry. He has never cried, not once, not even when diagnosed. It was awful. I ran to the nursing station and told them my father was having a melt-down and were going to need help. He started screaming "I won't I won't I won't" and begging my mother, "I won't get to see you again?" until we were all in tears. He was yelling for us to kill him, that he'd kill himself. He tried to get out of the gurney and leave. Finally one guy came, a middle-eastern guy. He said his father has Alzheimer's. He managed to get my dad back into the gurney and put up the rails and a foot board to keep him in. Remember this is all in the hallway, with not even one of those curtained privacy panels.
I had to go the bathroom and when I came out, my dad and husband were gone. He had gone to get an x-ray because he told us his upper left arm and chest hurt and they were worried he had another heart attack. They only managed to get one of the two x-rays they needed because my dad would not cooperate. Will tried to help but he fought my husband too and called him a "beasterd" which I guess is a beastly bastard. That part was pretty funny.
The same middle-eastern guy came back and got blood from my dad with no problem. I told him not to explain, just do it, and that seemed to work.
When my dad was lucid, he was looking at the bruises on my mom's arms and the scratches on her face. "I didn't do that," he said over and over mournfully, touching them. "I didn't do that." "A bad man did that," Will said. "Not you." And he wasn't lying. The man touching my mom's bruises is not the same man who created them, even if he lives in the same body. "Get that bastard," my father said to Will. "Kill him." "I will," he promised. "I'll get him." My father keeps looking at the bruises, muttering "bastard. kill them."
By the time it was 3 p.m. we were all hungry again (eaten hotdogs at 11:30, dad hadn't eaten at all). I went in search of whoever I needed to ask if my dad could eat. That's when I discovered the mean woman we talked to first was his nurse. She had to find Dr Curran. Eventually she said he could eat. There is a Dunkin Donuts in the hospital (talk about health food) and my husband and I went there. I got my dad an egg, cheese and bacon sandwich (the closest they have to food) and a bottle of Pepsi. I got a random chocolate donut and some water.
My dad was in an okay mood at that point. He tried to give his sandwich away to all of us. We explained it was his. He pointed to my donut. "Those are good too," he hinted. I broke off a big piece and gave it to him. He ate the sandwich, the donut and half his soda. Pepsi changed their label and he spent a long time studying it, trying to read it, and showing us the features of the new logo.
At some point, the nasty nurse wandered by. "When is my dad getting a room?" I asked. "We have no rooms, he has to stay in the hallway for duration of his stay." "That's 48 hours, that's not acceptable!" I replied. "We have no beds," she said and left.
By now, we just wanted to take my dad home. If he killed my mom, so be it. She didn't care anymore. No one in the ER cared that we were there. No one was looking after us. My mom took my dad to the bathroom and I found the nice middle-eastern guy. He came back around 4 p.m. to say they were moving someone else out of a room in order to put my dad in.
By that time my head was killing me, and I don't use that term lightly. I was dizzy and could hardly see. My mom stayed to see my dad settled in and I stopped for a pizza, ate a couple of slices, took a shower, called a couple of friends to fill them in and basically passed out in bed by 5:30.
We'd picked up our second kitten on Friday (my dad came and was delighted to see and play with all the kittens) and the little one's constant crying to get on the bed, the bigger kitten chasing her, etc, kept waking me up. At around midnight I found a blue-gel eye mask and stuck it in the freezer. I'd been taking 2 advil liquid caps at a time with no effect. I started drinking nyquil, which usually works, but I couldn't stay asleep for long. Either the cats or the husband or the tv or the AC would wake me up. Around 4 a.m. I retrieved the frozen eye mask, wrapped it in paper towels and went to sleep with it on my head.
My mom called at 9:30 to wake me to go to the hospital. She was taking my father home, she announced. They were abusing him. Turns out her neighbor works in the ER and came over to tell her my dad fell and hit his head. My dad doesn't fall.
It took us a little while to find him. They had moved him from one crappy, tiny room (without even a tv) to another. He was heavily drugged and tied to the bed, thrashing and incoherent. Turns out he tried to strangle a doctor with the doctor's stethoscope, then proceeded to take out two security guards. This was after he had fallen. He fell because the aide assigned to watch him couldn't control him, was scared of him and when he got out of bed and wouldn't listen to her, she ran away rather than stay and help him. Not cool. Although how he fell is still not clear--because like I already said, my dad doesn't fall. He doesn't have balance problems.
The new aide had been there when he strangled the doctor. She seemed impressed. He just grabbed the guy's stethoscope and started pulling, she explained. She said she had never heard a doctor scream like that before, and when he was freed, the doctor ran away. He then attacked the two security guards but somehow they managed to get him into the bed and into restraints. (I think a big fat needle full of horse tranquilizers was involved.)
I stayed there with my mom for about 3 hours. He never gained any coherency. He was screaming, half awake, about "I have no fucking dollars" and the "buckles" on him (the straps). I tried to give him water but he wouldn't drink it. They did not give him any of his medicine Saturday night or Sunday morning. They wanted a "drug screen" from his pee. He wasn't peeing due to severe dehydration (all he had to eat or drink was the soda and sandwich I'd given him.) The aide said she had managed to get him to eat a little toast and a glass of OJ at breakfast and they'd given him 3 bags of saline to rehydrate him. We explained that one of his medicines is to keep him calm and he needed that one but they wouldn't let us give it too him even though we had all the pills with us. Finally the aide took off the condom catheter and gave him a johnny bottle and he peed right away. But they never said what they found in the drug screen. They also asked about all the wounds on his arms and legs, where he picks at himself. I think they think we hurt him. We did not talk to Dr Curran at all (he was there; I saw him from a distance). The nurse was nicer and eventually agreed to unbuckle one arm and one leg, but then he was trying to pull out his IV.
The psychologist was an idiot. He would come by, we'd try to wake my father up and he'd leave before we got him awake. He said he needed my father to speak. We said he was too drugged to speak. He asked my mom all sorts of questions as if my dad was a psychotic and not like has a brain illness. He would come by every 2 hours and stay for less than 2 minutes. No patience.
I stayed until around 2 p.m. It was evident my dad wasn't going to wake up and we weren't taking him home. The aide, who was very sweet, said that we would get 90 or 100 days of free care from Medicare based on this weekend's events and he'd probably get sent to the Alzheimer's unit at Masonic, which is very near my house. That would be okay if that is the truth. If he did get sent home, she said we'd be able to get Medicare and/or the AARP insurance to pay for a home health aide after this.
Well that is all I know for now; when more happens I will update. Probably tomorrow.


Anonymous said...


I'm sorry you and your family are going through this - what a nightmare! I hope that all this leads to better care for your dad.

Take care of yourself...


Anonymous said...

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Alzheimer’s Association, the world leader in Alzheimer research and support, is the first and largest voluntary health organization dedicated to finding prevention methods, treatments and an eventual cure for Alzheimer’s. For 25 years, the donor-supported, not-for-profit Alzheimer’s Association has provided reliable information and care consultation; created supportive services; increased funding for dementia research; and influenced public policy changes.

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Makeda Saggau-Sackey