3,287 Comments for Danvers State Hospital
- Location: Danvers State Hospital
- Gallery: Tiptoe
- Location: Danvers State Hospital
- Gallery: Dreary Skies
- Location: Danvers State Hospital
- Gallery: Dreary Skies
- Location: Danvers State Hospital
- Gallery: Dreary Skies
- Location: Danvers State Hospital
- Gallery: Tiptoe
- Location: Danvers State Hospital
- Gallery: Tiptoe
- Location: Danvers State Hospital
- Gallery: Tiptoe
But you know they've already done it so I guess whats done is done.
- Location: Danvers State Hospital
- Gallery: Tiptoe
- Location: Danvers State Hospital
- Gallery: Dreary Skies
I had secured a home to become the community residence of four adults who were virtual lifetime residents of an institution slated to close. Funding was in place to make needed structural modifications, purchase appliances and furniture, a van for their transportation in the community, etc.
Although they had significant orthopedic and medical problems in addition to sensory deficits and severe/profound mental retardation, we wanted to have an open kitchen so that the residents could participate in some meal preparation commensurate with their abilities. The fire marshall and one state licensing board came in and said that we had to close the kitchen off from the rest of the house due to the residents' disabilities.
Because each of the people used a custom wheelchair and had a 24-hour positioning schedule with side-lyers and other devices, we chose to furnish the living room with mat tables and the positioning devices. Then we were cited by another group for having "institutional" furniture and floor plan. None of the residents could sit in a regular sofa or chair, and we did have some chairs for visitors, but they said we needed a typical living room sofa, coffee table, etc. We eventually prevailed on that as the regulators got to know the people better, but were cited for the kitchen's enclosure on every review. There would have been no community residence at all had we not enclosed the kitchen. As it was, the residents were being driven down the interstate on the last day the institution had been open while the fire marshall was making his final inspection of the new home, and we were all on pins and needles, just praying that he would issue our certificate of occupancy before they arrived and found themselves homeless. The fire marshall also required that in addition to the standard two exits, each of the two bedrooms have a direct exit to the outside. This was so that if there was a nighttime fire, the residents could be safely evacuated in their beds rather than having to take the time to position them into their wheelchairs. Of course we also had sprinklers, exit signs, emergency lights, an alarm wired directly to the fire department, etc. We were not allowed to refer to the exit ramps as "porches" or "decks"--they were purely "egress ramps." On this, we were cited for not having any swings or planters or other "homelike" furnishings for the people to enjoy (but had we put such items there, we would have been in violation of the fire code and therefore "neglectful" of our residents). So it's not even just that there are multiple standards with which to comply; it's that one regulator requires one thing and other regulators demand different, mutually exclusive things.
On another review at a different home, we received a very serious citation because a bottle of medication was stored improperly. It was a controlled substance (Schedule IV) but was inaccessible to any of the residents, so no "harm" was done. But the citation, on its face, sounds like the bottle was open on the dining room table and being passed around during dinner.
We also had conflicts regarding use of antidepressants. A lady who had been with us for years had been diagnosed with depression and treated by one of our psychiatrists. When her case was reviewed, the reviewed concluded that we did not have baseline data that warranted the use of "behavior-controlling/altering drugs." We argued that the medicine was not to control her behavior, that depression was a medical condition, and that the medication was to treat the illness, just like a blood pressure pill or thyroid pill. We lost, and had to taper her medication, document symptoms of depression as they re-emerged, and then re-start her medication. Even our argument of "ok, we agree, we messed up, but don't make her go through this" did not help us. We did monitor her mood very closely, to document the tiniest observable change, so hopefully we got her back on her antidepressant before she suffered too much.
- Location: Danvers State Hospital
- Gallery: Tiptoe
- Location: Danvers State Hospital
- Gallery: Tiptoe
In addition to what BigEd (thanks, BTW, "impulse control problems" is what I was trying to say in my post on another picture and couldn't manage to remember it) and Lynne said about "extreme precautions," for me they would also include no rings, watches, or bracelets, long hair tied back, keeping an "escape" route between the patient and myself, and having a means for requesting assistance if I needed it. Sometimes we had to assign two staff to work with one patient in especially extreme cases.
- Location: Danvers State Hospital
- Gallery: Tiptoe
Most patients in a state hospital, especially in a "violent" ward, were not "fine" and just in need of "a little help." I care very deeply about each person I have worked with, and try to always focus on his/her strengths. But that doesn't mean I can ignore the symptoms of paranoia, delusions, extreme irritability, lack of coping skills, lack of ability to foresee consequences of their actions, etc. that require closer supervision and more intensive treatment. This sometimes requires involuntary commitment to a locked psychiatric facility.
- Location: Danvers State Hospital
- Gallery: Tiptoe
- Location: Danvers State Hospital
- Gallery: Tiptoe
- Location: Danvers State Hospital
- Gallery: Tiptoe