for someone hearing voices?

mandana · May 17, 2006

We just went through this with a family member and it was so difficult.

My family member desperately needed medical attention and was 100% resistant. We tried sweet talk, coaxing, begging, crying, you name it - ultimately, we had to put him in the car kicking and screaming and literally carry him into the MD's office. It took four of us and it was miserable. You should have seen the faces of the other people in the waiting room.

But it wasn't totally fruitful - of course, he wouldn't take his meds willingly and it started a very bad family dynamic that never totally resolved (in his lifetime). Of course, he WAS a danger to himself and quite possibly to others, so there really wasn't a good option.

Amanda

Amy2005 · May 17, 2006

thanks

in this case, there is only one family member around,

and the older person is stating "you have to stop calling me insane ... I heard you, and I know that you are planning to try to put me into a nursing home ... I know that you are planning to drive me to another city to put

me into a nursing home, and I'm not psychotic" - no one has called this person insane, no one has plans to try to put this person into a nursing

home

all of these ideas are coming from this person

but the person won't go to the doctor

what else can be done?

sanctuary, BSN, MSN, RN · May 17, 2006

Don't know about Canada, but in some States down here, a friend, neighbor, family can petition the court for an on site assessment. They have to describe what the person is doing that makes them think help is needed. A social worker or nurse goes to the home and attempts to talk to the person. If they refuse, a court order is made, and the county sheriffs can pick them up and take them to a local mental health agency. There usually needs to be some level of dangerousness to self or others, or inability to care for self.

Otherwise, gently respond that you did not say that, and are not planning to take them anywhere. It might be more a type of self talk due to fear, than hallucinations.

Amy2005 · May 17, 2006

actually it's been going on for about a month when he/she spoke of hearing voices speaking and singing with various concerns that were not reality.

But now, the voices/thoughts are about being called insane, and about power being arranged to put the person into a nursing home.

And the person insists that these are not imagination, and that a specific person is saying these things (but the other person is not saying these things).

Self-care seems to be okay, except for not going to the doctor about the voices.

Dangerousness? The person must be worried about this imaginary plan to be put into a home in another location against his/her will.

A visit from a home care person is a good idea for an assessment - does a person have to agree to this, or can the professional be invited into the home by the other family member for this purpose?

RENAISSANCE RN · May 17, 2006

hi, sorry for your situation. Since this is a new mental health change. Maybe you should see if you could get his/hers electrolytes drawn. Sometimes M.D. are too quick to put a patient on antipsychotic with out looking at the medical terms.

Could this person be extremely anxious and this thoughts are related to the anxiety? Any of his/hers friends been put in a nursing home lately?

Sometimes the thought alone can make someone paranoid?

Good luck. I hope I never have to deal with that. Both for me or my relatives.

mandana · May 17, 2006

Don't know about Canada, but in some States down here, a friend, neighbor, family can petition the court for an on site assessment. They have to describe what the person is doing that makes them think help is needed. A social worker or nurse goes to the home and attempts to talk to the person. If they refuse, a court order is made, and the county sheriffs can pick them up and take them to a local mental health agency. There usually needs to be some level of dangerousness to self or others, or inability to care for self.
Otherwise, gently respond that you did not say that, and are not planning to take them anywhere. It might be more a type of self talk due to fear, than hallucinations.

Unfortunately, there is actually very little that they can do. They do make the assessment and they make recommendations, but unless the person physically assaults the investigator (which in our case was a social worker) the social worker really can't do anything.

If you do get a court order and you do get a sherriff to take them to a local mental health agency, the best you can hope for is a three day hold for evaluation. Then, they are either released to home or a referral is made to a LT/SF facility. Of course, a three day hold only serves to increase the anxiety/paranoia because the altered mental status becomes a self-fulfilling prophecy. Then, this person either comes home livid and more aggressive than before.

It's virtually impossible to have someone put in a LT care facility against their wishes, especially when they are together enough to realize what's going on and to respond mostly appropriately to questions about it. At least, that's how it played out in my state. There are large protections in place to prevent elder abuse/theft from elders, which I understand and applaud. But when you are trying to get help for a relative that isn't capable of helping himself, those protections are a real hindrance.

It's a terrible situation for sure. There is so little that can be done until whatever disease process is causing this behavior either resolves or worsens to the point that the person can no longer protest so much!

I had no idea how difficult it would be to do the right thing until we tried to get it done. I wouldn't wish dealing with this on anyone.

Amanda

sanctuary, BSN, MSN, RN · May 17, 2006

"A visit from a home care person is a good idea for an assessment - does a person have to agree to this, or can the professional be invited into the home by the other family member for this purpose?

Most people in the US are protected from over-zealous kin by the courts. That prevents Granny from being "put away" to get her millions. So it takes a court order to allow a mental health professional to visit and eval without consent. Of course, with consent, she might be evaled by a local clinic. Not sure how mental health laws are in Canada. If you find out, please let me know.

Amy2005 · May 17, 2006

several years back, this person did start to assault the family member, and

the police were called for some assistance

this person does have some memory problems

the family member has warned the person that if there is any further threatening or violent behaviour, then the police will be called again (problem is, that he/she denies the behaviour)

so, will see how things go

sanctuary, BSN, MSN, RN · May 18, 2006

several years back, this person did start to assault the family member, and
the police were called for some assistance
this person does have some memory problems
the family member has warned the person that if there is any further threatening or violent behaviour, then the police will be called again (problem is, that he/she denies the behaviour)
so, will see how things go

Best of luck. This is always a tough situation.

Canadian Princess · May 18, 2006

Hi,

In Canada it works much the same...one could phone a Mobile Crises Unit to the home for a Crises Assessment or the police if Self harm or danger to self/others is a possibility. A Certificate or form may be issued under the Mental Health Act to be seen by a Physician or Psychologist. An individual can apply for a physician to see the person under a form 1.

Google the mental health act for the province you reside in.

Bobo