Huge decision to make. Incredibly long post. Sorry!

KentishLady

OK. I've types up my thoughts and concerns as follows. Comments welcome!!


[FONT=Times New Roman, serif]KentishLady's concerns regarding DH's discharge from hospital. [/FONT]


[FONT=Times New Roman, serif]In order for me to continue to have DH in my life, I need to ensure my physical and emotional safety and wellbeing. This means I must ensure my needs are met and do not become secondary to other peoples needs – this includes DH and my family. [/FONT]


[FONT=Times New Roman, serif]In view of the above and DH's behaviour last week I no longer feel I can continue in my role as DH's carer as I am not able to provide him with the care he needs without putting my health at risk. It is clear that he has been unstable in the years since our move to Kent despite my best efforts at managing him and his behaviour. This is his only hospital admission since 2004, however, his behaviour and instability has been such that he could have been hospitalised on a number of occasions in the last two years. I have been off from work with depression since April this year and will be returning to work in the next few weeks. [/FONT]


[FONT=Times New Roman, serif]I am prepared to accept some responsibility for ensuring that DH's care plan/package meets his needs and is appropriate. However I will no longer take responsibility for providing the care and support myself. [/FONT]


[FONT=Times New Roman, serif]My Needs[/FONT]


[FONT=Times New Roman, serif]In order for me to be able to be a support to DH I need to ensure that my needs are met. I need:-[/FONT]

1. [FONT=Times New Roman, serif]to be able to live in my home without risk of verbal or physical abuse to myself or my extended family. This is non-negotiable. Any further occurences of threatening violence, or behaving violently towards me, my family, or objects within my home will result in an irretrievable breakdown of our relationship and in the police/mental health team being contacted.[/FONT]
2. [FONT=Times New Roman, serif]To be able to work without being pressured to take time off to care for Stuart when he is in crisis. I currently work M-F 9-5 and will be out of the house between 7 am and 7 pm. I will be able to take time off for scheduled Dr's appointments but will no longer take emergency leave or time off because DH wants me at home. [/FONT]
3. [FONT=Times New Roman, serif]To be able to study without being interrupted so I can complete my degree. I need a minimum amount of time of all day Saturday and 3 evenings each week. [/FONT]
4. [FONT=Times New Roman, serif]To have my family visit my house without risk of DH hurting them, or of them witnessing behaviour like that last week. I need one weekend per month without DH in the house so that I can have my nephews over to spend time with me safely. I do not feel that it is safe or appropriate for them to have any contact with DH. [/FONT]
5. [FONT=Times New Roman, serif]To have respite from DH for 4 weeks each year. Two of these weeks I will stay at home and continue working – these two weeks DH will need to go stay with his family. The other two weeks I will go away for University summer school or similar – DH can either stay at home with appropriate support, or, go stay with his family. [/FONT]
6. [FONT=Times New Roman, serif]Providing the household chores have been done by DH then he can have two evenings of my time each week and all day Sunday to spend as he chooses (within reason). If the chores have not been done during the week then I will do them on Sundays and we will then spend time together once the chores are completed. [/FONT]
7. [FONT=Times New Roman, serif]We must have an agreed care plan in place before DH can be discharged to our home. This must include[/FONT]
   1. [FONT=Times New Roman, serif]Agreed activities that DH will try and continue doing if he finds them enjoyable. Suggested activities that DH has enjoyed in the past include fishing, playing pool/snooker and watching football matches. [/FONT]
   2. [FONT=Times New Roman, serif]A named professional responibile for reviewing and managing the care plan on an ongoing basis. [/FONT]
   3. [FONT=Times New Roman, serif]A “Wellness & Recovery Action Plan” which details (in addition to the normal care plan contents) how we will prevent crisis from occuring, how we will identify the potential crisis, how crisis will be managed including treatment options such as hospitalisation. [/FONT]

SUESMITH_2

nothing to add really but i just wanted to send you hugs and say i'm thinking of you, i can't imagine what you've been through but i think your last post is with what you would like to happen is very reasonable,

Optimisticpair

You are one strong, brave and obviously capable girl. You are no good to anyone though if you break your own health from having more to cope with over an extended period than you can manage. I think your notes there are good sense and fair all round. You do have to take of yourself to be there for everyone else and it has to be the first priority for that reason. The only thing I can think of that might be added is some kind of training support for yourself.

I wish you all that I would wish for myself and mine.

Floxxie

I'm really sorry to hear of the difficult situation you find yourself in.

I was wondering if your OH has had any blood tests recently? I ask because my father displayed very similar symptoms as your OH and it transpired that the medication he was taking had caused his salt levels to become too high (I may have got the 'salt' element incorrect but it was some major chemical).

Regardless of the cause of his behaviour, I agree that you cannot continue as you were. I wish you well.

Floxxie

Steel_2

That is a fantastic. Brilliant and very clear.

Will you give that to the doctors?

And good on you for not letting that nurse back you down.

Errata

Stick to your guns. You understand very clearly how seriously ill your OH can become and the implications of that. I honestly can't see how your needs as you have detailed them can be met, but the next step could be a suggestion from the mental health professionals that your OH has trial home visits and weekends with you.
My suggestion would be that he moves into a 'halfway house' where he can demonstrate that he is stable and able to function reliably and safely. It doesn't have to be a straight choice between being in hospital and living with you at home. Best wishes.

Giraffeseeker

KL - I've been following your thread for a couple of days and I wanted to say how strong and brave I think you are being. You have such a busy life - family, lodgers, full time work and a degree, as well as caring for your DH - you are obviously an incredible person to be able to fit it all in. I think your notes are very clear and give you what you clearly badly need, which is respite from your DH and time for yourself that you deserve. I think that one weekend a month and 4 weeks per year is completely reasonable. I really hope you get the professional support you deserve and can make things work for you with DH at home. Best wishes xx

Dill

I just wanted to say well done for being assertive. Not an easy thing to do when dealing with professionals who, because of lack of resources, often just seek the easiest and quickest solution.

Do you have someone there who deals with the Carer's needs, who can support you?

yoni_one

You have clearly thought this through and identified your needs. I am very relieved to see you prioritise your safety and that of your family.

Your determination to have a voice and remain an important link in the care provision is really commendable. You are considering the option of DH continuing to live in the family home but as a lodger, from all you have described it does not appear that this arrangement will reduce risk of harm from physical, verbal, emotional abuse in the home. I have no idea how you will balance your needs and your wants but I am pretty sure you will find a way to manage it effectively and within your boundaries.

Have you considered contacting Women's Aid for support for you? I know this is not a typical case of Domestic Violence and Abuse given the severity of your DH mental health problems, however, if you can access a good outreach worker they should potentially be able to bring further options to the table all of which will be underpinned by the need to stay safe.

At the very least they can provide a professional ear for you to bounce off.

My heart goes out to you for all you have been living with and the decisions you face. If you wish to contact an organisation dealing with Domestic Violence and abuse you can locate your local agency on www.womensaid.org.uk or ring the freephone national helpline on 0808 2000 247. You may also find out more about your rights and options regarding your divorce from Rights of Women - www.row.org.uk

Can I just add that I really admire your communication skills and your ability to identify your needs objectively however your feelings are not so clear (which may be as you prefer). However, Womens Aid will also offer the opportunity to offload all that in a safe and non-judgemental environment, should you find that helpful.

I am so sorry you are in this position and really wish you all the best in the future.

pickle

I think it's great that you're making it clear what the terms are. I would add how often you want the situation reviewed (point no. 2 at the end) otherwise it's left to the caseworker as to how often. I would also make it clear that he is currently pyschotic with paranoid ideation (believing that bugs are in his teeth etc.) and as he has made threats in the past that this is unacceptable and that you must see evidence that his pyschosis has been resolved before you will even consider discharge to your home. I really think that this is an issue as the paranoia could turn against you (which he has indicated before). I think that clearly stating that you will no longer be responsible for his care is also a good step as often it is assumed the family will step in and fill the gaps. They will have to make a proper discharge plan with services if you withdraw support. But it would need to depend upon your safety and others in the house as the primary concern. Good luck with it, you're going about it the right way in my opinion. Often the loudest get the most. If you say nothing you get nothing in my experience.