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Broken, Sacramento, CA (2025)

08/10/2025

We had what they called a ‘care conference’ Thursday afternoon. I expected it to be a meeting in which we talked about plans and expectations for my FM.

It wasn’t.

It was a brief update about his progress. They went over his meds and hygiene and meals. He has done well in each of those areas. They listed his meds and doses. Exactly what it should have been. Thank goodness. I was anticipating that there were changes I was unaware of. Of course I was. There have been errors far too often in my FM’s meds. Way too often. Not this time.

Remember in my last post I said he wasn’t doing groups? I knew that would be one of his biggest challenges. He has never liked doing groups. However, the update in his group attendance was shocking.

He went to 27 groups in the first week and 20 in the second!! Holy moly!! My jaw dropped when they said that! I’m so proud of him! It’s odd that he told me he hadn’t been going to any groups, except the church group on Sunday morning. Im not sure why he didn’t/couldn’t tell me that he was doing groups. That’s odd. But at least he’s going! Yay!

I’m still very happy with the facility. As a private conservator I’ve had a lot of negative experiences with admin staff. Maybe it’s bias against family members. Maybe they don’t want anyone looking over their shoulders. Who knows.

It’s so different here. They prefer visitors to make an appointment to visit. They need 48 hours advance notice. I called to schedule and was told that since I’m his conservator, I can come anytime I want. No appointment necessary. Wow!

I visited him today. It was over 100° outside where they usually allow visits. I asked if there was a place we could visit inside since it was so hot. They allowed us to visit in a break room only because
I’m his conservator. Again, wow!!

This is one of the rare places that respects family conservators and understand schizophrenia. They should all be like this. There is no good reason they can’t be.

I am so jazzed about his group attendance. I don’t know yet how many he attended this week. I hope he’s keeping up his attendance. The team decided we do want him to go through all the levels before he moves again. Graduating from this program will get him the skills he needs to succeed anywhere. I feel so hopeful!

08/07/2025

He’s been there just over two weeks. He’s still doing well, but he’s not doing groups. That’s what he tells me. Sometimes he answers me without really thinking about the question. He struggles with memory issues. Often, he can’t tell me what he had for dinner an hour earlier. Memory struggles are a big part of schizophrenia.

A few days ago he insisted that he needed to be moved. He said there is nothing to do there and he wants to smoke more. In fact, there is so much to do there, but he just doesn’t want to do it. I tried to get him to talk more. What I figured out is that ‘there is nothing to do here’ actually means ‘I can’t play my video games here’. 🤦‍♀️

I told him I’d work on another placement but first he’d need to do groups, etc. He asked if I meant ‘work the program’. Yup. That’s exactly it. Each time he asks about being moved or wanting som**hing from me, I tell him I need som**hing from him. I bring up a different activity each time. I tell him to just try it. Even if he goes and doesn’t participate, it’s a start. I hope it will be a good way to motivate him to engage.

We have a team meeting tomorrow afternoon. I asked for it. I thought it would happen sooner. I think it’s better that it didn’t. They know more about him now and I know more about their programs, too. I’ll ask them to get creative in ways to engage him, among other things.

Speaking of getting creative: when I visited him last week, I stopped by the nurses station. I wanted to know how he was doing. It was good news, mostly. One of the floor workers overheard us and told me one thing he did to motivate my FM. My FM didn’t want to get out of bed. He told the worker that he needed ‘rest therapy’. The staff member suggested that my FM could stay in bed and he’d just wheel the bed to the group meeting! Lol that’s funny! And creative. He told me my FM left the room and within two minutes my FM came out and went to the group. That’s what I’m looking for: Out of the box thinking with some humor added in!

I saw him today. He was in good spirits. We had some good conversation about how he was doing. He isn’t asking to be moved anymore and seems a little more clear-headed. That’s a good sign.

Later, I got a voicemail from him. He asked me to get him some pajama pants because he found out that “it’s in the routine” that patients change into pajamas at bedtime. He never sleeps in pajamas. He sleeps in his clothes. He wears the same clothes day and night for several days in a row. I’m glad he’s interested in following the ‘routine’!

I’m looking forward to the team meeting. I’ll also be talking with his psychiatrist on Friday. I haven’t chatted with him yet but he has an excellent reputation.

Overall, I’m still hopeful. It’s still early but so far so good. If we can come up with a good plan and get him to engage, I can see him doing very well. ue

07/28/2025

Guess what? He was moved on Monday! He got a bed at the Special Treatment Center (STP). He’s never been in that type of facility so we both have a lot to learn.

The place is beautiful. There is a skilled nursing facility and some independent living cottages for SNF patients. It’s cheery and looks brand-new. It’s in a typical older residential neighborhood.

I met him there for intake. I was a bit overwhelmed as several staff met me in the lobby and took me to the unit. I felt like so many people were telling me about the place and I was absorbing everything around me. It was a lot for me. I’m sure it was a lot for him.

They directed me to him. He was already on the smoking patio having a cigarette. He looked so comfortable and relaxed and was talking to another resident. Already!

Everyone I met was competent, kind, and professional. There were a couple of nurses at the nurses’ station. Kind and efficient. 24/7 nursing staff!

He said he was fine there and liked it. Yes!

The next morning he called me. Early, for him. It was 9:30am and he sounded so good! He was able to communicate better and sounded confident and happy.

He had eaten breakfast, attended a group, and had a cigarette. I asked what he ate. He said eggs, sausage, hash browns, pancakes, and grits. Wow! I don’t know if they serve buffet style or not, but it would make sense to. And it would make it easier for him if he got to have some choices in food.

I asked him if the bed was comfortable. They have large rooms for the residents with hospital beds. He has one roommate abd he really likes him. And he said the bed was really really really really comfortable! I asked that back and he laughed and said it again. He laughed!!

He rarely calls me. He seems to be engaged. And busy. He hasn’t asked me to buy him anything all week! Wow!

I took lunch to him Friday. Visiting is on a nice patio. It’s private. The program counselor introduced herself to me and asked if I had questions. Boy did I!

I mentioned the planters wart that keeps growing back, as well as a concern about his ankle. She said they have a podiatrist there, on staff!! And a dentist. And they offer haircuts and shaves! (Like he’ll ask for either of those, lol! It’s good to know they have them.)

A dietician meets with each patient once a week to work with them on proper diet and foods that they will eat. There are lots of groups, including three exercise groups, hygiene, community groups, and I can’t remember what else. In order to level up to more freedoms, they must attend 27 groups a week! That seems like a lot to me, but she said it’s not hard.

The motivation for him will be door dash. At level two, they can have door dash once a week. I still don’t want to do door dash, but if it motivates him to do what he needs to do, I’ll send it!

There was a hiccup yesterday. He had an episode of spirits that led to him trying to leave the place. The doors are alarmed and staff were there right away. They calmed him down and got him back inside.

The nurse called me and I told her what I thought might have triggered it. During the week they are kept busy. They have less structure on the weekends and I think that put him back ‘in his head.’ He hadn’t had issues with the spirits until last night. The nurse heard my opinion and said she’d call the doctor for a prn.

This morning, she called me to update me. That’s impressive! She said the doctor prescribed Zyprexa and trazadone. That seemed to do the trick, as the nurse reported he was ok after the meds kicked in and was good this am.

I asked her about door dash, and that’s when she told me about the benefits of leveling up. He called me right after her update and asked for door dash. I explained to him about earning door dash and other benefits when he levels up. He said that’s fine.

Who is this guy? He’s doing groups. He’s eating their food. He likes it. He takes no for an answer. He has a lightness in his voice that I haven’t heard in a very long time.

I think a huge part of him doing well is that they keep him busy enough that he doesn’t get stuck inside his head. A psychiatrist once described it to me as foreground/background. The more activity there is in the foreground (like groups, tasks, interactions the less activity there is in the background (like spirits, etc). This is what’s happening for him. It’s so important!

Another thing the nurse mentioned in her follow call is that there were a couple of residents who are in level two and were allowed door dash. They had Taco Bell. She thinks that triggered his anxiety later. He had asked me to door dash him some Taco Bell. I told him several times that I would bring him food at the next visit but no DoorDash.

I am impressed that the nurse connected the other guys getting door dash as a possible trigger. Of course that triggered him. And she understood that.

If things continue like this, it will be the best program he’s ever been in. I see no reason it won’t be good, as long as he is willing to put in the work. They will motivate him to do so, as much as they can.

I wish I’d known about this type of placement sooner. But things happen in their own time.

I almost forgot: They okayed his mp3 player! And he loves it! I put so much music on it that I know he likes. His favorite group is Berried Alive, so I added all of their music. He’s happy about that, too.

07/18/2025

He had an interview today with a potential facility. Yay! We already heard back from them. He was accepted! Hallelujah!

This is a sister facility to the one that denied him. I was afraid this one would also deny him on the same grounds the other one did. So glad they didn’t.

I haven’t seen the place in person, but there are photos on the internet. Of course. It’s a beautiful place! It’s an STP (Special Treatment Program) and is part of a skilled nursing facility. It’s more restrictive than the last placement he had, but he kept awoling from that one. For now, this should be fine.

The place that denied him didn’t allow any electronics. Not even an mp3 player. Thank goodness this one does! He uses music to help him cope. I’m so glad they’re ok with it. I downloaded a bunch of music for him already. He won’t be able to access the internet there so I want it to be loaded.

They seem to have more focus on ADLs (activities of daily living). That’s good because he really needs help with that. They also have a nutritionist and more of a medical focus. I hope the nutritionist will be able to help him with the food issues. It’s been ok at the inpatient place he’s currently in. A lot of it depends on what they offer.

In looking at the pics on the internet, I see big differences between the SNF side and the STP side. The SNF looks warm and inviting. The rooms look homey. They state that there are meal options and seconds are always available.

In the STP, the rooms look like hospital rooms. Very cold. Just another area in which families like ours are considered unworthy (?) of comparable care. I hope I’m wrong.

It also stinks that he has no choice in this. He has to take the first bed that he’s approved for. As his conservator, I could say no. But saying no would mean he’d be stuck where he is. That’s not good.

Step one is to move him to the STP. Once he’s settled there, I’ll get him on lists for other levels of care. If he makes progress, he should be able to move to less restrictive levels of care.

At the board and care home and at the adult residential facility, he received higher amounts of SSI because he was required to pay $1420/month at each of those. At the STP, Medicaid pays for it all. Since he won’t be paying anything, social security policy is that his benefit amount is reduced. Greatly. He’ll get $62 per month. That has to cover anything he needs that is not provided at the facility.

They allow smoking so ci******es will come out of that. If he needs new clothes, he won’t be able to buy them. He loves to shop but won’t be able to. I’ll have to buy the things he needs but I don’t make much, either. It will be hard.

Maybe that will be motivating for him, the reduced benefit. Once he goes back to a board and care home or adult residential facility he’ll get more money. Then he can shop. I hope that motivates him.

This move couldn’t have come at a better time. He has been having some challenges where he is. Yesterday he told me he was kicked by a patient. My FM was lying on the floor in the quiet room and the guy came in a kicked him a few times.

When I visited my FM yesterday, he had a red spot on his forehead, so I asked how he got it. He told me about the guy kicking him. He said his toe was injured too. His case worker was with us and said he’d look into what happened.

When I talked to my FM later that night, he said his toe still hurt. I told him he should ask for Tylenol and an ice pack. He said he would.

Today, his case manager called to talk about the transfer. He also told me that he did check with staff about what my FM reported. They said nothing even close to that happened. There was no altercation. Weird. My FM was so clear about what happened. He also told me he had apologized to the other guy. But none of it happened.

This is bizarre to me. It’s so different. He was very specific. If it had been an hallucination he would have said it was the spirits. I believe staff but I believed my FM when he told me. If this had been any other facility, I probably wouldn’t have trusted the staff report. But this place is the best he’s been in. I trust them.

So weird.

Big changes ahead. He moves on Tuesday. We’ll both learn new policies, new rules, and meet new people. I really hope it goes well. I want him to be happy there. I want them to engage him. I want him to have friends. I want him to gain confidence. I hope he gets that and more.

I’ll keep y’all posted. 😜

07/04/2025

Back on the merry-go-round. Yesterday, his team (me, treatment team at the acute facility he’s in, and county placement coordinators) met to discuss next steps. It was like the wind was knocked out of our sails when the placement we thought he’d have fell through.

Now we try harder. There is one place that is new but they don’t accept people who have private/family conservators. I don’t understand that. Family members can provide so much more info and support than a public conservator. But that’s their policy.

There is another STP that might have an opening in the next couple weeks. The county will submit the ‘application’ to them. It’s not what I want for him but it’s som**hing better than where he is, only because it’s a long-term facility rather than acute care.

I got a list of approved augmented board and care homes. So many are in bad areas. I did find one that looks good. It’s a large house with six bedrooms/three bathrooms. They can have up to 13 residents. More freedoms. He can smoke. Have games etc. the problem is that they have very little turnover. That speaks to the quality of the program there. It also means it won’t be easy to get a bed.

For now, we’re trying to get him into the one that will likely have a bed sooner. And then I’m getting him on the list for a couple of board and care homes. I wish it weren’t so hard to find good homes in good areas.

We also discussed his meds in the meeting. His doctor is amazing! He respects my input, likes my FM, and is willing to think outside the box.

He understands that my FM has a separate anxiety disorder and is willing to treat it with benzodiazepines. He’s had him on 0.5mg at dinner time. He explained that it can work better if he takes them twice a day. When it’s only one dose, it loses effectiveness before the next dose is due. He proposed having him take a small dose (0.25mg) in the am. He started that today.

We talked about a lot of things. I brought up what changes/additions I think we need in our county. Of course I did. 😜 We talked about Social Rehab Facilities (SRF). They hadn’t heard of them. I hadn’t, either, until recently. They are residential. Have med management. As I understand it there is more focus on social skills, ADAs, future employment skills. There is one not far from me. There is another that my friend Diane Rabinowitz told me about recently. Actually, she’s the one who first told me about SRFs.

The county doesn’t have contracts with any of them but the whole team is very interested in pursuing them as another option for treatment and housing. I’m hoping to tour a couple in the next week or two. Hopefully, I’ll connect with them well enough to introduce them to county placement. This would be a great way to meet the unmet needs for social skills and ADLs.

We have the best team! We share and learn from each other. This should be the rule, not the exception.

Now we wait. When a bed is available, and he moves there, maybe he can avoid the merry-go-round for a bit. I hope so!

06/24/2025

We’ve been waiting to find out if he’ll go to the place I talked about in previous posts. They were very slow in their process. Frustrating slow.

They interviewed him through video on Friday. Everyone said he did very well. He liked the people from the placement.

Sounds good, doesn’t it?

It’s not. I was notified today that they would not accept him. They feel his drug use needs to be more under control. And they won’t budge on electronics even though music and games are his coping aids. They had concerns about him awolling, too.

He is not a drug addict. He sometimes uses m**h, but typically only when he’s symptomatic and wants a break or when he’s lonely and needs ‘friends’. The people who share drugs with him are social. They have no problem with him hanging out. No judgment. He’s comfortable with them.

Before the latest round of placements, he was on Wellbutrin to manage the cravings. It seemed to work because he only used 3-4 times in six months. At the most recent placement, he used twice. He wasn’t in Wellbutrin any more, which might have been a factor. He had been dealing with a lot of change and loss of freedoms. I’m not excusing his use, just illustrating why it’s occasional and not frequent.

The doctor at the acute psych facility also added Naltrexone. The American Society of Addiction Medicine (ASAM) has recently suggested using naltrexone and buproprion to reduce cravings for m**h. His current psychiatrist brought this up. So now he takes both in addition to psych meds.

The refusal to allow music is odd. Why would they ban what helps him? I understand they have a policy. But he wouldn’t have access to internet. The music would be pre-loaded onto an mp3 player. What could be the harm?

The place seems very rigid and they may be cherry-picking. This may be why they have a good rating. If you only admit people who don’t have challenging needs, good outcomes come much easier, right?

Clearly, this isn’t the right place for him. So now what?

There is a new STP in our area. They haven’t officially opened as they don’t have their license to operate as an STP. They’ve been a SNF for a couple of decades and only now expanding to add an STP.

Maybe they’ll take him? Maybe they won’t be so strict?

I did a google earth search. It looks like a typical SNF from the outside. The neighborhood is residential. There are gas stations, fast food places, and a small strip mall very close by.

The proximity of stores will make it more likely that he’ll awol. That wouldn’t be good. I’ll still go through the process since there are few options.

That the STP that wouldn’t accept him seem to think his needs won’t fit with them really bothers me. As a mental health facility, isn’t their job to work with people with these illnesses and challenges to improve their daily lives? If they don’t do that, where can he find a place that will? Does that even exist?

I know CA has so many more than most of the country. But that doesn’t always matter if they aren’t the right options.

I read a book about a woman going through the revolving door of psychiatric care. A journalist got special permission to access the hospital and the patients to do a piece on what it was really like in a psych hospital. This was in the early 1970’s when privacy wasn’t as a big a concern.

It’s called Is There No Place on Earth for Me? The author is Susan Sheehan. It’s a fascinating look at how the system was a half century ago. Some things are better. Some are worse.

The title keeps going through my head. Is there no place on Earth for our loved ones?

06/18/2025

He’ll be transferred soon. The place we applied to last week has an opening. They have to interview him and finish up paperwork.

This is the place that is considered an STP. Special treatment program. It shares space with a skilled nursing facility and also seems to have a medical component.

I spoke with the administrator last week. I’d asked for a tour and he informed me that they don’t do that for ‘safety reasons’. I’m not sure what that meant. His safety? Other residents safety? Probably just the words they say to explain why they don’t do pre-admission tours.

I had a few questions for the administrator. The first being smoking opportunities. He will be able to smoke. There are only two smoke breaks per day for the first week. That’s what their psychiatrist wants. Since my FM hasn’t smoked for over a month, it makes sense to start slowly.

I asked about electronic devices. My FM loves video games and has an excellent handheld device. He’d also like to have his phone with him. So would I. It’s easier to text with him than to do phone calls.

Alas, electronics are not allowed. They want them to focus on the program without the distraction of electronics. I’m not happy about this, as games are a good coping mechanism for him. Certainly, he’ll have some downtime. Why not let him use his gaming system?

Later, I thought about how he also uses music to help with the spiritual torture. How could they withhold his music access? I hope they’ll allow music. I got him a decent mp3 player that I can fill with his favorite music. It won’t need WiFi (even though it can be used with WiFi) so there won’t be any gaming or web surfing. Just music. I hope they’ll agree. 🤞🏻

There will be a zoom interview any day now. I thought they’d do it sooner. He presents very well in interviews! I’m sure that will go well. Once that’s done, I should be able to move him the next day.

He likes where he is but wants a little more freedom. Ok, he really wants a LOT more freedom, but this will do for now. He wants to smoke. He wants to spend time in the outdoor areas. He needs that.

They have a gym that’s used for the physical rehab of the nursing facility. He’ll be allowed to use that, with supervision. They have a nutritionist on staff, so I asked that he receive that service due to his eating issues. The administrator agreed to make that happen.

It’s not ideal, in any way. I’m working with my FM to get him to knuckle down and engage. To do what they need him to do. If he can do that, and if they support him in these goals, then I can move him to a lower level of care.

This STP was the quickest placement, so that’s where he’ll go. Once he’s in there and progressing, I’ll get him on a list for a community augmented board and care home. Beds are few and opening are rare. Getting him on a list soon is the best I can do.

This may be the first place he really needs to be motivated. I hope he buys in so he can move on soon. I hope the staff assist him in reaching his goals.

It will take some time, but if all goes well, he’ll learn better life skills like hygiene, self-care, and independence. We both need that for him .

06/07/2025

We’re looking at a different type of placement for my FM. This type is new to me but apparently they’ve been around for a bit. It’s a Special Treatment Program (STP) and it’s a ‘behavioral health’ unit in a skilled nursing facility (SNF). The one we’re looking at is about 45 minutes from me. The unit has been open for a few years at this location. I hear only good things!

The STP is designed to treat people with severe and persistent mental illness with a co-occurring physical health issue. The definition on the physical health issue is pretty broad. It can include someone who has schizophrenia but needs more assistance with learning ADLs and moderately impaired ability to handle the demands of daily life.

This facility looks great. It’s large with lots of outdoor space and patios. They allow smoking (his main requirement!) and he can walk around the place if he wants. There may be limits when he can do that. Most places have limits.

They are on the same site as their traditional SNF. They share some amenities, like a recreation area and a physical therapy gym. Recreation therapy seems to be a focus. Thank goodness!

The county placement team raves about this place. They’ve had several good outcomes for people they’ve placed there. The plan is to improve their abilities to be more independent in their self-care, med management, and ability to navigate the system better than before going in.

It all sounds great! But then, everywhere he’s been sounds great, at first. Open mind about this one. It’s a different class of care and seems to include more medical care. This could help with my concerns about his lab results that have been so off.

We’ll tour the place next week. I’ve looked at the website and it is very nice. He’ll share a room, of course. The rooms have a lot of storage space and they have hospital beds. That’s not like any other residential treatment program. But, he always feels safe in a hospital setting so this could be a good thing.

He’s doing really well in the county psych unit. I moved him a week ago. There was a slight hiccup. When we were waiting for intake, he got antsy. He didn’t want to stay. So he left. Walked right out the door. I went after him for a bit but he was determined.

Staff filed a missing person report because he’s at risk. It was also 100° outside. I went to look for him again. After around 15 minutes, I spotted him. I pulled over and he got in the car. He agreed to go back. Thank goodness it was easy!

Later that evening he called me. He was having a good day and wanted to tell me he felt safe there. He sounded good. He likes this place and usually does well there.

I noticed that since he’s been prescribed klonopin regularly (every afternoon) he hasn’t had episodes of passing out. That probably means the passing out is due to extreme anxiety. The klonopin helps manage the anxiety so he can focus on other ways to reduce his anxiety.

Overall, I feel good about the plan for the STP. They don’t have a bed right now but if he feels good about it, we’ll start the process. I hope it doesn’t take long for him to go there. Then we can both move forward!

05/22/2025

On Sunday, I moved him to a PHF (pronounced Puff). That’s a Psychiatric Health Facility and they are available for short-term treatment in a locked setting. It’s not ideal for him since he’s not in crisis. But it’s the only option at this point.

The one he’s in should only be a few days. He’s waiting for a bed at the county PHF. They have much better programming and they know him. They are a county facility and can keep him longer, if needed.

Poor guy. He doesn’t understand why he had to leave the other place. I explained that they were concerned about the awols and want him to be safe. He’s confused about why he’s in a locked place. I don’t blame him. He’s had so many changes in the past few months. It’s been a struggle for him and for me. But he’s been in a very unstructured home with freedom to come and go to a structure program with rules about leaving. He needs som**hing in between.

The PHF he’s currently in has a different way of doing things. And I don’t mean better. All psych facilities are run their own way. At this PHF, I have to schedule an appointment to visit with him. There are typically set visiting hours in other places and you can just show up to visit at that time.

I had to call for an appointment in the am. I was told there were no available appointments that day and I should call back the next day. She said I couldn’t book for the next day but had to call early the following day to get an appointment for that day because there were some already booked. Huh? I asked why I couldn’t schedule for the next day since clearly others had. She repeated that I had to call in the am. I didn’t push it because it wouldn’t be worth my time and energy.

I called the next am and talked to a very nice person who knew what she was talking about. I got an appointment that day. I asked what I could bring him. Typically, I can bring food. Not there. No food. Maybe a book or deck of cards.

A case manager also had to be in the room with us. Awkward. She just played on her phone and we played cards.

He’s so sad to be there. He called me in tears twice. Heartbreaking. Such a horrible system.

He should be moved to the county PHF by the end of the week. I hope so. Once he’s there, I’ll be pushing hard for a good home in the community. One that will help him with ADLs and provide some activities or som**hing. Our county has Augmented Board and Care homes. These are homes that are held to a higher level than most board and care homes. He was in before, without the extra supports.

This is what ABC homes are required to do. They are also required to “provide structured activities and outings, a minimum of one hour per week to meet the specialized needs of each individual, adaptive daily living skills such as cooking, self-care, shopping, using public transportation, etc” and much more. I hope I can find one that adheres to these requirements and also has an opening soon. 🤞🏻

Broken

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