She doesn't wash (herself)
She mostly refuses to change her clothes, including sleeping in them.
She never does her own laundry
She can't cook
She can not be trusted with her own finances (she is likely to give money away to buy friendships)
She hardly ever does any positive household chores
She refuses to take her medication regularly
She is oppositional in pretty much everything eg "its time to go to bed now results in I am going to stay awake all night", "let's have something to eat results in I am not going to eat today", "let's go to....wherever.... = I am not going".
She is constantly abusive
Sunday, 24 May 2015
So now it is quiet
The outcome of the meeting was that M was discharged from hospital again. Fortunately the services in Cumbria had already put in place a plan to take her to a 'home' for people being discharged. If it had been in Lewisham she would have simply been discharged.
So now it is quiet, at least for a few days while M settles into this new institution. This means that I can have a few days off from the constancy of anxiety, the long days running around between places.
So now it is quiet, at least for a few days while M settles into this new institution. This means that I can have a few days off from the constancy of anxiety, the long days running around between places.
Wednesday, 20 May 2015
a new day
8.00am
I go downsatirs. M is there still wearing the clothes that she had on yesterday having point blank refused to get ready for bed last night.
Me "hiya" "lovely morning isn't it" "You have slept in your clothes again, you need to get ready to go to the meeting".
M RANT: "oh FUCK OFF, you don't fucking understand, you are a fucking piece of shit what do you care.....etc etc"
The abuse is picked up straight from where it was left off last night.
I go downsatirs. M is there still wearing the clothes that she had on yesterday having point blank refused to get ready for bed last night.
Me "hiya" "lovely morning isn't it" "You have slept in your clothes again, you need to get ready to go to the meeting".
M RANT: "oh FUCK OFF, you don't fucking understand, you are a fucking piece of shit what do you care.....etc etc"
The abuse is picked up straight from where it was left off last night.
Tuesday, 19 May 2015
eleven days later
Eleven days. Truth is there hasn't been a moment to write anything down. It is either work or M or just M all the time. Day to day things are done on the fly - shopping, paying bills, run, run. To the Social Services, to the hospital, to work, to the phone, run, run.
Phone call just now. "Hi Dad...they've just told me they are going to press charges against me".
She slapped a nurse apparently. This was several days ago but no-one thought it appropriate to talk to me, despite seeing me every day, so it comes as a shock. She has herself been restrained several times, face down on the floor, a bruise to her forehead and her legs (a proper bruise) while she is injected in her backside. She perceives this as violence towards her. She is very wound up, not saying she should slap anyone but maybe unsurprising in some ways that she has; she is sorry. She says that after the slap (followed by another restraint and injection) the nurse had said "now we are even".
Learning Disabled young adult in another Acute Psychiatric Ward - again. Mental age of a young child, emotionally unstable, medicated, anxious, depressed. Now to a police custody unit.
I come away from work and spend several hours first at the hospital arguing the toss about the letter that they have given to me to take to the police station which is short and states that M 'has capacity' (ie to be treated as an adult who has committed a crime), and then we go down to the police station where she is taken through security doors, down long corridors, out through a yard with high fences where I imagine many serious offenders have walked the same journey, through heavy security doors and finally to a large room with a raised central area and in front of the custody officer before being walked past cells and into an interview room where she is 'interviewed' under caution with the tape recorders rolling.
It is 'the procedure' the ward manager told me; is it appropriate? I had asked. I can see in her eyes that I am now the enemy for asking questions. Since the 'incident' she had made a lot of progress; now she is back to almost uncontrollable anxiety, taking to herself again, peaking and troughing in behaviour every two minutes from little girl to wild behaviours copied and learned from her environment in an Acute Psychiatric Unit (that everyone keeps saying she shouldn't be in....).
"Perhaps if you had raised these issues of capacity and her care in the past....", I cut her off pointing out that we have been engaged with services for most of M's life, raising issues and desperately asking for support while we received endless assessments and new diagnosis from the next set of professionals, but no real help. She moves onto a new subject without acknowledging what I have said.
Early in the interview under caution process where I am present as her 'adviser' M is asked whether she gives permission for her DNA to be taken for the PNC (Police National Computer). I point out that she doesn't have any clue as to what is being asked. Her behaviour is child like as she tries to grasp what is being talked about. The officer clutches the letter stating that 'she has capacity' throughout the questioning, he repeatedly re-reads it and the poor guy looks bewildered.
Phone call just now. "Hi Dad...they've just told me they are going to press charges against me".
She slapped a nurse apparently. This was several days ago but no-one thought it appropriate to talk to me, despite seeing me every day, so it comes as a shock. She has herself been restrained several times, face down on the floor, a bruise to her forehead and her legs (a proper bruise) while she is injected in her backside. She perceives this as violence towards her. She is very wound up, not saying she should slap anyone but maybe unsurprising in some ways that she has; she is sorry. She says that after the slap (followed by another restraint and injection) the nurse had said "now we are even".
Learning Disabled young adult in another Acute Psychiatric Ward - again. Mental age of a young child, emotionally unstable, medicated, anxious, depressed. Now to a police custody unit.
I come away from work and spend several hours first at the hospital arguing the toss about the letter that they have given to me to take to the police station which is short and states that M 'has capacity' (ie to be treated as an adult who has committed a crime), and then we go down to the police station where she is taken through security doors, down long corridors, out through a yard with high fences where I imagine many serious offenders have walked the same journey, through heavy security doors and finally to a large room with a raised central area and in front of the custody officer before being walked past cells and into an interview room where she is 'interviewed' under caution with the tape recorders rolling.
It is 'the procedure' the ward manager told me; is it appropriate? I had asked. I can see in her eyes that I am now the enemy for asking questions. Since the 'incident' she had made a lot of progress; now she is back to almost uncontrollable anxiety, taking to herself again, peaking and troughing in behaviour every two minutes from little girl to wild behaviours copied and learned from her environment in an Acute Psychiatric Unit (that everyone keeps saying she shouldn't be in....).
"Perhaps if you had raised these issues of capacity and her care in the past....", I cut her off pointing out that we have been engaged with services for most of M's life, raising issues and desperately asking for support while we received endless assessments and new diagnosis from the next set of professionals, but no real help. She moves onto a new subject without acknowledging what I have said.
Early in the interview under caution process where I am present as her 'adviser' M is asked whether she gives permission for her DNA to be taken for the PNC (Police National Computer). I point out that she doesn't have any clue as to what is being asked. Her behaviour is child like as she tries to grasp what is being talked about. The officer clutches the letter stating that 'she has capacity' throughout the questioning, he repeatedly re-reads it and the poor guy looks bewildered.
Wednesday, 6 May 2015
Continued
In yet another waiting room in a secure ward. M is in a state. Not sure if she will see me.
Tuesday, 5 May 2015
Arrested
So after a week-end of M being sometimes angry and very wound up and sometimes very happy and easy, me constantly trying to judge how to intervene, whether to intervene, what to say. This was a three day week-end due to a bank holiday - so a long one. I get out a bit on my bike, walk the dog for quiet time, sometimes she just needs time to calm down. She is so angry with her lot but so confused in what she says and what she wants making it so hard to give her what she needs. She says she wants support but then rejects it when she gets it.
In rooms next door she rants and rehearses arguments with people who are not here, shouting at them, repeating mantras of how she needed them to be there for her and not leave her in mental hospital, how she will tell everyone the truth about how she has been abused, how her mother is a druggy etc etc. These regular bouts of aggression are hard to bear, but then at other times she is sweet and easy, we laugh sometimes when I say who are you shouting at on your imaginary phone?! Sometimes a comment like that goes well, other times it is the red rag to the bull, knowing which is very difficult.
By bedtime last night she was back to lovely (partly due to me pretending to be a dog and crawling around on all fours barking and pretending to wee), smiles and "I love you dad...you are the last one that I should fall out with".
Today the Social Worker came to see her to tell her that she is making connections for M so that she can actually go and see what 'supported living' is on offer. No-one has ever shown her this before so it is great that the Cumbrian services are doing this so quickly. But it can't happen this week as someone is away on holiday, so M rejects this and rants and storms off swearing.
I express how difficult the week-end has been. M demonstrates the situation very well by ranting and screaming at me in front of the SW, calling me everything under the sun, how I am a terrible dad, how I never give her the support she needs etc. It starts to get you frayed at the edges to constantly be given this abuse, to be shouted at so much. M also rants at the SW who actually has been helpful and quickly put in place a 're-ablement' service which is people who come to visit M three times a week to help her learn independence skills like cooking, laundry etc. This has been put in place and quickly delivered in response to M's stated desire to live independently. I do privately express that M is a million miles from this sort of independence, but I am glad that something is there - it is an expression of M being taken seriously in her stated desires and I'm grateful for the support. When the re-enablers come usually M doesn't want to do anything with them, though on the Bank Holiday Monday (yesterday) one of them got her to have a bath at least, first in a week.
I leave and apparently M calms down. The SW arranges to come back later at 3pm when the CPN (Community Psychiatric Nurse) is also due to visit.
At 3pm the SW arrives. M is already wound up. She shouts and screams at first the SW and then CPN when he arrives shortly afterwards. This is all just ranty abuse about how none of you fucking people help me and a long list of historical examples of how she is always let down. She leaves the room from time to time and we have brief snatches of conversation between ourselves about how to manage the situation, what each service might be able to offer, how I need support. They see how difficult it is but we also agree that we need to keep her from an ultimately unhelpful outcome of a return to Psychiatric Ward, as the CPN says "it's a question of whether you can cope" as the Acute Psychiatric Ward is all that the NHS has. So I am caught between a rock and a hard place, I do need relief from the abusive behaviour and daily stress, but I don't want her back in the Psychiatric Ward.
M escalates. She gets to the level of throwing a chair at the SW and grabbing some scissors and behaving threateningly with them. The CPN to his huge credit goes into the kitchen with her while she is waving the scissors in his face and helps her to calm down. Later he talks to me about how she is always looking to see what effect her behaviour is having and how he knows that this is a signal of inner control rather than out of control behaviour. But at her heightened state accidents are very possible.
The support and engagement in Cumbria is human and real, especially in the light of the lack of it in Lewisham. It is a frustrating irony that M wants the support in Lewisham, but Cumbria NHS and Social Services do not see this as any reason to not engage with M, even though we all know she may 'up sticks' at any moment. I do feel supported here, and that everything is being done in a truly engaged way for M, though the limitations on provision are a frustration to us all. Having said that I receive texts and conversation from the services here, CPN SW and I have intelligent conversations about finding solutions, about recognising M's needs, these conversations and texts
SW and CPN decide to leave, and we talk about how I might leave too in order to allow her to calm down for a bit. Adrenalin takes 90 minutes to leave the system I am told, which is helpful to know and does fit the leave her alone for a while scenario that I have come to adopt.
As they are leaving M plays her trump card which is to pack her bag and announce that she is leaving 'to go to London'. We call her bluff. SW leaves, but CPN says he will watch in his car from a distance. She stands at the end of the lane for half an hour. I keep checking to see if she is still there, hopefully she will calm down. Fortunately I live in a small town, where she would go is pretty easy to predict.
She disappears. I drive around and find her. She tells me to go away, that she doesn't need me, that 'she is going to London'. She is so distressed, she is the child, but so full of her 'adulthood' that she will not comply with any pleading.
I can't let her wander around, and even less so can I let her get on a train to London and god knows where.
I go home and call the police and explain the situation. They quickly find her, near the station. They call me. By the time I get there, 10 minutes, they have arrested her due to her talking of suicide, they have the provision of a Section 136 detention to stop people from hurting themselves; this is not new to me.
She is taken to a hospital 30 miles away. There she will be assessed. I am sitting here waiting for my call to be returned from the new (to her) people that will be assessing her, they say that this may be as late as 2 o'clock in the morning. I need to speak to them to help them to understand what is going on with her, and as the police say - to make sure that they don't just open the doors and tell her she is free to go...to where. She is Learning Disabled, she has a low IQ, she is vulnerable.
The workers in the NHS, the police, the Social Services are not able to offer what they want to offer.
In rooms next door she rants and rehearses arguments with people who are not here, shouting at them, repeating mantras of how she needed them to be there for her and not leave her in mental hospital, how she will tell everyone the truth about how she has been abused, how her mother is a druggy etc etc. These regular bouts of aggression are hard to bear, but then at other times she is sweet and easy, we laugh sometimes when I say who are you shouting at on your imaginary phone?! Sometimes a comment like that goes well, other times it is the red rag to the bull, knowing which is very difficult.
By bedtime last night she was back to lovely (partly due to me pretending to be a dog and crawling around on all fours barking and pretending to wee), smiles and "I love you dad...you are the last one that I should fall out with".
Today the Social Worker came to see her to tell her that she is making connections for M so that she can actually go and see what 'supported living' is on offer. No-one has ever shown her this before so it is great that the Cumbrian services are doing this so quickly. But it can't happen this week as someone is away on holiday, so M rejects this and rants and storms off swearing.
I express how difficult the week-end has been. M demonstrates the situation very well by ranting and screaming at me in front of the SW, calling me everything under the sun, how I am a terrible dad, how I never give her the support she needs etc. It starts to get you frayed at the edges to constantly be given this abuse, to be shouted at so much. M also rants at the SW who actually has been helpful and quickly put in place a 're-ablement' service which is people who come to visit M three times a week to help her learn independence skills like cooking, laundry etc. This has been put in place and quickly delivered in response to M's stated desire to live independently. I do privately express that M is a million miles from this sort of independence, but I am glad that something is there - it is an expression of M being taken seriously in her stated desires and I'm grateful for the support. When the re-enablers come usually M doesn't want to do anything with them, though on the Bank Holiday Monday (yesterday) one of them got her to have a bath at least, first in a week.
I leave and apparently M calms down. The SW arranges to come back later at 3pm when the CPN (Community Psychiatric Nurse) is also due to visit.
At 3pm the SW arrives. M is already wound up. She shouts and screams at first the SW and then CPN when he arrives shortly afterwards. This is all just ranty abuse about how none of you fucking people help me and a long list of historical examples of how she is always let down. She leaves the room from time to time and we have brief snatches of conversation between ourselves about how to manage the situation, what each service might be able to offer, how I need support. They see how difficult it is but we also agree that we need to keep her from an ultimately unhelpful outcome of a return to Psychiatric Ward, as the CPN says "it's a question of whether you can cope" as the Acute Psychiatric Ward is all that the NHS has. So I am caught between a rock and a hard place, I do need relief from the abusive behaviour and daily stress, but I don't want her back in the Psychiatric Ward.
M escalates. She gets to the level of throwing a chair at the SW and grabbing some scissors and behaving threateningly with them. The CPN to his huge credit goes into the kitchen with her while she is waving the scissors in his face and helps her to calm down. Later he talks to me about how she is always looking to see what effect her behaviour is having and how he knows that this is a signal of inner control rather than out of control behaviour. But at her heightened state accidents are very possible.
The support and engagement in Cumbria is human and real, especially in the light of the lack of it in Lewisham. It is a frustrating irony that M wants the support in Lewisham, but Cumbria NHS and Social Services do not see this as any reason to not engage with M, even though we all know she may 'up sticks' at any moment. I do feel supported here, and that everything is being done in a truly engaged way for M, though the limitations on provision are a frustration to us all. Having said that I receive texts and conversation from the services here, CPN SW and I have intelligent conversations about finding solutions, about recognising M's needs, these conversations and texts
SW and CPN decide to leave, and we talk about how I might leave too in order to allow her to calm down for a bit. Adrenalin takes 90 minutes to leave the system I am told, which is helpful to know and does fit the leave her alone for a while scenario that I have come to adopt.
As they are leaving M plays her trump card which is to pack her bag and announce that she is leaving 'to go to London'. We call her bluff. SW leaves, but CPN says he will watch in his car from a distance. She stands at the end of the lane for half an hour. I keep checking to see if she is still there, hopefully she will calm down. Fortunately I live in a small town, where she would go is pretty easy to predict.
She disappears. I drive around and find her. She tells me to go away, that she doesn't need me, that 'she is going to London'. She is so distressed, she is the child, but so full of her 'adulthood' that she will not comply with any pleading.
I can't let her wander around, and even less so can I let her get on a train to London and god knows where.
I go home and call the police and explain the situation. They quickly find her, near the station. They call me. By the time I get there, 10 minutes, they have arrested her due to her talking of suicide, they have the provision of a Section 136 detention to stop people from hurting themselves; this is not new to me.
She is taken to a hospital 30 miles away. There she will be assessed. I am sitting here waiting for my call to be returned from the new (to her) people that will be assessing her, they say that this may be as late as 2 o'clock in the morning. I need to speak to them to help them to understand what is going on with her, and as the police say - to make sure that they don't just open the doors and tell her she is free to go...to where. She is Learning Disabled, she has a low IQ, she is vulnerable.
The workers in the NHS, the police, the Social Services are not able to offer what they want to offer.
just a child
I caught myself thinking (not disparagingly but sympathetically) what a child M is, and then stopping myself because the whole system now regards her as an adult, and then thinking 'no, she IS a child'. Her behaviour is tantrum-esque, no different from when she was little. Shouting and screaming in her desperation, and yes moodiness. Up down up down, I tiptoe around her hoping that she will settle to a more even state.
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