The past couple of months have been some of the hardest months of my life, if not the hardest. I am having to watch my mum dying, a slow and painful death, all the while the people who can help, the medical professionals who can save her life, do absolutely nothing.
As a family, we have exhausted all our resources trying to get my mum well. She has been an alcoholic for as long as I can remember, but has always managed, after a relapse, to ‘pull herself round.’ This time, however, things are very different.
My mum is refusing to accept that she needs help. Despite being told yesterday that her platelet count is 44,000, when the normal range is 150–400,000, she is still unwilling to get the help she so desperately needs. And when the UK’s stance on alcoholism is so outdated, it’s hard to remain hopeful…
The law
The only way that someone can be made to stay in a hospital in the UK is if they are placed under a section, yet the grounds for an alcoholic to be sectioned compared to anyone else are so much more complex.
Generally, the circumstances required for someone to be sectioned under the UK Mental Health Act are:
- Sectioning is required as the patient is a danger to themselves or others.
- The patient is suffering from a mental health disorder that requires hospital treatment.
- Treatment cannot be provided effectively unless the patient is sectioned.
My mum would tick all these boxes if alcoholism were actually deemed to be what it is, a mental health disorder… Alas, someone can’t be sectioned if they’re intoxicated, this being something that I can’t believe, especially as someone who was sectioned themselves…
Writing from experience
When I was 16, I was sectioned and detained under section 3 of the Mental Health Act. I was forced to get treatment because if I didn’t, I would die. The only difference between me and my mum is that she is addicted to alcohol, whereas I was addicted to starving myself. I had anorexia. It just seems so wrong that my mum is being neglected on the basis that she is ‘too intoxicated’ for anyone to do anything, when that is precisely the reason why she needs to be sectioned.
‘When the UK’s stance on alcoholism is so outdated, it’s hard to remain hopeful.‘
My mum is an alcoholic who has severely relapsed. She is never not intoxicated. Drinking six bottles of wine a day, she wakes up in the mornings still heavily drunk from the night before.
Given how intoxicated she is, the only way that my mum could be sectioned is if she were deemed to have no capacity, and this is where it gets tricky…
When approximately 50% of dependent drinkers are at risk of having frontal lobe damage because of brain injury, and the frontal lobe plays a key role in impulse control, many patients are wrongly considered to have capacity, because in a simple assessment environment, they know the right things to say. However, given that their frontal lobe might be damaged, when it comes to acting upon what they have been told, (in my mum’s case, that she will die if she doesn’t receive treatment), they are driven by impulse and therefore can no longer weigh up options.
In other words, my mum understands the consequences of drinking; she understands the very real risk of death, but the compulsion to continue drinking is too strong to ignore.
This sense of compulsion, as described above, is where the word ‘addiction’ itself comes from. It is a Latin word and implies enslavement. Those who are addicted are ruled by the bottle.
It can be argued, then, surely, that addiction is, by definition, a loss of the ability to make choices, and, in turn, reason enough to section someone.
The above is true of other countries, so why not here?
In Australia, for example, people can be sectioned if they are alcohol dependent and meet the following four criteria:
- Severe dependence (tolerance, withdrawals, loss of capacity to make a decision).
- At risk of serious harm (physical or psychological).
- Likely to benefit from treatment but refuses.
- No less restrictive treatment available.
It’s hard to know that if my mum weren’t in the UK, she wouldn’t be left to die at home.
Yes, my mum knows her name and where she is, the only questions she gets asked when she has an ‘assessment’, but how anyone can say that she has the capacity to make her own decisions when she is putting her life on the line (which, by the way, is grounds to section someone), is beyond me.
‘Ruled by the Bottle.’
If my mum weren’t so unwell, she wouldn’t be going to the hospital for treatment, only to get agitated and leave before anything could be done.
My mum goes to the hospital with the right intentions, to get well, but pointing back to the lack of impulse control again, eventually, her want to drink takes over her need to get better. This is why, after being at A&E for 6 hours yesterday, she pulled her canula out and left.
Despite being told that she could bleed to death if she got a single cut owing to her extremely low platelet count, she ripped a needle directly out of a vein in her arm and went home.
The whole situation is just going round in circles. We get the tiniest sliver of hope that something might actually be done to save a mum, a daughter, a wife, and then we’re knocked back down and back at the start again.
The law needs to be changed.
I understand why sectioning laws are so tight, don’t get me wrong, because to be placed under a section is to essentially have your rights taken away from you and your freedom restricted, but surely assessments should be done on a case-by-case basis.
My mum is a high-functioning alcoholic. She always has been. She is neglecting herself now more than ever — she’s not eating, she’s not washing, all she is interested in is wine — but even now, she can still answer the two questions that are asked when people perform a capacity assessment — ‘What is your name?’ ‘Where are you?’
Referring back to myself again here, when I was sectioned, I didn’t have to answer those questions because I wasn’t brain-dead, just like my mum isn’t brain-dead. Like her, I knew my own name, and I knew where I was and what was happening, but did I have the capacity to make a safe decision for myself when my mind was focused on one thing and one thing only? No. Undoubtedly not, hence why I was sectioned and forced into treatment (which, if I hadn’t been, I’d be dead now).
Surely this level of neglect cannot be allowed to continue.
Time is running out for my mum. She is already showing signs, I believe, of late-stage liver failure. If she carries on drinking without any intervention (i.e., hospitalisation), I fear that I will be attending her funeral in the not-too-distant future.
I write this so that should the unthinkable happen, I have documented that I have tried. We have all tried. Unfortunately, we can’t do anything more now. We just have to hope that the people who can, will do so, before it’s too late.
Portfolio of Hope 