Restraints in hospitals....

A patient was admitted to a mental health hospital in Japan.
For 10 days he was tied hands and feet to the bed.
After 10 days he had a heart attack - the family suspect Deep Vein Thrombosis.......Economy Class Syndrome...whatever it is you want to call it.

Lack of movement and exercise in a mental health hospital. Restraints.
Something apparently long criticized as inhumane by international commentators.

Sound familiar?

A very sad story about a Kiwi English teacher in Japan.
you can read it here. 


Okaasan is doing ok. DS told me.

He went to see her Sunday. She was up in the wheelchair and trying and failing to stand. She had lunch at the table in the day room. She chatted to him. He came away happy. This week the physical therapy will start.

Tomorrow Dear Son will meet case worker and social worker......

Black Butterfly

First things first.

Okaasan is still in a better place, mentally.
Since last Monday she has been on new meds and so far the doctor is happy with her progress and stabilization.

And Okaasan is spending most days sitting upright in a wheelchair in the dayroom of the hospital - watching TV and even interested in newspapers. The restraints are used to stop her taking out the injection needles and tapes on her arm. The hospital will try to reduce their use...

She has slight pneumonia.....they are monitoring that.

All good. No feeling yet about when she might be ready to come home/move to a care home. Only 1 week so far of fairly stable condition.

BOTH of us went to see Okaasan in the mental care hospital yesterday.
It's a new, large hospital - nicely surrounded by gardens. Different buildings. I could see people sitting in day rooms with large tables and TVs...staring a bit vacantly.

There was a whole range of security systems to get in - and then the woman doctor came to meet us and I got invited upstairs with DS for the doctor/family meeting and Okaasan visit.

Okaasan SAW me and SMILED and WAVED!!!
As we came out of the elevator on our way to the doctor's room she was being wheelchaired to the meeting room - and she SMILED AND WAVED!!! I've never been so happy to see that!! Felt all overcome with emotion :-)

We sat and heard about the latest drug regime and how it seems to be working better. Her moods are better and she is more mentally alert.

And then the PET? MRI? photographs came out. I couldn't whip out my smart phone for a picture - so you'll have to make do with some stolen-from-the-internet images.

Okaasan's brain is like that right picture - she has a big black butterfly in her brain. It's the space. In Japanese the "heya" - which can be "space" or even "room". She has a lot of space, filled with fluid.

To be honest, it was a bit shocking. We've lived with her all these years and known her mental condition. But to see it in technical detail in a hospital. Kind of shocking.
In fact her brain has an even bigger, and fatter butterfly than this picture here. The doctor said she may have excessive brain fluid, which could be adding pressure...another hospital could ultimately do further scans and there are procedures to test by drawing out fluid thru the spine - and if it has good results to drain off fluid from the brain.

All a bit shocking to think of for an 86 year old, who has already suffered 6 weeks of hospital life.

That's a future possibility.

For now - the immediate concerns is continuing the drugs and hoping for another week or two of good mental/emotional condition.


And then we went to see Okaasan in the meeting room. Hiding our hospital visitor name cards. Sitting across the table from her in an all-white room. We stayed 40 mins.

She was happy to see us. Smiled. Looked tired. Kind of passive. Listened to our double-act, prattling on about stuff conversation (which we carefully did all in Japanese) and occasionally responded.

Yes, I've been to South Africa
Australia
Maybe Kenya
New York

Okonomiyaki pancakes? Yes, like those.

Dear Son had forgotten to take the holiday travel pictures to show her and chat about, so he and I waffled on and on. A strange conversation - Okaasan sat across the table from us and sort of followed it. The weather - food - travel - on and on.

Many years ago as a reporter in the UK I went with a woman to visit her son in prison. He'd hit another man with a baseball bat in a  fight and killed him. Mother was campaigning to prove his innocence. She invited me as a "friend" to prison visit, so I could write a story. We sat in the
prison visit room with her boy chatting about normal life beyond  the high walls - family news/food/sport...and it was pretty strange. 

Visiting Okaasan was like that. I think Dear Son was grateful to share the visit with me.

So.
Future?

We can't really imagine Okaasan coming home for another few weeks....
Coming home. Care. Signing the documents about the house sale.

Any of that. Not yet.

And the whole brain fluid - whether it could be drained and make a difference? Not a priority.

So, there we are.
After the hospital DS and I biked downtown. Enjoyed the park on a Saturday - flower festival and sights. Rare for us to be together downtown.
We went to a big buffet place and ate ourselves stupid. There was a $6 dollar all-you-can-drink-wine plan. We drank. I ate ice cream with loads of dried fruits.
We came home and slept in the afternoon. 

Onwards.

Happy..................

LISTEN to those lyrics!

Okaasan is HAPPY!!!!!

Dear Son reports from the hospital that she is smiling and calm and HAPPY!
He went and sat with her for an hour, watched her eat her lunch.
Chatted about things....or listened to her chatting about things.

Amazingly. She was happy.

So, we are happy. And we aren't on meds.

Is this possible in just 24 hours? Was this just a lucky moment that when he went she was on a high? He said she seemed naturally happy, not manically so. She said the last time they'd met was maybe downtown...she knew who he was.

Really wonderful. 

He met her in a meeting room of the hospital and the nurse brought her in a wheel chair. She wasn't allowed to have one of her magazines (too much outside stimulation) and she isn't allowed TV (in fact we did notice at the weekend that Tv seemed to enrage her even more, "WHY are those children working at 7 am?? WHY?").

So. There we are. The meds are helping. Thankgoodness for modern medicines.

We had a nice calm after work evening. I weeded the garden. He watched football on TV. The cats lounged on warm concrete. We ate dinner together in the kitchen....I take Okaasan's chair at the table now (work out the symbolism of that...) and then after some TV we slept. It was nice  and normal.

Meanwhile.

***WOW!! You lot - blog readers.
Thankyou so much for all the messages and support. They kept popping up on my e mail feed all day on my smartphone. Gave me lots of warm fuzzy feelings. Thankyou - I know there ARE people reading this blog, but at times like this past week I really understand it.***

What happens from now on, we'll see.
But several barriers have been broken - specially with Dear Son and his thinking. He has accepted outside help from care manager and social worker, and doctors. He has accepted that medicine maybe has a role to play in his mum's care. All of that is quite a lot. He is his mum's son, her attitudes to hospitals, doctors and medicine have inevitably influenced him.

But now. Medicine and a hospital are maybe helping.

HAPPY!!!!!!
🙋

Guilt

In Japan. You know who is in and out by the shoes in the entrance hall.
I came home yesterday to find Okaasan's slippers.

So. I knew she was out. Gone. Not at home in her room raging at the curtains, us, the ceiling, the Tv, the blanket, the water.....

The house was empty and quiet. I changed into my home clothes, opened a beer, fed the cats and cut the lawn.

Dear Son came home soon after, looking exhausted and emotional.

Okaasan is now in a mental health hospital. In a locked room. With a restraint on the bed, so she doesn't get up and fall in the night. On drugs to try and level out  the anger at us and the world.

And we feel awful about this. Guilt.
What have we done to Okaasan? Is this the best thing to do? Really?

Apparently, an elderly care home won't accept her at the moment because of the anger issues. Consideration for other residents and staff. If she calms down enough to be with other people then admission to a care home is possible - probably a private room with staff looking after her. Or home? Maybe.

But this was the next stage advice from social worker, day service manager and the doctor at the orthopedic hospital - that Okaasan's fury needs medication, and then once she is manageable another stage of care home or real home can be considered.

Dear Son took his mum yesterday. They had a short joint interview with the doctor, in which Okaasan denied ever being in the orthopedic hospital for 3 weeks etc and waffled on about going downtown alone every day. Then a nurse took Okaasan gently away and Dear Son talked to the doctor alone about their suggested program. To keep her at the hospital, try some dementia drugs to find a good level for her.....a level which will let her be easier to care for. 

Finally, after years of ignoring the drugs options. Dear Son is accepting that drugs may help his mum.

He was shocked to be in a mental health hospital. However new and bright it was. Many many locked doors. Warnings about not bringing sharp objects, outside food...restricted visiting hours, questions about who was allowed to visit. All of that. Me too - I have images of One Flew Over the Cuckoo's Nest.

We went and ate soup curry near home. We went to a local bar. We drank and talked quietly. Both just shocked, and feeling sad and guilty.

"It's like a pet that people throw away. That's how I feel. I think I should have done better for her" said Dear Son.

And I agreed. I tried to gently soothe his feelings by saying how much we have done for Okaasan over the past 10 years. So many things we HAVE done right. To make her happy here with us. How we have taken the right decisions along the way...and in the past 3-4 weeks.

She needed to go to hospital for the back.
She needed to stay quiet in a corset in bed.
The hospital has no mental health care for patients.
We tried to have her at home.
We tried to protect her physically, and mentally.
We tried. 
 

We have tried to look after her at home. It isn't possible now. That isn't our fault. It's the sickness of dementia that has taken over her mind. If someone is injured or sick, you try to get help - professional help. And that's what we are doing.

We tell ourselves this. But we don't feel it.