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When they have to be hospitilized
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<blockquote data-quote="Christy" data-source="post: 295507" data-attributes="member: 225"><p>Sorry your are facing such dificult decisions and the behaviors that lead up to them. We've had experience with inpatient hospitalizations so I thought I'd offer my two cents.</p><p></p><p>Your questions...</p><p></p><p>~ Is Little Bear really considered being a danger to others since he is just 5yo?</p><p></p><p>Yes and no. No one should be allowed to hit, kick, bite, etc... but since he is probably small enough to pick up to move to a safe place or restrain by yourself then you may not feel endangered. It does however fit the definition so it is your call. We handled things at home until our difficult child was to big to handle his extreme episodes on our own but sometimes I think that we waited too long and really put ourselves through h*ll.</p><p> </p><p>~ Do we decide to place him inpatient or his Dr?</p><p></p><p>You can take him to the emergency room and ask for a psychiatric evaluation based on the behaviors. This should be done while difficult child is enraged or immediately following an episode. You can call the police or an ambulance to help with transport if needed. The ER is a sometimes necessary but terrible experience for everyone involved. Expect to wait 12 or more hours to be seen by the psychiatric nurse who does the evaluation. Should he/she feel based on observation and your answers to interview questions that inpatient stay in warrented then you will wait until a bed is found and insurance issues are worked out. Our last ER visit started at 10 AM and we checked difficult child into psychiatric hospital at 1:00 in the morning. Another time, I spent the night in the hospital psychiatric ward with difficult child because no beds were available until morning at the psychiatric hospital. </p><p></p><p>Some psychiatric hospitals will do direct admission. You can call and discuss your situation and schedule an intake evaluation if beds are available. This is less stressful than an ER visit but still takes several hours. Keeping a journal and documenting unsafe behaviors is very helpful especially if you are doing a direct admission. </p><p></p><p>Once upon a time, the average stay in a psychiatric facilitiy was 60-90 days. Now the average stay is 7 days. The goal is crisis stabalization rather than the medication overhaul that may be necessary to make significant behavior changes. About every 3-5 days, the psychiatrist has to prove to insurance that the stay is necessary so it is hard to get the time necessary to get off one medication and get to a theraputic dose on another medication. That said, twice we've had good result from the medication changes made while difficult child was inpatient. We've also had two inpatient stays that provided no long term stabalization. </p><p></p><p>~ Has your child been placed inpatient and at what age?</p><p></p><p>Yes. He was 9 years old the first time that he was hospitalized and has been hospitalized 4 times. Children's units usually have children up to the age of 11 or 12. I've seen much younger kids on the unit but they will be with older children and this can sometimes be problematic. Also, it's been my experience that the staff on the ward expect the children to be independent when it comes to bathing, shampooing hair, teeth brushing, remembering to ask for a pull-up at night if necessary, etc... This was hard for my difficult child because even at nine he was very needy. </p><p></p><p>~ How did you decide or what prompted an inpatient stay?</p><p></p><p>The short answer is when difficult child's behaviors became so extreme that we were unable to handle them and keep him and ourselves safe. </p><p></p><p>His first hospitalization was reccomended by an in-home behavioral therapist after she witnessed difficult child's behaviors over the course of several visits. He was becoming increasing violent towards me and after a particular extreme episode lasting several hours, we called a psychiatric hospital and arranged an evaluation/admission. The second hospitalization resulted from an episode where difficult child ran out of the therapist's office and on to the highway. The therapist called the police and difficult child was EP'd (emergency petition for evaluation) by the police. He was taken to the ER by ambulance. The third hospialization was during a manic episode in which difficult child hit both myself and the in-home therapist. We were unable to get him to calm down and this went on for several hours. Mobile crisis and the police were called, we were able to vovluntarily take him to the ER and start the process yet again. The most recent inpatient visit resulted from an episode at school whrere he became out of control and violent. The police took him to the ER and we met them there. </p><p></p><p>Leaving difficult child at the psychiatric hospital is the hardest thing we've ever done, we worry about him constantly while he's there. We hope for a miracle and soon discover that that the psychiatrists there don't have all the answers, getting the hospital psychiatrist to communicate with our regular psychiatrist is extremely difficult, the other children can be a bad influence for difficult child, the entire thing is emotionally draining but in the end sometimes it necessary and sometimes it even helps. We hope not to go through this again but also realize that it may be necessary.</p><p></p><p>Good luck to you with your struggles,</p><p>Christy</p></blockquote><p></p>
[QUOTE="Christy, post: 295507, member: 225"] Sorry your are facing such dificult decisions and the behaviors that lead up to them. We've had experience with inpatient hospitalizations so I thought I'd offer my two cents. Your questions... ~ Is Little Bear really considered being a danger to others since he is just 5yo? Yes and no. No one should be allowed to hit, kick, bite, etc... but since he is probably small enough to pick up to move to a safe place or restrain by yourself then you may not feel endangered. It does however fit the definition so it is your call. We handled things at home until our difficult child was to big to handle his extreme episodes on our own but sometimes I think that we waited too long and really put ourselves through h*ll. ~ Do we decide to place him inpatient or his Dr? You can take him to the emergency room and ask for a psychiatric evaluation based on the behaviors. This should be done while difficult child is enraged or immediately following an episode. You can call the police or an ambulance to help with transport if needed. The ER is a sometimes necessary but terrible experience for everyone involved. Expect to wait 12 or more hours to be seen by the psychiatric nurse who does the evaluation. Should he/she feel based on observation and your answers to interview questions that inpatient stay in warrented then you will wait until a bed is found and insurance issues are worked out. Our last ER visit started at 10 AM and we checked difficult child into psychiatric hospital at 1:00 in the morning. Another time, I spent the night in the hospital psychiatric ward with difficult child because no beds were available until morning at the psychiatric hospital. Some psychiatric hospitals will do direct admission. You can call and discuss your situation and schedule an intake evaluation if beds are available. This is less stressful than an ER visit but still takes several hours. Keeping a journal and documenting unsafe behaviors is very helpful especially if you are doing a direct admission. Once upon a time, the average stay in a psychiatric facilitiy was 60-90 days. Now the average stay is 7 days. The goal is crisis stabalization rather than the medication overhaul that may be necessary to make significant behavior changes. About every 3-5 days, the psychiatrist has to prove to insurance that the stay is necessary so it is hard to get the time necessary to get off one medication and get to a theraputic dose on another medication. That said, twice we've had good result from the medication changes made while difficult child was inpatient. We've also had two inpatient stays that provided no long term stabalization. ~ Has your child been placed inpatient and at what age? Yes. He was 9 years old the first time that he was hospitalized and has been hospitalized 4 times. Children's units usually have children up to the age of 11 or 12. I've seen much younger kids on the unit but they will be with older children and this can sometimes be problematic. Also, it's been my experience that the staff on the ward expect the children to be independent when it comes to bathing, shampooing hair, teeth brushing, remembering to ask for a pull-up at night if necessary, etc... This was hard for my difficult child because even at nine he was very needy. ~ How did you decide or what prompted an inpatient stay? The short answer is when difficult child's behaviors became so extreme that we were unable to handle them and keep him and ourselves safe. His first hospitalization was reccomended by an in-home behavioral therapist after she witnessed difficult child's behaviors over the course of several visits. He was becoming increasing violent towards me and after a particular extreme episode lasting several hours, we called a psychiatric hospital and arranged an evaluation/admission. The second hospitalization resulted from an episode where difficult child ran out of the therapist's office and on to the highway. The therapist called the police and difficult child was EP'd (emergency petition for evaluation) by the police. He was taken to the ER by ambulance. The third hospialization was during a manic episode in which difficult child hit both myself and the in-home therapist. We were unable to get him to calm down and this went on for several hours. Mobile crisis and the police were called, we were able to vovluntarily take him to the ER and start the process yet again. The most recent inpatient visit resulted from an episode at school whrere he became out of control and violent. The police took him to the ER and we met them there. Leaving difficult child at the psychiatric hospital is the hardest thing we've ever done, we worry about him constantly while he's there. We hope for a miracle and soon discover that that the psychiatrists there don't have all the answers, getting the hospital psychiatrist to communicate with our regular psychiatrist is extremely difficult, the other children can be a bad influence for difficult child, the entire thing is emotionally draining but in the end sometimes it necessary and sometimes it even helps. We hope not to go through this again but also realize that it may be necessary. Good luck to you with your struggles, Christy [/QUOTE]
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