Monday, August 29, 2016

Lessons learned – Episode 1

This is the practical part of this blog - perhaps the only part you are really interested in.  Maybe you are wondering: what did you learn from your experience that will be useful to others? Or, Holy Moly I am freaking out and sailing without a rudder can you please share something that might help me?

Ok, fair enough. So here are some take-aways from the first episode, in no particular order:

1.     If a person you love is acting bizarre and is just not himself/herself (you will know this in your gut) then you need to get them a medical evaluation and most likely on one or more medications. Ideally, they will agree with you and go along willingly to a Psychiatric Hospital. However, depending on how far gone they are, they may be highly resistant to the idea. Psych hospitals can only do voluntary admissions (i.e. the person gets on the phone and says that they agree to come in). Alternatively, a Psych Hospital can do an involuntary admission with a 72-hour hold if the patient has been referred from the ER. So your best bet, if you are dealing with somebody who is completely uncooperative, is get them to the ER and then the “process” will take over. It’s unpleasant, and may involve your loved one traveling to the Psychiatric Hospital handcuffed to a gurney in the ambulance, but sometimes for their own safety you have go through this. 

2.     Do not take as final any opinion that is rendered on the spot by an ER medical doctor. They are not trained in diagnosing psychiatric conditions, and sometimes a definitive diagnosis takes many days of observation. 

3.     You will be your loved one’s advocate at the hospital. No difference here between a psychiatric hospital and a medical hospital. Staff are busy and looking at the big picture. You are focused on the well being of one person. Be pleasant, make friends with the staff, find out what is allowed and what is not, ask questions and if you don’t like the answer, research it. 

4.     Expect that they will have a stay of about 2 weeks (on average) as inpatient at the hospital. You will be able to bring them things that will make their stay more pleasant. Like a brand new pillow, favorite clothes or certain snacks. Everything you bring will be searched by the staff before it will be brought to your loved one. If you are bringing sweatpants or a hoodie, you will have to remove the drawstrings. This is not only for their safety, but for the safety of all the patients on the ward. 

5.     There is much to be said about the selection of the hospital. Based on our experience, I would suggest pretty much any of them other than the adult male ward at New York Presbyterian in White Plains. The Haven at NY Presbyterian was wonderful and I would definitely recommend it, however it comes with a really big price tag, which most people can’t afford. I know we can’t.  Plan on about $1K per day as your out-of-pocket expense (i.e. the portion that your insurance will not cover).  I will say more about our experience at other hospitals in later sections. 

6. Before your loved one is discharged from the hospital, make sure there is a plan in place for next steps. There should be a referral to a psychiatrist and a first appointment already made. Understand that they will be fragile and should not plan on resuming "life as normal" immediately upon discharge. 

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