Need help committing a family member - page 2

I know this might be a sour subject but I would like any help getting proper help for my sister. She needs committed. My parents cannot care for her any longer in there home and I fear for them. Today my sister called the cops on... Read More

  1. 0
    TraumaNurseRN,
    So sorry to hear of your situation. It's difficult to face a relative going through a hard time.
    First of all, it infuriates me that they did not admit your sister to psych after such a serious attempt (her OD)! That's pretty much unwritten protocol in my hospital- the pt comes in, goes to ICU until they're off the vent, then gets transferred to us. I don't know the whole story, but from what you said, that borders on medical neglect in my book. At that time, your sister would have been totally appropriate for an involuntary admission (I don't know where you live, I am just telling you how it would have been done under IL mental health code).

    The criteria for having someone involunatarily committed is "Are they a threat/danger to themselves or someone else at the time of admission?" If the answer is truly yes, and that answer can stand up in court and an MD will be willing to back it, we've got a case. Understandably, if there's not good reason to commit someone, the MDs won't do it because they're legally responsible.

    As far as your sister's behavior goes, sounds like she may have quite a bit of an Axis II diagnosis going on (just my opinion, not diagnosing). Those are hard to treat and even more frustrating for the families, so I am sending you lots of support. When you say she's having episodes of drunkenness, is she getting a little drunk once a week or super, blacking out belligerent drunk every night? What I'm saying is, do you think there are enough severe behaviors to have her committed? Honestly, I work as charge RN often and I hear about many pts in the ED who I think are will be admitted right away and then I hear back later that they got sent home after screening because the MDs don't think they can commit them. It's shocking, really. Please don't think I am in ANY WAY discouraging you, I just want you be prepared for what could happen because it does happen frequently (where I work, anyway).

    Also, the long term hospitalization- in IL once you're admitted, you're there until the MD discharges you. It might be a day, it might be 3 months. There is no set period and we make sure to tell pts that upfront. If the pt is involuntary, they will be going to court hearings on the floor and the MD and nurse documentation have to maintain good reason for that pt to still be here. If that can't be found in the chart by the judge, usually the pt gets to sign a voluntary which usually means they sign a 5-day notice as well, or the MD has to release that pt. Sorry I can't offer you better advice on the long-term hold part, we don't have a set 24-72 hours for our pts. You also said that your sister doesn't have health insurance, but I would say 90% of our pts either have Medicaid, Medicare, or are self pay.

    Let us know how it goes. We are thinking about you.

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  2. 0
    My experience was in IL as well, where the standard for involuntary admission is "immediate threat to self or others". Other states have standards that are easier to meet, such as "unable to care for self".

    So my first bit of advice is to find out what the standard is in your state.

    Secondly, I would suggest that you obtain the paperwork necessary for involuntary admission in advance and begin to fill it out. We had to document a number of episodes of dangerous behavior that demonstrated a consistent pattern. With the forms in hand, we were able to document incidents over a number of days, while they were fresh in our minds, and while we had access to witnesses. When the "final" episode happened, the cops were willing to intervene because we had documentation of multiple examples of his behavior. If we had not recorded the previous incidents, they may not have been willing to intervene when they did.

    Keep a written log of things like drunken behavior, drug use, mixing of drugs and alcohol, threatening others, driving while impaired, creating "scenes" at local businesses, rages, small crimes such as shoplifting, driving off without paying for gas, etc.

    Best to you. You are not alone.
  3. 0
    There are 3 conditions to where a person can be committed involuntarily: danger to self, danger to others, or if the person is deemed gravely disabled. Often, a person gets committed short-term with a PEC (Physician Emergency Certificate). The ED doctors will write PECs. I know some law enforcement agencies that will write them as well. So, if your sister is unwilling to go to the ED, call 911 and see if the police will do it. Now for a warning, if you do this, your sister will probably get very angry with you. But in the end, it is an intervention that will get her the help she needs, so it will be worth it.

    PECs will last until the patient no longer meets criteria for involuntary treatment or if the patient files a 3-day paper. The 3-day paper contests the PEC and grants the patient a probate hearing. At that time, the probate judge will determine the future of the patient and their treatment. Sometimes they determine that the patient can go home. Sometimes the judge forces longer treatment.

    Your parents can become conservators of person for your sister through a judge. Usually, the patient has to have a long history of disability for that to happen. A social worker or psychiatrist can usually help set that up.

    I hope that helps.
  4. 0
    Quote from goettin98
    TraumaNurseRN,
    So sorry to hear of your situation. It's difficult to face a relative going through a hard time.
    First of all, it infuriates me that they did not admit your sister to psych after such a serious attempt (her OD)! That's pretty much unwritten protocol in my hospital- the pt comes in, goes to ICU until they're off the vent, then gets transferred to us. I don't know the whole story, but from what you said, that borders on medical neglect in my book. At that time, your sister would have been totally appropriate for an involuntary admission (I don't know where you live, I am just telling you how it would have been done under IL mental health code).

    The criteria for having someone involunatarily committed is "Are they a threat/danger to themselves or someone else at the time of admission?" If the answer is truly yes, and that answer can stand up in court and an MD will be willing to back it, we've got a case. Understandably, if there's not good reason to commit someone, the MDs won't do it because they're legally responsible.

    As far as your sister's behavior goes, sounds like she may have quite a bit of an Axis II diagnosis going on (just my opinion, not diagnosing). Those are hard to treat and even more frustrating for the families, so I am sending you lots of support. When you say she's having episodes of drunkenness, is she getting a little drunk once a week or super, blacking out belligerent drunk every night? What I'm saying is, do you think there are enough severe behaviors to have her committed? Honestly, I work as charge RN often and I hear about many pts in the ED who I think are will be admitted right away and then I hear back later that they got sent home after screening because the MDs don't think they can commit them. It's shocking, really. Please don't think I am in ANY WAY discouraging you, I just want you be prepared for what could happen because it does happen frequently (where I work, anyway).

    Also, the long term hospitalization- in IL once you're admitted, you're there until the MD discharges you. It might be a day, it might be 3 months. There is no set period and we make sure to tell pts that upfront. If the pt is involuntary, they will be going to court hearings on the floor and the MD and nurse documentation have to maintain good reason for that pt to still be here. If that can't be found in the chart by the judge, usually the pt gets to sign a voluntary which usually means they sign a 5-day notice as well, or the MD has to release that pt. Sorry I can't offer you better advice on the long-term hold part, we don't have a set 24-72 hours for our pts. You also said that your sister doesn't have health insurance, but I would say 90% of our pts either have Medicaid, Medicare, or are self pay.

    Let us know how it goes. We are thinking about you.
    She wa admitted to the psych unit the time she ODd but it took me throwing some weight around. Thankyou for your support....I will keep you updated.
  5. 1
    Thank you thankyou.....This stuff is helping!

    At this point she is not at my parents. She took off in her car after packing a bag and taking her dog. Both my mother and I know she is more than likely at her friend's home because we see that she is online.

    According to my mother she became angry with my parents 2 nights ago and called the cops on them accusing physical harm. (2 days prior to that she accued my father of thinking he was going to throw boiling water on her when he was just moving the pot of water to the back burner) My aunt and mother were there and saw the whole thing.

    Since the police have been to my parent's home before....The 2nd time she threatened suicide and refused to let me take her to my ER....She was drunk had been driving when my mother saw her on the road coming home from the hospital after my dad was in recovery for a total hip replacement. grrrrrr...My mother called me for help because my sister was so drunk she was driving through stop signs, etc.,,,and then came home. Once I got there she was laying nude in the bed, refusing to talk, threatening suicide so the police were called and took her in their vehicle (EMS was called too) but the police escorted her instead.

    Since this incident 2 days ago my parent's have been in contact with a police squad dealing with these incidents and have given my parents information and contacts for them for help. The information you have given me has been helpful as well....Thankyou!
    SuesquatchRN likes this.
  6. 1
    Quote from Suesquatch
    I wish I had something to impart.

    My sister has schizophrenia, has had for 35 years now.

    I'm sorry you and your family and your sister are going through this.
    I did relief work in a pharmacy whose clientele was composed mainly of the chronically mentally ill, and am totally convinced that schizophrenia is the very worst thing that can happen to a person and their family.

    SuesquatchRN likes this.
  7. 0
    Sorry, I must have misread. I thought you meant she manipulated the medical doctors and they let her go. I'm glad she did get a psych admit that time. Keep us posted.
  8. 1
    My mom committed suicide on March 18, 2008...she was not a clinically diagnosed bi-polar patient, but I know she was. I still hurt so I feel your pain. I believe if you contact your district attorney, regardless of her state or your petition, by law him or her must look at the case and have a hearing within 72 hrs. I was in the process of doing this, but was too late. I do not want it to be too late for you. 20% of bipolar patients commit suicide that number is too big. Please reply if you want and if you want my email let me know. I want to be a help and an advocate. Losing my my mama to suicide changed me forever.
    I hope I can help in some way
    Take Care
    SuesquatchRN likes this.
  9. 0
    It sounds to me like your sister needs you.
  10. 0
    Quote from algebra_demystified
    It sounds to me like your sister needs you.
    Actually she hates me.


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