16/11/2025

Let me start with an update before I tell you about my small mercies….

On the 9th October we had a meeting on teams with both Dr Anderson from RADS and Dr Strong from Carleton Clinic, both are psychiatrists. Unfortunately the previous positives for Molly presentation have not been sustained. Molly’s appetite continues to be a problem and her sleep has been deteriorating back to the point she is mostly up through the night, several nights a week and is also excessively changing her pyjamas. She remained irritable and more negative. She is not presenting with stiffness, or tremors and no re-emerging of catatonia. (Note: Olanzapine has a side effect of an increased appetite).

It was therefore agreed to reduce the Olanzapine to 5mg to be taken once in the evening. The challenge was described as understanding Molly’s current mood state, she is returning back into irritable hypomania – mixed symptoms, Dr Anderson asked “are the medication side effects contributing to her presentation?” Dr strong will review Molly over the next coming weeks.

Molly was then reviewed by Dr Strong at home on 17th October 2025, Mountview team leader attended, I did not, as I didn’t want to trigger stress for Molly or let her believe I was there to collect her, I worked though and prayed it went well. Molly did not allow a physical examination, no tremor witnessed and she was mobilising independently. (Note: she has had 3 falls of late). Since the reduction of Olanzapine Molly has been less agitated but still ‘on the go’ all the time with little rest. It was noted that staff and myself have see Molly’s eyes looking over the top of our heads (Ocular Gyric Crisis OGC). No changes to medication were made at this point in time.

13/11/2025 MDT held over teams with Dr Strong, I believe Molly’s presentation is because of the medication and her sensitivity to it, she is not at her baseline and struggling to engage in her routines. She is very tired during the day and lack of sleep at night is definitely impacting everything.

Action: I will review Molly over the weekend 15/16 November for a 24 hour period, then feedback on Monday with the view of having a further meeting later in the week with Dr Anderson.

Molly arrived at my home yesterday, I had to use distraction techniques early evening to stop her going to her bed, she asked to go back to her own house a few times and seemed confused, using ‘now and next’ simple sentencing (less is more), giving her loads of time to process really helps. We put on our coats and walked the dog under the street lights getting home intime for Strictly. Molly went up to bed around 8.30pm and got up around 2.30am, she then helped herself to her prepared overnight oats, got her iPad and remained awake thereafter. Today we went to church, had dog walks, done a bit of shopping, visited her dad and on the way back to hers she said “Mam, I have had a nice day with you today”.

Hearing that……. meant the world and I am very grateful for the small mercies in these turbulent times. And with a smooth transition back to Mountview…….. ‘Just for today’ I am feeling very content.

Luv C x