Access denied?

Hey all, I wondered if I might have some advice/input here. For those of you who have read my posts you'll know that my father in law is making tremendous progress. Last night, he was even reading and trying to respond to an e mail from a friend.

It has always been the plan that he go to "The Wellington" which is apparently a fantastic neuro rehab centre. Everyone is excited for him to go, because as much as the staff have been wonderful at Barts, he's on a cardio ward and their experience and facilities for rehab is limited.

Since coming out of his artificial coma, my father in law has showed a lot of irritation and resistance. When he was first coming round he would "fight" the staff. When I say fight, no one has been injured, kicked, punched or injured.

Each day the aggression/frustration levels go down and he is less "fighty" than he has been. If the hospital want him to calm down, they call my mother in law who can generally get him to cooperate. Suffice it to say, he's been what the staff would call "a little difficult" but they all love him and come and see him on purpose and ask after him.

Last night a consultant told my mother in law that he "might not be able to go to the wellington because of his aggression/agitation" she was heart broken to hear this as it pivotal for his recovery and of course the waiting list for places elsewhere would be about 6 months at this point.

Am I right in thinking that this one consultant is probably full of s*** and that he/she is unnecessarily worrying my family? I feel the god complex thing is getting old with a lot of the consultants .they come in , upset everyone and are usually wrong anyway. So does anyone have any kind of experience with. Delay in rehab due to behaviour? Thank you.

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  • I have only limited experience of this, my husband, too, was difficult to deal with when he first began to respond after his bi. but he soon improved. This behaviour will hopefully not last, it is probably caused by confusion and frustration and as he is more able to deal with his problems logically he should calm down.

    Social workers have plenty of experience of this and common sense says that the people making the decisions know enough to realise that it could only be a temporary behaviour. Who is dealing with his case, does he have a social worker? Someone must be making the decisions here, not the consultant who can only advise. Maybe your mother-in-law or one of the family need to have a chat with whoever is overseeing his rehabilitation and tell them that you are worried and how desperately you want him to go to the Wellington. He has been doing so well at such an early stage that they will surely realise how much further he can progress with the correct help, their experience of these cases should enable them to understand that a little more time might easily solve this problem.

    Lot and lots of luck with this. Keep talking to the experts, make sure that your father-in-law is one of the patients they keep at the top of their lists.

    Jan

  • Thanks Jan,

    I'll see if I can find out who is dealing with his case x

  • There's a world of difference in the medics on a cardiac ward to those on a brain-injury one. Staff in brain injury units are trained to deal with all types of challenging and often aggressive behaviour from patients.

    In Salford Royal, where I was treated, there were some extremely difficult cases where patients had to be escorted everywhere owing to their volatility and unpredictability. And some even had their beds removed so they could sleep on the mattress to prevent them from climbing over the safety rails and injuring themselves.

    To be perfectly blunt, any rehab facility refusing treatment to someone so minimally aggressive would surely be questionable anyway, although I suspect the cardiac consultant is more used to an orderly environment and has never seen the fantastic work done by staff on a neuro rehab ward.

    He has a duty of care to your dad-in-law and can't be allowed to second-guess whether another hospital would refuse vital treatment to a vulnerable patient.

    I hope your father-in-law receives the care he deserves. Please keep us informed Curly. xx

  • a smile can hide a lot cat. i never had you down as the aggessive type!!!

  • Hi Curly,

    Definitely a god complex at work there, how distressing for you all.

    I suggest that someone heavily sedates the consultant and let the rest of the staff who support your father in law get on with helping him.

    Apart from that......... great advice from other members here.

    Best wishes

    TN x

  • This made me laugh! Thank you guys! <3 sedating the consultant... I can think of other things too! :P

  • Being a little difficult is one of the haulmarks of brain injury, Plenty truly do fight the staff.

    Nero wards would be very used to it.

  • Hi curlycuz.

    You say that it has always been the plan for rehab at the Wellington. Have you got a copy of that?

    Do you know whether it was the neuro or cardio consultant who said that to your mother in law?

    It can make a world of difference.

    Hoping it all works out.

    Love n hugs

    Xoxo

  • HIya, I think it was one of 2-3 options that were offered. He has private health care... I don't know if that makes a difference. I also don't think it was the neuro consultant who said it because he comes once a week usually on a Thursday and this was last night ( Sunday) .

    The other options were not as good ( I can't recall how) and required along waiting list.

  • Hi, no I don't know for a fact that the Drs always planned it. I know that my mother in law wants the best of the best for him. I think they were told that this place is jus that. She didn't want him transferred to somewhere "in between" if possible.

    Last night it kind of all kicked off because they decided to move him off of the cardio ward to a regular ward. She argued that he would be terrified and upset and co fused. She is so angry and talking of just "taking him home" I know she won't and that they wouldn't let her, plus she doesn't have the resources in place at home to take care of him. I get why she's angry.

    Hospitals are for that initial stage, but now that he's starting to recover and want to do things, they aren't able to cope.

  • It sounds like it is time to really push for the neuro consultant to get involved and make a referral.

    On the bright side it may be that his rate of recovery would mean it would be better for him to be at home with community rehab.

    Please ring Headway and see what is available for your father in law in his area.

    Love n hugs

    Xoxo

  • Thank you!

  • curly before my bi my experience was working with adults with adults with learning disabilities who could be violent.........post bi eventually ( i was fine for the 1st 6mnths ) ibecame moody and aggressive, my wife just didnt know what i was going to do next and had a melt down at work.

    doc gave me medication to ease my aggressive tendencies, which work most of the time.

    so back to your question and there are 2 important points to take into account

    where will your father in law be happier, taking into account hes got used to the staff and just as importantly, they know him, when hell be cooperative when to back off a bit, showing him respect.

    you say it has " always been the plan " whos plan an agreed plan including your father in law or a plan by your mother in law.

    my conclusion ..............i think you should ask your father in law what he wants..........because at the end of the day hes the one stuck in hospital!!!!

    sorry if that wasnt the answer you wanted hear, but if you think about it, its the right one.

  • Hi Steve, I hear what you're saying. Without wanting to sound patronising, he's only JUST starting to string two thoughts together. He's still acting innapropriatly intermittently, like sticking a finger up at the nurses and acting like a small child. So i don't think the family will ask him to choose a rehab. Don't get me wrong, they're explaining everything to him as he goes along. When he's there, he's pretty lucid, I guess until these lucid moments get longer and he starts retaining more short term stuff it's difficult to have these conversations . Does that make sense. One thing is for sure, he's frustrated . Rest assured though, his family will only settle for the best when it comes to his health and if he's not happy it'll get changed . Hugs x

  • curly ever thought that finger could be his way of saying hello.

    im not sticking my nose in, but maybe try a couple of visits to this other place and gauge his reaction.

    when youre mother in law talks to him, look him in the eyes they will either smile or be sad depending on what he wants.

    difficult time

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