PDA

View Full Version : How does an adult end up in a group home?



fidgiegirl
1-19-11, 10:18pm
My BIL and SIL are divorcing. She is mentally ill and has been for a number of years. I am very concerned about what will happen to her but have no one I can ask about it - no one who really knows what might happen. Research online has turned up nothing. I do not know her diagnosis, only that she is currently in the hospital since finding out the news. :(

I'm sure it varies by state, but how does an adult end up in a group home? What are the steps? I know she is not on Social Security disability (yet). I ask about this particular aspect because the others in the family seem very sure that this is what will happen (the group home), but I have the bad feeling that it is not so easy to actually accomplish.

I just want to know what might happen to her . . . I mean, we can never be certain what will happen to any of us, but it's quite troubling. She's not a woman who will be able to adequately care for herself independently. :( The only ones who might be able to advocate for her are her 23 and 21 year old children since she is estranged from her own family and now will be divorced.

goldensmom
1-20-11, 6:13am
Help may be sought through the mental health system, your state social service agency adult protective services or the courts by filing for guardianship. You could start by a referral to adult protective services who can assess her situation and refer accordingly. Anyone can make a referral, it does not need to be family. If she is currently in the hospital, the hospital social worker should make the necessary referrals as part of her discharge planning.

iris lily
1-20-11, 6:56am
fidgie, you are probably right that it's not simple about getting into a "group home." I know that others like your relatives love to offer pat answers to complex situations and I'm with you that the process for your SIL is likely not a tidy solution such as going from hospital to a waiting home, group or not. Her children are so young to have to take on this burdon, but who else will do it?

One of our neighbors of 20 years went downhill mentally, getting stranger and stranger. He had to be evicted from his house when the bank forclosed.One of our neighbors offered him a basement in which to crash for a while, but eventually the man's young daughter came from out of state to get him.I was so sorry that she had to deal with this, she's only about 27.

jennipurrr
1-20-11, 3:35pm
Has she applied yet for Social Security? If not she needs to ASAP, like yesterday! If she does receive it, it will make getting any sort of medical services soooooo much easier because she will be on Medicaid. This includes the possibility of a group home, or other assisted living situation. Also, some mental health meds, especially some of the newer good ones, are super expensive, so SSI is really important there too.

In my area, group homes and supportive apartments have a waiting list and people have to meet very specific criteria for admission. I don't want to be a downer, but it is not an easy process to get in one. It will definitely take someone, whether that be her kids, you, a caring caseworker, etc to be her advocate. There should be someone at the hospital who can help and discuss what the path looks like.

screamingflea
1-20-11, 6:07pm
If she's hospitalized right now, that's a fantastic resource. Milk it for all you can. Because of confidentiality guidelines they may not be able to get too specific with you about her condition but they can probably point you in the right direction. There's also Adult Protective Services. There are quite a few other groups that specialize in disability advocacy as well. Every state has a department of Protection and Advocacy. I would highly recommend contacting them. You could also ask your local NAMI chapter as well - the National Alliance on Mental Illness.

I'm sure this has to be a difficult thing for you - here's sending you lots of gentle thoughts and support.

redfox
1-20-11, 7:28pm
I would strongly recommend providing your support for your niece & nephew. They are young, and this will be hard for them - as well as a relief I imagine, as they have no doubt noticed her diminished capacity.

Group homes are usually for developmentally disabled adults, not for those with mental illness. Mental illnesses are often treatable, and if she complies, she could potentially be independent. I say this of course without any knowledge of her diagnosis. NAMI is a great resource.

The social worker where she is hospitalized cannot divulge information - but s/he can listen. You can call them and offer your information and support, and they can work that into any conversation with the hospitalized patient. She will likely go through many ups and downs... support and unconditional love for the long haul is important... blessings on all of you.

Jemima
1-20-11, 9:53pm
There aren't many group homes for the mentally ill in my area (southeastern PA), but there are a number of boarding homes where people with a history of mental illness can live. The person gets a bedroom of their own, meals are provided, and the house manager, often the home owner, will see to it that medication is taken. The accommodations aren't luxurious for those on SSI, but they are adequate.

Many of the residents of these homes attend day hospital, a supportive group therapy situation which I expect also helps the home manager to cope with a houseful of the mentally ill. The only difference between a group home and a boarding house that I can see is that group homes have to provide therapeutic activites throughout the day but the boarding homes do not. Day hospitals fill in that gap.

djen
1-20-11, 9:59pm
I second (third?) the recommendation to talk to and rely on the hospital social worker as much as possible. Hospital social workers are THE BOMB! When my MIL was in the neuro ICU for a month in 2008, her social worker straightened out everything from the insurance to which rehab to choose, to how to know which doctor to go to when we had different kinds of questions.

And everyone's right that the social worker won't be able to tell you much unless your SIL (or whomever is making decisions for her if she's in a condition where she can't) has given him/her permission to do so. If you're going to be helping in that capacity, you'll have to get that sorted out right away.

HKPassey
1-20-11, 10:36pm
Some thoughts from someone who had to do more research on the subject than anyone could want to:

You might see if your state has any programs based on the ACT (assertive community treatment) model or other "recovery model" services, and see if they have a "mental health transformation project" in process. ACT programs provide support for families as well as the individual, and include family members as members of the treatment team. Services are to be provided in the community as much as possible - the person's home or other place they are comfortable, rather than a clinic environment - and individualized in-home supports that help a lot of people stay at home. Hospitals and providers can talk to you with written approval from your family member, although many providers are pretty ignorant of what the privacy laws really say, so you/her kids may have to get assertive with them. A family member or other involved person may accompany the individual and be involved with the person's verbal consent (although some clinicians will get out the garlic and holy water when you try). Information is your best tool for getting through the system's barriers. There are certain rules - like the right to request an expedited enrollment process and assistance with Medicaid applications - that are federally mandated by Medicaid, but that you may not be informed of unless you ask. Many programs are also specifically mandated to facilitate and assist with applications for benefits of all types, including residential placements and funding sources, but again, you may have to ask. Start with your adult protection and advocacy agency, as suggested earlier, to see about getting her an advocate, and check out the NAMI information. If you have difficulty getting specific services that should be available, see if you can get a copy of the provider's contract - some are available online, the rest should be available on request from your state human services - and show it to them. Hopefully you can find a professional advocate for her (nobody's going to pay attention to her kids, unfortunately), but realize they often only know what the providers know, and the system is deeply mired in inertia despite movements toward reform, so you may still want to be informed.

Some key phrases to know are "recovery-based services," and especially, "least-restrictive environment."

Is her divorce attorney aware of the mental health issues? He/she won't be able to give any information, but can listen or read a letter. Assistance setting up services could be a negotiated part of the divorce settlement. Also, if she's not yet on SSDI, contact a local SSDI attorney for help getting her enrolled: the process is so encumbered that the feds actually have set procedures for attorney involvement and fees (I think it's 25% of back payments only, from SSA directly to the attorney). They're not allowed to bill the client for their services, and they're a sanity-saver when it comes to navigating that system.

Bless you for being concerned for her welfare, and best wishes in this.

Bronxboy
1-20-11, 11:20pm
Her children are so young to have to take on this burden, but who else will do it?

I agree, the best solution is probably to aid your SIL's children in taking the responsibility. Having two high school/college age nieces who have stepped up well in aiding their father (including an impressive emergency response), I believe that they are not too young to do it with guidance.

Simone
1-21-11, 6:34pm
Just want to add that in addition to there being few managed, much less therapeutic, group homes for the mentally ill, the patient must actively consent to live in one.
Has your SIL herself expressed any desire to live in a group setting?
Agree with all the posters who urge that you support family members in every way possible.

fidgiegirl
1-22-11, 6:49pm
Agree with all the posters who urge that you support family members in every way possible.

I wish I knew the best way to do this. I am recently married into this family and not close to any of them, though we all get along. Not sure how. The daughter is living about four hours away and the son is kind of part-time at home and part-time at his dorm at school. My BIL has been open but he and my DH are not close. Plus the whole reason for the divorce is that he's pretty much done, so not even sure he wants to talk about what her arrangements are going to be, because frankly, I'm not sure he's going to be very involved in making them . . .

Do I call them? Send them cards? Share the resources you all shared with me, even though that would be unsolicited? I also strongly believe the kids need to be in counseling as they go through this difficult transition, but not sure how or even if to share this opinion.

As far as me personally helping her, it's not my place. This isn't a person who is helped once and then it's done. I think that's why my BIL burned out. It's been like 18 years of this for him. But it's very hard to face this reality, because it means that all of us on my BIL's side of the family will basically be standing by doing nothing . . . the ones who will end up doing the front-line helping are going to be social workers and possibly the kids.

Boo.

I really thank you for all your input. While it was I suspected and didn't really want to hear, it gives some concrete things to look into.