"My elderly mother has not received the care she requires"

My elderly mother has not received the care she requires. She was recently diagnosed with Parkinson's as well as BiPolar disorder and, now, unmanaged lithium levels. Mum’s recent emergency surgery for a twisted bowel came after nearly a year of trying to get a scan on her bowel for severe symptoms of constipation.

Although no scan came, when my mother woke up vomiting blood and excrement, she was admitted by blue lights for emergency surgery on (what turned out to be) a twisted bowel. Post operation, she required time in ICU and HDU. She was in hospital for approx four weeks. Despite my mum’s mental functioning and mental health being stable before being admitted into hospital, after the operation she did not receive her Parkinson’s and lithium medication regularly. This led to a decline in her mental functioning and a further diagnosis of post-operative delirium. Despite this and the subsequent mobility issues, mum was then discharged without a care package in place.

My father has tried to cope but the challenges faced by looking after someone with delirium and mobility and physical issues without professional support has led to a decline in his own daily functioning. At present there is still no care package in place.

When my mother’s CPN came to visit, she took blood to assess lithium levels. The results came back as 1.3 (which is 0.1 above the upper level). However, despite the risks around this no advice on what to do next was given.

Yesterday, a week later and due to a further rapid decline in my mother’s cognitive functioning, my sister was asked by the community mental health team to fast track mum to A&E to get her lithium levels checked as a matter of urgency. They said due to her risks and presenting symptoms, an assessment by the crisis team was warranted for possible detention under the MHA.

 My sister arrived at A&E at 4pm then triaged where the situation was explained. Bloods were taken but at 9pm they still hadn't seen anyone. My mother had last eaten at around 1.30pm and due to the urgency of the situation they had no food on them. The vending machine was pretty much empty; there wasn't a drinks machine that was working or had drinks in it and nobody offered her a drink.

 At around 8 my sister enquired what was happening as my mothers confusion was increasing and she was trying to remove her clothes in the waiting area.

A lovely nurse found a cubicle for them so my mother could pay down on a trolley. At around 8:30 my sister asked for some information about why our vulnerable elderly mother had not been seen. In an unprofessional tone of voice, a doctor replied by asking what exactly we wanted them to do about it? My sister asked them to check the lithium levels of my mother’s blood. It turned out that this test hadn't even been completed with the already-taken blood sample, so more blood was taken meaning they had to wait even longer.

While the busyness of the department is understood my mothers deteriorating health was at risk of further decline. In the whole time we were there nobody enquired about the symptoms she was experiencing.

It was discovered that her lithium levels were high and she was dehydrated. The psychiatric liaison team assessed her as not having the necessary capacity to make a decision regarding her own care and treatment. This was at approx 11.30pm. When I arrived at 11.45pm my sister said they were still waiting for the crisis team to assess her under the MHA. At around 3.30am - nearly 24 hours after my mother had first attended A&E - a doctor came to the bay and said that organic causes for my mother’s decline had not been assessed, so these would have to be explored before a MHA assessment could be undertaken. They said that a bed was available in the assessment unit.

20 minutes later a nurse arrived and asked if my mother had been taking her medication regularly. I informed them that she had been being cared for by my sister and brother in law and, yes, she had been taking medication for Parkinson’s and bipolar. The nurse expressed surprise, and I found out they did not know about her Parkinson's.

When the nurse led us to the bed on the assessment unit, we were initially told that no bed was available. Then they said there was a bed but they had no idea it had been allocated to my mother. When my mum had been supported into bed, she was provided with a hot cup of coffee in a vending machine cup. I told the nurse that my mother doesn’t have the coordination skills to independently drink from the cup and she would likely burn herself. I explained she had Parkinson’s and they were also not aware of her conditions. This nurse was supposed to be her named nurse and should’ve received a full handover from the other nurse ...

Gratefully this nurse went to find a double handed beaker. I supported my mum to drink, and at 6 am (after being in work myself since 6am the previous day) I went home.

Today we have been told that nobody is allowed to sit with her. This is a terrifying prospect.