And it Continues...

I'm still working on the complaint to the facility my mother was hospitalized at in June.  Turns out the VDH doesn't take complaints on Psyche facilities.  It goes through the Human Rights Committee local to the hospital.  The way they work it is: they take my complaint, forward it to the facility, the facility investigates itself (and I expect will find no fault in themselves) and then I have to file an appeal.  No facility should be allowed to investigate itself.  That's just ridiculous.  And to top it off they forwarded my complaint to the very person at the facility who lied to me when I called.

Thankfully I found that out this morning when I called for the email address to send the more complete complaint I wrote up for the VDH.  I was told that the complaint would then have to go to a higher up official at the facility.  Sad thing is that the guy who was part of the problem is on the Human Rights Committee Board.  Now I know this complaint will go no where. But I have to go through proper channels before I can sue them.

The guy in question called for more information this morning and when I informed him he was part of my complaint he had the audacity to laugh at me.  That and his condescending tone tells me he isn't taking this seriously and figures I'll just go away.

It is now my personal mission to make sure he loses his job and is living out of a cardboard box.

My mom, meanwhile, is still suffering the effects of her stay.  She isn't delusional, but is horribly depressed.  Her mood is flat and she lays in bed all day.  She only gets out of bed for meals.  She didn't even show interest in the chocolate my brother brought her the week before.  Chocolate never lasted more than an hour in her hands before. I really wish there was a way to just take her off all her meds and have her somewhere she can't hurt herself or others.

It's pure fantasy and just manages to make myself more depressed.

The Never Ending Battle...

It seems when things finally start to slow down it speeds up.  I am deep in caregiver fatigue that I can't seem to claw my way out of.  Here's hoping for some light to appear at some point.

I headed out of town for a few weeks for a conference and a family commitment and got a call that my mother believed Satan was attacking and marking her body.  She was evaluated by the CSB and was taken to Norfolk General.  For some strange reason she was placed at a hospital in Kilmarnock VA despite the fact the Gero Psyche doctor who had treated her in Norfolk was busy making a space for her in the local facility.

To make the story concise and short the facility in Kilmarnock seemed great until we realized they were refusing us access to our mother.  They had our Guardianship papers, but felt it didn't cover a psychiatric stay.  They were confused about what medications she was taking when she arrived and pushed her out as soon as we started pushing the Guardianship issue.  They tried to use HIPPA against us to protect my mother's "privacy."  They ordered a medication for her that has already caused Medication Induced Parkinsonism and I'm worried it will become worse.  And I think she is worse off than she went in to the hospital.  She's very confused and quite delusional still.  I've called a lawyer and have been suggested another one.  All this while I'm knee deep in her bills, exhausted and figuring out how to get her house sold so I have one less thing on my mind.

Below is a copy of the complaint I am making against the hospital with the VDH tomorrow.  At some point we have to catch a break.  There has to be someone out there who can make my mom at least functional.  It's killing me to see her this way.

My mother was hospitalized at this facility following an episode at her assisted living facility (Lydia Roper Home) in which she believed she being attacked by Satan.  She was evaluated by Norfolk CSB, transported to Norfolk General ER and later placed at Bridges Behavioral.   One of the Guardians of my mother insured copies of our qualification papers were placed in the hands of Sheriff's Deputies with ER records sent to the facility.  A nurse on duty at Bridges verified that the papers had been received.  During the course of my mother's 8 day hospital stay the doctors refused to speak with either of her guardians (my sister and I have full guardianship and my co-Guardian called on a daily basis to check on her progress) or provide us the information needed on her care.  The medical staff did not speak to her private doctors or the ALF where she resides.  They asked my mother what medications she was taking and which doctors she saw.  She could not remember so they based medical decisions on her  garbled memory while in psychosis.  When we pressed for access to her medical information and to speak with her physicians we were denied because the facility didn't think that Guardianship covered psyche services.  They cited HIPPA as the reason for their refusal despite actively violating HIPPA regulations.    They had my mother sign some kind of document allowing us to speak with the nursing staff, but since she has been declared an Incapacitated Adult by the Circuit Court of Chesapeake, VA she does not have the legal right to sign any document giving anyone access.    

Despite being told there was no discharge plan in place on Monday June 25, 2012 (when we pressed for information and access based on our status as legal Guardians) on Tuesday June 26, 2012 at approx 515pm I received a call that she was to be discharged on Wednesday June 27, 2012 because Medicare had refused to pay for her to stay longer.  I spoke with Jack Grumwald, Program Director for the hospital at approx 730am on Wednesday June 27, 2012 and he informed me that Medicare had cut off funding and they were giving my mother the "courtesy" of an extra day and should have discharged her the day before.  He believed she was not under the care of a private psychiatrist, although I personally had taken her to see her psychiatrist 5 days prior to her hospitalization and she is visited twice weekly by a psyche nurse through Hope in Home Care.  I asked to be put on record as opposing the discharge and asked for the decision to be reviewed by Medicare because my phone call two days prior indicated to me that she was still very confused, lethargic and suffering from delusions.  I was refused.    I contacted Anthem BCBS who administers her Medicare plan when my mother's person advocate, Laura Buchanan was first available approx 845am the same day and was informed the hospital had not asked for more time and there was no denial on record.  The hospital had not asked for Wednesday June 27, 2012 to be covered.  I was not given any discharge papers from the hospital, but was provided copies of records requested and received by her ALF.    

My mother was prescribed a medication during her stay at this facility that her private neurologist believes has caused the irreversable medical condition - Medication Induced Parkinsonism.   The two Board Certified Geriatric Psychiatrists my mother has seen in the past year have stated that the drug in question, Haldol, should not be given to any patient over the age of 50.   The doctors at this facility indicated at discharge that they had increased her dose of Zyprexa to 10mg (they believed she had been on 5mg, but wasn't taking it).  She had been on 12.5mg of Zyprexa per day prior to her hospitalization and the Medication Administration Records at her ALF reflect she was receiving her prescribed dose and no refusal of meds were noted.   A copy of her current Physician's Orders were sent to the facility along with all of her ER and Guardianship papers.  If there were questions they certainly should have known who to call. 

On Wednesday June 27, 2012, my mother was discharged and driven to her ALF without notifying my mother's Guardians or the ALF, despite being asked to do so prior to her physically leaving the facility.  She arrived at the ALF filthy and had bruises on her left arm and her legs per the Director of Nursing's recollection of events.  The director had her bathed prior to my co-Guardian's arrival who then took pictures of said bruises.

Reading through the records provided to me it appears that the physicians treating her at this facility believed she was not taking her medication nor being cared for by her private doctors.  With this assumption they were effectively practicing medicine blindfolded with their hands tied behind their backs.  This is the very issue that brought our family to sue for full legal Guardianship in the Circuit Court of Chesapeake Virginia on June 8, 2011.  We wanted to avoid these mistakes and act as her voice in these situations.    I feel my mother's care at this facility was inadequate and inappropriate for the situation.  As her Guardians, my sister and I could have easily provided all the information they would have needed to make appropriate medical decisions for my mother.  They chose to ignore the information freely offered and could have easily cost my mother her life in the process.  Seeing her before and after the hospitalization I feel her mental state declined instead of stabilized during her hospital stay and I am now afraid to get inpatient help for her despite feeling it is needed.  And if the hospital indeed gave her Haldol during her stay they have made treating the tremors more difficult.  It appears from Rappahannock General Hospital's website that none of the doctors working at this hospital are board certified in Geriatric Psychiatry.  They therefore should not be treating anyone over the age of 50 who requires a Geriatric Psychiatric facility.  They also had her diagnosis wrong on her paperwork which could have possibly made a difference in her treatment.  She does not have Schizophrenia - paranoid type.  She has Schizoaffective Disorder - Bipolar Type.    

I feel she was discharged prematurely from this hospital, but after reading the documentation I feel her life and health was at risk if she had stayed at this facility.  This facility needs training on what Guardianship means and to utilize information given to them.  Before we had been appointed as her Guardians we would provide letters to medical staff at such facilities to insure they understood the entire situation.  Guardianship was supposed to mean that I no longer had to be at the mercy of a nurse or physician actually reading my letters as many of these letters never reached her physicians in the past.     There was no Social Worker available during my mother's hospitalization.  We were told she was on vacation.  Any psyche facility should always have one available during regular working hours at minimum to help in such situations. 

I fully intend to seek legal counsel to ensure the hospital does not provide such poor treatment to another patient under their care.