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"Why did they send her home?" My sister is now a major amputee, declared mentally incompetent [1]

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Date: 2023-11-05  

The hospital psych intern asked me a very good question over the phone a few days ago.

“Why? Why did they send her home?”

He didn’t really expect me to answer that. It’s not even a real question. If you’d heard that 6 inches of blue gumballs fell in the Phoenix area this morning, you’d reflexively go, “Why? How? How can that be?” So it’s more like that.

I’ve written a couple of times about this before, referring to my diabetic and mentally ill sister, who got evicted and moved in on my mother (hundreds of miles away from where I live) against my mother’s will a few years ago, as “Shirley”. In August 2021 :

Shirley contracted MRSA in her legs a few years ago and had a very bad case of it, and this has been complicating things. Shirley sincerely believes the infection was caused by a “bioweapon”, engineered by “them” as another attempt on her life. Shirley, however, has not been to a doctor (or dentist, and her teeth are falling out) in years, because she is, of course, her “own doctor”. Then our mother passed away in April. [...] Shirley’s legs are not healed (they still bleed out now and then), she essentially never leaves the house, and she does not clean up when a cat pukes or shits on the carpets, because after all, we’re going to replace those anyway. Why should Shirley knock herself out? Her solution for all the flies that have shown up as a result was to buy a bug zapper. That’ll do it! [...] The real long-term issue is what on Earth will happen going forward, where you have someone who will not seek employment, who will not visit a doctor, who has essentially no savings, and whose business is not even close to sustainable.

And then once again , after the s**t really hit the fan, just about a year ago now:

Then in late September 2021, it was becoming evident to me and my cousin (whom we will call Magda), from conversations on the phone with Shirley — that Shirley’s health was deteriorating. Magda recommended we do a “302” — that is, a wellness check in which the authorities might decide that involuntary care would be administered — on Shirley. I was unsure about this whole thing, but Magda eventually pulled the trigger in early October 2021. The police and ambulance came (as did Magda, who lives 30 minutes away) and whisked diabetic (and frankly, near-death) Shirley off to the hospital. For how long, no one knew. Shirley would wind up in a rehab facility — or really more like a nursing home (where she still is today) — within a week or so. But what would happen to the house, and all those cats?

Err, we can skip over the part about what happened to most of the cats, but if you must know, read the above diary. Not good.

Magda, by the way, lives in Minnesota now, to be closer to her son, because she has begun to have some health issues of her own, so she is not around to help out anymore.

So after more than a year at the rehab place, including another rush to the hospital for near-fatal kidney failure, with the very modest estate of my mother having now been completely exhausted to pay bills on the house (including money I should have inherited that really would have helped with my kids’ college costs), they decided to send her home!

Magda and I had been trying to explain that the house was a squalid biohazard zone, as repeatedly noted by contractors — yes, they used the “B” word — and that someone from Adult Protective Services needed to get over there and see this because it would not be a safe discharge, but no one ever did that!

While Shirley was originally at the hospital, a psych eval was supposed to be done, but she wouldn’t cooperate with it, so no diagnosis was made, and everything psychiatrically was therefore officially peachy! Never mind that Shirley told everyone that Magda is secretly a CIA operative and that is why Magda reported Shirley’s condition (though surely saving her life). And never mind that all the nurses would tell me that oh yeah, Shirley is pretty f***ing crazy.

So yeah, home she went! And she lasted about 6 days before having panic attacks that she could not take her insulin and other medications and she could not understand bill-paying.

So back to the rehab place she went. And after a month or so, they sent her home again!

She lasted less than 24 hours that time. Surely this had to be the end of the whole “independent living at the house” charade, right? (There goes that “surely” word again, said in so many ways regarding my sister that that’s why she is “Shirley”.)

Nope! They sent her home again in March and set up a visiting nurse to come over three times a week for like an hour. That would fix everything.

And the awesome thing is that the visiting nurse Shirley got said, “Shirley, you’re lucky you got me as your nurse, because all the other nurses would have reported this place to APS right away.” Visiting nurse was such a weirdo that even Shirley called him “Rodeo Clown”.

Lucky!

So what does Shirley do the minute she hits the ground? She gets more cats! I pleaded with Shirley to please not do that until she was sure her own health was in order, but to no avail. She got turned down by a couple legitimate shelters because they could tell something was off. That’s OK, Shirley found some owners desperate to get rid of their cats, and so that was that. More cats for Shirley! Like, 5 of ‘em!

Shirley ran out of money in June, as I knew she would, so I “lent” her $500, knowing full well I would never see it again. And she also took a “loan” from the one real friend she seems to have — let’s call him Gerry, and I don’t know how on Earth Gerry puts up with her, but he has thankfully been genuinely helpful. We originally tried to have our cousin Drew, who had previously been living with his sister Magda, stay there and help out, but he turned out to be a total deadbeat who may have stolen some things and did not clean up anything as he had promised to. So that was just another really s****y chapter in this whole saga.

Gerry convinced Shirley that she better accept food stamps (Shirley is a “libertarian”, and food stamps make people dependent, you see, so better to take “loans” from your family and friends) and apply for disability, so she finally listened, and that kept things barely afloat, but Shirley was supposed to pay her property tax out of the last strings of estate sunlight that I secured for her, but she didn’t. Because she wasn’t making any money but still doing things like ordering food from Doordash.

Well, then the s**t hit the fan yet again about two weeks ago now, and Shirley realized she must be near death after denying she was sick for about three weeks (with constant diarrhea, hacking cough, and an episode where her left hand “stopped working”), ignoring Gerry’s and my pleas for her to call a doctor already, and actually finally took it upon herself to call an ambulance. Gerry went over to the hospital with her at 5 A.M. He comes off as a working-class average Joe when you talk to him, but he’s like some kind of bodhisattva that I can’t comprehend. He’s the one that deserves that house.

Well, Shirley had more bad infections in her legs — in-home “care” be damned — so bad that the rest of the toes on her left foot had to be removed (she already had 2 taken off in her previous hospital stay), and her right leg was amputated just below the knee. They found a screw embedded in her right foot that she did not know about because the neuropathy was so advanced. One hospital nurse told me she was shocked at the level of neglect of the wounds. Shirley was in the ICU on a ventilator for several days because the infection had spread to her lungs. They had her in an induced coma for awhile. She’s in a stepdown unit now.

The septic shock seems to have damaged her brain to some extent also. She used to be able to put thoughts together coherently, and although it was often based on nutty conspiracy-theory stuff, at least if you accepted those things as true it felt like you were dealing with a good English speaker. Now she texts me choppy 5-word things that aren’t even all words, though I think she understands what I text her. When she calls, I pick up the phone but she doesn’t say anything, maybe not knowing she has called?

The psych doctor had a visit with her a few days ago, and afterwards I got a phone call from the discharge RN informing me that Shirley has been deemed permanently unable to make medical decisions for herself and would I like to be her power of attorney? I don’t have that power right now, and I honestly don’t know if I want it. They want to send her to a facility that is a step up from the nursing home she was at before, and that’s the appropriate thing to do, and they don’t seem to have told Shirley this yet, but I suspect Shirley will try to fight it when she finds out, even in her current state in which she admits “im falling apart”. They will make her sell the house to pay for it, and I don’t know if her incompetence to make medical decisions extends to legal decisions as well. She has no guardian now, but I guess one is going to have to be appointed, and I am very leery to do it. I don’t want to fight with her about this.

Gerry says she’s only “so-so” in holding up a conversation when he goes to visit her at this point, which he has done 2 or 3 times now. She went through a “chatterbox” phase for a couple days where she would just dump out impulsive topic after impulsive topic, but now she’s rather quiet, and usually it’s some arbitrary worry that she has, and sometimes they sort of make sense, and sometimes they sort of don’t.

I’m still waiting to hear from the psych doctor on what the diagnosis is. Somebody finally made one, and it’s honestly a few years too late.

This country just does not have the will to deal with mental health issues, and things don’t have to end like this, but they do all the time. I don’t claim to have all the answers, but if you have mental illness, the U.S. is just not a good place for you. My sister had Medicaid and visiting nurses, and this still happened.

Previously they had said that Shirley could go home if she chose because she wasn’t a danger to herself or others. Really?

It’s cute when people have delusions about Bigfoot or the Loch Ness Monster, but not when they are incapable of discerning cause and effect in terms of their health and hygiene and finances. That’s how people end up homeless and dead.

Not to mention those cats, stuck again. I hope Gerry can find them all and doesn’t have to set traps and then eventually find…. oh, I said I wasn’t going to talk about that.

I saw the video earlier today where Arnold Schwarzenegger warns of the danger of blaming your own problems on scapegoats and not being honest about your own problems. He said it takes away your responsibility and doesn’t make you strong, but actually makes you helpless and weak. He said you don’t want to see the end of that road because it’s not pretty. Well, my sister did that all her life, and here we are at the end of the road, and you’re right, Arnold: It’s not pretty.

It didn’t have to be this way. My sister is an intelligent person who never got the help she needed (though wouldn’t accept it anyway), and it hurt a lot of people in my family, and it hurt a lot of her friends, most of whom gave up on her. I’m not pointing fingers at anyone in particular right now because there’s plenty of blame to go around, and I don’t know exactly how we can do better, but it didn’t have to be this way.

Why did they send her home?

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