My mother has been decompensating over the past two months. Her mental state has been slowly declining and her psychiatrist has said he cannot do anything for her on an outpatient basis. She needs to be hospitalized. So at her appointment we came up with a plan on what to do if her delusions did not improve. It included the old standby of calling Emergency Services of whichever city she is physically in.
Those of you who have been through this process you know that having someone hospitalized for mental health reasons is never an easy process. If things aren't emergent I look at my schedule and figure out a time when I have two full days to devote to just the process of getting her admitted to a hospital.
It's supposed to really go like this.
Contact Emergency Services and explain the situation
Emergency Services comes out and evaluates the patient
Emergency Services decides patient needs to be hospitalized and calls to find a hospital bed that's available
Patient is usually held in an emergency room or magistrate's office until the bed is available
When a bed becomes available the patient is transported by the Sheriff's office to the facility to receive treatment.
But it never works that way. Usually my mother ends up needing to be medically cleared before the mental state can be evaluated. Each time it takes about 24 hours or more to complete this process. It's aggravating and time wasting and down right painful to go through. It usually ends with watching my mother be shackled and put in the back of a police car. Never something you want to see.
This time was more painful than usual. Well, I shouldn't say "was" because it's still ongoing. And we passed the 24 hour mark 7 hours ago.
On Saturday my mother was acting very strange when I visited her so I decided it was time to put her in the hospital. She was saying her doctor and the people who work at the ALS she lives at were trying to kill her. She was whispering to herself and acted clearly confused at what was going on. She wasn't giving the staff any trouble, but I've seen these signs before and I know it will only get worse. I had my kids with me so I couldn't do anything right then. I decided to wait till the next day to start the process. It was also so I could get a good night's sleep before the grueling ordeal begins.
I called on Sunday at noon and was told by the very unsupportive man at the Norfolk CSB that they would come to evaluate my mother, but to not bet they would believe she needs hospitalization. I was told I needed to hurry to her ALS because I'd better be there when they got there. There was no promise of a time frame. I hurried. When I told my mother someone would be coming to evaluate her she gave me this horrible look and gestured to hit me. At 4pm I still had not heard from the NCSB so I called to see what was going on. The woman answering told me that she'd told me several times already that my mother's doctor wouldn't let her go to the hospital. I told her I was sure she was confused as to who I was (I hadn't even given her my mother's name) and it took a bit to convince her that yes, she had confused my mother with another patient. I was informed they were not coming because only the facility could call and invite her in. Of course since the facility didn't witness her behavior if they did call the concern would be dismissed. I informed her that she embodied everything that was wrong with the mental health system in Virginia. It clearly sounded like it wasn't the first time she'd heard that.
So, with no other real option, I drove her to the emergency room at Norfolk General. I was met with a wonderful nursing staff, but a doctor who informed me that for geriatric psyche patients they can only be admitted to a facility 8 to 5 Monday through Friday. This was Sunday. I was told I should take her home. To do what, I have no idea. But I've been around the block a few times and I know that if you go home and come back the next day you only increase the cost and lose your place in line. So I refused. The Norfolk CSB informed me I should not have come and that I should have done it their way (refusing to evaluate her at all is apparently "their way.") I was informed that the CSB worker at the hospital was present during my "many phone calls" and he knows I was told to talk with her doctor first. I must be falling asleep and calling these people because I remember only speaking with them on two occasions and I don't remember them telling me to call her doctor ever being part of the conversation. He said they had a big file on her and then later said they seemed to have no paperwork on her.
We were informed she would be admitted if there was a bed in the morning and we could avoid the temporary detainment order (TDO) which would save a step. Then in the morning we were informed that she would have to be reevaluated and placed under TDO. Seems no one at the Norfolk CSB has any clue. NO wonder I've been told to avoid them at all costs.
Since she has insurance and we have guardianship I asked the doctors if we could just avoid even dealing with the CSB, but it isn't possible. It's the way things are run. And because of budget cuts there are less and less psychiatric beds available and longer wait times in the Emergency Room waiting for one to come up.
So my mother is waiting in the emergency room waiting for a bed. It is 730pm on Monday and this whole ordeal started Sunday at noon. There is no end in sight and the nurse informed me that it would at least be a couple of days. Thankfully the hospital did bring a psychiatrist to see her and changed her meds so it's not like she's floating. But, she also isn't receiving the care she would receive in a psychiatric ward.
There was a man with Alzheimer's Disease waiting in the ER there as well. His wife said they'd been there since Friday evening. At 4pm Monday the hospital was promising him a bed, but it hadn't happened by the time I left.
With the aging population we have more of this to look forward to. God help us all.
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