Can you hire a private psych nurse to give meds?

  1. I DO know that this is not legal - to force meds on someone.....So possibly what I am looking for is outside the law....something more like a hit man: - A shot man.

    But here is my question:-

    How do I go about hiring a psych nurse who will get my Schizophrenic, Bipolar, Borderline 20 yr old son to take his meds? ( 9 years of diagnoses) I can't do it and am spending all my time off work in trying. I am exhausted. It destroys the one relationship he has left, with me, so it is bad for him that I have to be the bad guy. I feel that a non family member would have less baggage, and may be more effective. Don't suggest sneaking it in his food/drink. He s so suspicious of being poisoned everyone has ZERO access to the few morsels he ever eats.

    Someone who will come by and just give him his 300 mgs Seroquel, no more BS.

    Is Seroquel injectable or implantable? - I know there are longterm Haldol shots, but he can be fully rational and human on Seroquel and has been on (and off) it since 2000, (and I think Haldol is more leading to TD.)

    Are any of the other newer antipsychotics like Seroquel injectable or implantable? Geodon, Abilify, Zyprexa?

    I am in Northern California. I know what the laws are. I really just need any advice that may be a solution to this problem.

    I really hope someone has some experience or advice that is helpfull in solving this.
    Last edit by Nurse Ratched on Jun 10, '04 : Reason: language
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  2. 13 Comments

  3. by   lovinghands
    It sounds as if you are at your wits end. Your son's diagnoses are quite complex. I encourage you to speak with your son's psychiatrist. Your son will need to sign a release of information for disclosure, as he is an adult.
  4. by   exhausted mom
    Quote from lovinghands
    It sounds as if you are at your wits end. Your son's diagnoses are quite complex. I encourage you to speak with your son's psychiatrist. Your son will need to sign a release of information for disclosure, as he is an adult.
    Thankyou, yes I am at wits end. I have spoken to his various psychs, the current one out at the county hospital, he laughed and pointed out that its illegal, that even at the hospital they cant force meds. this is how I know this would be more along the lines of hiring a hitman than a nurse! But I just wonder if there is any way.....any ideas?
  5. by   lucianne
    Let me see if I understand this: are you asking about hiring someone to risk his or her license and face possible criminal prosecution to give your son medication against his will? Or are you just asking about hiring someone to attempt to get him to take his meds? If it's the second scenario, you could look into a home health agency that does psych home health (don't know how many of those there are, but I know some do).

    I do believe you are at your wit's end and I have the utmost sympathy for you. I think schizophrenia is a devastating, heartbreaking disease. Adding bipolar disorder and borderline personality disorder to the mix is awful. I hope that you can find a solution soon. Unfortunately, people with schizophrenia are notorious for going off their meds.

    luci
  6. by   Blackcat99
    I am sorry to hear about your sad situation. In the "old days" we could give forced medications to help the mentally ill. However, today it is all about "patient's right's".
  7. by   exhausted mom
    Quote from lucianne
    Let me see if I understand this: are you asking about hiring someone to risk his or her license and face possible criminal prosecution to give your son medication against his will?
    Oh my goodness! I only just found out that even you guys in the system can't make them take their meds: But I didn't realize it meant risking your licence and livelihood!

    At home its the oppsosite. My husband and I risk our jobs when we cant get him on his meds. The chaos that ensues is more risky to us than letting him stay on Benzos/off Seroquel.

    So I can see that as motivated as I am to get him on an even keel (and Seroquel does it for him!) that in hospital you are actually pushed by this law to do what he wants - which is just supply the Benzos - which actually disinhibit him without the restoring the rationality that Seroquel provides, so they make him dangerous and in need of hospitalisation.....

    Is this law crazy!!!!!!??????:angryfire

    What is the point of creating these wonderfull effective antipsychotics and then not utilizing them?

    The only time my kid has functioned at his pre illness level in the last 9 years was in 2 years of Cedu high schooling at a therapeutic boarding school, Boulder Creek Academy in Idaho. There the nurse just gave the kids their meds every day. Somehow they took them....Maybe because they were minors? It seemed like a miracle at the time....now even more so!
  8. by   Nurse Ratched
    So he's willing to take his benzos, but not the Seroquel? Sounds like a possible dual diagnosis issue - is addictions an issue also?
  9. by   Crazy Mama
    You asked about injectables, Geodon, Zyprexa and Respiradal Consta can be given IM.
    Have you thought about having your son put into a psych unit to get his meds regulated? Of course you have! I'm not sure if all laws regarding psych nursing are the same, but if your son is in the hospital and he continues to refuse his meds then the doc will usually do an emergency medication which is one of the above meds. (I spoke w the Seroquel rep. and he does not know if they will ever have an inj.) They can do this based on the fact that he is not getting enough nutrition/hydration, due to his parinoid state(if this is the case). Once the meds are in his system, he may be agreeable to continue the meds. then he may be released to home w/ a HHA that can give psych meds. But he still has to agree to take them. Have you thought about guardianship? W/ the new law, a guardian can sign for the person to go into a psych unit. This is good for 24 hours and then it is up to the judge if the pt. stays for treatment. but the good thing is the guardian can sign for the patient to take the meds ( pts on a psych unit have to sign for all their psych meds when admitted or they can not be given unless under an emerg.) Remember, even if you sign for your son to take the meds, I do not know of a home health psych nurse who will give them if he refuses. Good luck! Please check into the laws of your state, keep asking questions.
  10. by   elkpark
    Since the laws regarding this topic vary greatly from state to state, people here can't really advise about what's legally possible unless we are actually familiar with the CA law. Are you connected with any of the advocacy groups for the chronically mentally ill and their families, like NAMI? A local chapter would be able to give you a lot of good information (or direct you to someone who can) about what is legally possible or not.
  11. by   exhausted mom
    Quote from Nurse Ratched
    So he's willing to take his benzos, but not the Seroquel? Sounds like a possible dual diagnosis issue - is addictions an issue also?
    Yes, you are right - he is an addict too. But when he was on Seroquel, for the most part he was able to battle his addictions better. That is a big problem.
  12. by   exhausted mom
    Re "I spoke w the Seroquel rep. and he does not know if they will ever have an inj." Crazy Mama

    Thanks for asking the rep! If you see them again, please ask them to consider a Seroquel IM!


    Re "They can do this based on the fact that he is not getting enough nutrition/hydration, due to his parinoid state(if this is the case). "

    Wow! Well yes he isnt. I should send them a pic of him at his normal weight. They might just have thought he was always that skinny.

    Thanks Crazy Mama and Nurse Ratchet etc I will see about HHA in CA.
    Last edit by exhausted mom on Jun 10, '04
  13. by   elkpark
    Please contact someone who is familiar with the laws related to psychiatric issues in CA, like NAMI or another of the advocacy organizations. I assume that, if your son is not willing to take his meds, he is also unwilling to be hospitalized and would have to be committed involuntarily. Some states specify in their commitment laws that inability to adequately care for oneself is a sufficient criterion for IVC, and some specifically do not allow that as grounds for commitment. I don't know anything about the commitment laws in CA, since I don't live/work there.

    There are also different laws in every state regarding circumstances under which a person can be medicated against her/his will, including persons who are involuntarily committed to an inpatient psychiatric unit.

    I know that this is a terribly difficult and painful situation for you and your family -- best wishes.
  14. by   lmkrn
    In any state I would imagine you will be facing the same difficulties.As a nurse and a parent of a recently dx son I know how difficult this is (difficult does not even come close to it) .Even with court orders mandating treatment following hospitalization (often written as 30 or 60 day alternative treatment orders -never seen longer here). Once the person is out of the hospital they are RARELY enforced. In Michigan a person must be a danger to himself /others /or unable to care for self AND be unable to recognize the need for treatment. Once a person is out of the acute phase of the illness and d/cd from inpatient many could actually (albeit briefly) contest that continued treatment is a violation of civil rights and to force meds injectables on someone could result in worse than losing a license but assault and battery( I considered this myself in desperation) .Its also pretty hard to get any one to do something they dont want to do order or not .While I am not trying to make this seem hopeless the best situation would be to engage (somehow?) the person in treatment.Most but not all at some point in their illness/treatment cycle recognize the benefits of treatment primarily the improved functioning.Another dr , treatment agency ,partial hospital ,or med may be more to his liking . If he is highly noncompliant repeatedly he may be eligible for a State Hospital which is only a temp. fix . Until he recognizes the benefits of treatment he will repeat. That being said Haldol or prolixin (other Ds) can improve functioning for alot of people (but young guys do seem to have higher rates of some side effects some of which can be permanent ) and works nicely on paranoia. Possibly only temporararily until he can be engaged in treatment. Despite the risks we considered it seriously. The paranoia , hallucinations and isolation were too frightening to him ,too disruptive to life (not eating or sleeping). Luckily he responded slowly to zyprexa 40 mg with Effexor sr 150 and has been stable for 3 mo. on 20 /75. For now . I wish you and your family well .I wish I had something more positive to say and I wait with you for FAR better treatment options for our children .

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