DIATRIBE

This is a loooong post. It is mostly so I can keep track of what happened this past month. The short version is that placing an adult in 24 hour care is very difficult if that person is neither violent, observably aggressive, incoherent nor comatose when persons in authority are in attendance. Legal problems you never thought of will arise. Insurance won't pay for nearly anything. Paperwork to prove anything is never where you thought you put it.

I'm still working through a number of things, but I am getting where I want to be: physically, emotionally, mentally, socially.

The word of the day for May 2, 2009 is "diatribe" — Pronunciation: \ˈdī-ə-ˌtrīb\
Function: noun
Etymology: Latin diatriba, from Greek diatribē pastime, discourse, from diatribein to spend (time), wear away, from dia- + tribein to rub — more at throw
Date: 1581
1 archaic : a prolonged discourse. 2: a bitter and abusive speech or writing. 3: ironic or satirical criticism.

I could not find a quote for today, so you get the diatribe:

Sequence of Events Concerning Placing Lloyd Combs in 24 Hour Care:
1. In the weeks before March 13, 2009, Lloyd would often refuse to eat what I fixed and left for him. He claimed he could get his own lunch, but would not eat or take his meds unless reminded by someone in the house.
2. Jimmy Fields of Home Instead Senior Care warned me that Lloyd was denying that he was married to me and also that Lloyd would refuse to eat if he thought I had fixed the meal. However, most afternoons, Lloyd would take his meds at Jimmy’s direction and would eat a snack and supper with me after I got home from work.
3. On Thursday, March 12, Lloyd demanded to know why I thought I was in charge. I told him because I love him and wanted the best for him. He said I didn’t love him and then denied that we were married.
4. The morning of March 13, Lloyd had a difficult time, he had one of his anxiety fits about 4:00, but settled down. At 6:00am, I could not rouse him to take his meds and eat his breakfast. He had several more anxiety fits before heaving himself to a sitting position. He got out of bed, but fell forward into the bathroom. He did not hurt himself, but managed to pull himself up to sit on the toilet.
5. I took his glucose reading, gave him his meds and left his breakfast for him, as I had to be at work.
6. I came home at 11:00am as customary and found that he had not eaten his breakfast. I fixed his lunch and left.
7. Per prior instruction, I called Mrs. Roberson, the nurse who usually attends Lloyd’s examinations by Dr. Buth, and told her that Lloyd had fallen. I also explained about the anxiety fits.
8. Monday, March 16th, I made an appointment with Elizabeth Henry to discuss obtaining guardianship and conservatorship for Lloyd because I knew that he would resist being put into 24 hour care.
9. Tuesday, a nurse from Dr. Buth’s office called and told me to make an appointment for Lloyd to see Dr. Buth. The first available time was on Thursday, March 19th
10. March 18th, I met with Ms. Henry and explained the situation. She said she would go to court the next Monday and get me temporary guardianship.
11. The 19th we saw Dr. Buth. Lloyd was given a mini-mental test, on which he scored 12 out of 30, a definite decline from the past mini-mentals he has taken. Dr. Buth told Lloyd that I would need to arrange 24 hour care, as I was no longer capable of giving him the care he needed.
12. That evening, Lloyd asked repeatedly if Dr. was joking. I answered, “No, you need more care than I—even with Jimmy’s help—can give you.”
13. Lloyd refused to eat or take his medicine—both pills and insulin. He also refused to allow me to do the blood glucose check. He threatened to call the police on me.
14. I called Dr. Buth and explained the situation. Dr. Buth told me that if Lloyd refused his medicine in the morning, I should call EMS and have him taken to Via Christi/St. Joseph for a psychiatric evaluation.
15. The next morning, the 20th, Lloyd refused to eat or take his meds, again threatening to call the police. I called 911. An EMS unit was sent out, but they would not take him as I had no guardianship order in hand and by that time, Lloyd was not violent nor unresponsive.
16. I paid Ms. Henry to start the guardianship proceedings.
17. I looked at a couple of nursing homes and talked to staff at several others and settled on Sandpiper Healthcare and Rehabilitation Center.
18. Angie from Sandpiper came out to do an assessment.
19. Thursday, the 26th, from the Agency on Aging came out to do an assessment. Pamela Thompson, who was assigned by the court to represent Lloyd postponed her meeting with him until the next Tuesday.
20. Tuesday March 24th, Ms. Thompson came and served the court papers on Lloyd and talked with him (making her assessment).
21. I went to sign admittance papers to Sandpiper for Lloyd, Thursday, April 2, for admittance the next day. I asked what I should do if Lloyd refused to go to Sandpiper with me. They told me to call EMS and have him delivered to St. Joe’s.
22. When I got home, Lloyd was dressed and wanted to know when “the lady was going to take [him] away.”
23. April 3 Lloyd refused to go with me to Sandpiper. I called 911 for EMS. Even with the guardianship papers, as Lloyd was neither violent nor comatose, they wouldn’t take him against his will. Fortunately, one of the EMS personnel persuaded Lloyd to get in the ambulance.
24. I followed to see that Lloyd was properly admitted to the Senior Behavioral Health unit.
25. After admission to the hospital, Lloyd decided that he did not want to talk to me.
26. April 9th, Lloyd was transported to Sandpiper.
27. I took the dog to visit Lloyd on Friday, April 10th, Lloyd was overjoyed to see us.
28. Monday the 13th, I received the court order that I was to post bond and sign an oath for the conservatorship.
29. I visited Lloyd at Sandpiper again on Saturday morning (giving him a shave) Sunday evening and again Tuesday, the 14th (again shaving him)
30. The nursing staff said he wasn’t taking his meds or eating and they had done a blood test at Dr. Bryant’s request.
31. April 15, 2009, James from Sandpiper called to let me know that Lloyd had fallen while being helped to the toilet in the early morning hours. After getting back to bed, he had one of his anxiety fits. When James tried to help him, Lloyd “turned over and started trying to punch” James.
32. Dr. Bryant was called. He ordered that Lloyd should be taken to St Joe’s.
33. I arranged for a bond policy, which I will sign April 16th.
34. At some point on Wednesday, the St. Joe staff was told that Lloyd hit someone at Sandpiper.
35. Lloyd told me that he had had a fight with “one of the black men on the staff” at Sandpiper. He had to defend himself as he “didn’t want to be beaten to death.”
36. I went to the Wednesday staff meeting anyway. The dietician, Donna, witness to Lloyd’s episode. She said he was sitting down in the day room when he cried out for help and started shaking all over as though he were having a seizure. James, a nurse, went to help him. When James touched him, Lloyd pushed him against the wall, pinning him between the chair and the wall, and came up swinging. He also said, “You want a piece of this?” Donna called to him: “Come over here, Sir. You’ll be safe here.” James escaped during this distraction. Lloyd looked at Donna and said, “Why would I want to do that? You’re just as bad as the rest of them.” Then he sat back down in the chair as though nothing had happened.
37. Visited Lloyd at St. Joe every day.
38. Dr. Marsh put him on Haldol for “paranoid delusions”. The staff also worked to get him to eat with the others and attend in the day room instead of hiding in his room.
39. April 28, Lloyd was released to Sandpiper again.
40. I took Speedy to see Lloyd. Lloyd told me that the male nursing staff were a bunch of thugs, that I had made a mistake by sending him back to Sandpiper because the men were talking and conspiring against him.
41. I gave Lloyd a shave and told him that I would see him Thursday. He was upset, and did not want to go in to supper.
42. Thursday, Lloyd was cheerful and there was no mention of conspiracies. However, someone asked the name of his dog. Lloyd said, “That’s not my dog, it’s my mother.” The nurse said, “What’s your mother’s name?” His answer was “Cybil.” Not sure if this was a joke, a memory lapse or an attempt at a joke when he recognized a memory lapse.
43. I’ve asked that Sandpiper do his laundry. Doing laundry all week is too tiring for me.