This morning I got a frantic phone call from Mom and Katie telling me that they are going to DISCHARGE Julie today. I also talked to Julie personally.
Let me say it now..... I HATE THE SYSTEM!
In my eyes... the system failed Julie.
Here's what I know so far....
The long-term treatment facility won't have any beds open for at least 2-3 more weeks.
The long-term treatment facility won't accept Julie if she goes home - they accept transfers from the hospital only.
The hospital states that Julie is no longer suicidal and 'better' and therefore must discharge her. However, how can they discharge someone who is mentally incompetent? I don't understand!
Katie and I are going to go down to the hospital today for a meeting at 5:30 where this will be discussed. Katie has said that she WILL NOT sign anything agreeing to the discharge. If I am given the opportunity to speak... here is what I have written to talk about:
I am truly sick over this whole thing. I can't think of anything else other than this. I had been hoping for years that Julie could go to long-term treatment... and here it was... days or maybe only weeks away... and it's not going to happen.Julie has been mentally ill since she was very young.
Dr. Vijapura has been Julie’s treating psychiatrist for at least 10-15 years. In that time, how many times has Julie been to the hospital for care? Literally hundreds if you count medical and mental.
Obviously the long term treatment facility was going to help Julie in many ways, one of them being that she will learn to take care of herself to the point where she is not hospitalized so often (both mentally and physically). Is it then your opinion that Julie is ‘cured’ to the point where she is going to go home and not require frequent medical and psychiatric monitoring?
Only 12 days ago, a judge ordered Julie to be mentally incompetent. In those records it states: “Julie is manifestly incapable of surviving alone OR with the help of willing and responsible family or friends… and WITHOUT treatment is likely to suffer from neglect or refuse to care for herself, and such neglect or refusal poses a real and present threat of substantial harm to the patient’s well-being.” Is it your opinion now that this no longer applies to Julie? Can you guarantee that Julie is going to go home and take her medications as prescribed, eat as directed, and not abuse any medications? If Julie goes home and does what she usually does (eat herself sick or overdose on medication) – are you willing to accept full responsibility? If so, and Julie does hurt or kill herself, you can expect a malpractice suit from the family.
Only 12 days ago court documents state that “There is a substantial likelihood that in the near future the patient will inflict serious bodily harm on herself or another person, as evidenced by recent behavior causing, attempting, or threatening such harm” Is it your opinion now, only 12 days later that this is no longer relevant? If so, and Julie goes home and hurts herself, again you can expect malpractice liabilities.
In the court documents dated 12 days ago, it reads “A Guardian Advocate is necessary to act on the patient’s behalf in issues relating to express and informed consent to psychiatric and medical treatment in that the patient is incompetent to consent to treatment because the patient’s judgment is so affected by her mental illness that the patient lacks the capacity to make a well reasoned, willful and knowing decision concerning treatment.” Will the Guardian still be needed? If yes…. My other sister Katie was appointed as Julie’s guardian. How then will Katie be able to monitor Julie’s medications (some given as much as 4 times a day) on an outpatient basis? If it’s said that it is no longer necessary – can Dr. Vijapura then guarantee that Julie will begin taking her medication exactly as prescribed? Note that Julie has been non-compliant with her medical care (as documented in nearly every hospital visit she’s had) for many years. Does Dr. Vijapura think that this too is ‘cured’ in only 12 days?
I would like to add that, although there are some in this room who may feel that Julie can now be monitored at home and will begin taking care of herself, there are those of us who have known Julie all her life and completely disagree. Julie’s most recent hospitalization - where she was trying to eat enough to get her blood sugar to a level to put herself in a coma so she could wake up 6 years later and everything be normal and she could get her kids back – happened while Julie was under Dr. Vijapura’s WEEKLY treatment. Furthermore, this was not a one-time “depression” episode… this is a way of life for Julie. She is in the hospital or at the doctors for things all the time. Headache, blood sugar, stomach hurts, depression, etc. We, her family, had hoped that being in a long-term treatment mental health facility might be her only hope of turning things around.
Julie has a documented history of narcotics abuse. Julie has a history of looking for medications or things she can get a ‘high’ from (ranging from her prescribed Klonopin to huffing household aerosol cans). In Julie’s hospital medication record, it shows her taking 30 medications, 19 different medications she is required to take every day (11 are taken ‘as needed’), and daily she takes no less than 37 pills every single day. Of these medications, how many are habit-forming?If discharged on any habit-forming medication, can someone here assure the family that Julie will not become addicted to them and/or abuse them? If discharged, will Julie be able to function as a normal adult (working, driving, etc) on these medications? Would you want her, taking all of these pills, working for you? Or driving your kids to the mall?
Finally I would like to say one last thing as the permanent guardian of Julie’s children. I have had the children in my care since late 2005. During that time Julie has tried many things to keep herself well and out of the hospital, nothing had helped. I was truly hoping that long-term care might – at the very least – help Julie. In the very first records from DCF regarding Julie, it was suggested that Julie go to long-term treatment for a minimum of 6 months. To date, that has not happened. This is what concerns me as her sister.
As the permanent guardian of her children, it concerns me that the only thing Julie can think about is getting her kids back. It is her reason for seeking help, her reason for trying to get better, and the reason that she TRIES to do better. When the court gave me permanent custody of the children, it was stated that Julie would almost positively never get the kids back. They are teenagers (13, 14 and 16) and that – by the time Julie was well enough to take care of herself mentally and physically, even IF it happened that she could do so – the kids would be adults. One of the things Julie needed to do to ‘get her kids back’ was to not be in the hospital or at the doctors as much as she has been. Julie, in her adult life, has NEVER, to my knowledge, gone several months without going to the hospital for something or another. The likelihood of this happening is slim to none. Julie refuses to accept the fact that I have “permanent custody” nor acknowledge what the word “permanent” means. To this day, Julie believes she could have her kids back in 6 months to a year.
When the kids visited Julie earlier this week, she gave them paintings she had done but told them they couldn’t take them home to my house – that she wanted to put them up in ‘their bedrooms at home’ for when they come home. The kids, being mentally competent and having been to counseling over the past year, understand that they are likely not going home. But it hurts them to know that their mom is incapable of believing that. Not that she WON’T believe it, but that she is INCAPABLE of believing it. At her last visit with the kids while in Memorial, the kids began to cry when Julie talked about them going home. She talked about how she had been doing lots of work in their bedrooms making everything just perfect for them. The kids were crying saying “I miss you”. Julie hugged them saying they’d be home soon. In my eyes, this bordered abusive. I have personally talked to Julie’s doctor who agrees that Julie just ‘doesn’t get it’ and that “Julie will believe whatever Julie wants to believe.” At what point does her continuous talking to the kids about their going home become abusive to THEIR mental health? If Julie’s doctors can not talk to her about this and resolve this, I feel that further action might be necessary to keep the kids mentally safe.
I can’t stress enough how much of a mistake I feel the doctors would be making should they decide to discharge Julie. I hope that this decision will be reconsidered.
I honestly believe that Julie thinks that she is better. When I tried to talk to her today about her medications, she got very defensive saying that she is on LESS medication now than she was before. I find that........... incredible. Sad. And incredible.
Mom said that she talked to some people at her hospital (works at Tampa General) who say that this kind of thing happens 'all the time'. That they have one patient upstairs that has been waiting for a bed at the long-term treatment place for 2 months and still hasn't been able to go. How truly sad is that?? Undoubtedly, one thing I think we all agree upon is that Julie WILL be back in the hospital again soon. And at that point, they can again 'put her on the list'... but most likely, she won't get in. And thus the cycle continues, as it has for many years.
I'm also extremely sad knowing that Julie is probably going to go home from the hospital, get online and read my blog... having no idea how I've felt about any of this. I fully believe that SHE thinks she acted just fine at the hospital. She fully believes that she is not acting 'doped up'. And I totally get that... it's hard when it's YOU and you have to try to assess yourself. I'm sure in HER eyes... she's no longer wanting to kill herself so she IS much better. However, those of us family members who have been through this hundreds of times before know it's going to happen again and again and again. Sigh...
The other HUGE fear I have is that, in the very near future, Julie and I are not going to be happy with one-another. Surely she's going to read about how I feel or something is going to come up in what I'm saying to her and she's going to be angry with me. As I said above, I feel that some of what Julie does is mentally abusive and I MUST find a way to stop it. I've asked her psychiatrist for help... they won't. As I said in an earlier post... my relationship with Julie is very odd right now. Not friends, not just sisters... I don't know what it is. But the last thing in the world I want those kids to have to go through is dealing with us if their mom and I are at odds with one another. And yet, I am so sick of the whole thing I just want to throw up my hands and say 'screw it all' and get to the point where I no longer care about Julie's feelings and just say whatever the heck I want. That would be bad for everyone.
One thing I should mention about what I said above... I am not a sue-happy person by ANY means. I worked for doctors for 16 years and I've seen some sue-happy kind of people... out for money with no conscience... believing that a doctor's judgment while 'in the moment' - if ends in a bad situation - is worthy of financial profit to the family. I get all that, I really do. But, in my opinion... them discharging Julie after everything that was stated 12 DAYS ago is in-and-of-itself INSANE in my book. Insane and medically nothing short of negligent.
Okay... let's move on to the kids. They are on spring break this week. I'd ALMOST forgotten how much these kids can eat. I went shopping on Sunday night to buy food for the week. While there I purchased (among many other things) a gallon of milk and a loaf of bread. Monday afternoon I get a call asking me to pick up milk and bread on the way home from work. LESS than 24 hours later... a gallon of milk and a loaf of bread - gone. Holy CAJOLIE! And what's worse is that Jonathan wasn't even there on Monday... he was with a friend. Jonathan can EAT, let me tell ya. Recently he had FIVE sandwiches for lunch. And he's so THIN! I think that means he's going to go through a growth spurt, which is not good for me because he will then be TALLER than his mom! I guess it was bound to happen! LOL
Every time I think about all they eat, I keep reminding myself that I need to get back on that SHARES Florida plan. The food was so inexpensive... I've GOT to get more involved in that. I think I'll go check out the website now... oh yeah... here it is for March:
* 30 oz Birdseye Voila Garlic Chicken Meal
* 1 lb Boneless Skinless Chicken Breast Fillets
* 8 oz Sliced Canadian Bacon
* 1 lb Italian Rope Sausage
* 1 lb Italian Meatballs
* 7 oz Maple Sausage Links
* Broccoli (1 Head)
* Potatoes (2.5 lb Bag)
* Tomatoes (2 Each)
* Green Peppers (2 Each)
* Salad Mix (1 lb Bag)
* Radishes (1 Bag)
* Oranges (4 Each)
* Apples (5 Each)
All this for the price of only $18.00. Yeah... cool huh? Again, that website if anyone else is interested is: www.shareflorida.org You need only to volunteer in some capacity to qualify for the discount. Very cool. Gotta do it again. :o) Granted it doesn't replace grocery shopping as you can't pick and choose what you get, but still... all that food for $18 - and it WON'T go unused in this house. :o)
I had better run... I must get some work done today. I skipped lunch because my stomach is so tore up over this whole thing.
Please keep Julie and the kids in your prayers. Say an extra prayer for Katie, Mom and myself while you are at it. I know that this is mentally and physically draining for the three of us as well. Our meeting is at 5:30 tonight, so if you could focus your prayers around that time it would be really great.
For I can do everything through Christ, who gives me strength.
Philippians 4:13
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