mentally ill & pain management

[anita_43]

a middle age man with underlying mental and physical issues - from severe liver disease, back & circulation problems, migraines, past drug abuse from age of 8 years old to 2002, past prison (non violent) history. Special education when attended school/left school in beginning of junior high.
Patient is on interferon ribavarinin, methadone, (120mgs a day) dilaudid 8 (4xdaily) Xanax 1mg 4xdaily, celexia 20mg daily.
GAF score: 40
Diagnosis:Dementia from multiple sources: TBI/concussions, seizures, remote history of polysubstance dependence.
Major Depressive Disorder, severe with psychotic features and suicide ideations.
Intermittent Explosive Disorder
Generalized Anxiety Disorder
Personality Changes secondary to general  medical conditions, disinhibited aggressive type
Personality disorder NOS with features of depression and antisocial character traits.
Learning Disorder NOS with history of special education
Current physical concerns: Hep C, chronic back and head pain, endocarditis, circulation problems, vision problems, rule out other.
Pyschoscocial and environmental stressors: disability adjustment problems, financial problems, independence, problems, non-intensive treatment, relationship and support group problems.

Having the above issues, and being on what appears too be very hard narcotics, can or should this person be allowed too make legal/medical decisions on his own?
I am his caregiver, and am very worried because how he explains and thinks is most of the time different from how other's would explain or recall past or present conditions. Can someone in this condition be a reliable source? I would think not?
He isnt able too manage his own affairs/banking, cooking (leaves burners on stove on) no driving, and medical appointments are done w/myself present.

[Tuckamore]

Hello Anita,

Where is the patients family??? Are you a family member? If not how are you related to this person? Yes I agree with Mollyrae.

We all have a right to make our own decisions as long as possible. If this person is not capable than it should be up to the physician(s) or family to address that concern with the appropriate sources. And please be careful not to violate any HIPPA laws.

Tuckamore

[Mollyrae]

PS-  I forgot to mention that the Interferon and Ribavarin in my opinion are adding to the mental angiush he has endured.

Thank's

[Mollyrae]

Hello Anita. Welcome to MH. I can understand the flustrations a concerns with you being the caregiver but has anyone ever given this man a chance to make is own Medical decisions? As far as legal ones, what are your concerns and what decisions is he having to make or will make? Just from reading the post, I do not know enough about his judgement abilities to really give you sound advise.

What I am concerned about and you being the caregiver should know that the medication he is on, namely the Interferon and Ribavarin can and will cause:
Severe Depression
Personality changes
Sight issues
Stress
Body aches and pain (back included)
And many other health issues that I have not mentioned. Narcotics are almost a must when taking the powerful drugs he is taking, without them, he would be in a very painful state. I have also taken the Interferon and Ribavarin and it make me so sick that I was Hospitalized 3 x's during the course of treatment.

Just from reading the little  have, it sounds to me like you should at least let him attemp to make some decisions regarding his own healthcare.

Good luck in the future and take care,

Mollyrae