It is so frustrating as an administrator to deal with families who are so against getting advice and medication from psychiatrists. I have a resident who came to assisted living with short term memory problems, poor hygiene, had been sundowning before she was hospitalized at a behavioral unit, was extremely agitated and paranoid. After working with a psychiatrist for several months, her behavior significantly improved. She still did not understand why she could not "go home", but seemed to accept that "for today" she was going to stay with us. That was when the daughter was directing care. Unfortunately, another family member has now taken the lead in directing care. This family member is a physician himself and is one of those with the "God complex". He has a bias against psychiatrists in general and with this psychiatrist because he confronted him about his inappropriate ways of dealing with this resident. Since I have been called out to break up an argument between the two of them in the past and to deal with him "going off" on my staff members, the confrontation was necessary. So time to find another doctor who will go along with the anti-psychiatry bias.
Not only did the new doctor take the resident off an anti-psychotic medication "cold turkey", but decided to get rid of the Aricept because "what did it matter". It also angers me when a general practitioner labels someone with mid-stage dementia as having severe dementia. If you had worked in the long term care industry as long as I have and seen the people whose disease had progressed to where they require complete care for all their needs, then you can tell me when it is severe dementia. If someone has some short term memory loss and needs prompting to take care of hygiene, doesn't remember what day of the week it is and may call people of short term acquaintance by the wrong name-they do not have severe dementia.
So now, not only are we going to have to deal with behaviors that had been resolved with the medication, but the most frustrating aspect is to know the resident is upset by her paranoid delusions. How unfair to subject someone to that emotional pain because of the family member's ego issues. I've worked in and out of mental health for 20 years. When will the stigma ever go away to where people can get the help they need and deserve?
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