Surprise visit from the facility shrink

Yesterday afternoon around 5 PM or so the facility psychiatrist and his assistant walked into my room. I was a bit surprised because I have not seen him since 2012.

When I first came here,I was told I had to see him. But, he was not the psychiatrist that I would want to see and, two years later I asked the nurse manager if I could look for another psychiatrist. It's not that large a town so there would not be many. I did see one for the next three years. I only went every three months for 10 minute medicine appointments. The psychiatrist would talk briefly with me and update or change medicines based on what he and I felt I needed.

But since I did not want my medicines changed or increased, the visits were pretty much pro forma. Also the facility had to transport me and all I could do was go out to that short appointment and come right back. Before, I was able to hire someone to take me to the psychiatrist and then afterwards we'd go shopping and get lunch. The outing afterwards always made the day better.

I got tired of the process in 2015 and stopped going to the psychiatrist.

This month the nurse manager said, "You won't see a psychiatrist". That isn't exactly correct. But there is a system for folks on Medicare/Medicaid who see a psychiatrist. I knew I would have to make regular visits. I also don't know if the psychiatrist I saw before would see me again.

I told Dr. S I was surprised that he came in. His assistant wanted to know if I was told he would be seeing me. I told her I do not remember being told. But I said it was okay and I did not refuse to see him.

He said, "I'm trying to prevent them from throwing you out of here for not following your medical regimen". I was a bit surprised and felt like he was threatening me. I know a physician or psychiatrist can make recommendations about discharging a resident, if they feel he or she is a troublemaker. I don't want that. I have been involuntarily discharged once and I really do not want to repeat it. Although, it happens a lot more frequently than most people realize.

Dr. S asked if my Zoloft (50 mg a day) was working. I told him I thought it was okay. I said last July the dosage was dropped by my GP/medical director here. He said that was a government directive and shouldn't have happened. Nevertheless, it did and I didn't do anything to change it afterwards. Studies have shown that psychotropic drugs cause problems in people over 60. Some drugs make them drowsy which can cause them to fall and get injured. So, it makes a certain amount of sense. It also makes economical sense to cut back on the number of drugs that seniors (whose population is growing at an alarming rate) are taking. It would save Medicare and Medicaid as well as private insurance money. So I'm wondering if that's not one reason it's happening.

Dr. S said he would recommend I take 125 mg of Zoloft now. I have not taken that much since 1995 or 1996. I told him I really do not want my medicines changed or increased.. He said he would take a look at my med list, and that he would not change anything without discussing it with me. Resident Rights designate that's what's supposed to happen. But I don't know that it always does.

When I emailed a couple of friends about what  Dr. S said during his visit, both commented that he threatened me. One thought I should register a complaint. But, I'm pretty sure that would go nowhere. Nevertheless, I am glad I told my friends. I'm sure some of them have no idea what is said to nursing home residents, even ones like me, who are "alert and oriented x3".