Monday, December 29, 2008

We visited Sam on Christmas Day morning to take presents. We were greeted by the nurse in charge dressed as Father Christmas and Sam was just returning from a game of pool.

We had a pleasant half hour with Sam opening presents then we left and Sam's Granny and Grandad and aunt saw him for a little while to give him their presents. Sam was lovely with them and was very pleased with a book about climbing from his aunt.

It made a good start to Christmas day for us all.

We visited Sam again on Boxing Day when he wasn't so well but there were at least no serious problems but on Sunday Jane visited again with my sister and stayed for ages - Sam was very calm and enjoyed their company.

We're going to visit friends for the New Year - so an early Happy New Year to you all.

Wednesday, December 24, 2008

We had a family meeting with Sam yesterday - was it really only yesterday? With preparing for Christmas it seems an age ago now.

It went well. This time the clinical psychologist from the ward and sam's named nurse joined us too. That was much better - and they said they'd found it very useful. Sam's clinical psychologist from the Assertive Outreach team led it. He is very skilled. Also Sam trusts and respects him. That helped it go so well. We were in there for nearly an hour and a half which is a long time for Sam to concentrate - though he was able to pop out ocasionally for a cigarette break or to get a drink if he felt the need for a break. Towards the end it got slightly hairy - it looked as if Sam might be violent towards me but he gave me a hug. The nurse was very skilled though - he got close to intervene if necessary but let it go - trusting our judgement rather than jumping in too soon.

So that was good.

We have arranged to visit Sam tomorrow morning - Christmas Day morning. This is in the middle of preparing Christmas dinner for six. I think Sam will find it difficult being locked up again on Christmas Day. So we will have to be very flexible and respond to his mood tomorrow.

I would like though to take this opportunity to offer seasonal greetings to all readers of this blog. Thank you for continuing to follow this story. For those of you who celebrate Christmas I hope you have a very special day. Please spare a brief thought for Sam.

Sunday, December 21, 2008

We visited Sam just briefly yesterday. We planned it that way from the start. We did not want time for any antagonism to be created - and so to avoid any problems. But we wanted to see him so he knew we were not abandoning him.

He'd phoned quite well a couple of days before - talking articualtely about some music artists - so I took him a music magazine in. He was dismissive of it - he wasn't interested in rock music. He started asking again why he was locked up - was it because he could fly and change the television and read people's minds? The doctor was an idiot.

So we smiled and told him how much we loved him and left, avoiding any conflict.

I was upset as we walked away - wondering what we might see of him over Christmas.

Thursday, December 18, 2008

When we met with Sam last Saturday he was calm and friendly at the start. I found myself just looking at him as he sat there quietly. I was imagining what if he started what might pass as a normal conversation. What if he was better and we could put it all behind us?

Just a short dream.

But how wonderful it would be . . .

Wednesday, December 17, 2008

Jane went to the ward round meeting yesterday. They weren't ready for her so she had to wait on the ward - and of course Sam was about. It wasn't at all easy even though staff had been told not to leave them alone together. It would have been good to have had chance for a private discussion with the staff but Sam quite understandably didn't want people talking about him behind his back.

In the meeting he got angry and aggressive again about why he is locked up. This time it was the psychiatrist who got the brunt of it. Normally we are not always so understanding of psychiatrists but he had a bad cold and had probably only come in for this meeting as he was going home to bed straight after. So to have Sam restrained by staff from attacking him probably wasn't the best tonic.

Jane found it all very hard but the staff were still very understanding and supportive. It is certainly a change from the previous ward.

But it still leaves the worry of what next ...

Sunday, December 14, 2008

We visited Sam on Saturday. As he came in he apologised immediately for what had happened on Tuesday. He so rarely apologises it was good to hear it. He was calm and sensitive and seemed genuinely well. He asked for a cuddle from his mum and things were going well.

A ittle later he suddenly started asking me again why I had locked him up. Was I trying to punish him? He wouldn't be distracted from his questions but became more insistent. His eyes had changed and he was staring at me in a fixed way.

I was worried. I would have found an excuse to leave the room but he was between me and the door. I was worried that a movement from me could actually provoke something as he was becoming more and more agitated in his questioning.

Because of what had happened on Tuesday two members of staff had been positioned outside - there was a window in the door and the wall. But they couldn't see anything awry and I couldn't catch their eye. I was worried that Sam was going to hit me. I just kept trying to calm the situation and lower the tone. Then Jane said something to try to reassure Sam.

Without any warning Sam slapped her across the face with a hard blow. I jumped up and Sam stood. I tried to hug him to turn the situation away from violence as the nursing staff rushed into the room. Sam just stood there with an empty expression on his face. The staff took hold of him firmly by his arms and led him away as I turned to Jen.

A female nurse came to join us and talked to us kindly as we checked that Jane had not been seriously injured by the blow.

Where next ...

If we cannot even visit Sam now without him being violent - then we are becoming part of the problem not the solution. Sam is still so very poorly - he was talking again of being able to fly and being on the television for instance and has recollections of first being detained that have no connection with the realty of it. It is as if he is continuing to get worse - yet there are nurses who still talk of just finding the right medication - as if after over eight years of trying different combinations of medication that this wouldn't have happened by now.

It is harder and harder to maintain hope.

Thursday, December 11, 2008

I had a call today from a nurse on the ward - Sam was using up lots of batteries listening to his portable cd player - please could we bring him in some rechargeable batteries and a recharger. Of course. I wonder what happened though to the same we took in to his previous ward having received the same request.

It took visits to five shops before I found one - they seemed all full of Christmas items. Though I would have thought batteries were an essential item of so many Christmas gifts.

I asked him how Sam had been since the meeting on Tuesday. It seems that after the meeting he went to bed. The nurse didn't describe it as an "incident" though - I forget his words now but it was more in the sense of a minor difficulty. Far smaller things have been built up on other wards into major incidents. Here they seem to play things down which is good - and seems to show their level of confidence and experience which is reassuring. Twice since then Sam had been angry and threatening but it had been easily defused. I am gaining more confidence in this ward to deal with these kind of situations appropriately.

Wednesday, December 10, 2008

Yesterday we had one of our family therapy meetings on the ward. It is the first since he has moved there. As with most places though the ward staff seem removed from it and almost suspicious. It isn't part of what they do. At the moment they are "observing and assessing". As Sam is asleep most of the time there is little to observe or assess.

A member of the nursing staff agreed to be involved - but they clearly saw it as monitoring rather than being involved. There had been a lack of communication somewhere along the way. Sam had to be woken up. It takes him ages to come round. It was not a good start.

He began by telling us how he could fly. It was hard to hear him because his speech is so slurred now with the effects of the medication - that is clearly having no positive effect. Together with the noise of the air conditioning fan, understanding him was hard.

He became angry that I would not believe that he could fly and tried to explain that the "Incredible Hulk" on the TV was fiction not reality. He was angry with me for locking him up. It was all my fault. Without warning he picked up the table and hurled it across the room. We calmed Sam and sat him down again just as several burly nurses crashed into the room - it is all supervised by closed circuit television. We reassured them that everything was okay and we wished to continue. Sam's psychologist is very skilled and together we soon calmed Sam again.

Sam sat with his mum and asked for a cuddle. We chatted some more. Sam went for a cigarette - he said he would be sane when he came back. He has managed that before. He can make himself sane sometimes when he is motivated enough - a cigarette seems to help. But mostly it is easier to be mad.

When he came back though he was not better and continued to be irrational and argumentative. He is so angry at being locked up and now has no leave at all - and apparently little to do other than sleep.

Jane and I had to go. Jane had a train to catch. As we left Sam pushed past to try to go with us - to escape from his confinement. Of course there is another locked door. He knew he could not get out. I took him by the hand and led him back into the room. Once in he became angry again. I was the one who had brought him back. He pushed me onto the settee and made as if to throw a punch at me.

The burly nurses arrived again at that moment and restrained Sam. I don't think he would really have thumped me but he is so very angry. One day he will.

That evening he phoned. He wanted me to believe he could fly. I tried to change the conversation and, when that failed, to end it. Sam started banging the phone against the wall. It's the last I have heard from him. I haven't phoned the ward. What is there to say?

I've just been weary and very tired.

For the first time Jane is beginning to get pessimistic about outcomes. What more can we do?

Monday, December 08, 2008

"I'm sorry I kicked you, Mum."

They were Sam's first words as we sat down in the quiet room for our visit on Saturday. It was the first time we'd met since Sam had kicked his mum during the visit last week. I'd almost forgotten. Sam so very rarely apologises - he feels too hard done to I guess - so this seemed like a good start.

From then on though we were talking of aliens and time travel and religious experiences and him being on TV and being able to change the music coming from the radio ... he seemed down, depressed, fed up at having been locked up for so long.

The next day I went on my own as Jane wasn't too well. The meeting seemed to start where we'd left off the day before and I was desperately trying to move the discussion from illusion to reality. Then Sam laughed over something and I laughed with him. He discovered enjoyment in laughing so I started saying some silly things - and we just had a laugh together over nothing really. Sam didn't want me to go. He was enjoying himself.

It's good to have a laugh sometimes.

Monday, December 01, 2008

As we left yesterday the nurse was describing the assessment process to us ... how it would take six to eight weeks to assess Sam.

Sam has been in hospital and assessed on an ongoing basis for many years. Cannot they pass records on to each other? Sam's now fill a filing cabinet. Because there are so many they are useless. Can they not produce a transfer record to save them having to find everything out again for themselves? Or do they have as little faith in the judgement of their colleagues as we do?

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