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When Your Loved One Can’t Get to the Doctor

2018-09-06T16:53:34+00:00 March 22nd, 2018|Schizophrenia|0 Comments

About two and a half years ago, my family member had an experience that caused a deeply held delusion. At least, I think it was an actual incident. It could just as easily have been a psychotic delusion that started this firmly held delusion. My family member had been put on an involuntary psychiatric hold in the local ER. The only bed they could find was three hours away from us. To get there, the ambulance had to drive on a narrow, high bridge over a wetland area. …read more.

When I went to visit my family member, I noticed the bridge but didn’t pay much attention to it at that point. I think something may have happened on that bridge.

When he was discharged (after two weeks), he insisted on riding in the back seat of the car, lying down. This isn’t something he had done before, but my goal was to make him feel comfortable and safe. So, it was fine with me that he rode in the back. I didn’t realize how terrified he was.

In the following days, it became clear that riding in a car, or any moving vehicle, terrified him. He’d tell me he’d rather walk than ride with me. It was November and cold, so I tried to get him to ride in the car. He wouldn’t. Or couldn’t. On occasion, he’d call me to pick him up from the park or somewhere. When I’d get there, he would sometimes tell me never mind, that he decided to walk. Other times, he’d get in the car and as soon as I got to the first or second stop, he’d jump out. He was in a panic and couldn’t ride in the car any longer.

He had a new treatment team at that time. I begged them to do some sort of therapy to help him overcome this fear. I was continually told there was nothing they could do but to encourage him. At one point, the team lead asked him if he could ride in a taxi instead of a car. Seriously. He really asked this. With a look of incredulity on my face, I asked him if he realized that taxis are cars, as well. I felt like he was minimizing my family member’s dilemma and treating him (and me) as though we were ignorant. The rest of the team was of no help, either.

In the months and years that followed, I tried everything I could think of to help him overcome his fear. The psychiatrist on that treatment team actually came to our home for the first three months. Then, she refused to come any more. She believed he was ‘playing’ her. She refused to refill his meds unless he came to her office sixteen miles away. He couldn’t, so she refused his refills. Needless to say, at that point I realized it was time to find another treatment provider.

I got lucky. I found a private pay physician who was two blocks away. He said he’d give me the paperwork I needed to get reimbursed from Medicare. I was excited! As was typical, the excitement was short-lived. This doctor fired my family member three months later, with no warning. He felt my family member needed more care than he could provide, yet he refused to offer a referral.

Shortly after losing that doctor, my family member landed in a psych hospital. He would be hospitalized five times in the following year.

It was time for me to get creative again. I found an agency with a medical outreach team that went out to homeless camps to provide treatment. On their website, they said they would treat people who couldn’t get to a provider due their illness. Fantastic! I called, and we had an appointment within a few days. In the beginning, they made it clear that this relationship was to fill in the gap. They would only be able to come out for a couple of months, as they were short-handed, and we were far out on the outskirts of the county. I had to take what I could get.

They provided refills and care to my family member for over a year. At the last appointment, I was told that they were restructuring and would no longer be able to provide care or refills for my family member. He was given three refills. I don’t know what we’re going to do now.

How do you get treatment when your loved ones’ illness prevents them from getting to the doctor?

Our only options left are to let him go off meds or to find another solution. In my research, I’m learning a lot about TeleMental Health. This is sometimes called TeleHealth or TelePsychiatry. In this treatment modality, technology is used to accommodate treatment. Rather than going into an office to be treated, the patient and doctor meet electronically, on the phone or via videoconferencing. (MyHealios uses telehealth to conduct caregiver coaching.)

TeleMental Health can help for many people with schizophrenia. Too many of our loved ones are isolating in their bedrooms. Some of us live far away from treatment centers and make long journeys to see a psychiatrist for ten minutes. Some have co-occurring illnesses like diabetes that make travel difficult. Some are like my family member and have severe delusions that keep them from going to a doctor appointment.

How do you get treatment when your loved ones’ illness prevents them from getting to the doctor?

Our only options left are to let him go off meds or to find another solution. In my research, I’m learning a lot about TeleMental Health. This is sometimes called TeleHealth or TelePsychiatry. In this treatment modality, technology is used to accommodate treatment. Rather than going into an office to be treated, the patient and doctor meet electronically, on the phone or via videoconferencing. (MyHealios uses telehealth to conduct caregiver coaching.)

TeleMental Health can help for many people with schizophrenia. Too many of our loved ones are isolating in their bedrooms. Some of us live far away from treatment centers and make long journeys to see a psychiatrist for ten minutes. Some have co-occurring illnesses like diabetes that make travel difficult. Some are like my family member and have severe delusions that keep them from going to a doctor appointment.

What are the benefits of TeleMental Health?

There are many benefits to TeleMental Health, such as convenience, better appointment attendance, and treatment satisfaction. There is also improved privacy for those concerned about being seen in a psychiatric clinic. It can be less expensive to serve patients through TeleMental Health than in a traditional brick and mortar office.

Of course, TeleMental Health isn’t for everyone. If your family member has trust issues or paranoia, electronic communications may not be suitable. But for others, like my family member, TeleMental Health could be a godsend.

Unfortunately, this type of medical care isn’t readily available. I’ve checked with my county mental health department, and they don’t offer this type of care. Some areas offer TeleMental Health, but not in home. The patient would have to go to a local satellite clinic to have an electronic session with the psychiatrist.

TeleMental Health is an expanding field. Until recently, Medicare would not pay for TeleHealth services. Now they do.

What’s important is that society keeps up with changes in lifestyle and that service providers become flexible in how they provide services. Each client has individual needs and should be treated in the way that works for them. TeleMental Health is one field that definitely has the potential of providing services to people who don’t fit the typical criteria of going to appointments.

What do you think?

I hope this information is helpful to you. Please comment with questions, suggestions or other information. For information about how to receive caregiver-centric support, stress-management, and disease-specific tips and techniques (from the convenience and privacy of your own home via telehealth), visit MyHealios.

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