Police are calling about a 62-year-old man. He has been causing a nuisance in the neighborhood for some time. Several care reports were made by the police. The neighborhood called the police because they had not heard any sign of life from the man for 4 days.
After ringing the bell, the man did not open whereupon the police decided to force the door. At first they find no one there, but eventually he turns out to be in his bed. The house is hugely polluted. There is also to be a dog in the house that appears severely neglected. The man makes a confused impression and cannot give adequate answers. He doesn’t even remember his dog’s name. The police would therefore like a psychiatric assessment. Initially, we referred this to the mental health crisis service. However, the mental health crisis service was called off because the man was confused but not psychotic. The police do want an assessment in this troubling situation.
The man says he has been in bed for days. He did not eat or sleep for 5 days. He also indicates that he has not taken his medications for days because, according to him, they were not there. After a brief search, the medication did appear to be there and he was helped to take it. Although the house was completely cleaned by the municipality a week and a half ago, it now seems as if the house has not been cleaned for quite some time. In the bedroom there are two buckets, one he drinks from and one he spits into. The whole house is covered with all kinds of stuff, dog poop, buttermilk, other filth and a lot of things that are indefinable. Also, according to the system, the man is known to the district team and has an application for inpatient care open.
Our colleague Amber goes there to make an assessment. Upon arrival, the man lay in his bed and police impounded his dog. When Amber says hello to him he sits up. When asked what happened, he tells a very unclear story about something he allegedly agreed to do with the police. He does not appear to know exactly why the police are there. He indicated that they would come and bring him something.
Amber then asks what he has been doing for the past few days. While searching for his shag, he indicated that he had smoked some mushrooms and mixed some flowers and plants with his shag. He doesn’t know what day it is or how long he hasn’t seen his friend. Together with a friend, he regularly walks the dog or goes fishing together, but the last time was many weeks ago. The man gets up from his bed and walks to the couch where he continues his search for something to smoke. He indicated he was very hungry and wanted food to be arranged for him.
At this point, removing the man from his environment is not going to help. In addition, as time passes, he also appears much more approachable and the medication seems to be doing its job. The HAP family physician medically examined the man. Other than the fact that it is easy to see that he is eating far too little, he is “healthy” and there are no signs of medical problems. However, he cannot take good care of himself and needs urgent care. Therefore, it has been agreed that we contact the counseling service from which he himself indicates having had counseling in the past. In addition, Amber agreed with him (after leaving him some breakfast cookies) that he eat them, drink enough and take good care of himself that night.
The next day we contacted ongoing relief efforts. They appeared to have never been inside because he never opens the door. This indicated that he needed urgent care and scaled up so that he would receive the care he needed.