It is Sunday afternoon when Eric receives a call from his colleague on coordination duty. They received a report of a mother with an adult daughter who called in a panic and fled from her own home. Her resident daughter is aggressive and has been beating her. This is not the first time. The daughter has an intellectual disability and she frequently suffers from seizures. Many counseling programs have been completed, but her daughter does not see the point of working toward, say, assisted or sheltered housing. Because of her daughter’s adult age and because she indicated her unwillingness to cooperate with counseling, no counseling is involved at this time.
Eric calls the mother. She indicates that she is sitting in the car in front of her house. Eric agrees to get to it. If the situation worsens in the meantime, the mother should contact his colleague, or-if physical violence is involved-the police. After Eric parks the car and walks toward the house, the mother is already walking toward him. It is a petite woman in her old age, weathered hair, red color on her face and she has some drops of sweat on her forehead. Considerable discoloration can also be seen near her left eye. She indicates that it is now safe to come inside. With a stranger, her daughter is not so quick to confront and she is now in her room. If she is angry and once there, she usually doesn’t come down so quickly.
Since the daughter changed medication due to epileptic seizures, aggression has increased. The mother says she has already suffered frequent bruises and scrapes. Her daughter is a hefty woman and physically the mother cannot handle her. If something doesn’t go the way she wants, she gets frustrated. If not appeased, this could get out of hand. In addition, due to the current corona period, there are few opportunities for diversion. Before the corona outbreak, they had several activities. The days then were filled with dancing, bowling and daytime activities at an organization or club. In particular, they share the passion around dancing. Now that none of that is possible, tensions are rising faster.
The daughter’s other (social) network is also limited. Many people panic during an epileptic seizure, but the mother knows exactly what to do at such a time. People who panic themselves are then more of a nuisance to her. Consequently, she has been caring for her since birth, but is now running into . The mother worries about the future, for example, if she were to pass away and her daughter was not living independently.
Eric asks his colleague to contact the home health agency to discuss whether adjustments regarding medication are possible. The home health agency indicates that the daughter is in such a specialized pathway that they advise against making any adjustment regarding medication without a review by the doctor she is being treated by. Together, the mother and Eric conclude that consideration should be given to how to bridge the next few hours at home until other people are available tomorrow (Monday) to explore more options.
When the undulating invective has stopped, Eric asks at the bottom of the stairs if the daughter wants to talk to him. She indicates she does not want to come down. Eric asks if he can come upstairs and the daughter indicates that he can, but that door remains closed. Eric says he is not so comfortable talking to a door. After saying this several times, she opens the door. After a brief conversation about small talk, the daughter says she knows she is sometimes aggressive and that this is a side effect of the medication. She also regrets this in retrospect, but says she cannot stop it. Eric notices that she experiences misunderstanding, fear (of the unknown) and that she has no control over her moods. She says she sometimes walks the dog when she is restless, but because the dog is elderly, she cannot go far. She does not dare to undertake anything (on her own). She likes that her mother takes care of her and that she can rely on her especially during epileptic seizures. However, this also sometimes leads to frustrations, which she cannot deal with. By now the tension has subsided, but she says she is very tired. The mother also indicates that the situation also takes a lot of energy from her. When Eric inquires further about her idea about counseling, it turns out that she is not quite sure what is meant and what to expect from it. In doing so, it also makes her anxious, she has lived with her mother for so long who is always there for her. Eric notes the details of the family doctor and the district team so they can look at more options for the daughter.
The situation between mother and daughter is calm again. They thank Eric for the visit and the conversation. Then he leaves again. In the car, he tells the progression to his colleague, and in the office, he ensures a proper handover for the social worker who will take up the case next.