Sunday, May 20, 2007

Just Say No and Other Stories

We've been freaking out a little because the doctor at the hospital where my dad currently is said he could be discharged perhaps even as early as next week.

I said I would be profoundly uncomfortable with that. I said that I absolutely believed that if he lets him out next week, he will turn around and try it again. There is, in fact, no question in my mind of this. He is not stable. He is not yet OK.

We've been doing frantic research on what to do. Trying to figure out what our best options are for places.

Serendipitously, I recently met a guy who is getting his PhD in psychology. He has been phenomenally kind, asking his professors their opinions on places, for recommendations, etc. Really lovely, taking a lot of time to help me. Plus he's just been amazingly sweet.

And he has a great perspective, and this incredibly calm, comfortable demeanor. I don't know him very well, but the time I've spent with him feels kind of like lounging in the grass in a park on a gorgeously warm, sunny day. Maybe you're reading a book, maybe you're just lying on the ground enjoying the smell of the grass and how the sun sparkles through the leaves of the trees. You know what I mean?

I was sharing some anguish with him the other day and said, "I bet you thought I was going to be all light and fun, huh?"

And he dryly replied, "Whenever you meet a woman and one of the the first things she tells you is that her father just tried to commit suicide, you have some idea that no, it will not all be light and fun."

Such a good point.

On a side bar, last weekend Jane, lovely, hilarious, California Jane, was in town and I told her about this guy. And she said, "Lis! This is so awesome! Just think - if it goes anywhere, you could get therapy and sex in the same place!"

And we laughed raucously. In the way that you do over something profoundly twisted and wrong.

Anyway, that's totally out of the question. Because I have a therapist I adore.

So back to the issue at hand.

My brother spoke to the head of admissions at a highly recommended private facility. What this woman said, very frankly, was that my dad is currently very high risk - in "imminent danger," was how she put it. He needs somewhere more secure than their facility, at least now.

My brother asked her what we do.

What, she asked, did he mean?

Well, what we're looking at is the hospital discharging him, without anywhere safe for us to put him. And we simply don't feel like he can come home yet. What do we do?

She said that quite frankly it's an insurance issue. Essentially, the first 10 days of trauma care can be billed at 100% without any questions. As time goes on, the amount that the hospital can get from insurance decreases.

So it behooves them, from a money standpoint, to shove people out the door as soon as possible.

However, she continued, we can say no. Because, look, he tried to kill himself, and he damn near succeeded. He really, really damaged himself physically. He's only a couple days out of intensive medical care. No, it's not OK to discharge him.

So it turns out we can say no, at least for a couple weeks, which will hopefully be enough time to get a further option lined up. He's comfortable there. He likes the psychiatrist. We like the psychiatrist. This is a relief.

We can refuse to accept him. He's in imminent danger. The liability lies with the hospital. We simply refuse. They can't just put him out on the street.

It's kind of shocking, isn't it? Of course it's about money. I don't know why I'm so naive that I was surprised. And I'm certain this is not uncommon for myriad people with varying circumstances. And we are lucky - luckier than many - with the insurance they have.

But at least we know. We can just say no. For now.


  1. I have some experience with what you are going through. Stick your ground, and refuse to let him be released into your (or your family's) care. It's unfortunate that insurance companies treat lives as just numbers in the whole money game, but just stick your ground.

    And it sounds like even though they want to discharge him, he seems to be getting decent care. Just keep an eye on that. I don't know the kind of facility he is in, but just be aware. In the situation I had been involved in, the psychiatrist would see the patient for 5 minutes a day, if that, see if the drugs were "working", and never actually ask if there was anything WRONG. He ASSUMED the depression was a chemical imbalance. It was almost like the doctor forgot to identify whether this person's depression was chemical or situational! It was a week of - "Here, try these meds...", and at the end of the week, they let her go. This is a tricky tightrope to cross, but it sounds like you're doing all of the right things, and asking all of the right questions.

    Good luck.

  2. Thank you for the support and the advice. It's so scary and confusing and difficult. And the thought of him coming home before he's stable is just terrifying.


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