Category: Diary Blog

Anti-psychotic drugs – Proceed with Caution!

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It is long overdue that someone challenges the potential misuse of anti psychotic drugs with people with dementia. We have 340,000 people in Australia diagnosed with dementia in Australia and I have seen first-hand the turmoil they can cause if unchecked.

My Dad was prescribed an anti-psychotic that turned him from a generally happy, mellow person with memory loss and some occasional tears, into a raging bull with paranoia and hallucinations. This then resulted in 6 weeks in a locked ward in the RAH involving security teams on multiple occasions. We were told most people benefit from the drug, but 1 in 20 people have adverse reactions. I suspect this figure is much higher and many cases would go unreported. After insisting the drug be ceased, the behaviours and side effects reduced dramatically.

My concern is that there are several ‘go-to’ drugs on the market that are regularly prescribed without adequate follow up to determine the impact they have on the individual. Family members of people with dementia place complete trust in doctors to offer the best advice, or their ‘best guess’ to combat the behaviours and side effects associated with the disease. Dementia is an extremely complex and difficult progressive disease that has over 100 different types with varying symptoms, and we are in fact asking for a guess, as each case is different … This is dementia.

This blog is not intended to disrespect our doctors in anyway but moreso highlight the shortfalls in the current methods. The medical ‘follow up’ on patients is often reliant on a family member to try and express what they have seen (or heard from care staff) to the doctor in a 15 minute appointment and expect the doctor to make a call on potentially misguided or flawed information. If the patient resides in an aged care home the family will know very little. The family may not be educated in dementia and not know what to look for. Is every carer fully trained in dementia? If a carer unknowingly exaggerates or misinterprets a behavioural incident, the pending decisions may be the wrong ones.

If a resident grabs a carer’s arm is that agitation, aggression, violence or assault? I have personally seen all four words used for similar incidents. My concern is the consequences can potentially be disastrous for the person with dementia. If the relatives have minimal or no involvement with the resident they are at the mercy of the system, and may unnecessarily end up in a mental health facility.

I believe a pre-determined regular follow up after an anti psychotic medication is prescribed is the key. This could potentially reduce the behavioural incidents, which in turn relieves the pressure on the services and the health system overall. I believe the doctors need to directly contact the care staff, as they witness the changes in behaviours and reactions on a daily basis. The registered nurses administer the medications, but it is the front line staff that will be critical in the follow up reporting in conjunction with the nursing staff.

Every case is different and to change our healthcare methods that are well entrenched is not easy. It surely must be worthy of consideration in 2015 and beyond?

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When a Crying Crowd is a Compliment

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Just wanted to share a recent public speaking experience that took me by surprise.

I delivered my first speech for Alzheimer’s Australia yesterday and was blown away by the reaction. Being on stage with one of the leading international dementia speakers in the world on her Australian tour was simply awesome. Gill Ayling (also known as the ‘Grand Poobah’ of Dementia) was simply a nice person who is ‘pint sized’ but making global change in the dementia world.

Prior to the event starting I was sitting on stage chatting to another speaker called Ian who gave me some speaking advice. He said ” When you get up to speak, you are in charge”. He is a former Police Sergeant who now has dementia and has been presenting for years for Alzheimers Australia. I found his advice very ‘copper like’, and too forceful for my speaking style, but I took it on board regardless.

I was extremely nervous beforehand (after some recent shaky and forgettable public talks), and simply could not settle beforehand. I guzzled a litre bottle of water prior to the gig, and I was pacing as per usual, but in my head this was my ‘Grand Final’ and I had to deliver.

But in some ways this speech was different….

I stopped worrying about remembering the words and just spoke from the heart and let the passion take over.

The video cameras and microphones felt like they were everywhere, but there were only three. Even after 30 years of being on stage in bands, some things are still intimidating, but eventually they seemed to disappear into the background.

I wanted to take the audience on our journey with dementia and have them feel like they were in the room with me when I relived challenging times.

The audience laughed, cried, and even became angry….but in a good way. The energy in the room was silent, but intense..also in a good way.

The mood kept shifting as I changed topics, yet I felt they were on my side.

It didn’t matter that it wasn’t the most polished speech, but the raw emotion and passion cut through and the words came. (phew) This speech was therapeutic for me and was a release of 3 years of life changing material, uncorked!.

It was a strange feeling when I got angry on stage and explained some of the rough treatment Dad received on his journey. The crowd concurred and applauded mid speech. ( I was gobsmacked)

I could see shiny eyes on me which is a strange feeling when you have no idea who is judging you. Is weird to bare your soul in front of strangers but it certainly stirs the adrenaline.

When I sat down ‘completely cooked’ , Ian leaned over to me and said ” You just owned the room my friend”

….Mind blown! ( and humbled)

After the panel speech I met a few emotional ladies. As I shook their hands to meet them and hear their stories, I handed them a tissue from a conveniently placed tissue-box on stage. ( this must happen often at these events!:-))

It was awesome to receive positive emails, facebook posts and phonecalls ( plus a free lunch:-)) after the event.

A tough rollercoaster experience but a solid platform to build on.

My mission has only just started…

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First Speech to 35 Home Carers

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Had my first dementia speech ( as a carer) this afternoon with this fantastic group of carers. They were a great audience who gave me some real perspective on how difficult their roles can be. Carers that help out families at home are at a great disadvantage as they do have the support of a registered nurse on hand, they have very little idea on what medications are being taken (if taken at all). There is also the family dynamic that comes into play where the son or daughter or spouse may want certain instructions carried out, and the person with dementia may have different ideas.

It was awesome to tell “My Story” to a really engaged group. Hopefully the word spreads about ‘Dementia Downunder’ and people can interact and learn from each other.

A very touching speech was delivered by Don ( the Director of FHSS) about his times spent with Dad ( Bob). It was fabulous to hear the positive effect Dad has on all around him and I was humbled by Don’s kind words.

A great experience , and I hope to present to them again one day with more tips on dementia. Next time I look forward to hearing their stories and working on some positive solutions.

 

The Care Plan – The Carer’s Bible

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I have decided to make a difference to the way carers look after people with dementia by suggesting to make some additions to the care plan. (This is the background information on the person with dementia eg likes, dislikes, hobbies, medical conditions etc….). In my opinion it is the most important document every carer should read and remember.

I have realised that in a single week Dad may be exposed to up to 30 different carers or nurses of different cultural backgrounds, skills, knowledge and expertise. What are the chances of one of them not knowing how to handle dementia or accidentally trigger some undesirable behaviour from a resident? I would say EXTREMELY HIGH.

Agency staff are often used to fill gaps in the roster and these people have to walk into an aged care facility, with no knowledge of the facility or the residents and just start caring.

As aggressive behaviour is the most concerning of behaviours in a nursing home, I believe it can be short-circuited in a simple manner. Simply add two new sections to the care plan.

1. Flashpoints

This is simply a list of events during a day that may cause a resident to become agitated. Eg using a cold flannel in shower, getting arm stuck when putting on a dressing gown, or giving medication on a spoon etc. if the carer knows when to be alert the caring experience can be a lot smoother.

2. Signs of Agitation

This is a list of triggers or signs/clues that indicate a resident is becoming agitated. Eg pulling on bed sheets, bad language, eye rolling, rigid hands etc….these clues will allow a carer to predict when things are escalating.

10 Days at the Repat Hospital

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Day 2 was certainly different for us as Mum and I entered the ward with mixed emotions. I kept thinking to myself “Will Dad be agitated or will he be happy?”. When we spotted Dad in the ward he was rapt to see us both. He gave us a huge hug and almost cried. We grabbed the footy and had a few kicks down the corridor like old times. Dad then wanted to sit on the communal couch in front of the tv, where he grabbed the Sunday Mail and started to read it. This was strange because no newspaper has engaged him in the last 12 months.

His speech was more coherent and he was doing plenty of laughing.It was lunchtime so we were ushered into the family room where we watched Dad eat lunch. He had a great meal of roast pork with all the trimmings, and I ate some off his plate as well. I was discreetly video recording Dad whenever he talked so I could capture his mood and behaviour changes. Mobiles are not normally allowed on the ward, but I was I was advised it was ok in the family room as long as I only filmed Dad.

Other patients kept walking in and had to be redirected. As we were in a high dependency ward, we were amongst some psychotic people. One guy told me how he wanted to ‘ slit his wife’s throat’, which was confronting so early in the piece. We enjoyed the lunch and the carer explained how Dad behaved overnight.

The carer then described the fine details of his Detaining Order under the Mental Health Act. This basically meant the State now has full control over Dad and where he ends up, and Dad is not able to be removed from the facility for 7 days when the order will be reviewed. I thought this was pretty over the top and long winded and actually scared Mum. I kept saying to the carer that “we want Dad to be here” ( voluntarily) as we felt he needed a Geriatrician and Psychiatrist’s help, as opposed to standard doctors. I can understand the majority of family members would not want to have their loved one detained, but we are so close to the action that we know this is the safest and best path for Dad.

It is obvious they are very drilled in the ward with a focus on watching patients closely. They follow their every move and are ready for any bad behaviours. It was clear they want to do all the nursing as we are limited to 90 minute visiting times during set hours. They are clearly more skilled carers than any other staff we have seen to date, and are very intense with how they monitor each patient. The ward has a feeling of a jail as the eyes are constantly on everyone’s moves and you need staff to buzz you in and out. The Oxazepam (calming medication)was spread out further to almost tempt Dad to be agitated. This would influence his new medication routines and med timings. We were told he became agitated on the first evening and they gave him a PRN (extra meds).

The following day I had a day off from visiting and enjoyed the lack of responsibility. My sister went in my place and was asked by a carer to help with the showering. Dad was was so confused, they ended up showering him with his tracksuit pants on. They filled up with water, became heavy and this forced Dad to remove them. After the shower and shave, Dad and my sister kicked the footy in the ward, but were getting strange looks from staff. She went and asked if there was a problem and they advised of an incident involving Dad after we left the day before.

Dad was kicking the footy with me on the previous day, and I left the footy on his lap for some comfort when we said goodbye. Not long after we had gone Dad was given a hot cup of tea by a carer. He became confused, thought he was holding his footy and kicked the cuppa like a football. There was a huge drama as the cup broke, mess was everywhere and the place was on edge as it was cleaned up. This really rocked the staff and was the first time Dad ever did anything like this.

The following day I visited Dad at 10.30am and found him in good spirits. I received a huge welcoming hug and my presence gave Dad a big relief. We were ushered into the family visiting room so we could talk alone without other patients intruding. Dad and I ran out of conversation after two minutes and Dad stared at me, smiled, and said ” So….now what?” Then burst into laughter. I decided to put some music on via the chained up cd player. The Elvis cd instantly had Dad dancing around the small room on his own. Every 5-10 minutes a staff member would open the door or peer threw a window to check on us. I was getting the feeling many of the patients in this ward are capable of anything.

I discreetly filmed Dad via my phone as I continue to document his progress and behaviours. I am hoping to catch strings of sentences that make sense and possibly any moods that indicate agitation. Dad is oblivious to being filmed and I was more worried about being caught by the very serious staff as I dont think many people video things. We then setup a game of coits where Dad stood directly over the top of the board and dropped his rings all on the same hook. I asked him to step back to make it harder, but this completely confused him.

I then heard a thump as a male patient hit his forehead onto the glass window and pushed his nose up on the glass and just stared at our every move. I ignored him and handed Dad a pile of CD’s to look through. He was enjoying reading the covers when he grabbed a pile of actual cd’s out of their covers and started throwing them at the board. I stopped him instantly and this indicated to me the level of confusion as he thought he was throwing rings at the coit board. After about 30 minutes we decided to re-enter ‘general population’ where a staff member instantly gravitated to us and began to follow us. Dad started to dance around with me ( which was a first) and then introduced me to others as ” John” which was also the first time ever he has got my name wrong….hmmm.

I mentioned to the carer about the CD incident as a way of explaining how Dad made the mistake with the cup of tea the previous day. I can imagine how the report on Dad would have possibly looked:

INCIDENT: Bob violently kicked crockery and smashed everywhere. Major confusion which upset others.

The way I think it should be reported:

INCIDENT: Bob very confused and mistook full coffee cup for a football. He kicked the cup and broke it causing a scene. Bob was not agitated( non aggressive), was simply confused.

I will never know what they wrote down but I thought it was a great example of how an incident can be subjective and reported in different ways which may result in a medication increase or influence a doctor’s overall assessment. This reporting is something I believe should be standardised to ensure consistency across nursing homes and hospitals.

As Dad was wearing half day clothes, and half pajamas, I asked the carer if I could change him into track pants. They said “ok” but involved an escort, unlocking his bedroom door and bathroom and the carer hovered over me as I struggled to get Dad to understand what I wanted him to do. The carer then said ” Lets leave this till later, as I need to get back to my post”. I am used to being allowed to dress Dad and dealing with his care with no restrictions. The carer finished by saying ” I am glad you struggled with the dressing like we did”. She only gave me two minutes to get him changed, and I explained that difficulty with simple tasks is normal and simply a part of dementia.

As a family we are tired and drained emotionally. We feel guilty when we have a day off from visiting. This ward has very little emotion shown by staff and everything is controlled, and very black & white. We do not have the bond we normally do with care staff as they appear to be intently focused on the patient’s behaviour and do not release much information to us. I believe Dad is behaving at a calmer level than many of the other patients in there and will be returned to his nursing home sooner rather than later.

This is dementia….

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Continue reading “10 Days at the Repat Hospital”

Day 1 – Repat Hospital (Mental Health Assessment)

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11542095_10153948534974918_8337940093156331977_nDad arrived at he Repat Hospital and we were blown away by the place. We walked in the door and were met by a carer and a nurse. We were shown to Dad’s private room, which has nothing in it besides a single bed , a cupboard and a bathroom.The room is huge with no television, nothing on the walls, and is pretty bland.

As this is a geriatric ward, safety is paramount and cords on dressing gowns have to be removed, plastic bags are not allowed, and the ensuite bathroom remains locked. Each carer is allocated two patients and there are only 8 beds in the ward. One interesting rule is that during the assessment period the carer must sight their allocated patient every 15 minutes.

Patients are requested to dress in normal clothing (not pajamas) and encouraged to keep out of their room during the day and to spend their time in a common room consisting of a communal tv, couches, a dining area and a secure outside garden. Visiting hours are 10am – 3pm and is preferable if we are not visiting at meal times to reduce distractions.

A blood test and blood pressure check was done instantly to get a starting point for the nursing staff to work with. We discussed some rules and regulations and were told that ” in this ward…we do the nursing for you, and you get to be the family”. This was a huge relief for myself and Mum after 12 solid months of daily caring for Dad.

I knew Dad was in very good hands by the knowledge of the staff and the way they looked after all of us The staff were really friendly and bonded with Dad instantly. The vibe of the ward was one of serenity and the silence was unbelievable in comparison to our time at the RAH (Royal Adelaide Hospital) . They have a security team on site, however they are rarely engaged as the ward staff are trained to handle difficult situations.

The dementia expertise was really evident as the psychiatrist sat in the room with me for almost an hour and discussed all the medications in detail and talked about behaviours and strategies. It was such a pleasure to discuss Dad’s situation with people that really understand dementia and know more than us. In the other hospital (RAH) the nurses are not specialized and are regularly rotated, hence we had to train them on the run in how to deal with dementia patients.

We then met the nurse looking after Dad on his first day, and she sat down with me for over an hour and discussed the fine details about Dad. It was so therapeutic for me to be able to offload and explain every single strategy and tactic we use to care for Dad on a daily basis. I went through all the ‘triggers’ that indicate to us an escalation in agitation and how to best manage them.

It was the fact the staff actually took the time to really listen (with no time pressure), and document every fact which gave us great comfort. I knew that I was not wasting my time, and that the information I provided would be passed on in a detailed handover to each staff member. This meant that they would now be caring for Dad like we would, with the aim of improving his medication management and behaviours to allow him to return to his nursing home.

Dad must have felt like a freshly released prisoner, and was enjoying having the freedom to walk around the ward and interact with patients and staff without restriction. In the RAH he was confined to his tiny space within the ward and was re-directed back to his bed every time he wandered. This went on everyday ( and night) for a month and was exhausting.

The Repat Hospital has a completely different atmosphere and was exactly what Dad needed at this time. We were so impressed with how smooth the transition was and how each team member interacted with us like a well oiled machine. It was almost like the staff adjusted all their plans to make our first day a pleasurable one for all concerned. It certainly was appreciated…..bring on day 2:-)

New Ideas for Aged Care

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I was just chatting with a 94yo lady in the nursing home, and realised she was holding her watch which had a broken band. I wanted to get it fixed for at a local watchmaker ( who could probably put a 2nd hand one on for her free ).

I then started thinking about the few possessions elderly people have and thought it would be great for businesses and individuals to help out in similar situations.

Other Areas To Be Looked at:

Teenage kids could program the televisions of residents so they automatically turn on in the mornings and turn off at night at set times.

People who are retiring from jobs or are out of work could act as ‘welcoming friends’ for a new resident entering a nursing home. They can sit with them and make the transition a smooth one. ( I was watching a 97 yo lady walking around alone and aimlessly on her 2nd day at the home)

Hmmm…. The possibilities are endless

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Day 1 – A Month in Royal Adelaide Hospital (RAH)

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Today was one of the worst in my life. I visited Dad at the nursing home at 8.30am like I usually do,but today was different. I usually get handed my day by the registered nurse or a carer. My usual routine is to hunt down the first person I can find and say ” Goodmorning…Where are we at?”. The Nurse knows what I am looking for…Did Dad take his morning dose of Oxazepam? This drug is the saviour of any family with a person with dementia. It is the drug that settles the resident and calms them. The doctor allows us to have a PRN which is an extra tablet of Oxazepam which can be administered when the resident is highly agitated and aggressive. I went into Dad’s room and he was twisting up a bed sheet and I knew instantly what I was in for.

I went back to the nurse and said ” Can I have a PRN ready , I think I am gonna need it today”. Dad was pacing and coming in and out of his room. Before I arrived I did not realise he had already hit another female resident who had been crying and was very upset. The normally happy carer that knows Dad well was trying to have her usual light hearted banter with Dad. He was acting strangely and in a highly ‘amped’ sorta way.

I have been watching Dad’s body language on a daily basis for a year now and I didn’t like what I saw, He kept putting his hands out to grab people’s arms and would try and shake your hand but then try and crush your hand whilst looking you in the eye as though nothing was happening.

The carer had a small round fridge ice pack in her hand and whilst Dad was charading as a happy resident I knew damn well he was in that ‘dark’ mood where he could hurt someone. Dad reached out to the carer and she was laughing off his clumsy moves and touched his arm with the ice pack for a bit of light-hearted fun. Dad went a bit quiet and then grabbed the carer’s arms in almost a bear hug. It is not unusual to allow a resident to hug or embrace a resident, but this time I didn’t like the way his body was moving. It was jerky and tense and I could almost feel the tension he was putting on her arms. Before he could put the ‘real squeeze’ on the carer I reacted in a lightning fast manner and peeled his hands off of her. I had to use considerable force to release his grip and when I did the situation simply escalated out of control.

Dad let go of the carer and then turned his anger on me. He swung a big elbow at me, which luckily missed me. I then lunged for his arms to stop the immediate danger, but as I grabbed his left arm he raised his right arm in a very threatening manner and raised it above his head as he tried to ‘ hammer fist’ me to smash my arm away. i saw it coming and released my grip so he missed me again. I then grabbed both his arms with force to stop the frenzy. My mind was swirling but I was running on adrenaline and was hyped up for anything. Dad was wrestling with me and then bent forward at the waist. His head went down towards my arm and my gut instinct was that Dad was trying to bite me, his head was facing away from me so I could only assume this was what he was doing. I knew instantly that we had a major problem and that Dad was simply out of control.

Somehow we got Dad back to his room, I called for the male carer to hang around as I felt I needed him. He was reluctant but almost had to because he was the only person strong enough to help me. Dad continued to pace around the room in a highly agitated state. We are very specific when describing Dad’s behaviour as this determines what is written in the progress notes and daily report. We are used to writing words like ‘agitated’ or ‘slightly aggressive’, but today’s word was ‘violent’. This puts Dad in a new category where decisions have to be made for everyone’s safety, and things may be  escalated if required. My single goal was to get some Oxazepam into Dad to settle him down. He had already refused his medication with the nurse before I arrived so I knew he was wound up already. I attempted to give Dad a tablet with water in my usual way and bribe him with a cup of tea afterwards. I knew I was going to fail today so the carers became creative. We decided to crush an Oxazepam and mix it into a half a cup of tea. We had never given  it to Dad this way, but it was worth a shot. I grabbed the cup and a few biscuits and headed for his room.

I held out a biscuit to Dad to disguise the real reason I was in the room, to dose Dad up with the loaded cup of tea. Dad was smart and often instinctively knew when we were giving him medication hidden in something. A few days before I had placed an Oxazepam tablet inside a banana which I thought was really clever. When he took a bite he noticed the texture change and instantly spat out the banana and tablet into the toilet. Watching that tablet floating in the toilet bowl  is heartbreaking. ( I did not want to waste the tablet as they are vital for bad behaviours).Today we used a cup of tea and as it was the first time we did it this way so Dad did not pick it. He normally slams down his brew and today was no exception. I breathed a sigh of relief as I knew he had swallowed it. I now had to distract him for 15 minutes while the drug took hold. I would talk about nothing, offer him biscuits, offer to play footy, but then I thought maybe a family photo album may calm him? I had Dad sit next to me on the bed and I would pick out random people and just create conversation to divert Dad’s thoughts. I went as slow as I could and Dad seemed to calm down and eventually lost the aggression and he moved towards the bathroom. I then decided that maybe a warm shower may have a further calming effect and as it was his normal morning routine he may comply and just go through the motions. Thank goodness Dad did just that. This routine saved me as there are many steps involved and Dad was completely distracted. Unfortunately the damage had been done, and the fact that he had hit a family member sent alarm bells with nursing home management.

The Head of Nursing Manager came over and watched through the crack in the bathroom door when I was showering Dad and she saw him at his worst. He grabbed a toothbrush and did his hair with it. I then had to clean his teeth for him (even open his mouth) and he simply did not know what to do. It was a new low point in his personal hygiene standards. The Head of Nursing Manager had been monitoring Dad closely and she knew that he was almost beyond their care. He had up to 8 aggressive incidents on report in the last two weeks and was escalating. Dad was now a danger to himself, family, care staff and other residents…action had to be taken. I even remember saying to carers in the heat of battle ” Dad has tried to hit and bite me…and I am family…..this is unacceptable”.

Once everything was calm again Dad returned to the ‘circle’ ( the resident’s lounge) where he conducted the music on tv and threw the footy to other residents. I was hiding behind a wall over Dad’s shoulder to ensure he did not flare up and hurt anyone. I observed him for probably half an hour and I was satisfied that the danger had passed and Dad had returned to his normal happy self. I then went to work but was in a zombie like state. I walked around Burnside Village trying to rationalize what had just happened. People would talk to me and I was vague, and I was unhappy with a staff member not watching the store properly but I was not in the right frame of mind to address the issue. I handballed this to the store team leader to fix. I also explained that we have family health issues and people will have to handle stuff.

Mum was at the nursing home with Dad and I was in regular contact  with the Nursing Manager on the phone who was advising me of our options. She rang several agencies to help us and advised the doctor of progress. I was doing no work so I decided to head back to The nursing home to be with Mum. My instinct was to get everyone in the same room so we can discuss the next move. I was tired of passing on the story multiple times, and we needed a meeting to make the calls. The Manager joined us in Dad’s room and we had the conversation in front of him as he was clearly not listening. We were. closely monitoring his every move so we were comfortable talking in code in front of him.

It was decided that the Adelaide Clinic was the best course of action, however the protocol is that the resident has to be assessed at the RAH first. Due to our trauma there over 12 months ago, we were reluctant but knew we had to put the wheels in motion. The nursing manager arranged medical reports, doctor’s letters, pill charts and  power of attorney info on our behalf. She was amazing and having her step through things was very comforting.

We tried to load Dad into the car but he was getting agitated, Mum was trying to remove baby seats as I tried to keep Dad off the road away from danger. He went towards my van and triedto get in, so I changed the plan and told mum to get in my van and I will drive to RAH. On arrival I was determined to make a scene at the entrance to get quicker attention for Dad. I dropped them off at the ambulance entrance and then parked the van. Security moved me on so I had to drive kilometres to get back to the hospital carpark. It felt like an eternity.

Mum and Dad were in the admissions triage of the RAH and everything was still fairly calm, but with the potential to flare. Straight away I assessed the room. We had two prison guards with one handcuffed to a prisoner in a green tracksuit. There was a bizarre looking lady with long dark hair who I thought may be a mad prostitute, and a couple of other people with more conventional injuries eg. Broken ankle etc

We waited about 30 minutes before we were called into the ER. Dad refused to get on a stretcher bed, so we walked alongside it. We reached cubicle 27 and this was our new temporary home. We  had doctors,nurses and Registrars all talking with us. I connected with a male nurse , who told me he had worked in Dementia before. I latched on to him as he “get’s it”. We formed a bond instantly and he personally called for the best people in Geriatrics to look after us.It was almost like we were talking our own language and we could ‘cut to the chase’.   The male nurse found me the doctor in charge. He was hard nosed, but trying to be compassionate. He had to make the big calls and was making them. We had limited medical options as Dad reacts badly to anti psychotics, so he could only have benzo’s. ( diazepam, etc). It is amazing how quick you pick up and adopt  the lingo when in this pressure cooker environment.

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The doctor needed to get bloods and temperatures etc, but unfortunately this sent Dad into a rage. The nurse was able to get about a quarter of a syringe if blood, but was not enough. It was at this point that Dad started to thrash and was grabbing my hands and trying to crush them. The doc called for a code black and in under 15 seconds I had 6 burly guards bear down in Dad. The power enforced on his 69 year old body was unbelievable. I remember the ‘whoosh & thump’ as they all grabbed Dad and held in unison. I went from being under threat on my own to being under threat with up to 8 people watching. Mum was moved to another room as we struggled to hold Dad down. It went on for at least 15 minutes and Dad was still punching and trying to bite me. It was instinct to put my hand in his even though I knew he was going to try and break it. I guess his hands are the biggest indicator of where Dad was at. If he released his grip I would know he was settling.

The guard next to me near Dad’s head said through his mask ” We cant have 6 guys hold him forever” (it was 15 minutes I was told by a guard later) . A supervisor must have given the all clear for an intra muscular sedation injection. I was so busy at the head end that I never saw the injection given. He started to weaken eventually and the doc asked me to give him a Diazepam tablet. I had to force his mouth open and shove it in his mouth. Dad then went to sleep. We spoke with doctors and nurses over the next 45 mins and it was time for an x- ray. Dad was moved to a another ward and I noticed a different prisoner handcuffed to a bed. He was rattling the cuffs/chain which certainly keeps you alert.

I then had a young guy from the x- ray dept take me to an isolated room for a chest x-ray for Dad. I warned him that we had just had a code black and he needed to be careful of Dad’s hands as he will try and crush your hand if given a chance. The X- ray guy told me he was an MMA Fighter ( mixed martial arts) and could handle the situation without any problems. As soon as the film board went underneath Dad he rolled over and tried to crush the guy’s hand and tried to bite my wrist when I went to release his grip. He was thrashing, kicking and punching and I managed to block everything. As there was a commotion, their people joined in to help restrain Dad. It was a really public and moving circus as we dodged punches and kicks whilst Dad was in a moving bed. I remember seeing a group of 5 visitors all scatter for their own safety as they saw us coming. One lady was on the phone and had the most terrified look on her face as we passed by. She was barking down the phone what she was witnessing in real time.

Another Code Black was called and it was all hands on deck as we tried to restrain Dad. Eventually the male nurse in charge ordered me to step down as they needed to be more forceful and inject Dad again with more sedatives. I walked away past the visitors we scared and I stood alone facing the other way. The tears came and I was exhausted both physically and emotionally and in shock with what I just saw, and was involved in. I knew people were watching me, but I simply did not care. I had a polar neck knitted jumper on, which was soaked with sweat by the end of the ordeal. It was not exactly the best outfit to be wearing during such a physically demanding situation.

As I composed myself I turned to face the visitors and I apologised for what had just happened. I explained my Dad had Alzheimers and was not himself, and out of control. What happened next blew me away. Mum walked up to the large group of people with tears in her eyes. All the visitors were between us, and they showed some compassion once they knew what was wrong with Dad, and asked us some questions. The horrified lady who was on the phone then stepped towards Mum with open arms and gave her the biggest hug. She said to her “you look like you need this”. This was a really pivotal moment for us at an extremely emotional time, and made us feel good when we were so flat and upset.

We had gone from calm and joking in the waiting admissions area to full blown mayhem in an hour and continued to escalate. I will never forget the visions of Dad screaming out in pain, him trying to bite me and kick me and the restraint team forcing Dad to stay still. I remember sitting with Mum and saying to her “I think we made a really tough decision today, we may not feel it was a good decision , but it was the right decision”. ( taking Dad to hospital)

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