Mental Health

[kelts]

Update:
Sorry for the short post, but I’m rooted.
However, it appears we’ve made some substantial progress. Ma is now an in-patient at Loei Psychiatric Hospital. My wife and I are now on the banks of the Mekong at Chiangkhan, which is beautiful. But not all pleasure,there is apparently a nursing home here that takes patients like Ma full time, ongoing, that we’re going to have a look at tomorrow, before going to visit Ma in the morning. I’ll have a full update tomorrow, because it’s needed. We still traversed many a pitfall today and for those reading down the track it’s worth the dialogue. Thanks.
Kelts


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[Riojasue]

So pleased you’re making progress even if it’s slowly. Take the little happy moments together when you can with your wife. Don’t feel guilty about it coz you’re working so hard to find solutions for this awful problem. Hope it goes well again tomorrow. Thanks again for the updates.


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[NancyL]

kelts, so good to learn that Ma was admitted as an inpatient at a psychiatric hospital, at last.  I imagine you and your wife had a very long and trying day to get to that point.  It can be a trying process to help a family member get admitted to a gov't hospital when the patient is cooperative, but can be very difficult when the patient is uncooperative.  

 

Good that you found a pleasant location to rest.  You and your wife deserve this small comfort.  

[Sheryl]

I'm glad to hear this and thanks for the update. It did nto occur to me to suggest Loei because of the greater distance but it may be that it is less crowded and hence more able to admit patients and for longer - the police apparently knew that.

 

Given that this is not her first hospitalization and she has apparently been non-compliant with treatment ,and also presumably getting on in age, the nursing home is indeed worth considering if you find it to be a satisfactory facility. Plerase let us know the outcome and the details as it will help others in the future.

[kelts]

Sorry for the absence, it’s been hectic! We visited Ma yesterday morning on the way back to Chaiwan, which gave us a better insight into the facility and a gauge on how Ma would receive us. It’s pretty positive. The facility seems under staffed and under pressure but not as much as Chaiwan or Udon, and I suppose this is a global problem. Ma was really happy to see us, which was a major relief after spending her first night incarcerated (for want of a better term). We only got a few minutes with her, through a small window, big enough to hold hands, not big enough to embrace. Despite the lack of time and contact, I felt it was positive, but possibly in a really sad way. I will explain. The other in-mates (again for want of a better word) seemed amazed that we had come to visit or that there were visitors at all. Ma was positively beaming at the attention and I suppose they wouldn’t get a lot of farang in these parts, and I do stand out a bit, at over 6’4”, 110 kg and long dreadlocks. Just painting the picture as most of you would be used to the unabashed staring you receive when entering a small town or village. ; )
The sad part was the other in-mates racing to the window asking us to call their relatives. Screaming ‘please help me’ in English. Yelling out phone numbers in the hope we’d call someone for them. I don’t know what I was expecting but this was disturbing and so, so sad. Nancy, I’m sure you’ve probably experienced a lot like this, and thank god for people like you! I respect this so much. [emoji1317]

So, the reunion went well, and we promised to return with Nat, (my wife’s brother) and Grandad. A 3 and a half hour drive home, and that was yesterday done.
I’d like to backtrack to some of the aforementioned pitfalls. Just because we had a referral did not mean guaranteed admittance for Ma. It depends on their occupancy at the time, and the doctors opinion on the urgency.
Because my mother in law is obviously female, and past middle age, this is seen as less of a threat to society. We did not end up engaging the police, as on the morning of departure we were able to connect with Ma enough for her to agree to come without the need.
I was regretting this when her potential admission was still up in the air, and police van after van kept arriving dropping off patients. We had a envelope with cash ready to draw at any given moment, which we did do, somewhat prematurely with the officiating nurse. Her matronly response was gold, as she looked down her nose and uttered, “it is not up to me. It’s up to the doctor.”
We never did need that envelope, and Ma is now secure for 2-4 weeks. 2 weeks is standard, 4 weeks is maximum. I’m taking my wife, Nat and Grandad back to Loei first thing in the morning to visit Ma. We’ll stay overnight in Chiangkhan, and visit her again on our way back home. There are still lots of questions and we haven’t checked out the nursing home as yet, but will certainly do so in the coming days. Thanks again for all your support, and I’ll have another update on our return to Chaiwan on Tuesday evening.



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[NancyL]

All government hospitals are short-staffed on weekends, so I'm not surprised the facility seemed lightly staffed.  Even the private hospitals and nursing homes don't have their "A teams" on duty on the weekends.  

 

A better term to use to describe the other patients would be "patients" or once Ma gets into a nursing home "residents".  Certainly not the term "inmates".  This is an incorrect term and disrespectful.  Also, the patients haven't been incarcerated but rather have been admitted.  Admittedly, some are police admissions and can't leave without police OK, but still they aren't in jail.

 

I know exactly what you mean about how just the final decision to admit is up to the doctor.  I've brought in some older expats who were clearly in the midst of a psychiatric episode to Suan Prung, hoping for admission and the person gets their act together to talk with the doctor rationally.  However, when I and sometimes his friends/family explain how he's been acting in previous days and how he can't be controlled by them, we can get him/her admitted.  I would expect you explained how your sweet-looking, older MIL has a recent history of destruction of property in wats.  That's definitely inappropriate behavior and family and friends can't help control. 

 

Incidentally, I've never been in a situation where medical professionals hint at wanting a payoff.  Police, yes, for helping to bring someone into Suan Prung, but never the medical professionals.  Frankly, I think the police deserve a little something. I've always seen them treat an out-of-control person kindly and use just enough force to move them along, without injury., often ending up the person's bodily fluids on themselves, in the process of carrying the person.  In my country, they would use tasers and be very rough in these situations.   

 

The situation you describe for how the hospital handles visitation is very different than what I experience at Suan Prung, but it's possible they have higher security buildings that I just haven't seen.  Of course, I'm always a foreigner visiting another foreigner and the other patients keep their distance.  Sometimes, another Thai patient will approach, normally to show off his English-language skills and I don't want them around and ask an orderly to intervene.  Whenever I visit, I've been able to sit across a table from the patient and talk freely.   Suan Prung has visiting hours from 9 am - 4:30 am and family and friends are encouraged to come and stay as long as they'd like.  You often see patients sitting in salas on the grounds with visitors. (never by themselves, of course).   However, if it's evident that the visitor is making the patient agitated, they're asked to leave.    I've never had another patient ask me to do anything for them.  It's possible that your MIL has been placed in a high-security building for initial evaluation and can be moved into a lower security wing or building with broader visiting privileges once they know her condition is more controlled.

 

 

 

 

[kelts]

Thanks Nancy. Yep, you’re right. I’m sitting in a sala right now with Ma and the family. They wouldn’t let her out to see us on Saturday as they thought she might be difficult to get back in. Now that my wife’s brother and Grandad are here it’s ok for her to be out in the grounds. She seems a bit agitated today, but my wife’s brother is also acting aloof. It may take a while longer to repair some rifts I suppose. Thanks for all your help again, I’ll let you know what I can find out about the nursing home.


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[NancyL]

Kelts, I hope your wife's brother can come to understand that it was your mother's illness that made her act the way she did and not any personal feelings she had towards him.  Sadly, this is very difficult for family members to forgive and try to move on in rebuilding their relationship with the person undergoing treatment.  If they can, it can go a long way to reinforce the necessity for Ma to stay on her medications, for them to praise her and comment on how much better she is acting and behaving.  To smile, engage her and give her positive reinforcement.  

[kelts]

Kelts, I hope your wife's brother can come to understand that it was your mother's illness that made her act the way she did and not any personal feelings she had towards him.  Sadly, this is very difficult for family members to forgive and try to move on in rebuilding their relationship with the person undergoing treatment.  If they can, it can go a long way to reinforce the necessity for Ma to stay on her medications, for them to praise her and comment on how much better she is acting and behaving.  To smile, engage her and give her positive reinforcement.  

Yeah I understand. It was quite sad really. I only just now had the chance to talk to my wife alone, and you’re 100% right. He feels aggrieved, he’s upset, and because of the 2 years distance emotionally, Ma didn’t know what to say either. She kept repeating herself about instructions for the garden, but she did try to cuddle him and play with his hair before we left. A big step for Thais and public displays of affection. I’ve just read your letter out to my brother in law, with my wife translating. He seems reflective. I’ll let it sit for a bit. He’s a good man. Very gentle, very soft, and this is why he’s hurt so deep, methinks. Again, thank you so much. I’ll come back when he’s had some time to digest.


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[kelts]

After many trips to Loei and back, we seem to have found a solution.
We spoke to the nursing home based in Chiang Khan at length, and they needed to speak to the nurse in charge to ensure that they were equipped to deal with Ma, and her behavior. This is a standard response, but for good reason. After talking to the nurse yesterday, she was hesitant to recommend this particular nursing home, solely based on Ma’s condition and her inclination to want to go home. This nursing home offers a lot of services, but security, or preventing patients from leaving isn’t one of them. This may be helpful to others though, I will include contact details at the end of the post. The nurse indicated there may be similar services in Udon.
At the end of the day, we want what is best for Ma, and that is to be comfortable and have a chance at happiness in society. Ideally.
This may or may not workout but this afternoon we came to an arrangement with the local village hospital for support.
8000B a month for a nurse to be in charge of her medication, which includes them holding it, bringing it over twice a day, ensuring she takes it, and monitoring her behavior. This could be a great outcome for Ma, as she truly values her home and garden, mango trees, bananas, chili’s, and other vegetables I can’t pronounce or recognize.
We’ll give it a shot, it’d be amazing to see her enjoying life once again.
I’ll keep you posted, and I’ll monitor any questions on mental health or anything else I may be able to help with. I owe this forum a great debt. Thank you all for your input, especially Sheryl and Nancy, and hopefully this thread helps someone in the future. Many thanks.


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[kelts]

BoonSiliployyada Nursing Home
Chiang Khan
Khun Gulaab
098-210-7846

086-965-6237


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[kelts]

‘It’s my Thai translation of the information given. I’ll send the original Thai script/ language info tomorrow.


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[kelts]

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[kelts]

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[kelts]

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[NancyL]

kelts, so good to learn that your family may have found a good outcome.  It's wonderful that the local hospital is working with your family in having a nurse come to visit Ma twice daily to administer medications and monitor her behavior.  This can work since she doesn't have a history of substance abuse and presumably will otherwise take care of herself, as in eating good meals, getting enough sleep, etc.  The price quoted is less than 300 baht per day for two daily visits, which is quite realistic for the attention of a certified nurse.  

[kelts]

kelts, so good to learn that your family may have found a good outcome.  It's wonderful that the local hospital is working with your family in having a nurse come to visit Ma twice daily to administer medications and monitor her behavior.  This can work since she doesn't have a history of substance abuse and presumably will otherwise take care of herself, as in eating good meals, getting enough sleep, etc.  The price quoted is less than 300 baht per day for two daily visits, which is quite realistic for the attention of a certified nurse.  

Yep. The head nurse wanted 30,000B per month. It turned out there was a cousin who just finished his degree but has been working at the hospital for many years, which is the case a lot of the time in these small towns. There’s cousins everywhere, lol, so it worked out well. He seems very knowledgeable, I went through every possible scenario with him and he knew what to do, so it’s up to Ma now. Fingers crossed. Thanks again Nancy.


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