Relative in denial of type 1

[tim2000s]

Sadly, @MickyFinn she sounds as though she rejects any kind of authority - the situation with Antibiotics and going off the ward, or eating before an op forcing it to be cancelled appear to be pretty good examples of that. Anyone telling her what is good for her will also fall under that aspect of her personality. Whether it is a personality disorder or something she does deliberately is something that we haven't a clue about.

I don't know what her current condition is, but I suspect that the only thing that is really going to make a difference to her is a massive shock, whether that's something like retinopathy or neuropathy, or whether it's being told that her toes need amputating.

What often happens is that the sudden shock combined with the realisation that she might not be therefore for someone she loves, probably the kids in this case, jerks people into the realisation of what they are doing to themselves. I wrote a bit about it here, and it's a real challenge for the medical profession and friends and family to be the catalyst that brings about the required change.

 

[noblehead]

It's the only hospital in the area, so her consultant would work there, so that is one possibility.

A consultant would be ideal, if they feel it's necessary I'm sure they could involve a counsellor or psychotherapist to assess her.

 

[MickyFinn]

Sadly, @MickyFinn she sounds as though she rejects any kind of authority - the situation with Antibiotics and going off the ward, or eating before an op forcing it to be cancelled appear to be pretty good examples of that. Anyone telling her what is good for her will also fall under that aspect of her personality. Whether it is a personality disorder or something she does deliberately is something that we haven't a clue about.

I don't know what her current condition is, but I suspect that the only thing that is really going to make a difference to her is a massive shock, whether that's something like retinopathy or neuropathy, or whether it's being told that her toes need amputating.

What often happens is that the sudden shock combined with the realisation that she might not be therefore for someone she loves, probably the kids in this case, jerks people into the realisation of what they are doing to themselves. I wrote a bit about it here, and it's a real challenge for the medical profession and friends and family to be the catalyst that brings about the required change.

Most people would have taken an insect bite becoming infected and turning to sepsis as a wake up call. The sepsis was in no small part due to her own neglect of her health and refusal to go into hospital for treatment. She has taken none of it seriously and thinks it's all a laugh. When she was told that eating the biscuits when she was nil by mouth before the op, could easily have caused her to choke to death when the tube was inserted and she was anaesthetised, she laughed that off too.

 

[azure]

To be honest, she's running rings around the hospital staff and thinks it's funny to do so. She has a set time for antibiotic treatment in the evenings apparently, and the nurse asked her to remain on the ward, so it could be administered next. She ignored that and cleared off downstairs to smoke, only came back 20 minutes later and declared that she was ready for the treatment, but had managed to knock the cannula out of her arm. She eats before a scheduled operation and gets it cancelled, and is apparently unrepentant. She should have one last been in two or three days for treatment on her infected arm, yet it's now two weeks, and she has been the direct cause of the prolonged stay. I could go on, but suffice to say, her attitude really isn't acceptable.

If I was in the hospital, I would do whatever I could to make sure I will in there no longer than I needed to be. I certainly wouldn't pull cannulas out, or go missing for scheduled treatment etc and try to cause as much disruption as I could. How long before her antics start to impact on other patients? So yes, it stinks, and from what I have been told last night, I am wondering if anyone can get through to her.

I might add that she has removed three cannulas herself in the past two weeks.

That sounds to me like she has an actual issue needing some kind of medical input. Sticking your head in the sand about diabetes is one thing, but sabotaging treatment like that, laughing at the trouble caused, etc, sounds like she needs some definite help.

If she'd only become like this recently, I'd think maybe there was an external cause like her children becoming adults or whatever, but as it seems, from what you say, that she's always had this attitude, then I personally think it needs professional assessment and input.

Interestingly, she hasn't refused treatment or left the hospital, she's just delayed things and made it drag on. I would imagine that's either because she can't help,herself or because she likes the attention and enjoys seeing people fretting over her. If it was the latter, that would inform my approach, but I really think her family should get advice from a professional about her whole attitude and what might be causing it, and what might help.

 

[Emily101]

I am not 100% sure who supplied her with the biscuits. It could easily have been a family member, but there is a convenience shop alongside the ubiquitous Costa Coffee on site in the hospital foyer, she can get them herself if she wants.

She's 45 and has three children of her own, two of which are young adults. Even my mother, who has more patience than anyone I know, has said there's no talking to her.

That sounds to me like she has an actual issue needing some kind of medical input. Sticking your head in the sand about diabetes is one thing, but sabotaging treatment like that, laughing at the trouble caused, etc, sounds like she needs some definite help.

If she'd only become like this recently, I'd think maybe there was an external cause like her children becoming adults or whatever, but as it seems, from what you say, that she's always had this attitude, then I personally think it needs professional assessment and input.

Interestingly, she hasn't refused treatment or left the hospital, she's just delayed things and made it drag on. I would imagine that's either because she can't help,herself or because she likes the attention and enjoys seeing people fretting over her. If it was the latter, that would inform my approach, but I really think her family should get advice from a professional about her whole attitude and what might be causing it, and what might help.

That sounds to me like she has an actual issue needing some kind of medical input. Sticking your head in the sand about diabetes is one thing, but sabotaging treatment like that, laughing at the trouble caused, etc, sounds like she needs some definite help.

If she'd only become like this recently, I'd think maybe there was an external cause like her children becoming adults or whatever, but as it seems, from what you say, that she's always had this attitude, then I personally think it needs professional assessment and input.

Interestingly, she hasn't refused treatment or left the hospital, she's just delayed things and made it drag on. I would imagine that's either because she can't help,herself or because she likes the attention and enjoys seeing people fretting over her. If it was the latter, that would inform my approach, but I really think her family should get advice from a professional about her whole attitude and what might be causing it, and what might help.

It sounds to me like the sabotage could almost be a distraction technique to distract herself and others of the real issue- the severity of her diabetes. Or as others have said, a defence. If she sabotages her health then she's in complete control, it's her terms, her fault. It's almost like someone being really mean to someone they like incase of them later being mean to them. It means if the person is eventually mean to them, they know the probable reason why. It sounds really confusing, I'm just struggling to explain it clearly xD

 

[catapillar]

@MickyFinn it does sound like it goes far beyond a traditional denial. If she's intentionally sabotaging treatment and enjoying the game (at what I'm sure must be terrible cost to her family). It might be worth suggesting that someone asks about a psych referral - it might be that the ward she is on would be very receptive to this given the behaviour you describe while she's been admitted & now might be the best chance of getting those psych issues noted, because they are being played out in real time at the hospital.

However, @Indy51 i don't think it is correct to say that a section would be a solution because:
- the risk to yourself bit is really concerned with immediate active plans to harm yourself, rather than neglect of a long term condition; and
- even if you are detained under the MHA as a risk to yourself, they can't treat you for a physical condition without your consent under the Mental Health Act, unless you lack capacity to make the decision, in which case you'd be treated under the Mental Capacity Act.

In this case, it would probably take a pretty brave psychiatrist to find that she lacks capacity, and then some pretty unpalatable deprivations of liberty (locking her in a room pre surgery to prevent access to food?) in order to provide treatment in her best interests.

That's not to say some sort of psych intervention might not be helpful though.

 

[MickyFinn]

It sounds to me like the sabotage could almost be a distraction technique to distract herself and others of the real issue- the severity of her diabetes. Or as others have said, a defence. If she sabotages her health then she's in complete control, it's her terms, her fault. It's almost like someone being really mean to someone they like incase of them later being mean to them. It means if the person is eventually mean to them, they know the probable reason why. It sounds really confusing, I'm just struggling to explain it clearly xD

It could easily be a distraction technique, suffice to say the hospital want rid of her and she has exasperated everyone.

 

[Emily101]

How are her children with it all? Also, is she still with their dad?

 

[MickyFinn]

@MickyFinn it does sound like it goes far beyond a traditional denial. If she's intentionally sabotaging treatment and enjoying the game (at what I'm sure must be terrible cost to her family). It might be worth suggesting that someone asks about a psych referral - it might be that the ward she is on would be very receptive to this given the behaviour you describe while she's been admitted & now might be the best chance of getting those psych issues noted, because they are being played out in real time at the hospital.

However, @Indy51 i don't think it is correct to say that a section would be a solution because:
- the risk to yourself bit is really concerned with immediate active plans to harm yourself, rather than neglect of a long term condition; and
- even if you are detained under the MHA as a risk to yourself, they can't treat you for a physical condition without your consent under the Mental Health Act, unless you lack capacity to make the decision, in which case you'd be treated under the Mental Capacity Act.

In this case, it would probably take a pretty brave psychiatrist to find that she lacks capacity, and then some pretty unpalatable deprivations of liberty (locking her in a room pre surgery to prevent access to food?) in order to provide treatment in her best interests.

That's not to say some sort of psych intervention might not be helpful though.

I don't think having her sectioned would be appropriate either. Psychological help may be of use but access can be limited due to a lack of funding in mental health.

 

[catherinecherub]

I would say that she has a personality disorder and they are very difficult to treat.
She is getting more attention by behaving in the way that she does. If she had gone into hospital, did as she was told and then came out again then the attention she craves would have been sadly lacking for her.

 

[Jaylee]

To be honest, she's running rings around the hospital staff and thinks it's funny to do so. She has a set time for antibiotic treatment in the evenings apparently, and the nurse asked her to remain on the ward, so it could be administered next. She ignored that and cleared off downstairs to smoke, only came back 20 minutes later and declared that she was ready for the treatment, but had managed to knock the cannula out of her arm. She eats before a scheduled operation and gets it cancelled, and is apparently unrepentant. She should have one last been in two or three days for treatment on her infected arm, yet it's now two weeks, and she has been the direct cause of the prolonged stay. I could go on, but suffice to say, her attitude really isn't acceptable.

If I was in the hospital, I would do whatever I could to make sure I will in there no longer than I needed to be. I certainly wouldn't pull cannulas out, or go missing for scheduled treatment etc and try to cause as much disruption as I could. How long before her antics start to impact on other patients? So yes, it stinks, and from what I have been told last night, I am wondering if anyone can get through to her.

I might add that she has removed three cannulas herself in the past two weeks.

She sounds like someone I used to know with a drug problem years ago.

I'll stick my neck out & say walk away from it...

 

[MickyFinn]

She sounds like someone I used to know with a drug problem years ago.

I'll stick my neck out & say walk away from it...

She did used to have a substance problem a few years back actually.

 

[MickyFinn]

Update: she had the second option, is being let out later tonight, but has apparently said she will try harder to manage the t1. She was told the rest of the the family would set me on her to tell her a few cold hard facts, apparently I don't take prisoners or suffer fools or something like that!

She's is claiming that she was told by her nurse that between 5 and 25 is normal bg range. We all know it's not, and the target should be to keep it between 6 and 8 and correct when it is either too high or too low. I am guessing the dn took a look at her log book, and said it seems a regular occurrence for her levels to be 20 or higher.

I have decided not to step in myself, although she stopped telling the porkies about diabetes and normal bg range when she was threatened with me pointing out the facts. It leads me to believe she does know some of the facts but is ignoring them as it's all too inconvenient for her.

 

[Madmaureen]

Yes it can happen in denial those bs are ridiculous and what support does she have? She must get help immediately!

 

[Jaylee]

apparently I don't take prisoners or suffer fools or something like that!
.

I like the "cut of your jib."

Your own way of managing diabetes will be a positive testiment to the contrary of your cousin's "way of life"..

I wish you & your family all the best.

 

[PseudoBob77]

She genuinely believes that a bg reading of 25 is perfectly normal, and justifies it by saying that normal range is different for everyone! She's more or less constantly in a state of hyperglycaemia. She also believes the carb counting guide she was given is a licence to eat any old rubbish without taking fast acting insulin! She appears to be oblivious to all the actual facts. When the surgeon/anaesthetist told her today that her eating after the allotted nil by mouth time before her operation because she could choke etc, she laughed it off and dismissed it. She's a law unto herself and appears to be completely ignorant. It has to be her attitude or lack of comprehension, as the diabetes care in this area is extremely thorough, I have found it to be.

Omg! it is also called delluded, absolute denial, refusing any form of responsibility.
I bet she'll take stock when her health takes an irreverseable **** turn then she will think *** 'I'm scared' 'I didn't think that was going to happen to me'.

At the end of the day, yourself and your family (plus the medical team) have endeavoured to do your best to support and get her on track as you see the broader picture and the severe consequences it will have if she doesn't take control. She will unfortunately be the result of her own neglect, as much as we want to help someone there is only so much you can do if your 'flogging a dead horse'.

I truely hope that she does have a turn around point soon for her own sake.

 

[cesoshe]

My mother is actually just like this lady, and I'm afraid they won't change until THEY want to, so just leave them to it. They are fully aware of the risks, it's a decision they make!

 

[col101]

Hi I'm a fairly recently diagnosed t1 but also happen to work in mental health crisis. A couple of thoughts, my diabetic team includes a clinical psychologist who I spoke with and was really helpful maybe someone similar could be available. I work a lot with people who harm themselves on different ways and for different reasons some have been t1 and used this as a means either by overdosing with insulin or not taking any. My experience with people who harm themselves is that trying to directly stop the harm rarely works what can help is space to talk about their lives and feelings without being judged. Also I know it can be really hard to care about someone going through this and I'm glad you're able to use this place to get some support. Maybe there are other means of support for you to use? Wish you both all the best. Take care.