From hospital to home transition

Family
1

With in the next few weeks or so, baring any problems, my youngest brother John is going to be coming home from hospital. He was diagnosed with bipolar 1. I was thinking back on when I would end up coming home.

The energy of the house was always seemed nervous, as everything seemed up in the air. There were lots of discussions about relapse, and support at home, and a whole lot of “what can we do different this time?” That last question never seemed to be answered well.

My kid sis was always told to give me space and don’t bombard me with questions, and keep her voice down, and the one that always made me wonder was no running. I think that was just thrown in there for my Dad’s comfort.

I do remember one time I was getting discharged and my Mom asked, “What do we do now?”
The nurse kept answering “Take him home.” That was it… just take me home.

Ok, I’ve had a major break down, I’ve only just begun talking to other people and not my feet, I’m stable a bit. I’m still a little shaky, I still don’t know why I had to go to hospital really. I sort of get it, but I’m still dazed. In hospital, meals are planed, therapy is planned, time is planned, life is by the clock, I’m walked to the washroom. I’m out now… So now what?

There was some outpatient counselling and an outpatient commitment and a conditional release, but that only last so long. But I do remember a lot of “what do we do now?”

So it really blew me away to see these links about the “from hospital to home transition” Because I don’t remember these when I was younger.

It’s amazing to me how the focus of treatment has broadened and even though it’s a long time coming, I’m seeing more comprehensive care for various stages of this illness.

http://www.omhf.on.ca/_files/file.php?fileid=fileZxrqSZFHTJ&filename=file_ALC_Report_FINAL4.pdf

http://www.dhs.state.mn.us/main/groups/children/documents/pub/dhs16_183007.pdf

2

These are great. However, in my experience, things are usually still in the ‘What do we do now?’ mode. Services are not coordinated before leaving the hospital, and they are so broken up depending on where the person lives, that it is difficult to find any way to get continuity.

Plus, social services have increasingly heavy workloads, are spread so thin, they can really only address a small number of issues for any one person. Additionally, there seems to be no central repository of information about what services are available, it is hit-or-miss finding the right care depending on which services the individual social worker or case manager knows about.

For example - the social worker at the hospital thinks my son needs level 2 care. She faxes me a list of Behavioral Nursing Homes in our area. She may have experience with one or two of them. There is no accompanying information about the size of the facilities, the services they might provide, cost, their typical demographic (most of them are geriatric). All I can do is start calling and doing internet searches.

Meanwhile, the hospital might be getting pressured by the insurance company to discharge my son, feeling he no longer meets inpatient criteria. This leaves me feeling desperate to find some place, ANY place, where my son can live. (Forget about me actually doing the job that I am being paid for - sorry, don’t tell anybody, but I am typing this while at work.)

3

Very true in my area also. All you can do is figure out your own plan-or hope a person that can make a difference show up in your life—Which does happen on occasion*

4

I was under child and adolescent services when I was in hospital for nine months over that time I was drugged to my eye balls withdrawn too fast and had my biggest break which I didn’t really come out of, I though I was in a political prisoner institution and had tried to push my mum and only carer away with very cruel and damaging allegations, I went in planning my death and still in control, over those nine months I lost my control.

When I was being discharged all they did was have a person from adult services come to my care review, I didn’t really see anyone for a while after being home and technically I was at my worst. I remember distinctly the nurse I had then (who was completely burnt out and had no empathy) saying ‘we don’t have any services for people like you’. I remember asking to change care managers and got the change, the next one was slightly better, listened to me more and had me assessed by my current nurse who then took over as I was obviously psychotic so he took over, then my psychiatrists changed to my current one and I was well away.

It was only with those changes, that I got the help I needed. But that’s the nhs… There was very little resources for me and no private therapy would have me because of the psychosis that’s just how it works near me as most of it is psychodynamic.

I feel for my mum, she was terrified of me and no-one helped her with that. I feel so guilty for what I did, apparently on the way home she had to illegally park on the side of a duel carriage way because I was inconsolable saying I didn’t want to kill her (Voices threatened her) I don’t remember that journey.

But that’s the past, I’ve got the help now. I wish there was more efficiency in getting me the treatment, maybe I’d have gotten a full recovery. But it took me those years just to have had enough of the terror I was living and become willing to take anything that could make it stop even though it took me longer to accept it as an illness.

But if things hadn’t happened the way they did I wouldn’t be the person I am now, on the path I’m on now, I try to remind myself of that before becoming to obsessed in what ifs.

I wish you luck with your brother, remember to keep a healthy balance with him so you can keep your energy (I know that sounds selfish but when I tried to get involved with a mentally ill cousin ish it drained me so much I fell into the depths) so just remember to be empathetic and do the things of you feel inclined you wish people had done for you but don’t go over board and stay steady.

Hope you don’t mind me saying that, take care,
Meg.

5

Wow, :boom: :boom: right there, bang. It sort of blows my mind when you type stuff that I have physically said and worked on as well. I too have done everything I can to keep the tidal wave of “what ifs” and past guilts from drowning me and kicking me back into depression.

If things hadn’t happened the way they happened, I wouldn’t be the person I am now. Since I’m feeling better more often and little by little I’m seeing my family heal as well, and I’ve set my sights for the feeling of content and not manic euphoria, I’m becoming more at ease with myself more often.

6

And here we go - My son will be discharged tomorrow - I am sure it is because insurance decided he no longer meets inpatient criteria. We didn’t even have a family meeting scheduled until Thursday - but of course now that will be some kind of rushed thing tomorrow before discharge.

I am HOPING the social worker will succeed in getting him admitted to a short term respite house - only 8 patients! - while we figure out what would really be the next step for him.

He has been calling me this afternoon, following a visit from someone from an assisted living. Very agitated, very angry. All my fault that he is in the hospital, all a misunderstanding. Speaking badly to me, insisting that I look for an apartment for him. He cannot see that it is just this kind of behavior that makes it impossible for me to consider getting him an apartment.

7

Don`t let that meeting be rushed! They should assign a case manager outside of the hospital and a doctor. My son was in a few half-way homes, but always managed to get kicked out, and this was due to his drug addiction. I wish I had an easy answer for you. C. had quite a few apts. on his own. Is your son going to be on med injections?

8

Sorry @valleypenne. You are certainly having a tough go of it. I agree with bridgecomet. Don’t let them rush through that meeting if you can. Adding my hope to yours that they find a spot for him in the short term respite house.