[CedarS]

On my state mental health division website a mental health advance directive is described as:

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..a written document that describes what you want to happen if you become so incapacitated by mental illness that your judgment is impaired and/or you are unable to communicate effectively. It can inform others about what treatment you want or don't want, and it can identify a person to whom you have given the authority to make decisions on your behalf.

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The National Disability Rights Network has state links so people can learn more about their rights.

Anyone worked up an advance directive yet for themselves? Is it helping, is it being used by the various mental health professionals?

I have not yet filled one out. My best friend has and she says it has helped already, all the information in terms of what she is allergic to, what works and what does not, and other issues are all covered in one document.

Sarah

[SpazKatt]

this is great, thanks

[mj14]

I do not have one, but the center where I see my T and p-doc strongly encourage people to write them.

[(JD)]

I copied Minn.'s off the State website (I think it was theirs) I can check. FL doesn't have such a thing, which is why I was using this one to draw from...as I agree, mj, it looks very much needed like a trust, a durable power of attorney, a living will... etc...

[CedarS]

I like the idea of writing one of these up while I am feeling relatively good, rather than waiting til all hell breaks loose and I am less likely to be able to sort out such things.

I've heard too that many folks say it helps them feel more in control, more able to think of concrete realistic things to help them. And it aids in sorting out just what kind of help we want from others.

Because it isn't strictly enforceable by law, it is not something that can force our caregivers to do. But it is a strong suggestion and certainly folks who care would appreciate having our info all in one place.

Some mental health clinics in my area, places that are already understaffed/underfunded/overworked, haven't been extremely excited about these, in terms of it would mean much more work for them if they need to help clients fill one out. But clients now have to be informed of them, there are brochures and forms people can get to help.

I also want to work up a new personal crisis plan, something I can post on my frig as a reminder.

Sarah

[(JD)]

I don't think my T really feels I need one... as HE is advisor for all my "psych needs" LOL But I guess I could put that into legalese, so they HAVE to listen to him!

Thanks. Here in eugene oregon it is called Declaration for Mental Health Treatment. Mine is filled out and on file with my primary physician, Therapist/therapy agency and the person that I chose as my representative should I be considered unable to make my own decisions. I also carry a copy with me at all times. That way if I can't tell the doctors I have one they will find it when going through my back pack during their routine searches that is done when someone is hospitalized on a mental health unit.

[CedarS]

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I also carry a copy with me at all times. That way if I can't tell the doctors I have one they will find it when going through my back pack during their routine searches that is done when someone is hospitalized on a mental health unit.


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Very good idea, I'm going to pass that on to friends also, very helpful, thanks!

Sarah

[Col303]

Thanks for all the great information everyone!

Your welcome and by the way the one here in oregon is enforcable by law. It says right on the form first page:

"Attention: This is a legal document which contains important information regarding the affected person's preferences or instructions for mental health treatment."

inside it states
"Once this form is signed and witnessed and given to the primary physician, Therapist, therapy agency and the chosen representative it is considered activated for three years. The representative MUST follow your wishes and the treating doctors must prove in court those wishes are detrimental to your health before they can go against what your representative and the Declaration for Mental Health Treatment plan states."

And the last page states the Oregon statutes numbers.

This form doesn't prevent being put into a mental health unit but your wishes must be followed just like a will must be followed or challenged in court.

[eskielover]

I had an experience with my mother when she was dying of cancer at the end of last year. She had the medical advanced directive in her trust......it was in place, but it was necessary for 2 Dr 's to write that she no longer had the cognative ability to make decisions for herself.

The catch was that when she was back in the hospital when she started getting worse, I could see there was a problem with her ability to think & reason.....like a question in the sunday paper she couldn't figure out the simplest answer to it......then it took her 15 minutes to figure out how she wanted the $100 to be broken up & when I tried to help she told me I was confusing her (& she had been a bank teller for years). After noticing this, I asked her Dr about it....thought she might have had a stroke or even the cancer spreading to her brain. He swore that is was only that she was getting older & that people with a chronic illness have that problem. I tried my hardest to be at the hospital when the social worker & her Dr were talking to her.....but was always left out because "she was capable of making her decisions" & she wanted to go home so bad she didn't want me to hear what they had to say. The problem was that I was the one that had to make the arrangments only I had no knowledge to make the correct arrangements. When she was discharged, I didn't even know what kind of care she needed at home which was part of the reason that the RN ended up in the home care picture. The RN knew exactly what was needed & could take care of everything & make it all go easy. I found out at the end from her Dr that both he & the social worker had told her she needed to be in a nursing home in the first place.

It wasn't until 3 weeks before she died that I was able to get the Dr's to admit that her cognative abilities were such that she could no longer make intelligent decisions.....where it should have happened a month before that. Maybe in the mental aspect of advance directives it is easier to get that determination, but in the medical area......she was able to hide her condition from those that didn't know her.

I agree that the advance directives are important....don't get me wrong......I do not disagree at all with them.....& am planning on having them put into place soon......but I hope that maybe from my experience any of you in a similar position that I was in may be able to push a little harder than I did & not get trapped into the situation I did.

I was in kinda a catch 22.....I was the trustee & I was the one questioning her capability which would take away any of her decision making on everything I would be in charge of(which I wouldn't have done completely. Finally at the end after the RN had OD'ed my Mother & she was back in the hospital, I told her that even if she wanted to go home again, I wouldn't make those arrangements again & that she didn't have any choice other than the nursing home that time.....but the hell I went through because of her decisions being able to be forced on me by default is the trauma I am still dealing with 10 months after her death.

It is a difficult position to be in because medical Dr's tend not to want to take away the decision making process from their medical patients.....it may be much more simple in the mental health situation since it is mental issues that are being delt with anyway.

I am planning to have a lawyer put together all my trust papers & advance directives along with making all the arrangements for my future so my daughter will have nothing to worry about when the time comes.

I also hope that maybe with the situation that I was in being made aware, that hopefully it may help anyone that might end up in a similar situation as mine be able to stop it from ending up like mine did.

I am glad you put this post out for the information you have provided is definitely a necessary thing for us to have in place for our lives......I would hope that situations like mine are not that common....but thought I would put it out there for realizing that things don't always go well even when things are specified.

Thank you,
Debbie

[CedarS]

Update on my Washington state info, I've found out that advanced directives by law now are supposed to be upheld. Though there is still often a disconnect between the letter of the law and what actually happens.

I've heard stories of folks who have an advance directive on file, yet the staff of psych ward can't seem to find it, tell patient that there never was one, then manage to find it on the last day etc.

yea thats why the person is now required to give the chosen representative a copy. that way if the psych ward says they found none the rep can say her have a copy of the one I have from this person. The treating therapist is also required to have one. the psych ward has to notify the therapist that their client is there to varify treatment plans and so on. the therapist automatically faxes their copy upon being notified that their client is on the unit so that the unit is aware of the treatment plans. The way it is now set up by law it is impossible for the psych wards to get away with cant find it claims as long as the person filled out the official form and distributed copies according to the directions.