between rock & hard place

Discussion in 'Parent Emeritus' started by AHF, Aug 17, 2011.

  1. AHF

    AHF Member

    It's been a while since I posted. Much going on, not much of it good. Peter Pan is now back in the Residential Treatment Center (RTC) where he was last fall. We got 1 week's insurance coverage for what is supposed to be a 6-week (incredibly expensive) program. When I agreed for him to give this another shot, I said verbally and in writing that if was not fully committed to the program and fully participating, I would no longer pay for it. Well, he is a far cry from fully participating, and we're at 2-1/2 weeks. The clinicians in the program are putting heavy pressure on me to cough up for the full program anyway--because discharge planning takes time, because they need his "buy-in," and because they fear he is at risk for suicide if they simply discharge him to the streets. I've responded that if they think he is at risk for suicide, they should take him to the emergency ward or the state hospital, but they say they do not have the evidence (i.e., an attempt) to do that. He has taken to threatening suicide whenever he can't get his way, and I can't tell if the clinicians are buying into his crying wolf, or if the risk is serious. So I feel stuck--wanting to preserve my limited resources for what is sure to be a long haul (he has now been definitively diagnosed with a personality disorder, and he is very deep in debt from poker), and wanting to hold firm on consequences for his non-participation, but not wanting to second-guess his care team or letting them pass the responsibility for his potential suicide over to me. Has anyone been in a place like this? Any advice?
  2. DDD

    DDD Well-Known Member

    Haven't been there done that but am sending hugs your way. What a crazy life we all lead. DDD
  3. elizabrary

    elizabrary Member

    No, but I've been going through a catch-22 with my daughter as well. Wish I had advice for you, but all I can think of is to find out exactly what the law is regarding this whole suicide thing- if the hosptal will take him, how long, etc. I agree you should save your resources and he should face consequences, but how and what? Hang in there, I hope things get clearer for you!
  4. susiestar

    susiestar Roll With It

    Many hugs. If they feel that strongly that he needs to be there, then they can bill him and wait for him to pay them off. I know it sounds cold, but this is super expensive and if he isn't participating on your dime, maybe he will on his own. Or maybe not and he needs to go to the streets and hit bottom. I don't know what is best, but I am hoping that whatever you do, you realize that no six week program will give significant help to a personality disorder. So throwing a ton of $$ at this seems a short term fix at best and if he isn't doing what he said, which is fully participating, I would tell them to send him to the ER or wherever for evaluation for suicide. If it is just a ploy to get his own way, well, the ER will figure it out.

    Either way, I know you love him deeply, but he IS a grown man and has to take responsibility at some point for his care. Yes, this sounds like a crisis, but it is one that you can honestly afford to fix for him? And if you pay to "fix" it iwth the therapy, is he really going to change or will he just continue to take advantage of you?

    I don't have answers and do NOT condemn you for ANY decision you make. NOT at all. But I just wonder if you are not throwing good money after wasted money in trying to get him treatment that he doesn't really want. It may be that he is just panicked because whomever he owes that poker money to wants it and he is trying to hide from them in an Residential Treatment Center (RTC) and all the $$$ you are spending on it is just giving him a short term hideout. Sooner or later he has to face the debts. I do caution you that if you pay his poker debts he will simply run them up again. I have seen gamblers do it over and over and over to people.

    I am so sorry that he continues to push his mess onto your life.
  5. DammitJanet

    DammitJanet Well-Known Member Staff Member

    I too think he is hiding from his debts and not really working the program. With personality disorders there are very few actual success stories until someone really wants to get well and most dont think there is a darned thing wrong with them, its everyone else thats the problem. It takes many years and a whole lot of heart ache for someone to see that maybe it is something inside them that needs to change.

    I dont think this place can require you to continue paying for him if you cut the funding. Tell them you are done and to transfer him to a state facility or somewhere else if they feel he is still a danger. They cannot legally discharge him into the public if they feel he isnt stable.
  6. MuM_of_OCD_kiddo

    MuM_of_OCD_kiddo New Member

    I second both Susiestar's and Janet's advice. Gambling is an addicition as bad [or worse] as alcohol or drugs, with the added clear headedness of being sober [most of the time] and the expert manipulations and lies that come with that. Save your funds for a rainy day, the rest of your family and your retirement - or perhaps to help him out AFTER HE HELPED HIMSELF recover.

    Bipolar or similar personality disorders are difficult enough to deal with all by themselves - add an addiction to this, and you are so out of luck. It's him who needs to do this, not you! You are just prolonging the agony of reaching rock bottom, by supporting him at this time if he is not working the program... Hugs to you!
  7. susiestar

    susiestar Roll With It

    Um, bipolar is a mental illness, not a personality disorder. PD's have a far lower rate of success with therapy because the person with the personality disorder must want help and they usually just don't. Bipolar is an illness that is treatable with the right combination of medications and therapy and has a much higher success rate - and is proven to be an actual health issue resulting from real problems in the brain. It IS possible to have both though.

    Just wanted to make that clear.
  8. Rabbit

    Rabbit Member

    Sending Hugs I will keep u and your family in my prayers. Rabbit
  9. AHF

    AHF Member

    Thanks to all. Yes, personality disorder is the diagnosis no one wants because there is so little anyone can do. I don't think he is hiding from debts--the way poker debt works, no one is after you until and unless you start playing on your own without paying them off, and he is in no position ($35 to his name and no credit cards) to do that. He does have other debts, but he hasn't felt consequences from them yet, so he doesn't care. I think he is hiding from life--from the possibility that the rules do apply to him, that he will have to work for his bread, that it will come slow and hard and with no magic. My thought right is that when they call this morning I will ask them to do whatever they would do if there were no generous mom in the picture. Would they keep him there? Discharge him? Or commit him to the state hospital? Whatever choice they would make under those circumstances, they should make now. And then when he is really ready for make a change, I can support him however I can. No matter what I do or they do, he will a) blame me and b) possibly kill himself. That's the reality I'm trying to face. And I have such a hard time facing it!
  10. MuM_of_OCD_kiddo

    MuM_of_OCD_kiddo New Member

    What I meant by >>> bipolar or similar personality disorders <<< is that either is difficult enough for both the actual person suffering from it, as well as the family members to deal with [regardless if it needs treatment with medications, which the person may refuse to take, or l.t. therapy - both require the cooperation and the honest desire for improvement and making lasting changes to be moderately successful]. Add to that any type of addiction, makes a positive outcome so much harder to achieve.

    In regards to Poker games - what you said may hold true locally in your area or with online games [or might be what you have been told] - but in real life, with hard core poker players - this can be an entire different can of worms. 20 years ago I temporarily room-mated with an older gentleman who was addicted to poker and was hosting weekend long poker runs at our joint home. I have seen cars, boats, motorcycles, RVs and in one case real estate change ownership at the table; successful businesses impacted, IOU's traded back and forth and collected, girlfriend's and wife's "favors" traded in exchange for debts, the works. Yes - if you had to read the last part again - it's exactly what that implied!

    I've seen paychecks thirdpartied out; big cash [seriously big cash] spend on an evening's fun and entertainment, I have seen grown men crying and afraid to go home to fess up that they lost their weeks or months earnings, I have seen wife's jewelry pass through my living room and worse. Poker games would start at 6 pm Friday nights and pretty much run into 3-4 on Sat. morning, resume Sat. afternoons through Sunday wee hours and some that couldn't get enough would come back in on Sunday afternoon as well. I wouldn't touch a for real gambler with a 10 foot pole!
  11. AHF

    AHF Member

    Oh, believe me, I know all the pitfalls that come with compulsive poker. And it may not be possible for Peter Pan to heal himself if he does not address that dysfunction. Just got off the phone with him and his care team. They twisted my arm into paying through Monday, with the constant threat of making a poor decision about discharge if the process is rushed. Easy for everyone else, including Peter Pan, to say, when they're not the ones paying! They will not keep him without payment up front; they do not believe he is "commitable"; but they still define him as "at risk," putting all the burden on me to decide if he stays or goes, lives or dies. And this is probably the best place in the country! If no plan by Monday, he will have to be discharged to the street, 1000 miles from home and penniless. He is too abusive to be allowed back home, and I cannot give money to a gambling addict.
  12. keista

    keista New Member


    They are trying to guilt trip you. Of course he's at risk. Otherwise he wouldn't be there. That has nothing to do with he fact that you simply won't/can't pay for a program if HE is not working it. They can just as easily keep taking your money for six weeks, say the program is done and he'll still be "at risk" because HE hasn't put any effort in.

    I say, stop the madness and put the money away for a time when he may actually be willing to do the 'work'. If the day never comes, you'll be able to take a cruise around the world when you retire.
  13. AHF

    AHF Member

    Want to report some GOOD NEWS for a change--and maybe this will be helpful to others. Frustrated by the vise I was in, I reread the insurance denial letter and saw the part about expedited appeal, which applies when someone's health or future is imperiled by an insurance denial. Seemed right to me, so I filed. They guaranteed a response in 36 hours and came through in 24 hours, after a psychiatrist had talked to my son's care team. And (drum roll) THEY OVERTURNED! So his stay thus far has now been covered by insurance, leaving us a little breathing room to make plans going forward. Don't know if this always works, but in my case it was sure worth the shot!
  14. keista

    keista New Member

    Yahoo! Congratulations! :choir:
  15. Bean

    Bean Member

    Well the insurance part is good news.

    I feel for you in your situation. I'm not sure what I'd do, either. But I don't see why they can "bill" him for it, if they feel he needs it so badly, and that he should stay. If he's not ready, he's not ready, and they should make him leave.
  16. AHF

    AHF Member

    Text message last night from Peter Pan's best friend. (This is an extremely unusual event. I like this young man, but we are not close.) "Just talked to [Peter Pan] and he was extremely depressed. I think u should know he told me he wanted to end his life. I don't think it's a good idea at all for him to be moving on as he is definitely very sick." Messages like this make it very, very hard to pull the tough-love cord and just throw him onto the street when he won't get motivated. No word yet from insurance on whether they are covering anything this week.