The Lonely Gerontologist

Kelly Yokum's Adventures in Gerontology

A Broken System: How to Keep Your Child Alive While Navigating the Mental Health System

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I’m using The Lonely Gerontologist as a forum for this post for a couple of reasons – it’s what I have, and really, if we don’t make it to old age, that should be an issue for a gerontologist and for all of us. This is a tragic and sad tale of a broken system and the people within who have lost their way.

My family has been immersed in a life-altering crisis for about 2 months, since April. My son became very depressed and tried to take his own life. We were very lucky that his attempt failed. But, besides dealing with all of the emotions and issues that come with severe depression and suicide attempts we were also thrown into a system that we knew very little about.

I’ll save you the sad and heartbreaking details that we continue to deal with on our end within the family. What I will share now are the disgusting details of a sick system that continues to leave our son in the cold, without care, and worse, a system full of people who could care less about his story or the urgency or the fact that we are just treading water trying to keep our son alive.

In the last 45 days our son has spent 19 days in two different in-patient psychiatric hospitals. Anyone who has any idea of what goes on behind the scenes to get him where he needed to be can already feel our pain. Throw in Wellspan Behavioral Health and Dr. Madapoosi and Dr. Talley. I won’t even bother you with the 8 hours we spent on a Friday when we found out about his second attempt, trying to get him in to Philhaven in Mt. Gretna, PA without putting our son through the trauma of the emergency room and crisis intervention. They did not let him in because we went through our pediatrician and his therapist. Nice. We’ll manage at home and take shifts checking on him to make sure he’s still alive.

Back to Wellspan. So, here’s what they tell visitors to their website:
“Regardless of the level of care, WellSpan Behavioral Health is committed to enabling patients to better cope with the stresses that brought them to treatment. Our goal is to provide the most cost-effective, least restrictive care and to provide innovative alternatives to treatment and maximize outcomes. Together we will partner with you, your family and other health care providers to get you the care you need to take control of your life.”

I’ll break this down from our perspective. They have Added to our stress, they have put up Barriers to access, least restrictive – that’s actually funny. Okay, not funny Ha Ha, but funny. And, a partner in his care? Again, Funny. And finally, getting the care we need and having control over lives? Well, you can imagine how I feel about that and I’m not even to the details yet.

The details include mental health professionals refusing to do their job, a teenager hanging on for dear life, and family in turmoil and standing helpless in the face of bureaucracy, burn-out, and incompetence.

Our son’s suicide attempt came less than two weeks after he was discharged from his first hospital stay of two weeks. He told no one. He told no one for 3 days. When we finally found out we worked hard to get him somewhere that would not just stabilize him but help him to walk out feeling like maybe he could get through this crisis and have the tools to face the next.

I placed a call to Dr. Madapoosi with Wellspan Behavioral Health. Made sense to me. He was the psychiatrist on record after my son was discharged from his first hospital stay. He met with my son 2 days after his suicide attempt, although he still said nothing to the dr. When I talked to Madapoosi he was cold, abrupt, wondered why I wasting his time. I asked him to help us gain access to a facility that required a call from a psychiatrist. I told him that we were in a life-threatening situation and that David had attempted to complete suicide and please, would he help us. This is what he said to me: “you want me to call places? I don’t have time for that. I don’t have time to call your insurance company. Take him to the emergency room.” I was stunned. I told him that I had already been in touch with the insurance company (Highmark has been amazing!). He was rude, scolded me for not having a follow-up appt. I stated that we didn’t make another appt because we weren’t sure where we would continue his care. There was no hope he was going to help us but that comment ended any chance. He said not only was he not going to help us but he wasn’t going to accept another doctors diagnosis so that is why he took him off the depakote and put him on Wellbutrin. Sweet.

We did manage to finally get our son into Brook Lane in MD. They were great, better than the previous facility. An interdisciplinary team approach to his care. Finally. I talked with Dr. Burke, his main doctor, every morning. I also let him know that Dr. Madapoosi should not be listed as his doctor on his discharge papers. They would help me find another doctor. They did. This is where the story gets even better. I know right? How could it get better?

My son’s appt with the new dr., Dr. Talley, was to be this week, on Thursday. Yesterday I received a call, while my son was in his therapy appt, from Tammy at Wellspan Behavioral Health. She informed me that my son’s appt needed to be canceled because we should have made the appt with Dr. Madapoosi.

My response: “Are you telling me that my son, who was just discharged from the hospital for trying to kill himself is having his scheduled appt canceled?”

Tammy was quiet for a moment and informed me that the appt should have been made with Dr. Madapoosi because he is the doctor on record. I explained to her that we did not want to continue with Dr. Madapoosi and that Dr. Burke arranged for the new appt.

Tammy informed me that she would have to check with Dr. Talley to see if she would be willing to see him. She would call me back. Thanks.

Today I received two phone calls. One from Tammy telling me that Dr. Talley was now not available at the time his appt was scheduled. She had a meeting. Nice. Funny that she didn’t when Dr. Burke’s staff set up this critical, part-of-the-discharge-crisis-plan appointment.

The second call was from Amber, Ashley, it doesn’t really matter. She said they wouldn’t be able to do anything until I called back to give them a reason why we did not want see Dr. Madapoosi. Really? Is this protocol? Do we, as consumers, now have to give a reason why we switch doctors, practices, plans, etc?

So, as it stands now, my son does not have an appt with doctor who can help him with his diagnosis, help him get his meds straight, help him get to a place where he is comfortable with his new diagnosis and feeling good because he finally has the right medication at the right dosage.

The past 6 weeks have been a challenge for us as a family. But more importantly, it has been life changing for our son. We have a new normal now. We need professionals who can help guide us through this maze that is the mental health system. We need professionals who still care about their patients and their well-being. I’m saddened at the thought of others who don’t have access to mental health, who don’t have wonderful insurance like we do and perhaps most importantly, who don’t feel empowered to advocate for themselves or their family members. I’m mad as hell and when I come out of this fog that has been our life for these past few months I plan to take my anger out in a way that has some impact not just for us, and in my son’s name, but for others as well.

I’d love to begin collecting stories like this. Stories of bureaucracy over care, stories of the helpers who don’t help, stories of a failed mental health system that leaves us feeling even more helpless than the issues that brought us to a point where we needed to seek help.

So, how do you keep your child alive while navigating our broken mental health system? You fight like hell. You learn as you go. You don’t give up. Use your social capital. Call on your friends (thank you Robin, Kristen and many others) to tap their knowledge base, their contacts. Call on your family for support and love – you’ll need a lot of this as many of you already know.

My son is alive. We fought like hell and now he needs to fight like hell, for the rest of his life. He doesn’t know that these doctors don’t want to see him. That he isn’t important enough to them. That his life doesn’t matter to them. That can wait for another day. A better day.

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Written by The Lonely Gerontologist

June 18, 2013 at 7:06 pm

Age, Identity, and the Broken Vase

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So, it’s late, I’m tired…but, I had to share, and of course comment. My friend Liss, Executve Director of Take Root, an organization created by and for survivors of parental abduction (http://takeroot.org/) posted to her blog today and I really connected and wanted to make a point about why what  happened to me (and has to many others)  36 years ago is still so relevant today. Identity. Liss really hit on someting important in her blog post. Who are we? How does our identity form? and what happens when that process is ruptured? When our self, who we are or who think we are, is dislocated? And, for me as a gerontologist, I wonder what does it all mean for our future selves?

From a life course perspective the abduction experience and the related dislocation of self and identity rupture are extremely intriguing. Planting my feet firmly on the ground for any period of time is extermely difficult for me. Part of who I am is rooted in that early experience of my dislocation of self, that identity rupture that occured and never came fully back together. Like a broken vase, glued back together, but never again that perfect fit, never again able to find that smooth edge where there used to be one full piece of glass. There is instead, a rough edge, a damaged edge, a side that can be hidden but, no matter which way you turn it, no matter how beautiful the flowers that fill it,  it’s still there. That’s my point. And, what it means for our future selves remains to be seen.

http://blog.takeroot.org/?p=135

Written by The Lonely Gerontologist

April 10, 2013 at 3:07 am

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Great post from a great friend and fellow gerontologist Keren Wilson. I’m looking forward to more.

60 and Counting

On December 5th, Encore announced that I was a Purpose Prize Fellow. I have won a fair number of awards over the years, starting in grade school with a blue ribbon for a pretty awful drawing of a scarecrow. The Purpose Prize folks encouraged us to use social media to announce our status. Well, I am not as much interested in telling you about winning fellowship status as I am to begin a dialogue about the work that led to my nomination and selection. Do not get me wrong, it is an honor to be selected, especially when you read of the amazing work the other winners are doing. Visit http://www.encore.org/prize/all_winners to read more about the Purpose Prize and the winners. Visit The Jessie F. Richardson Foundation, the foundation that I began nearly 40 years ago to help vulnerable older adults, at www.jfrfoundation.org to learn more about our…

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Written by The Lonely Gerontologist

January 30, 2013 at 1:46 pm

Posted in Uncategorized

Perpetuating Aging Stereotypes – Just another night in front of the tv.

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I was inspired by a recent comment from a reader who posted, “let’s get right down to it and talk about anti-aging…or not.” I’m up for this and you should be too! It’s a new year, with new opportunities to challenge ourselves and address important issues.  I challenge all of you to think critically about aging and the context in which old age is often presented.  Does it matter? If so, why?  And, more importantly, what can we do about it? I want to just mention two shows that I believe are a couple of the worst offenders. I know you’ll have others in mind, so send them to me, I’ll call them out! And, I’m always looking for classroom material to help me make my points.

Anti-aging. Let’s break down the term – Anti – we all know what that means, and Aging, the process of growing older. So, why would anyone be against aging? Isn’t that one of the three things we all have in common? We’re all born, we all age, hopefully living long lives, and we all die.  Do a Google search on the term and you get 96,000,000 results. I’m not sure what that means but I think we can make some assumptions about anything from big bucks to fear of aging.

Mainstream media is a good example of  how open we are to accepting negative constructions of old age and how much is out there. One of the worst offenders when it comes to perpetuating the fear of aging?  Dr. Oz. Now, don’t get me wrong…Dr. Oz has done some great things for his viewers including increasing awareness about health issues and making health education accessible to a wide audience. But, it’s that wide audience that is at the heart of why his constant use of the term anti-aging is so dangerous. Even Oprah has an anti-aging checklist.

The other serious offender, and I’ll probably get some grief over this one, Betty White. Yes, I said it. Betty White. I’m mainly referring to the television show, Off Their Rockers. This was touted as a series where older adults would be making fun of the younger generation. Maybe it’s me. Maybe I’m hypersensitive to all this ageism stuff. But, when I watch this show I don’t see the “younger generation” being the butt of the jokes. I see something quite different.  I see the us and them concept being perpetuated in prime time.  I so wanted this show to work. I so wanted something I could show my students that would  help illustrate the concepts of gerontology in a contemporary way.  This isn’t it. But, it may be what I didn’t anticipate. It may be something I use as an example of what I’ve just stated…a television show that perpetuates society’s ageist views.

Dr. Oz frames his shows on anti-aging around how to avoid aging, how to look younger. Because, who wants to look old? Why would anyone in their right mind want to grow old? Betty White and her crew use their old age as a tool to poke fun at…who? We should laugh because an older woman is on the phone discussing her sexual adventures? What are we really supposed to be laughing at? Oh…that’s right, old people don’t have sex so that scene is funny because it’s an older woman actually talking about having sex. Off Their Rockers takes every stereotype about old people – from bad drivers, to being asexual, to being off their rockers – and exaggerates them in a way that even I didn’t think possible.

As a social gerontologist I  think about how older adults are viewed and treated in society as well as how old age is socially constructed in this country. The song for the Betty White series is a Twisted Sister song,  We’re Not Gonna Take It. I feel the same way. I don’t think we should take it anymore.

Here’s a link to a clip from Off Their Rockers.  You Decide

Here are some tips from the Dr. Oz show. Again,“It’s every woman’s dream!”

Written by The Lonely Gerontologist

January 2, 2013 at 2:37 am

Volver – Film Review from Old Woman in Feature Films Blog

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A wonderful review of a film that addresses many of the issues we gerontologists and everyone who cares about aging from a substantive perspective should know about. I have yet to watch it but I’m on the search as we speak!

http://www.imdb.com/title/tt0441909/

Thank you http://oldwomaninfeaturefilms.wordpress.com for a great suggestion and a fabulous review!

ageing, ageism and feature films

The U3A screening at the Lexi in March was Almodovar’s Volver. The audience, as usual composed of a majority of women, greatly appreciated the film.   This was expressed by lively contributions by many of them.

There were general comments: idealisation of women by Almodovar, absence and/or stereotyping of men, and the resilience of ordinary women.   The themes mentioned were family lies, the need to deal with unfinished business and its relevance to us older women, the support of neighbours and friends in the country. More specifically the multiple  relationships between women: mother/daughter, sisters, grandmother/granddaughter, aunts, friends and neighbours.

Apart from the general comments, it was interesting for me to see how Almodovar’s mise-en-scene was also appreciated and commented on. The first scene in the cemetery, the landscape with wind farms between the town and country, the use of the ghost superstition, the motif of  the knife, the role of food, the…

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Written by The Lonely Gerontologist

December 28, 2012 at 11:59 pm

Posted in ageism, Aging, Old, Uncategorized

Hello? Is anyone out there?

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So, the title of my blog…aging is a lonely business. Particularly when you are trying to engage that 18 – 22 year-old crowd. And, really, can you blame them? Can you blame any of us? For those of us who know better, yes. Yes, I can and I do. When I first started my doctoral program in gerontology I never imagined that there would be anyone who wasn’t interested in issues related to aging. And, being a social gerontologist, I saw it all around me. The negative and the positive – Ageism, stigma, discrimination and also the contributions, the individuals, the history.

While the use of the word Lonely in my blog may not be immediately clear since we often hear about “seniors” on the nightly news, in political debates, discussions about Social Security, etc. we don’t often hear the voices of gerontologists like me and my colleagues who want people to pay attention to the substantive issues related to aging and the experience of growing old from both a personal and societal perspective. Gerontologists spend a lot of time talking to each other. We’re not that great at getting outside our own heads or our own in general.

Even on my own college campus where there are only two of us who teach courses in gerontology, it’s a struggle. And we are lucky. My colleague and I are fully supported when it comes to our program. I was hired to teach courses in gerontology. That’s actually amazing given the view of gerontology in higher education and in society in general. I came to my current position after the program I was directing, a 30-year old program started by Rosalie Wolf (see link below for more information) was discontinued after the Provosts from the 5 participating colleges and universities decided that aging wasn’t the direction they wanted to take. Really? It’s a shame none of them read the data presented to them on the demographic shift currently taking place. Or, the projections from the Institute on Medicine report entitled, Retooling for an Aging America: Building the Health Care Workforce (see link below). Or, just paid attention to what’s happening in our society around these issues.

In general there is a lot of confusion about gerontology. We have a major marketing problem. What do we do? Who are we? Doesn’t everyone know about aging? And, everyone has a grandparent right? We all must be gerontologists! As for students, they come to gerontology for a couple of reasons, they think the classes must be easy (it’s old people, how tough can it be?) or, they have a real personal interest because they were lucky enough to have a positive connection with an older person(s), usually a relative. A word of caution here though. Gerontologists are passionate. We have to be. Because we have to walk a very delicate line with our students who come to us with an interest but one that is framed around what Bob Binstock referred to as Compassionate Ageism (see link below). When I first meet with a student who is either taking one of my classes or comes to see me to find out about gerontology one of the first things I usually hear is, “I love old people!” or “Old people are soooo cute!” For me, that’s a dilemma. I usually try to reframe things for them. I really want to shout at the top of my lungs, “Noooo!” But, I don’t. I generally ask them if they love the idea of old people, or if they love how old people are portrayed in the media, or if they love the “otherness”, the us and them notion of those old people. So, you can see. The dilemma – both courses of action are right – immediate correction, or a delicate restructuring of their reality of what is old. I try to always take the right path.

I have much less tolerance off campus. And, therein lies the birth of my blog. I plan to use my blog in a variety of ways, framed around aging and how aging is socially constructed, not only in the U.S. but around the world. I want to educate, illustrate, be a media watchdog – Savannah Guthrie on the Today Show last week made a joke about “cougars”…really? Yes. I’ll need help from you – old friends, new friends, family, colleagues. Let’s have a conversation about the experience of aging and why we should care. It’s the only thing we all have in common…if we’re lucky. The alternative to growing old isn’t very attractive. Unfortunately, in this society aging = death. And, if we don’t let others hear our voices, it will stay that way. As an educator and a gerontologist, I want to motivate people to think differently about old age.  Let’s ask some critical questions, let’s shake things up.

I’ll be calling on my friends, family, and colleagues to help me with this. Let me know when you find something that’s not right, needs attention, or you have your own thoughts about aging. Want to be a guest blogger? Let me know! I’ll also be hitting up Ronni Bennett who has a great blog, As Time Goes By (http://www.timegoesby.net/), for ideas and commentary.

This lonely gerontologist needs you.

Rosalie Wolf: http://www.ncea.aoa.gov/main_site/library/cane/CANE_Series/CANE_wolf.aspx

IoM Report: http://www.iom.edu/Reports/2008/Retooling-for-an-Aging-America-Building-the-Health-Care-Workforce.aspx

Binstock: http://gerontologist.oxfordjournals.org/content/50/5/574.full

Written by The Lonely Gerontologist

December 26, 2012 at 3:31 pm