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My grandmother was admitted to a psychiatric hospital this past weekend. I’m actually wondering what happens if we wanted to take her out now instead of wait 14 days? My mom thinks it was a mistake to place her there and she is declining rapidly and we have to get her out now. But she’s upset over the 5250 hold because it sounds as if we’d be going against the State if we removed her from the hold. And she wants me to go back to the outpatient psychiatrist who helped us get this placement in the first place and have him “get us out of this mess he put us in.” I’m not entirely sure what to do.
At this point it’s pretty clear she has LBD and early/very mild Parkinson’s. That aside, she’s always had other mental health issues such as severe anxiety, some depression, probably obsessive/compulsive and definitely grandiose feelings/beliefs. We got her in her based on how she’s had prior mental health issues but my mom feels this psychiatric unit is much more people who are really out of reality most of the time. It is a geriatric psych unit. What to do? Grandma has been the same or maybe more upset since being there for 5 days.

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Update for anyone still interested:
Since my grandma has been in the psychiatric hospital, she has been completely hung up on how she’s there because a baby was born. At first it was hers and she said it was so ugly, but she was laughing so much over it. Over the next couple days she started saying it was my aunts baby (my grandma raised that little boy years ago, he’s in his 40s now). And over the days, each day she will tell us and the staff that he is another day older (as if she’s counting the days she’s there as the baby age?) and I mean yesterday he was 8 days old and today he is 9 days old. And every morning after breakfast she seems to believe she’s at a store or something getting baby supplies and plans to pick up the baby that night and go home. And then she’s denied, has a complete meltdown well into the night about how she wants to see the baby now and that he’s alone and scared. She doesn’t trust people so telling her someone else is taking care of the baby has rarely worked. Telling her the baby is grown now obviously doesn’t work either. Telling her to focus on herself and getting better while she’s at the hospital doesn’t work. And before anyone suggests, I really am pretty sure she can still tell the difference in a doll and a real baby.
Here’s the kicker. I finally realized why she has been so hooked on this baby. Part of it is true stories and memories coming back to her that are associated with a stay in the hospital. But majority of it is perpetuated by the darn nursing staff! They constantly will tell the patients things like “time to go peepee/poopoo” or “let me change your diaper!” Besides being completely insulting for adults, I am sure this has kept my grandmother completely believing there’s a baby for the past 10 days. I’ve spoken to the staff multiple times over the last 4 days but they are still using that kind of language. This is UCSF!! Aren’t they supposed to be one of the top hospitals? What should we do? I think this has really pushed my mom to insist she comes home ASAP.
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Mom seems a bit more relaxed about grandma today. Perhaps because grandma is having an okay day. In my opinion, grandma has almost seemed a little more.. mentally clear? She thinks she in the hospital because she had a baby, but outside of that she is seeming to recall the day and things that are happening or being said to her. It seems more like my mom feels a sense of guilt if she isn’t rushing to my grandmas rescue when she’s having a meltdown. But my mom has always felt a sense of guilt towards her mom. In a sense I guess I need to just be strong and stand up because I might be the one with my head on the straightest with this situation! I’ll keep y’all posted , thanks for the support.
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Ema
Is it possible that your mom could use a little treatment of her own?
Pay attention.
That being said, it’s sometimes very scary to allow the medical professionals do what they think is best for our loved ones.
Keep us up to date and let us know how everyone is doing.
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That's what the meds are going to address, Ema. The anxiety and agitation. Meds won't make gma happy. But they WILL make her less agitated about what's going on, we hope.
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Yeah I think it’s possible that really set the decline in motion because the safety net of familiar surroundings has all changed. But she does know us and our faces. She can’t always remember how we relate to her but usually does recognize. And she has gotten familiar with our house enough to usually know where things are and that her bedroom is hers... she just usually gets pissed saying this isn’t the place she wanted to be. She looking for her husband or her parents, rarely an actual place. But I think my mom is letting guilt take over. Since losing my aunt, she feels like keeping my gma happy and safe and healthy is what she has to do, but the “happy” part is going to be impossible, and the “safe” part is extremely difficult when she’s unhappy and completely defiant.
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If the outpatient psychiatrist could prescribe the right medications so Grandmother can be managed at home, your grandmother would not be where she is now.

Your family is very lucky that Grandmother has the attention of an entire team of experts. What they are doing cannot be duplicated at home. They are trying medications that can have side effects, and it is important that she be under observation so there can be immediate intervention if it is needed.

What do you mean that you don't have the final say in this decision? Your mother is expecting you to go to the outpatient psych doc and plead to get Grandmother out, right? And if you politely decline to do that because it is not in your grandmother's best interest, then what will mother do?

You are not in a mess. Grandmother has the opportunity to have medications tried in a safe environment. That is excellent. Don't throw the opportunity away.

I belonged to a support group of caregivers for people with LBD. Many members had their loved ones confined to a geriatric psych ward for medication management. Not one of them said they wished they hadn't done it.
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Wasn't that already tried--outpatient psych?

It's REALLY hard to titrate psych meds in the elderly, especially when long-standing mental illness is involved on top of dementia.

If you are even a part-time caregiver for grandma, you have the right, nay, the obligation to say that you aren't going to participate in her care anymore if mom brings her home.

As for familiar surroundings, Gma left them behind in her little town, didn't she? Your mom moved grandma across the country; which may have set in motion a steep decline.

Not pointing any fingers or blaming, just stating a fact.
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I guess my moms solution is that the outpatient psychiatrist prescribes the right medications and we manage that at home? I’m not sure. She doesn’t understand why my grandma needs to be staying at the psych unit and why we can’t get all of these services at home (one to one CNA, PT, OT, and doctor, etc.) because at home would be more familiar and when she wakes up she would be able to see familiar faces instead of strange nurses. I don’t know, I agree she needs to stay here but I don’t really have the final say in decisions.
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A 5250 is a 14 day psychiatric hold. It is generally an involuntary hold. It gives doctors time to do a complete evaluation and establish or adjust medications. If she is in a geriatric psychiatric unit it will give psychiatrists time to fully assess her status since she has past mental health problems, as well as other current neurological issues. Depending on policies in your state, getting grandma out before the 14 days thas passed may require a hearing.
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So is your mom's solution to bring gma home and let her keep lashing out physically at you all? And screaming and scrying and trying to escape from being held hostage?

Don't you think gma's been through enough anguish and deserves the peace that proper dosage and timing of psych meds?

It doesn't matter what the other patients are like. This is a short term crisis placement to get gma's meds straight. She's not there to socialize. She's there so the docs can give her meds until controlled circumstances.
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