Notes with regard to Margaret Dickins: 

Firstly, for Dr Julian Rambert, 03/05/2002

Originally had medication, one for her urinary infection: Ranitidine, 150mg., one tablet, at bedtime. Actually, it's an anti-histamine product, for reducing acid in stomachs.
and Risperidone, 0.5mg., one tablet twice a day. Another Risperidone site.

a) Went through horrors on Saturday night for 2.5hrs when on toilet constipated.
This resulted in possible haemorrhoids or split anus. She is going to the toilet
standing up, because of pain.

b) She has lower abdominal pains of a consistent nature, of both sudden and longer activities.
These come and go, and have not been diagnosed. She apparently hid her discomfort from the 
physician at the Civic.

c) She is definitely psychotic, and cannot relate to illness as being internal but, contrarily,
thinks that she is being constantly attacked by evil spirits: external influences only.

d) The psychosis may make interviewing her more difficult than would be usual, and she tends
to prevaricate about her pains, too.

Also, poor vision; very poor dental condition; strong halitosis; wears clothes, not including underwear, until they smell, and even then doesn't have them cleaned.

Emails:

December 14th. 2001, Paul:

I talked with Dr Gobessi, one of our psychiatrists.

Dr Gobessi and I will make a home visit to your mother on January 14/02 at 2:30pm.  

It probably makes sense for you and Mr Dickins to be there for that visit.  If you have other ideas, please write back with them.

In the meantime, if things get to the point where your mother is a danger to herself or to another, or if she reaches the point where she cannot look after herself and will not allow other to, you have the option to seek an order for a compulsory assessment order through a Justice of the Peace. 

OR, there is an after hours emergency mental health team that can come to your home if you have a crisis with mother after office hours.  They have the authority (one of them is a policeman) to take a person against their will to a hospital. They are called the Mental Health Crisis Service, their number is 241-0400 and they operate between 3:00pm and 2:30 am seven days a week.

I hope the above is helpful.  Please write back confirming the date and time of the home visit. 

Greg McMillan

January 16th. 2002, Hello Greg:

I have phoned Dr Rambert and have booked an appointment for Peggy Dickins for 11:30 hrs Friday, 18th January.

Let's hope that she allows me to take her there! Her psychosis was apparent last night when she asked Dad what he was doing there, and wouldn't talk to him. That's what he reported to me this morning, when he also told me that she was fast asleep at that time, half eight.

We were happy with the visit from you and Dr Gobessi, and I was delighted that you approached Dad with an offer to help him through this.

Regards,

Paul

January 17th., Hello Greg:

I heard from Mum that you had phoned, and possibly Dr Gobessi. Total denial as you are aware.

I have phoned Dr Rambert to cancel the appointment. His phone number is 613-737-5295. He is my uncle by marriage, and is my and my father's doctor.

I have updated my http://mattoid.com/data/Detritus/mommie_dearest.htm page, and, as I mentioned, this is not directly linked to my site, as far as I can determine! Also, I have pointed out that my father is becoming increasingly worried and upset about Peggy. Her attitude towards him now is atrocious, accepting nonetheless that it is neither his nor even her fault.

Please could you phone Dad, or email me with your thoughts on our future actions? Dad has an appointment with a specialist re his legs at 13:50hrs tomorrow, Friday. I will be going with him, as requested by Dr Rambert.

Could you pass my information on to Dr Gobessi, if needed? Also, raydickins@home.com is one of my redundant email addresses, and does not relate to my father. In fact, since @Home has succumbed to the dotcom idiocy, I suspect that address will fail shortly.

Warm regards,

Paul

January 18th., Paul:

Thanks for the communication. 

What I would like to do is to meet with your father to go over his options as I see them.  I can also offer him support in the form of someone removed from the scene to talk with.  This is extended to you as well.

I called today and talked with your mum.  She told me your dad was in hospital and was not expected to survive.  Unless there has been a rather dramatic change, I don't think this is correct.  At least ,lets hope this is not correct.

I can also meet with your mother to try to mediate things at home.  I realise the challenge here but it can be helpful as a longer term strategy  to get the thin edge of the wedge in place even if there is little to be done in the short term. 

I assume you are off with dad for the checkup you mention.

I will make further contact next week to set a time with your dad to meet. 

January 18th., Hello Greg:

Thank you for the news. I have put up on the page, http://mattoid.com/data/Detritus/mater_2002.htm, today, for Lynn and Sarah especially, the information that Dad does not need an operation at this time. Needs to undergo constant exercise to build the secondary arteries in his legs. Otherwise in good health. He is so relieved, it can't be measured! The thought of bedpans were constantly in his thoughts!

Mum is totally wrong, of course, and I am surprised she told you what she did, that Dad had died, without any basis in what we had repeatedly told her before leaving. That was: Dad is going to see a specialist to determine what needs to be done. And that I was to take him because Dr Rambert wanted me to witness the event.

Regards,

Paul

January 21st., Hello Greg:

Sorry to bother you, but, having had no reason to contact a Justice of the Peace so far, I searched the telephone directories in vain last night.

Could you advise me of the easiest way to contact such a person? Is it through the Municipal Courts? This is for a Power of Attorney. Maybe this is what you could discuss with Dad, sometime this week, because we both feel she needs to be placed somewhere for a complete mental and physical service, as it were.

Peggy has been really in the fruit bat stage over the weekend, both with Dad and with my (separated) wife, Michelle, and our daughter, Katharine. Not the most comfortable of visits!

Regards,

Paul

January 24th., Paul: 
I am looking into the whereabouts of J o P's.  Harder to find than I thought.  I will get you the 
information as soon as I can.

I discussed my latest visit (Jan 23/02) with Dr Gobessi.  She wonders if Mrs Dickins would 
take medication if presented to her.  
I know it is doubtful but tell me what you think.  
Also, I discussed the possibility of having a female nurse from the team see Mrs Dickins.  
The idea would be that I continue to support you and your dad while the nurse forges an alliance with Mum.  
My thinking behind this comes from the impression I have that your mum may feel
surrounded by men. She may respond better to a female. Again, tell me what you think.

Greg   
January 24th., Hello Greg:

When we had the visit by the MHCS, the policeman of the duo, nice guy, told us to go to 161 Elgin Street, the court, between 08:30 and 12:30; then 13:30 until 16:30hrs. Go in up to the left or right, can't remember, and obtain a Form to take to the Police Station on Elgin. It's also briefly described on http://mattoid.com/Detritus/mater_2002.htm

Also, Dad and I have talked about medication. We think that without hospitalisation and a development of a regime, that she won't comply.

It might be better with a "non-threatening" female, but she was antagonistic with the MHCS Psych Nurse, too.

Thank you for your meeting with us, even if Mum did say she didn't want to talk to you!

Regards,

Paul

January 24th., Paul:

I tend to agree that mum most probably will not comply with the offer of
medication at home. 

Are you going to go and get the forms at Elgin Street?  I will ask around
tomorrow for more information on this. 

I will also discuss the possibility of a nurse coming on board.  It may be worth
a try.  It is always a balance between trying something and swamping the
situation. 

Greg

February 5th., Hello Greg:

Last week, sometime, the secretary of Linda Gobessi phoned and asked for Peggy's Health Card No. I don't know if that was an indication of something coming up, or simply a lack of information.

Also, is it possible to meet with Dad and I at some near time in the future? Neither of us has a clear idea of what to do with my mother. For example, whether it would be better to have a JP order, or go solely with Psychogeriatrics and a possible hospitalization in some time frame determined by your organisation.

Dad asked me to get in touch, not only because we were supposed to see you recently, but also because Mum was absolutely horrid yesterday (not only then!) We can see her gradual deterioration increasing in pace. And, as I have mentioned before, I cannot help but feel that my father is suffering more and more from the stress caused by her psychosis/dementia.

At any rate, winter has come to Ottawa with a vengeance. Nice to see the skaters on the Rideau Canal.

Regards,

Paul

February 15th., Hello Greg:

We have had some medical problems with Mum, last night and this morning. I have written it up here: http://mattoid.com/data/Detritus/mater_2002.htm Please press the bookmark Devils Pains to reach the material.

She is clearly endangering her own health with this insistent denial that the medical world can help her. Can it be assumed that someone in authority could bring in a Nurse, or perhaps have her hospitalised, at the earliest opportunity?

I will try to phone you, and also try to contact Dr Rambert (613-737-5295) this morning.

Regards,

Paul

February 15th., Paul:

Thanks for the update.  I have been calling around, following up the ideas we had at our last meeting.  I also talked with Dr Gobessi. 

We are at the stage of trying to pull together the best response we can.  We are aware of the nature of your situation and are trying to help address things.  I talked with the intake worker at the Public Guardian and Trustee's Office (PGT) - 241-1202.  Their opinion was that you have no authority over mum outside of having Power of Attorney, which you do not have, I believe.   

Please feel free to call this office yourself, they are quite helpful in legal areas. 

I am following up the nurse role and will review what I have with Dr Gobessi early next week. My sincere hope is that I can offer you something more concrete then.

I talked briefly with your dad this pm.  I was trying to get a hold of you to talk about the above stuff.

Greg

February 15th., Hello Greg:

Thanks for the update, and we will see what happens this weekend.

I have just discovered what "wiping" herself indicates. So, we'll see whether we have to call the ambulance this weekend.

And, the rest!!

Regards,

Paul

February 17th., Hello Greg:

And now this: What transpired on Friday night and with persisting at other times in asking her if she is fine has determined that Mum is in constant pain. It's on the web page.

I fear that Dad and I will have to call in an ambulance on Monday. We will phone you should we do that.

She is in a good mood right now, at home after Katharine was here, but that will not last, given recent history.

Regards,

Paul

February 21st., Paul:

I met with Dr Gobessi this morning (Thursday, Feb 21/02). 

We will form your mother early next week, assuming you and your father are in agreement with this. 

The plan is for her to go to the psych department of either the general or the civic.  She can get a medical workup from there. Dr Gobessi has to actually see Mrs Dickins to do the form.  She will drop by the apartment, most probably Monday next in the late afternoon. 

I will arrange for the police to meet at the apartment Tuesday am and take Mrs Dickins to hospital. 

Another alternative is for you to drive her there but we thought this may not be feasible. 

Your thoughts? Would you please confirm that your father is in agreement with this and that the timing does not present a problem. 

Thanks,

Greg 

March 1st., Hello Greg:

Raymond, my father, is in total agreement with the next step that you outlined.

Can you talk with Linda Gobessi and ask what, if anything, we should pack for Peggy? We agree that it is not likely that Mum will allow us to drive her there, but we will try. If we can make her understand that it would be nicer for her to go there unaccompanied by the boys in blue.

Also, I would like to meet Linda in the lobby at 420 Gloucester Street on Monday afternoon. Is there an approximate plus and minus time range for me to sit there and read while waiting?

Dad is under extreme stress, obviously, having head pains, sight problems and similar overnight. We will both be grateful when Mum is in and has a medical, even if nothing can be done with her psychosis and dementia. Not that medication hasn't helped me, so there may very well be something that will fit Mum's diagnosis.

Regards,

Paul

March 1st., Hello Greg,

Not a problem about the reply function!!

Horrid Saturday and early Sunday for us. I hope the phone calls were not too confusing.

I have put the tale up on the webpage: http://mattoid.com/data/Detritus/mater_2002.htm Please press the Fracas bookmark at the top.

So, we expect to have Dr Gobessi there at about 4pm Monday. Even though the Civic, on duty psychiatrist asked her to attend the assessment, I doubt that she will be amenable to having either Dad or I take her there on Tuesday morning.

I was highly displeased with what has happened, especially with Dad's upcoming two day torture after the necessity? of me having to expound in front of Mum at the hospital.

We were pleased with the MHCS and Paramedic staff, but we were unhappy with the inordinate amount of time that was spent with Mum and others sitting twiddling their thumbs in the holding tank. And the conclusion.

Anyway, I hope to be in contact with Dr Gobessi tomorrow pm in the lobby. I will be there from 3:30 pm onwards. No problem, I will be reading something or other!

Regards, Paul

From : 
"Greg McMillan" gmcmilla@scohs.on.ca
 
To : 
dickins_paul@hotmail.com
 
Subject : 
Re: Charades, Fracas, what you will!!!!!!!
 
Date : 
Fri, 01 Mar 2002 14:48:34 -0500
 
Hello, just a note to keep in touch.  As you make note of in your web page, the
basic plan is to have your mum continue the meds.  If she stops taking them, Dr
Gobessi will look to do the form papers again.  Please keep in touch regarding
any changes (hopefully for the better).  Greg
March 3rd: Hello Greg,

Thank you for the message. Mum, I think, is going both ways! Dad and I will try to make her go to see Rambert asap, given that she was freaked out about the hospital visit.

For myself, I was really upset about the seemingly unethical performance of the on-shift pschiatrist. What think you?

Mum is definitely suffering from her stomach problems. They may or may not be related to her now medicated urinary infection.

Her thought processes are also convoluted and systematically flawed. We will definitely keep you informed about anything that occurs within your purview. Dad is better now he has his new driving glasses, but is increasingly stressed with Mum's continuous performances, almost, but not quite, charades.

Regards, Paul

March 5th., Hello Greg:

Doctor's visit was a success, and I am trying to get her to a clinic first thing tomorrow for her blood type! As if.

There are a lot of tests on the list that Dr Rambert gave me to hand over when we get there.

Plus, swimming helps Alzheimer's patients: I saw that on R8 of the Globe and Mail today, and chased it down on the web. It's now incorporated into a mention on the usual page: http://mattoid.com/data/Detritus/mater_2002.htm on today's date.

Everything seems to change with her every day, seemingly. Dad is a little miffed with her, as he showed when saying she always takes, never gives; probably meaning that she has always liked being the centre of attention. Don't we all!!

Regards,

Paul

March 12th., Hello Greg:

Sorry to be slow replying to your message. One thing was that I kept away from a computer for the whole weekend. Strange but true!

Dr Rambert should be contacting us either today or tomorrow, Wednesday. He is awaiting the results of comprehensive blood tests taken last week. She also had another urine test, which I took on the day after her tests. Dr Julian Rambert, at 737-5295, recognised when he saw her that she was mentally ill. Not difficult these days. I gave him the list of medications she was taking. Her infection medicines ran out today. All this is somewhere on the webpage, of course.

So, if you wish to meet, it might be advisable on your last day before your holiday! Friday, I presume.

Please let me know, and I should be able to tell you more about things. Mum is sick, Dad told me yesterday that she is worse than usual. It is strange that she has forgotten about the hospital, or more precisely, my part in that fracas. She is much friendlier, though of course thinks that I am at work, etc.

Regards,

Paul

March 15th., Paul:

Following our meeting today I sent a note to Dr Gobessi about medications. I also made a referral to CCAC.  You could expect to hear from them soon I hope.  

Greg

April 3rd: Paul, 

If your mum is having medical problems, either an ambulance to emerg or a trip to the GPs office is in order.  You may want to call Dr Rambert's office and ask advice over the phone.  The receptionist/nurse can liaise between you and the doctor when he is very busy and can help direct you appropriately.  The news of the job is great.  

Greg

April 3rd: Hello Greg,

Yesterday, when I returned home after another shift in my new part-time job (only being paid subsistence wage), Mum had been vomiting and, in fact, did that in front of me shortly after I started asking her how she was. This at Dad's request, because she won't talk to him properly.

We thought of having her taken to hospital, but, given our previous experience, doubted it would work.

There are notes on my web page about this, but perhaps you could advise?

Hope you had an excellent time on holiday.

Regards,

Paul

April 18th: Paul, 

Good morning Paul, 

Just a couple of points.  One, I heard from CCAC that your dad refused to have care go in to the home.  Is this correct?  Could we do anything to make this happen?  The other thing is meds.  I talked with Dr Gobessi this morning and she asked me to confirm with you how the prescriptions are going to be renewed from now on.  I guess through Dr Rambert. Is mum still taking the meds?  

Thanks, Greg 

April 18th: Hello Greg,

Dad mentioned that he didn't want any care team in there until it was "really necessary". I told him that it would be better if he used the system, but he is averse to "misuse". He couldn't understand, or refused to comprehend, the ramifications. Maybe you should talk to him?

Mum is almost at the end of her meds. She has told Dad that she doesn't need them. The renewal could be through Dr Gobessi or through Dr Rambert: your choice.

This constant harping by Mum about the vacant apartment is indicative of her mental state, and caused me to leave a phone message with you this morning.

Until we can have her committed to a lengthy period in a hospital, we cannot find the source of her constant complaining of these "devils" attacking many parts of her body.

She thinks she "talks" to Dr Rambert and that he has told her nothing can be done, at least by him.

Regards,

Paul

from: Greg McMillan

To:  paul@mattoid.com 

Subject: Paul, I had a discussion with Dr Gobessi this morning, following up on her home visit.

Date: Wed, 19 Jun 2002 09:54:32 -0400

Paul,

I had a discussion with Dr Gobessi this morning, following up on her home visit. I understand that your sister is coming into town for a visit. I wonder if you and I could meet with her. I would like to talk with her and see how she sees things. I am sure her view as part of the family who has not seen your parents for a while would be interesting.

Please e-mail me back. I realise you must be busy with the World Cup right now.

Thanks, Greg

+++++++++++++++++

Lynn, (sent 06/20/2002)
What do you think? Let me know asap, please. Plus, read my page on Peggy before answering, if you could.
Things are not too swift for me, I think the Black Dog is barking too often.
World Cup indeed, two days rest, and then we'll see!!

Paul