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[littleblackegg]

A little weed should be the least of your worries...

The physical rehab has a psychiatrist who handles outpatient meds without actually caring for the patient? In my two decades of nursing, I have never seen that. Didn't they refer him back to his regular psychiatrist? Didn't his regular case manager make his appointments? None of this makes any sense. And who is doing his daily care for his graft?

 

[Mizzoufan]

OP, none of us walk in your shoes. Only you can decide what is best for you and your family.

 

[littleblackegg]

I honestly would love to believe this is the case but in my experience the only time I've ever seen this happen was when my daughter was a "shriner's kid". shriner's has an amazing case management program that extends beyond the hospital walls, but between what we experienced with my mom and what I know from working in one state's health and social services department this wouldn't be the norm.

can't speak to other states but at least in California-

low income housing is handled by individual city and county agencies-they do not communicate w/ dshs except to occasionally get a verification of public assistance receipt. no communication w/social security or medical providers.

dshs despite being one agency can't communicate within itself a great deal b/c of HIPAA and other confidentiality laws. unless child or elder endangerment was an issue case management wasn't a service that was provided. granted I retired several years ago, but I just for the heck of it did a quick search to see if California is now offering this-the DID, for a fee-for a couple of years as a pilot program. that pilot was abandoned in 2011 so now there as some very limited services-but only for providers who are discharging Medicaid patients and it utilizes 5 call centers for the entire state (so there's no real personal management going on).

social security disability is handled by the feds-and while they can get info. from social services-it's not a 2 way street. we were precluded by federal law to get any information from them. the disability portion would be handled by the financial side of that house/the Medicaid would be handled by another-and they just handle processing the payments, no patient services to speak of.

the hospitals-well, they have social workers (in the county I worked for-they were our staff members) so they could provide "IGAR" (information, guidance and referral) but they didn't do case management after discharge (once you were no longer in-patient you were really on your own). the hospital my mom used was private so they had their own case managers-and sure they gave you a plan, some information on community resources but again-once you lost your 'in patient' status you were out the door (the follow up care nurse that came to check on mom right after release for the first couple of weeks-that was a contracted private company who just had the instructions they were given upon mom's release-they could advise but they didn't do case management, same with the physical rehab person-made advisements but no management).

it's scary, but there's not allot of medical case management available to most people-disabled or other.

In my experience, and yours could certainly be different, chronically and severely mentally ill patients (almost always those with schizophrenia or bipolar I disorder) are historically high users of inpatient services (and unfortunately, criminal justice programs). There are several federal/state case management programs set up to manage their day-to-day needs. These vary from day-stay types of enrichment programs to visits from an RN or LCSW on an arranged schedule. There are lots of other services, such as voc rehab, exercise programs, smoking cessation, etc. Not everybody requires all services, obviously, but if we can keep someone from decompensating by bringing them their meds, it saves the state and federal gov a ton of money. I did not think the poster's husband would be in case management for his physical disability. I would presume he would qualify for services based on his chronic and severe psychiatric illness, which currently includes a considerable self-care deficit which socially isolates him and interferes with him doing the activities that will improve his mental health.

 

[gwynne]

Just to address the "management" issue. A lot has changed recently. (And I understand it's state by state)...but...there is a reasonable chance a patient like the one outlined on this thread would be followed.
Basically, it's financially worth it to watch, monitor and catch medical/compliance issues before they cause unnecessary re-admits.

 

[jen0610]

A little bit of thread Co-dependency, I see.

I wonder if she'll have a baby and move to Canada.

Talk about a blast from the past. That there was some good reading.

 

[NHdisneylover]

This may actually be the most messed up thread I have ever read on the DIS (and that is saying something!).

OP, I am with many others deciding that you are not the sole victim in a one sided abusive relationship. Just reading what you write here, it is clear you often create the very situations you complain about and that you exaggerate issues to make yourself look more victimized and less in control than you are or can be if you want to.

Both you and your husband appear to have many serious issues that both of you are ignoring or making worse (mentally and physically). And you clearly do not intend to leave and are not desperate for anything other than sympathy--you keep turning down excellent advice from posts,and apparently a string of lawyers, over and over--choosing instead to prolong your situation.

I very much hope for your sake, that of your husband, that of your families and that of anyone else you drag into this mess (including how many lawyers whose free consult time you have used up knowing what they can offer you, having been to several before with the same issues) that you eventually decide to stop this horrid cycle and take the steps necessary to do so. In the meantime though, I agree with others that it is a waste of time and internet space to keep offering you advice. You know what needs to be done and simply do not want to do it. How sad.

 

[Frozen72]

delete

 

[lustergirl]

Talk about a blast from the past. That there was some good reading.

Hey I remember that one. Good for some laughs and head shaking.

 

[Frozen72]

Got the call from the Dr's office, they said go to ER.

 

[nancygirl1]

Get him to the ER then and DO NOT BRING HIM HOME AGAIN. As others have said, tell them that you are no longer capable of taking care of him & he cannot take care of himself. This is your opportunity to change your situation. Tell them everything that he is doing. Don't hold back. Just DO IT NOW.

 

[PlutoPony]

Just when posters are starting to run out of patience, we have an amazing turn of events.

Good luck to the OP and husband at the ER..... although I'm not sure what the preferred outcome is at this point.

 

[Arielle22]

I have been following this thread for days. I have some experience caring for my mom, MIL and two elderly aunts (at separate times).

One thing to remember is once a person hits elderly, you can be charged with elderly neglect if you know they need medical care and don't get it for them. I learned the hard way with the first elderly aunt. I didn't even live with them (two aunts are sisters) but I was the only family member who visited. When I called an ambulance during a visit because older aunt had not been out of bed for a week (imagine the smell from urine and defecation) the emergency room, by law, had to report it to elderly services. Luckily I was cleared when it was investigated.

 

[barkley]

The physical rehab has a psychiatrist who handles outpatient meds without actually caring for the patient? In my two decades of nursing, I have never seen that. Didn't they refer him back to his regular psychiatrist? Didn't his regular case manager make his appointments? None of this makes any sense. And who is doing his daily care for his graft?

a

never heard of one associated w/physical rehab-but this kind of arrangement is sadly kind of the norm in our region. when we moved up here we just assumed based on prior experience that w/psychiatric meds the patient got established w/a new psychiatrist (ideally had their records transferred) and it was all handled in house. nope....................we quickly learned that most if not all of the psychiatrists in the region do nothing but scrips. they schedule you for about 4x a year for a 10 minute 'med check' appointment and fax to the pharmacy the scrips that can be filled that way (with enough refills till your next 'med check') and hand you 3 individual scrips (2 with post dated refill instructions) that you personally deposit w/the pharmacy to file away so you can get your controlled meds. no therapy, no regular care-they just ask (but it's never been made apparent to us that there's any kind of confirming follow up on their part) that you are receiving on-going care from another provider (be it your primary care physician-none of whom are comfortable prescribing the psychiatric stuff-or a "counselor"-might be psychologist, might be an msw, might be god who knows what qualifications). the psychiatric community is "trusting" that the patients they are prescribing to are actually getting appropriate treatment and being truthful and forthcoming if they are not

very dangerous to our way of thinking but that's just the way it's done here.

 

[Allison]

You don't need to spend time updating us. Do what you are going to do with your life. Giving us day to day details isn't important.

 

[lustergirl]

You don't need to spend time updating us. Do what you are going to do with your life. Giving us day to day details isn't important.

Oh I am betting it is important by keeping us filled in. She craves the attention on this wild boat ride

<<<Just can't look away at this hot mess of a thread

 

[NewRVLady]

One thing to remember is once a person hits elderly, you can be charged with elderly neglect if you know they need medical care and don't get it for them. .

he's not elderly...he's 57

 

[Goofy_Disney_Dad]

I suddenly feel ancient...

 

[NewRVLady]

Got the call from the Dr's office, they said go to ER.

this was typed at 2:20
you finished the other report at 2:16
so in that 4 minutes you had a call from Dr office AND came here to type this?

really?????

 

[gwynne]

he's not elderly...he's 57

57 huh? I appreciate the info NewRV.
This has been one strange ride. I think we're probably missing about 90% of the actual story.

 

[Wishing on a star]

The ages have not been a huge secret here. She is actually quite a bit younger than he is.
People who are mentioning things like programs and laws which refer to the 'elderly', are mentioning them because, as a fully disabled person, many of these things might apply.

If the OP, however, thinks that SHE, might also personally benefit from any of thes programs or laws that are designed for the elderly/disabled, again, she is doing nothing but more 'wishful thinking'.