Lately my office phone has been ringing off the hook with prospective residents wanting to move into our facility. That’s really good for business, but at the same time, I am a wee bit worried. The callers are social workers, calling on behalf of elderly psychiatric patients who have been housed in mental health facilities for very long periods of time. That is not what troubles me. What DOES trouble me are comments like this:
” This patient has not had any violent outburst for two years. He is 80 now and seems to be slowing down.” ( Um, so he was violent at age 78? Slowing down? Not been violent for 2 years? Oh I feel really good about this one, said no one ever.)
“The client was found not guilty by reason of insanity back in 1983. He has aged and needs more care than we can provide.” ( Um, if you have had “the client” for over 30 years, what makes you think age alone will prevent him from doing whatever landed him 30 years in the first place?)
“The individual I am calling about was found guilty by reason of insanity. He stabbed his several relatives, but now that we have managed his thyroid issues, I don’t think he will have further behavioral issues. He needs medication management to remain compliant.” ( Ummmmmmm…..so his thyroid made him commit a crime? Kind of like the devil made me do it? )
” The individual has schizophrenia. But the good news is, now he has dementia, so he forgets what the voices are instructing him to do before he has time to act on them.” ( Oh, that clears that up for me.)
” The patient is very much into the environment. Very green. His triggers occur when he feels people are harming the environment. He loves spending time in the courtyards, communing with the trees. Your facility is the one with lots of woods surrounding it; is that correct?” ( Um, would it be wrong to lie and say that we were located downtown near the paper factory where millions of trees are slaughtered?)
” The client has a long history of ‘”peeping Tom” incidents and has a foot fetish.This is not a problem in our facility because everyone wears closed toe shoes. Does your facility have a dress code that includes shoes?” (Ummmm..?)
Lastly, my personal favorite:
The patient was found not guilty by reason of insanity. He has schizophrenia. The crimes were committed when he was 24. He is now 69, a severe diabetic, shows signs of confusion, high blood pressure and has multiple personality disorder, but all of his associated alter egos have always been aliens, totally harmless, more afraid of you than you should be of them. ” ( Ummm, did she just say aliens? Like ET, alien????)
Soooooo, maybe now you can understand why I am a bit worried. Hey, in no way am I poking fun at the mental health system, patients nor the caseworkers. I have a special place in my heart for psych patients, but I am not sure some belong in the same environment as a 93 year old great -great-grandmother. I totally understand that the aged, infirmed psych patient needs a spot in the long term care facility as well, but……..where? Where is the appropriate place for a sexual predator, axe- murderer or serial killer after they have grown old, feeble or cognitively impaired? Does age change them or make them more suitable to live among us again?
For me the choice to refuse admission of these types of patients was one I debated with myself, but ultimately decided that it was best to keep our facility committed to dementia, not mental health. I do wonder what will happen to them…What would happen, if say Charles Manson developed Alzheimer’s…..would the staff continue to keep him locked up 23 of 24 hours,;change his clothes each time he soiled them, bathe, dress and spoon feed him? Correctional officers typically don’t provide that type of care….so hmmmmm. I do wonder how all of those stories end…………..
God's Waiting Room 
Some things we never thought to worry about!
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Jessi, you are so thoughtful, it shouldn’t surprise me that you would pursue this tragic possibility. What happens to violent individuals who eventually age and suffer from Alzheimer’s? My own mother suffered from borderline personality disorder. Though I’m not trained to diagnose and she was neither ever diagnosed nor treated, I lived with the horror of a woman whose mental disorder created trauma, violence, and terror in the lives of her children. (I spent many years trying to figure out why mom was so extreme, violent, and unpredictable, then so friendly, charming, and gregarious, and decided on one condition after another before realizing it was probably BPD. A mental health professional who knows my mom well agrees with me.) Now mom suffers from Alzheimer’s and I find that the only way I can live with myself is to forgive her. She must also have suffered from her own first mental illness as she now suffers from Alz. And, yes, there are still occasional traces of BPD but they are muffled behind the more critical and current crises of Alz.
Thank you for such sensitive and compassionate articles about those who suffer from this disease. I notice (in the residents of the Alz. facility where my mom now lives) much of what you write about. People waiting for people who are long gone, wanting to go home, responding to music, art, poetry, photographs, not able to plan for a future or accurately recall their past, failing each day a little more – hard to imagine a more grievous illness to plague anyone. And we who stand beside our loved ones, we suffer as well.
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Usually I do not learn article on blogs, but I wish to say that this write-up very compelled me to try and do it! Your writing taste has been amazed me. Thank you, very great article.
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