Reach Far and Wide

My last blog post about geriatric consulting is one to reference in a less more formal call to action. Within the next month I will be doing research as to the plausibility of completing the circle of mental health care for elderly in long-term care facilities. I seek to obtain the perspective of every person effected by this gap in care. I wish to obtain the insight of nursing professionals, family members of residents, Certified Nurse’s Aide’s, and I will be speaking to long-term care facility administrators to present them the opportunity to provide services such as these to their residents.

A quick recap for those that have not been made aware; the mental health treatment of the elderly in long-term care facilities is provided at the suggestion of the overstaffed nurses to the psychiatrist/physician rather than a psychiatrist with a specific plan of action for progress including regular counseling which is a part of every treatment plan for adults under the care of a psychiatrist. In my three years as a CNA, working in four different facilities, not once did I ever see a psychiatrist personally evaluate a patient. Not once did I see a therapist/counselor come to the facility for an appointment for a patient, neither did I see a resident/patient transported away from the facility for this service. We have to ask why is there such a gap in the circle of mental health care for the elderly, and what can we do to remedy this?

I plan to work with psychiatrists and nursing home professionals to provide complete mental health care to residents/patients of long-term care facilities with one-on-one appointments. My goal being to provide educated evaluations to provide to the individual’s psychiatrist, as well as an opportunity for personal therapy which is sorely lacking for residents/patients no longer in their homes, under conditions they have very little control over, and potentially very little family near or available to be there when needed. I want to be that person to make the difference. For scheduled appointments, regular appointments, emergency appointments, or anything else that comes up to potentially be beneficial.

Please take the few seconds to share this information on any source you possibly can. It could literally change and potentially lengthen the lives of elderly loved ones. Link to my original business proposal below. Thank you!!

https://lifewithoutpain186595278.wordpress.com/2019/03/10/psychiatric-consulting-in-long-term-care-facilities/

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Geriatric Counseling/Therapy

I would like to address the lack of proper mental health procedure with geriatric patients. Adults that regularly see a psychiatrist are advised at every appointment to see a therapist/counselor. It is a core component of mental rehabilitation. Why is this not available to elderly in long-term care facilities when they are in fact taking medication for anxiety/depression? Wouldn’t someone ripped from their home, isolated from their family, in an entirely new environment that they have very little control over potentially be anxious or depressed? These people need someone to talk to on a regular basis because not all of them have family readily available. And to be able to use this time with them as a time to assess what their true needs are to pass along to their psychiatrist. By someone who cares enough to get to know them as a human.

Psychiatric Consulting in Long-Term Care Facilities

I have started a business. It is still in the early stages, though I expect to be working within three months time. What I wish to do is fill a void that currently exists in our healthcare system. Psychiatric care for the elderly is sorely lacking. My background comes from over three years of experience as a Certified Nurse’s Aide and my Associate’s degree in psychology. In my three years as a CNA, not once did I see a psychiatrist step into the building. The mental health care was being provided by the suggestion of the nurses; whom are not trained in mental health care, and statistically have less than five minutes of one-on-one time with each patient every day. How can this possibly be permissible?

I want to be the middle-man. I want to meet one on one with long-term care patients and elderly to be able to properly produce an evaluation on their mental status for a psychiatrist to make informed decisions about medication management moving forward. All too often I have seen a patient have one rough day and the next day have an ongoing prescription for a sedative that made them an entirely different person. It is truly negligence that deserves to be rectified. With this position I will also be able to include pet and music therapy which have plenty of research to back the immense benefits from an incorporation of different therapies such as these. Group therapies would be a prime opportunity for the homes to improve the quality of life of these seniors. One on one appointments will be a time to listen; for those that don’t have the family able to be available regularly.

With this venture I hope to move into a position in which I have a working relationship with several facilities where I can provide emergency psychological care. My primary goal is to help people and make a positive difference in their lives. I expect travel to be a part of this adventure, but I will do whatever it takes to maintain positive relationships and ensure everyone obtains the care they deserve.

Obviously the need is there, but where the problem lies is in the funding for a service such as this. Who is going to pay for it? Insurance companies who are already as stingy as they are? This would end up being an entire new policy for them. Some family members would recognize the need and be able to pay personally, but that leaves out the vast majority that deserves the care just as much as the others. In writing this it feels more like a social justice issue than a business.

I need to get in touch with people that are educated in this area. To help accurately evaluate the need, and potentially come up with ideas for funding. Perhaps there is another option I have not yet considered? Every single person I’ve talked to about this, even over the phone, has heard and interpreted my passion for this. All humans deserve proper mental health care, and it’s simply not happening.

Later on in the business I hope to incorporate therapies such as pet and music therapies. I feel group therapy sessions in long-term care facilities could also be immensely beneficial. This could even be a marketing technique by the facility to be able to offer these services for residents. In the following weeks I plan to be making as many contacts as possible with people within long-term care facilities to get as many perspectives as possible from the directors, nurses, and potentially even residents and family members if they are willing. Please be in touch with any information that could potentially be helpful. Thank you so very much for your time in reading this, and if you wouldn’t mind sharing this on other platforms the further this gets the better!

Quick Update – Feedback Welcome

I have identified a need in the geriatric mental health field. I have a strong desire and passion to help remedy the wrong. Our elderly are not being provided appropriate mental health care. I have an Associate’s degree in psychology and over three years of experience as a CNA. I am also still in school planning to obtain my Bachelor’s and masters in psychology with a focus in geriatrics. Though, school takes an extended period of time, and I want to make a difference now. Some say I’m not qualified to fill a role such as this. I would like to clarify that I do not wish to diagnose, prescribe or even suggest medications, and in no way would I be making any decisions about anyone’s health.

If psychiatrists are not going to personally evaluate a geriatric patient’s mental health needs, then let me work as an educated consultant to provide a detailed report in order for you (the psychiatrist) to make the most educated and informed decisions. I am not trying to take away the credibility of a nurse’s evaluation, but when they statistically spend less than five minutes one-on-one with each resident each day, generally because of being short staffed, how can an appropriate evaluation truly be made? Please leave me your feedback.

Unnecessary Medications

I have come to the realization that I have been taking the wrong medication for far too long, and I wonder how many people are in the same boat. How long have we been taking medications with more side effects than there are benefits? How do we realize this? How do we bring it to our doctor’s attention? Isn’t that truly their job to conclude? How long do we put up with this nonsense and continue to pump unnecessary chemicals into our bodies? Do we finally just adjust the meds down/out ourselves? How safe is this decision? How many of you are having to pay out of pocket for these medications causing unruly side effects with no real improvement in the quality of life? I can only share my story, but I know there are literally millions of people dealing with the same qualms.

I have been on a medication called quetiapine (along with many others) for probably around eight months now. And for those eight months getting out of bed in the morning has been physically impossible. Some doctors have referred to this as the “hangover” effect, and I have been told to just wait it out and “hopefully” it will just go away. It has been eight months and I still cry nearly every morning with overwhelming emotions and a body that feels like lead when it’s time for me to rise for the day. Though, there have been three specific times where this did not occur. When prescribed the medication I was told not to take it if I was not going to be able to get a full eight hours of sleep. Three times I have gone to bed super late, knowing I wasn’t going to get a full eight hours, and I did not take my nighttime medications. Even on only two hours of sleep, I felt better waking up those mornings than I had in many months. Why could this be?

Perhaps these medications are simply not right for me specifically, and I simply need to find another course. I recently started seeing a different psychiatrist, though instead of changing any of my current medications he simply added another one – a tranquilizer. He told me this would help with those overwhelming emotions, racing thoughts, and anxiety. Neither my partner nor myself have noticed any difference in those facets of my life. This doctor truly believes this medication will help me. I disagree. At what point do I take the situation into my own hands and just stop taking the medication(s)? If I feel a million times better (and less depressed and hopeless) in the morning without the medication, how can there truly be a benefit?

I have to acknowledge the danger of just stopping a medication – particularly some of the antipsychotics – without a doctor’s review. There can be more major side effects from this; another downside to these medications. Psychosis and depression can worsen to an extreme degree for the first several weeks off of a medication that was providing a steady level of chemical to the brain particularly for an extended period of time. When taking those medications it is, generally, supplying the brain with chemicals that the brain is supposedly not producing sufficient amounts of naturally – so the brain will stop self-producing these chemicals entirely because the pills are keeping the steady levels. So, when one removes those chemicals the brain goes into a varying level of shock – which can produce a multitude of different side effects on the brain and body.

Thankfully, I have insurance that pays for the doctors to keep throwing these different pills at me. Though, I’m aware of plenty of people that are actually throwing their hard earned money into these “treatments” – just to end up with horrible side effects and little-to-no benefit. People that are reaching out for assistance because this world and society have simply become too much to bear on our own. This is NOT a weakness. It takes a massive level of strength to ask for help. I would know – because I never do. I am one of those people that is entirely too stubborn and would rather fail on my own than ask for help to succeed. It’s a problem. Though, a long time ago I started down this path of medicinal mental health treatment because if I didn’t I was going to end my life. And that’s a kind of failure that was not fair to the individuals around me to embrace.

That is the primary reason I still support the current mental health system even with all of its flaws and broken aspects. Because there are people out there that do benefit from medicinal treatment. Less than we would desire or expect, but they are still out there. People that would be ending their lives otherwise and diminishing any potential they may have had. Yet, there are some people that have been in treatment for most of their lives and still can’t manage to survive. Robin Williams is the primary example. He struggled with anxiety and depression his entire life. He was also in treatment for it for most of his life. Though at a certain point, he simply couldn’t handle it anymore. He wasn’t seeing enough benefit from the treatment his surplus of money could easily afford to WANT to survive. There are all too many of us living a similar reality. At what point do we take a stand? HOW  do we even take a stand?

I am lucky enough to love and live with someone that accepts all of my flaws and helps me monitor myself. He reigns me in when my emotions become uncontrollable or unbearable, and he steadies me when I feel like I’m in a tailspin. I would do anything to wish upon all of you still reading this a person like I have. I would not still be breathing or typing this today if I had not met him. And it truly sucks to be dependent on another human in this way, but just the other day he was telling me how much better I am at handling myself and my emotions from a year ago. Not since the medications, because they came later, but because he has helped me to improve myself and make myself better.

Part of our treatment has to be what exists within our surroundings and the people we allow to be present in our lives. There are too many people suffering from depression and anxiety that is made entirely worse due to the toxic people they keep around them. A toxic job will also play a huge part in this. Leave that job, and leave that relationship. Even if the toxicity is caused by a parent or relative. Just because you may share some of the same genetic markers as another human does not mean they have to remain within your life and environment. It’s clearly easier said than done, but it is so very essential for our treatment. Perhaps it is only for a short while that you have to remove them from your environment in order for you to do some self-healing, but it is so very essential to be able to acknowledge these toxic markers that are preventing one from improving themselves.

I’ve clearly varied slightly from the topic of medications, but every word I’ve relayed is essential. It has taken over two decades of suffering to put the pieces together. And in reality, I’m still working on my self-healing. My brain suffered such severe PTSD that it actually developed narcolepsy. As if my brain just said, “I can’t handle this anymore, I’m just going to shut down and sleep at random times”. This is something that is going to take an extensive amount of time to heal. And I hope using the word “heal” is understood not in the way of repair, but rather the capability to move beyond the damage to still have a relatively happy and fulfilling life despite the things we are lacking. This is something we all deserve, and should never stop fighting for until we find it.

Psychosis

I’m going to start off by saying I’m using this title word very broadly here. This topic generally includes several smaller concepts that work together into one little word that many people are terrified to use. Why can’t we be honest about what is ailing us? How can a doctor, a medical professional, sit across from you and tell you that they do not “believe in” your illness? Why do we not have free healthcare across the board like so many countries that we claim to be lesser than us in stature and economy? These are our decisions, but the reason nothing changes is that we don’t talk about it. That’s how we end up with something so atrocious as the Fetal Heart Bill in Iowa. I will re-iterate it again and again; we have to talk about these chronic ailments, the lack of appropriate healthcare available, and how our government is making money off of all of us for these precise reasons.

Above the depression and anxiety I have been labeled with for years, I struggle severely with paranoia. It took a long time for anyone to help me identify that there was a word for what I was feeling. How, when I get into my car I have to check the backseat, my exposed trunk, and look all around me before jumping in and locking the doors immediately. Every. Single. Time. I have a locked garage. I do it every time. I do not have any explanation for this. At no point have I had a traumatic experience in or around a vehicle. My therapist believes there may be some suppressed memories. I did read an article a couple of years ago about women getting grabbed from their cars while they are getting in and to be wary, but I’ve been in this practice for as long as I’ve been driving. I’ve also experienced extremely rapid heartbeat, instant sweating while entering the vehicle, as well as loss of breath as if the act caused me to be tiresome. It was years before realizing this was not normal.

It doesn’t feel good to be different from this concept of “normal” when in school. That was only one symptom of the paranoia. There were plenty of others that caused numerous issues in my daily life. Like, serious issues; with my personal relationships, the care I took of myself, and for a spell I didn’t think I “deserved” to eat. I’ve been told consistently that it is all in my head, I just don’t try hard enough, and so many more. I beg you to get help. If any of this sounds familiar just talk to your doctor. If they respond in any other way than immediate concern, get a new doctor. And that’s no shit. You have the choice to pick another physician. Get a referral to someone more specialized or educated in this area. Please.

The paranoia generally goes hand in hand with depression. I’ve already written about this here so just to touch base, the paranoia and resulting negative emotions/feelings most often cause different kinds of depression. I say different kinds because there absolutely are, and labeling someone with major depressive order could mean different things. And my doctors have told me this. Some people withdraw. Some people self harm, yet keep a perfect public face. Some take up a hobby that they are able to completely absorb themselves in and obsess over. I’ve seen it all. Remember, all of this shit runs in the family; mother dearest being most bonkers of them all.

Anxiety and paranoia are different. This is an important distinction. Though, these do often go hand in hand with each other, but can still present differently in different people. This is why mental health treatment is so difficult because each human is unique, and the world is changing. We are exposed to chemicals every day, now, that did not exist even 100 years ago. And let’s not start on big pharma. Paranoia is most often coined as hearing voices that are not from other humans within your general vicinity. Some people hear voices outside of their head that are not other people. I hear my own. My own voice, distinctly separate from “myself” within my head, is telling me every single second of every single day the worst case scenario. When I’m driving my brain tells me every single way I could potentially get into an accident every trip I make. It is impossible for me to go up the stairs with someone behind me. There is too much risk that they may just be a friend playing a trick, or I’m just too vulnerable if there were a threat. I can’t do it. My significant other suffers from this paranoia the most for reasons I feel can be imagined. It fucking sucks yo.

Remedies! First and foremost, I encourage anyone that believes they are suffering from any type of mental illness or ailment to speak to your doctor or someone more qualified if at all possible. There are other things that can help besides the chemicals, however. Essential oils, for one, are near and dear to my heart for the many different healing properties they have. I have three bottles that literally are for three different types of anxiety I experience. They are superb. The other best legal treatment I have found is CBD. There are numerous forms and there happens to be quick access through yours truly; many ways to get in touch available. This is the aid I have found to be the fastest and most certain relief from anxieties and paranoia.

I will shit on big pharma and the use of chemical pharmaceutical treatments all day long, but I will also acknowledge that there are some ailments that are simply best treated with their use. Even over the side effects. Though, there are other options that may be more appropriate and therefore less harmful for some people. Any of you reading are near and dear to my heart, and if I reach even one person that needed this wake up call then my goal is complete.

 

 

Depression

Let’s get real. I’m going to share some seriously personal shit because people don’t talk about this stuff like they should. For the longest time depression was not even recognized by health professionals as something to be treated. The primary reason is because nobody talked about it in order to study or treat it. I’m fairly open about my mental health, but there’s still things people generally keep to themselves in conversation because it scares people to say that you hate every single second of your existence and if it didn’t negatively affect so many people financially in my life I’d slit my wrists right now. You just can’t really say that out loud.

The biggest obstacle I feel is trying to tell your therapist/psychiatrist just enough information to the point where they don’t feel the need to involuntarily hospitalize you. The ones of us that are able to get treatment and have access to affordable medications probably take it for granted. I am on title 19 Medicaid which means I only get to see the crappiest of doctors, but that’s still more than some people have access to. It doesn’t help that our government keeps lobbying back and forth whether mental health services should be covered by insurance. Then we have a president currently who is basically criminalizing mental illness; so the rednecks that didn’t “believe in” depression before sure as hell don’t now.

I feel the biggest struggle in communicating about this illness is the fear of the reprisal from the other person. Because every now and then you’ll get bullshit comments and/or suggestions; “You should just try harder”, “We didn’t have any of that in my day so you should just put on your big girl panties and get over it”, “If you just smiled more you would be so much happier”, or “Oh yeah, I was depressed once”. Mmmkay. I’m not going to address these individually because they all get my blood boiling. Every single time this shit comes out of a persons mouth all we do is smile politely and change the subject when what we really want to do is crush their larynx under the bottom of our shoe. It’s hard to educate those that haven’t lived through it, but I can’t express how important it is for us to try.

I was first diagnosed when I was 13, and at that point I had been begging my mother to let me get help for years. She was another one of those that didn’t believe in it. She called me a bratty kid and told me I would just get over it. Some might say this is malicious but I find it funny that she’s now disabled after a mental breakdown and three suicide attempts, but this same woman wouldn’t let her 12-year-old daughter (that was on her knees on the floor in front of her crying and begging) see a counselor. It makes me sick and so very angry. I simply have no empathy left for that woman, but the pain she has inflicted is for review another day.

Since then I have dealt with a multitude of different issues, had several different diagnoses, been on at least three dozen different medications, dealt with eating disorders (anorexia nervosa and bulimia), self harm (cutting), and many other struggles. It’s an odd feeling to post a fact that only three people on this entire earth know to the internet; please don’t abuse it. Most recently I have been diagnosed with narcolepsy as a result of the trauma of my childhood and early adulthood which led to “brain damage I’ve only seen in PTSD victims that have returned from war” according to my sleep doctor. I had no clue that trauma and such could lead to literal brain damage.

What I want the take-away to be here is that we HAVE to talk about it. We have to talk about our struggles and triumphs to find like-minded people. Not one of us is alone in this and we have to do our due diligence to find others; for our sake and theirs. Humans are not meant to be alone (as much as the depression makes us think we want/deserve to be). We exist as a species on this planet to lean on and learn from each other. And know that in all of this I am personally someone who will be there if anyone is in need; for any and all.