Caring for mentally sick ones at home

acollier-article20a-72212We know the condition of group homes in Tucson, Arizona
is a mixed bag at best, but what about those parents and friends
caring the heavy load by themselves in the home care situation ?

First, your loved one is loosely “monitored” by the “system”, which
for you consists of a case manager funded by the government
and a nurse practitioner or doctor in the psychiatric field,
who prescribes your loved one’s medications to attempt to keep them
stable and even able to reside at home at times.

Unfortuately, in severe mental illnesses that involve psychosis,
emergencies can still occur, which result in the loved one
being taken to hospital or other support center, or the
case management and doctor’s office. Keep documentation of
treatment contacts, court ordered treatment history, and
anything that can show the care facility personnel the diagnosis
and/or the name of the illness, etc. Otherwise, an evaluation
will need to be completed at the hospital’s psychiatric wing,
or other psychiatric facility, eg. SAMHC, Palo Verde, etc.

The sort of psychosis that can lead to someone being a
real danger to self or to others, will need to be managed
from home by calls to 911 or SAMHC 24 hours, 7 days a week
support help line: 520-622-6000.

When these special needs situations happen, it could be
at any time, especially the middle of the night, so someone
who works a regular schedule may lose sleep. One suggestion
is going to bed early, to allow for some up time for special
needs people, to wake you up a few times per night.

Some reasons why these poor sick loved ones get up at night ?
Its dark, and they get scared. They want or need company or just
some talk with someone who cares to really listen.

The special needs person may be needing meds for
anxiety or for their specific psychiatric condition. They may be ready
for a problem situation to (finally) be resolved in a trip to a help
center, or the hospital. If this situation is ignored, something bad or dangerous
could begin to get worse.

Close monitoring is needed when the loved one is “out there”,
and not present very much in “reality”, and so someone
will need to watch them nearly constantly, at least they cannot
be left alone at home to fend for themselves.

Needless to say, any weapons in the home (for self defense) must be locked,
and mentally ill persons must be prevented from accessing any items
of danger. Keep medications locked !

This is a big topic, discuss this with your loved one’s case
manager and doctor, and call SAMHC anytime, or NAMI Tucson office,
for more ideas and support for taking on this serious task
of caring for your poor baby (of any age) at home, your courage is large
to undertake such self-less love to care for someone who
may not always be tuned in to our world, and might be frightened
of our reality. They need your loving attention, and if you listen
in a very careful way, you will hear their thank you, gratitude and love.

Hang in there guys ! With the recent tragedies in metro Tucson and Denver,
more resources and ideas for proper care should come forth, and hopefully
reduce the need for home care for the severely mentally sick.

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Caregiver Improvements Needed in Tucson

article16Caregivers need to treat disabled with some dignity in Tucson.

Disabled mentally challenged patients need extra attention
from Tucson doctors and other health professionals.

In Tucson now, its hard for many mentally disabled children
and adults to even get to the caregivers, period.

When they finally get lucky enough to get transported to a doctors or dentists
office, usually a free clinic like El Rio (thanks guys !)
the real challenge just begins, which can affect the future
history of the patient ever going to a doctor again,
let alone really improve long term health problems they may have.

Communications with someone like this, who has no relatives present
is almost impossible, unless the caregiver at least
knows how to spot and recognize the person is mentally disabled,
and, if the patient is frightened, they can minimize necessary communications.
Nothing gets discussed, let alone solved.

This is time for the caregiver to contact a person who knows
the patient, for example a family member, group home manager,
mental health crisis personnel (eg. SAMHC), or anyone who has
had contact with the patient (even police escorts).

Unfortunately, the family members, when they are present with the patient
at the clinic, hospital or other care facility, are ignored, or not taken
seriously. The new CRC (Crisis Response Center) at UMC South (Kino) ignores
remote family communications (eg. phone calls and faxes), and “loses” patients.)

Our humanity means we care, how can we show we care, and fulfil
the doctor’s hypocratic oath, if the situation is rushed,
and treatment not done in a thoughtful manner, and at least
try our best to provide needed treatment and summary information to
other caregivers, eg. even just a note to the persons caring
for the patient, and hopefully the patient’s case manager.

The treatment of mentally challenged loved ones, must consider
the long term future, and whether the person has been treated with
fairness, and patience, in a manner that they will want to return
to the treatment settings, office, hospital emergency rooms
urgent care centers, etc.

Currently in Tucson, this is not happening as the normal thing, but is the
rare exception, lets congratulate and praise those trying their
best, and encourage all to resolve to address the special needs
of these patients, our loved ones.

Listening and taking notes is not just professional, its required
as competent care. Bad record keeping is very common, and getting
copies of records is problematic.

When we all encourage those involved to take an extra minute or
two to do the job right, and treat these people as “customers that come first”, then
mutual respect and trust can happen.

Those that love their adversaries are wise since converting an adversary
to a friend is challenging, but very worthwhile.

Again thanks to those who care. God bless those you love and those you don’t !

Mental Illness Awareness Issues for 2011

acollier-article12Thanks to all who have chosen the mental health profession, and all caregivers for doing so much to improve the safety and welfare of society in general. This is crucial for our safety.

Its apparent that the following issues will support the mentally ill and society in dealing with this crisis.

Thanks also to law enforcement who are housing the mentally ill in the jails, and who
are the current safety net. Your voices are being heard about jailing the mentally ill, the needless violence, and the daily red flags of people in psychosis. You are speaking in the news about prevention, and the costs of ignoring this continuing problem.

Finally, comparing our list of the past two years, many issues are now addressed, so progress is being made by our Tucson families.

And so here are our list of mental illness awareness issues for 2011.

2011 Mental Illness Awareness Issues

1. Unlicensed group homes conditions are generally unhealthy, need regular oversight and inspections by case managers and CPSA (taxpayer funded management for this). We are all paying for this, and this is the single largest problem area. Thanks to the few good homes out there.

2. Need for new housing solution for mentally ill. When they can pool their disability checks, they can afford to live in a mansion and hire security, nursing, and caregivers. This is currently stymied by Pima county zoning rules, and will require state of Arizona legislation to allow this to happen.

3. Food stamps are available for the mentally ill, about $26 per week. Case managers should help them to apply. Group homes are on a low food budget, and the patients are spending their few extra dollars for food. Group home managers should consider helping the mentally ill clients get food stamps to supplement the food situation.

4. Family members are being blown off by doctors. The mentally ill cannot express themselves well, and when family is trying to reach a doctor to provide the information, doctors refuse to return calls, and then can make serious mistakes not knowing medication allergies etc. This has been a problem for years in Tucson, especially at hospitals.

5. Day labor is available for the mentally ill, even those with criminal records. The clients need to have someone organize to get them to the day labor locations early around 5:30am to get work for a day.

6. Patient advocates are available to resolve complaints at the hospitals, and should be contacted when care is lacking in quality. No one should be left in pain, that is per US government guidelines.

7. Mobile meals of Tucson needs volunteers.

8. Nightly bed bug checks at all facilities is now recommended, the problem is spreading in Tucson group homes, and other facilities used by clients.

9. You can choose your destination hospital, its not up to the ambulance driver !

10. There are no good functioning psychiatric wards in Tucson hospitals, and no place to detox in a safe way. TMC has a cold turkey room with very poor supervision. Stay away ! The best is Kino, but they have communication problems.

11. SAMHC (Phone 520-622-6000) is the best 24 hour help system, but sometimes you can get an inexperienced helper, if so, ask for a manager and dont give up ! They will get help to pickup your loved one with or without police, just be prepared to explain the danger to self or others by making a list of what the mentally ill client is doing out of normal, or if they have stopped taking their medications.

12. Payees scandal – Tucson court case ongoing where disability check payees were stealing from clients. Suggest case managers check that payees are paying clients utility bills.

13. Group homes need to run police checks on all tenants before allowing them to come in. Until this is done, there is a dangerous situation with sexual assaults, thefts, and fugitives.

14. Computer games are increasing violence and worsening mental illness. Same for loud music in sub woofers. Sony announced warnings of seizures when playing their games. Nintendo warned in 12/2010 that young children can get eyesight damage when playing their handheld games.

15. Some group homes only have one manager 24 hours per day, 7 days per week. A minimum of two managers are needed to provide time off. Until then, there is unsupervised time when the manager just takes off. This is dangerous, since clients with active psychosis are being released to these group homes.

16. Group homes should provide some medication oversight-checking to monitor that medications are being taken, and report to case managers when clients are refusing medications, before danger happens.

17. Prayers and actions are working in Tucson ! Thanks guys, you are giving gifts of love.

Good Mansion Alternative

acollier-article9Billionaire Bill Gates and his wife Melinda have formed the famous Gates Foundation
as a way to help those in critical need. The Gates Foundation has asked the public
to submit ideas/dreams for them to consider in their mission to help solve society’s problems.

So, I have submitted the following idea, which we call the “Good Mansion”,
since disabled adults can afford to live in a real mansion by pooling their money,
and then also can hire full time nursing, part time doctors, and other staff.

From my letter to info@GatesFoundation.org :

Hi,

We heard that you wanted to hear some good ideas.

See our article on what is wrong with Group Homes now.

The Answer
We would like to see the mentally ill now living in very small Group Homes,
pool their Social Security Disability (SSA, SSI) monthly checks into having larger homes of 50-100 people where their monthly checks combine to get them full time nursing, doctors/dentists visits weekly, and much better living conditions.

The disabled mentally ill, when stabilized on their medicines are released
into the community to these unlicensed group homes, serving maybe 4-8 people
in each home, and making a profit for the landlords.

Unfortunately, when these patients, who get around $674 per month maximum,
pool their money, they could get much better results than the problems
found in the report we wrote for examiner.com quoted above .

Examples
1. 674/month times 100 people = $67,400.00 per month available for living.
2. 674/month times 50 people = $33,700.00 per month available for living.

So there is plenty of money to obtain a great standard of living
and reduce how many mentally ill people wind up in prison, costing
us all, when they wander away from the groups homes now, due to very poor conditions.

Please consider this idea to help these poor people, just by pooling their own money and
living in larger homes etc. with better staff, adequate food, and a decent life.

Someone just needs to organize this by obtaining/cosigning for the buildings, hiring the staff, and
these disabled people will come, they are all very unhappy with the current situation, as reported in my article.

Thanks for your time.

———— end of letter to Gates Foundation, sent 11-20-2010 ——————

Please spread the word to pray for this dream plan to move forward,
here is a list of benefits that could be obtained through this program called the

Good Mansion:

1. Reduced need for prison space for the mentally disabled.

2. New jobs for the public ! The Good Mansions will need management, nursing, and other staff.

3. Improved living conditions and improved benefits for the recipients of tax dollars for the disabled. The money is better spent as intended, with less going to third party landlords.

4. A solution for families that want long term safety for their loved ones, especially after the families are no longer alive or well enough to care for their disabled family members and friends.

5. Improve public safety by replacing unlicensed group homes with a secure place where the mentally disabled are not allowed to wander off into the community without supervision, as they do now, causing danger to self and to others.

6. Opportunity for researchers to study or live in this situation for identifying what works, social benefits and cures.

Group Homes in Tucson

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It is a shame what is going on with Tucson’s so called “unlicensed Group Homes”.

Some homes are much better than others, thanks to those who care.

Try to avoid the others who don’t care !

Here is the list of what we found wrong in the 2008-2010 timeframe:

1.    Not clean, unsanitary conditions. Even dishes for eating are not clean. The patients are required
to clean up, which is usually not good enough, even when they try hard. They are mentally ill !

2.    Not fed enough. Even though they say 3 meals a day, not true ! Patients buy their own food
to eat enough.

3.    Rent is too high, usually $500-525 per month for room and board. The maximum income these patients have is $674 on Social security disability, many get even less to live on. No one advocates to get them their full amount, which is sometimes denied at the initial SSI process.

4.    No hot water !

5.    No toilet paper or napkins.

6.    Coed homes, where improper behavior between patients happens, even though against the rules.

7.    24 hour supervision is promised, but doesn’t always happen. These patients can have a psychotic relapse, and so must be monitored, and safety must be maintained for all the patients at the group home in event of problems.

8.    Patients are largely ignored, their needs are not met as human beings. No one checks on them
at least weekly, in order to make appointments for their medical and dental needs. No one asks
them if they need something, which they could get with their own money, eg. toiletries, deodorant, etc.

9.    No published rules. Verbal rules are ignored. Safety is reduced.

10.    Stealing is going on from mentally disabled, cigs, clothes, food, personals. Walmart sells lock boxes and a couple locks for around $20. It’s worth it.

11.    Paroled drug offenders (street people) are being housed with the mentally ill patients, and are taking advantage of them, “borrowing money” and other stealing.

12.    Alcoholic beverages sometimes are given to the mentally ill.

13.    Good living skills are not taught. Bad living skills are not always dealt with.

14.    The mentally challenged are being made fun of.

15.    The patients are threatened, in order to get money, meds, clothing, and personal items. Or they are just taken from them in a confrontational bullying style.

16.    Sheets, pillows, and blankets were not available for the beds, only bed covers.

17.    No rides provided. No assistance to get a ride provided.

18.    Some doctors and nurses don’t know enough about mentally disabled patients, so they are of minimal or no help for these patients who have trouble communicating. No one helps them to write down their needs, or be there for support, to get the help needed. Group home supervision is completely absent for these needs, or to even call someone for assistance.
When a patient relapses into psychosis (DANGER), some group homes take no action to call SAMHC at 520-622-6000 for help to get the patient into emergency free treatment.

19.    CPSA group home grievance procedures are a joke, although they will write warning letters to the homes. Copies of notes of verbal reports were not provided. Sexual abuse report ignored. Police reports of hospital abuse were ignored. All these were ignored by the CEO.

20.     Safety of patients not handled well by case management, with some exceptions. So don’t count on them to help with group home conditions.

21. Bed bugs !

Finally, these mentally disabled patients could use a Buddy, you ! Contact Tucson NAMI at 520-622-5582 to join their buddy program to check on these people, at least once per week for a phone call, and maybe a monthly in-person visit.

The mentally disabled need your help ! The above conditions are happening to them now. It’s discouraging to their spirits, and reduces effectiveness of treatment. The impact to society comes when they just give up, and stop taking their meds, and become a danger to self or others. Then they become at risk for going to prison. Our prisons have many mentally ill brothers and sisters there who may not have been dangerous if only they stayed on their meds (medicines). Please, let’s care more for each other, we need it !

Mental Illness Awareness Issues for 2010

nee-pix3-dreamchildLast year we posted some goals in an article on Mental health awareness and related TV programs.

In the Tucson area, improved conditions have caused us to revise the top issues list, so here it is.

Top Mental Illness Awareness areas for 2010:

1. Unlicensed group living homes improvements. Dealing with Group homes has improved this past year. This was a HUGE set of issues. Thanks to those out there that showed they care !  Most of adult mentally ill and rehab people live in this setting after release to the Tucson metro area.
2. CPSA Oversight progress, memos can be generated on request,  to unlicensed group homes, etc.
3. Therapy, especially to develop ongoing goals. Therapy, even for court ordered patients is still optional ! Request it from case management.
4. NAMI Buddy program, get people involved. Any adult can volunteer to check on a buddy preferably at least weekly phone call and a monthly visit, to insure they are OK. Act to surface issues on their behalf to case management, or SAMHC crisis line.
5. Food boxes, clothing distribution. They do need help getting things, clothing is available through Casa Maria, and churches.
6. Free Dental options (UMC Dental School, free exams/xrays specials at local dental offices).
7. Safety at facilities, especially transitions during active psychoses, and for all court ordered treatment.
8. Using grievance processes available.
9. Thinking Big, mega group home concept development. Pool resources to be able to have full time staff, dr, nurse, 24 x 7 therapy. Prevents the problems that land mentally ill people into prison when psychotic. The meds need tweaking periodically, someone has to pay attention ! This would provide an alternative to the unlicensed group homes.
10. Cost effectiveness, adult mental health vs. prisons expansion – Funding of prisons is much more costly than funding housing and therapy programs. We need to help these human beings before they wind up in trouble. A man was found this week naked after killing a young police officer in Phoenix, we need to prevent this now !
11. Access to medical scheduling and rides assistance. Sometimes as simple as phone call to case management of psychiatric or medical providers/plans. They have case assistance available to help. A buddy just needs to do the initial call, and follow up.
12. Support for case management by friends or family to volunteer as power-of-attorney representatives, and get records access for reviews using a signed medical release form. Be able to act on the patients behalf, especially for emergencies !
13. Medical Living Wills to assure of pain management. Otherwise they suffer when they cannot communicate for themselves.

The 2009 List:
1. Funding of prisons is much more costly than funding housing and therapy programs. We need to help these human beings before they wind up in trouble.
2. Many more caring people are needed for these jobs: case managers, group home managers/couples/teams, drivers, doctors, nurses, therapists, etc.
3. The impact of new medicines is phenomenal, these allow patients to come back to reality, and avoid psychotic acts.
4. Doctors and nurses need to gain awareness of the importance of improving communications with those intimately familiar with the patients, especially family members. Sometimes these poor ones cannot speak for themselves, or are in denial.
5. The need to create care options for mentally ill persons with no family left to look after them.
6. Teachers must be better informed to identify early signs of mental illness, and to stop persecution and stigma.
7. Better understanding of the feelings of mentally ill people is needed. Anyone can send stigma/persecution reports to the Tucson NAMI office.
8. Advocates are needed for reform of the mental health system, especially problem facilities lacking best practices, especially those without policies and procedures.

Now that school is out, please volunteer ! For those that want to do door to door visitations, most local Catholic churches have Legion of Mary chapters that train and equip people to get out and meet those in need. Praying (auxiliary) members are also accepted.

We have noted college students at Mt Saint Mary’s University are volunteering this way, as well as students in other states, go get ’em guys !

– learning classes
– ask for suggestions.
– procedures for the homes to avoid food poisoning, periodic cleaning, inspections, house rules, how-to’s eg. get help

Causes of childhood death that you can prevent and the warning signs

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The following are preventable causes of death, let’s all do our part to watch for warning signs that we must act:

1. Suicide. warning signs are here.

2. Mental illness: becoming a danger to self or to others, warning signs and how to cope is here. There are reports that too much time on computer games was a factor in schizophrenia illness (hearing voices from the game).

3. Overdose – Some doctor’s offices are equipped to handle non-life-threatening cases of overdose, but in an emergency, call Poison Control at 1-800-222-1222 or dial 9-1-1.
Warning signs are here.
Interventions PDF document download here.

4. Alcohol Overdose – warning signs are here.

5. Child Abuse, warning signs are here. Relatives take note !

6. Negligent caregivers – Inspect your loved ones care facility and know the caregivers. warning signs are here.

Alert: Planned Parenthood has not denied that their employees do not report statutory rapes to police. They have also confirmed they use nurse practitioners to perform abortions.

7. Depression (which can kill slowly). warning signs are here.

To get help, or for more information, call:

NAMI – National Alliance on Mental Illness Free and Anonymous Advice, Toll free: (800)626-5022
SAMHC in Tucson – Free, caring and anonymous advice and help ! Call 520-622-6000