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HomeHealthCan A Dementia Patient Be Sectioned

Can A Dementia Patient Be Sectioned

What Are The Early Signs Of Dementia

Dementia, ‘sectioning’ and The Mental Health Act 1983 – Alzheimer’s Society podcast October 2015

The onset of dementia is not obvious because the early signs can be vague and quite subtle. The early symptoms usually depend on the kind of dementia that one has and therefore can vary greatly from one person to the next.

Even though the signs can vary, there are some that are quite common and they include:

  • Depression, apathy, and withdrawal
  • Memory issues, especially when it comes to the most recent events
  • Inability to handle the everyday tasks

At times, it is easy to miss to appreciate that the above symptoms could be an indication of something that is not right. Yet there are those who assume that the signs are normal and are associated with aging. It is also possible for one to develop the symptoms in a gradual manner and they may go unnoticed for quite some time.

People may not act even when they can tell that something is definitely wrong. It is important to have a checklist of all signs related to dementia and get the person the needed help when several of such signs are observed. It is important to get a more detailed assessment.

Memory loss and dementia: while it is normal to forget some things and remember later, persons with dementia tend to forget more frequently and they do not remember later.

Tasks: distractions can happen and you may forget to, say, serve one part of the family meal. For a person that has dementia, preparing the meal could be problematic and they may actually forget some of the steps that are involved.

Three Facts Worth Knowing

A section should only ever happen as a last resort when all other alternatives have been explored. If you dont think this has happened you can challenge it . A section is designed to protect, not punish, the person with dementia and keep them safe from harm. In 2012/3 nearly 9000 people over 65 were sectioned under the Mental Health Act, at least half of these were estimated to be sectioned as a result of severe dementia.

What Can Cause A Lack Of Mental Capacity

Lack of mental capacity can be caused by many things. It can be:

  • permanent, where someones ability to make decisions is always affected. This could be because of a stroke or brain injury, severe dementia or learning disability
  • temporary, where someone has capacity at some times but not others. This could be because of a mental health problem, substance or alcohol misuse, or confusion, drowsiness or unconsciousness because of an illness or treatment.

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Tips On Choosing A Care Home

One of the most important things to check when choosing a care home is the most recent Care Quality Commission report.

The CQC regulates all care homes in England. Its inspection reports can show you how well a care home is doing and any areas of concern.

When visiting a care home, spend time looking around and talk to the manager and other staff and residents.

It’s useful to take a friend or relative with you as you can compare notes after your visit.

It’s a good idea to make your own checklist before visiting care homes. These tips may help.

The Mental Health Act 1983

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The 1983 Mental Health Act is the current principal Act governing the treatment of people with mental health problems in England and Wales. Its primary role is protective. Whilst the Act outlines a range of responsibilities and duties, its power to enforce the compulsory detention of a person with a mental disorder in a psychiatric hospital is one of its best known functions. There are plans to review the Act at a future date.

Compulsory admission under the Act may take place when the patient is:

  • suffering from mental disorder and
  • detention is necessary in the interests of his or her own health or safety or for the protection of others. Only one of these latter grounds needs to be met and a person need not be behaving dangerously to be compulsorily detained .

There are three admission procedures under the Act which result in compulsory detention:

  • emergency admission for assessment for up to 72 hours
  • admission for assessment with or without treatment for up to 28 days, which is not renewable
  • admission for treatment for up to six months, renewable for a further six months, and thereafter for periods of up to 12 months at a time .

The patient’s ‘next of kin’ can also ‘apply’ for their relative to be detained under the Act and has the power to formally request an assessment under the Act in certain circumstances. For more about who qualifies as next of kin and what the duties and powers of a nearest relative are, see Further information.

Patients’ rights

Further information

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Who Can Be Sectioned

Under the Mental Health Act 1983, you can be kept in hospital for a specified period of time if certain conditions apply. These conditions are quite stringent – so you don’t need to worry about being sectioned if, for example, you visit your doctor with depression or anxiety. Nor can someone else call for you to be sectioned without good reason.

You can be legally sectioned if you need to be treated for a mental health condition, and you aren’t well enough to make decisions about your treatment at that time. Without treatment, your safety or someone else’s safety would be at risk, or your health would decline.

“There are specific steps that need to be taken before a person can be detained under the Act,” says Johnstone. “In most cases, three medical professionals – two doctors and an Approved Mental Health Professional – need to agree that you need to be detained, although this can be reduced to two if the circumstances require more urgent action. At least one of them needs to have met you before if possible, and all need to have assessed your case within five days of each other.”

During the coronavirus pandemic, the rules are slightly different: you only need to be assessed by one doctor rather than two, and while the doctor needs to specialise in mental health, they don’t need to have met you before. In some cases, you might see one or more of the professionals via video call.

Signs Of Death In Elderly With Dementia: End Stage

Dementia is a term used to describe the persistent or chronic decline in ones mental processes and this include personality changes, impaired reasoning, and memory loss. The most common form is Alzheimers disease and it accounts for over 70 percent of all the dementia cases.

It is one of the greatest causes of death in the United States with over five million people living with the disease in the country alone. One of the age groups affected by dementia is the seniors. If you are a caregiver, it is important to know the signs of death in elderly with dementia.

Most progressive dementias and Alzheimers disease do not have any cure. The diseases get worse with the passage of time, but the timeline can be very different from one person to the next.

Caring for persons with the diseases can be stressful and very challenging, especially when their personality begins to change and their cognitive function starts to decline. It is possible that the individual will not even recognize the people who are closest and dearest to them.

As the disease progresses, the person needs more and more support from the caregiver and the family. If the person is elderly, the caregiver needs to know about all the signs that the patient may be dying.

You may need to put the patient on hospice so as that he or she can get the appropriate care during such moments. This offers the family and the patient spiritual, physical, and emotional care.

Content:

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Who Can Get Section 117 Aftercare

You can get free aftercare under section 117 if you have been detained:

  • for treatment under section 3
  • under a hospital order under section 37
  • following transfer from prison under section 47 or 48
  • under a hospital direction under section 45A

See our information on sectioning to find out more about what these different sections mean.

You also have the right to section 117 aftercare if:

  • you have been discharged onto a CTO for the entire period of your CTO, or
  • you are a restricted patient on a conditional discharge.

You may have a right to aftercare when you are on leave from hospital. If your leave is open-ended, unescorted or for a long time, then you should able to get aftercare while on leave if you need it. You can speak to your responsible clinician about the support you need.

You have the right to section 117 aftercare after you leave hospital whether you:

Examples

What Is The Sdcp

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The SDCP supports people with very severe behavioural and psychological symptoms of dementia who cannot be cared for in a mainstream residential aged care facility.

The SDCP provides specialised care for people:

  • who live with very severe dementia complicated by physical aggression or other behaviours
  • whose residential care facility or carers cannot manage the behaviours, even with help from other services

The SDCP provides:

  • person-centred care from staff with dementia training
  • support from specialist services
  • a small, cottage-like, dementia-friendly living environment

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Ending Section 117 Aftercare

There are no clear rules in the Mental Health Act for deciding when a person no longer needs aftercare but section 117 of the MHA says that it is up to the health and social services who are dealing with your case to make a joint decision that you no longer need it.

They must be able to give clear reasons for their decision and your needs must be reassessed before the aftercare is ended, to see how your mental health and ability to manage would be affected.

Guidance says that even if you are well settled in the community, aftercare may still continue to prevent you from becoming ill again or from getting worse.

What Are The Warning Signs That Life Is Nearing An End

When an elderly person with dementia is almost bearing their end, it can be very traumatic especially for the loved ones. It is important to have an idea of what signs one needs to expect when the end comes as this can give you some sort of comfort.

When you think of a condition such as Alzheimers disease, a person can live for over 10 years with it. It is possible to make the person happy over those years. Since we are not immortals, at some point life does come to an end when you have dementia and it is something that one needs to be prepared for especially if they are caregivers.

Handling the final stage of dementia is much easier, especially when you are aware of the things that you should expect. It is important to give the person the kind of care that will award him or her dignified and peaceful death.

Usually, when a person is about to reach the end, the dementia symptoms usually get worse and this can be quite upsetting. Some of the things that you may notice include:

  • Limited mobility so they may have to be bed bound
  • Limited speech or no speech at all
  • Double incontinence
  • Difficulties swallowing and eating

It is important to note that the above symptoms do not really mean that the person will just die. There are people who can have such symptoms for quite some time. You should also remember that about two-thirds of dementia patients succumb to other ailments such as pneumonia.

Some of the other signs that can indicate that death is indeed close include:

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How To Test For Dementia

There is no single test that can determine a person is suffering from dementia. The doctor can diagnose different types of dementia such as Alzheimers based on their medical history.

This has to be done very carefully. In addition, the doctor may conduct laboratory tests, physical examinations, and changes in the way the patient thinks.

When all things are considered carefully, a doctor can be able to determine that a person is actually suffering from dementia with certainty. Determining the type of dementia can be hard, especially due to the fact that brain changes and symptoms that are associated with the different types of dementias sometimes overlap.

It is normal for the doctor to give a diagnosis of dementia without really specifying the type. In such a case, it is important for the patient to visit a specialist in this area like a psychologist or neurologist for a more specific diagnosis.

Who Pays For Care When Someone Is Sectioned

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Understanding who pays for care when someone is Sectioned is something that is actually quite straightforward. Its important to be aware of some key points, though.

One of the most important things to be aware of is the connection between the Mental Health Act and NHS Continuing Healthcare funding

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What Is Section 117 Aftercare

Some people who have been kept in hospital under the Mental Health Act can get free help and support after they leave hospital. The law that gives this right is section 117 of the Mental Health Act, and it is often referred to as ‘section 117 aftercare‘.

Aftercare is the help you will get in the community after you leave hospital. This can cover all kinds of things like healthcare, social care and supported accommodation.

Section 117 of the Mental Health Act says that aftercare services are services which are intended to:

  • meet a need that arises from or relates to your mental health problem, and
  • reduce the risk of your mental condition getting worse, and you having to go back to hospital

How Long Will You Be Sectioned For

How long you can be detained for depends on your individual circumstances. The Mental Health Act has different ‘sections’ , which are used for different reasons. However, the most commonly used is Section 2, which allows doctors to detain you for up to 28 days. This gives them time to decide what type of mental disorder you have, and what treatment you require.

Section 3 lasts for up to six months, and can be renewed.

There are also emergency sections, including Section 5 which lasts for no more than 72 hours. Under Section 5 , which only applies if you are a voluntary patient receiving treatment for a mental disorder as an inpatient, a specialist mental health nurse can detain you for up to six hours until a doctor or other clinician with authority to detain you can assess you.

Altogether, 49,988 people in England were sectioned between April 1st 2018 and March 31st 2019.

What happens when you get sectioned?

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When Patients With Dementia Become Combative Theres Often Nowhere To Go But A State Psych Ward

Cindy Piccirilli was out of options.

The Chesapeake assisted living facility where her spouse, 57-year-old Catherine Wright, had been living for nearly three months could no longer handle her violent outbursts and aggressive demeanor.

Wright, whose cognition had been steadily declining since she was diagnosed with early-onset Alzheimers disease five years earlier, periodically had what Piccirilli called violent, random episodes she would hit other residents and staff, and push and throw furniture around.

The former Virginia Beach public school teacher was younger than most residents in the memory care unit, and more able-bodied. It often took four staff members to bathe her.

When Wright became aggressive, staff at the assisted living facility, Commonwealth Senior Living at Georgian Manor, said Wright needed to go to a psychiatric facility, where her medications would be adjusted to deal with her dementia symptoms.

So one day in March 2018 after Wright had a particularly difficult weekend, Piccirilli finally agreed, hoping someone at a psych facility would figure out what was triggering the aggressive behavior and find a way to calm Wright down.

Health officials and experts agree this never shouldve happened. They acknowledge a state psychiatric hospital like Eastern State in Williamsburg wasnt the appropriate place for people like Wright, who become combative as a result of their dementia.

Joining The Quest: Studies Looking At The Link Between Dementia And Walking Difficulties

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Dementia can damage the brain in various ways and this includes mobility and motor skills. For people who are at risk, the exploratory studies around gait impairment as an early indicator for dementia, hold so much promise. With experts looking at changes in walking patterns and gait impairments as an early indicator of neurodegenerative diseases, private ventures are joining the research.

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Medical teams can intervene earlier with digital technology.

Early detection is crucial in improving the patients quality of life. However, the opportunity to detect dementia in its early stages is not always possible. Why? Most of the early symptoms of dementia such as forgetfulness or losing track of time are often relegated as age-related memory changes. Moreover, such impaired cognitive functions manifest gradually. Thus, by the time of diagnosis, dementia has already progressed. At this point, the patient has become totally dependent on others for self-care. With experts looking at the link between dementia and walking, we may soon have a better way of catching this debilitating disease in its early stages.

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