Posted by: Gina | 2009-07-29

Urgent psychiatric help needed

Hi Dr

I last spoke with you regarding a facility for my mom. She returned from Cape town even worse and is having all day and all night auditory hallucinations, non existent memories, convinced we are all raped and dead. She has not slept since she has been back on Saturday, and her shrink in CT is totally useless. Not even bothered to return my many calls, and by the looks of it gave her a bipolar med and an anti depressant. He also said that she wont get better, nor will she get worse (acute pontine mylenosis was his final diagnosis) I' m exhausted and am myself struggling to function on any basic level.

None of the mental facilites like crescent clinic or denmar will admit her, as she is unwill to go (unwilling to eat, wash, take meds etc). Where can we take her to get help where she doesn' t have to admit herself?
It feels like im stuck in the delerius nightmare of screaming, foul language, overt sexual connotations, and no sleep myself.

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Our expert says:
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Some meds, including those for bipolar disorder, need to be used cautiously if at all in elderly patients, let alone those with dementia, as they can add to their degree of confusion. I don't see how the fancy and rare diagnosis he suggests is of any real help.
I have been through an experience very like what you describe. You will ned a good local psychiatrist with whom to discuss the situation, and who can assess your mom, and/or a GP or general physician with an interest in geriatrics. Though it is to some extent controversial, I found extraordinarily good results with the use of Risperdal / Risperidone ( I think there may now be a generic version available ) which comes in small tablets and also in an oral solution, whih the person can take in coffee or other drinks, but never in tea ( which nesses up the chemical ). The controversial element is that there is some evidence of a possibly increased risk of stroke or heart attack in elderly people taking this medicine long-term. But as in such severely demented people life without such meds is hell, for themselves and others, the risk is, I believe, often worth it. In my mother's case, I wish we had started the drug earlier, and pleased we didn't wait too long.
When we started, she could be confused, aggressive and very miserable, and after a modest or even low dose in her coffee, literally 10 minutes later she would return to a state very close to herself. the grand lady she was, re-emerged from the clouds of confusion. Taken 2 or 3 times a day, she maintained an excellent state for a long time. And very early on, she was willing to take the med even if she might not fully have understod my reasoning for recommending it --- soon after her first dose, she was able to understand the explanation well enough to agree and later would even at times ask for it if she was starting to feel ragged again. I have no doubt at all that the medicine brought her more peace and contentment if not always happiness, in her last years than anything else.
Discuss this possibility with your doctor, and see if it might be worth trying.

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Our users say:
Posted by: Gina | 2009-07-29

Thanks Greg, in Jhb apparenlty Helen Joseph and a place in Hillbrow (! bad area) can admit her without her consent. So tomorrow Ill be there to at least get her to sleep a bit.

I' ll repost my thanks to CS

thanks guys


Reply to Gina
Posted by: Comment | 2009-07-29

Gina, CS cannot read another post from you unless you send it as a new post. And he really deserves the special thanks you' ve given him...!

Reply to Comment
Posted by: greg | 2009-07-29

have you tried taking her to a state psychiatric hospital - such as Valkenberg or Stikland (if your in the cape)???

Reply to greg
Posted by: Gina | 2009-07-29

More than anything, thank you Dr for your years of help you have dedicated to so many with mental health issues. It truly takes a good person to aid and assist patients, which is often a thankless journey. I will definitely follow this course of meds.

thank you


Reply to Gina

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