Advance Directive


PAMELA S WAGNER’S

PSYCHIATRIC ADVANCE DIRECTIVE

2014-15

first 2 pages

FOR WHEN I AM HOSPITALIZED AND/OR INFORMATION TO HELP AVOID IT

                                                                                                                                                                                           MISS WAGNER HAS EXPERIENCED MULTIPLE EPISODES OF PSYCHOLOGICAL AND PHYSICAL TRAUMA, INCLUDING DATE RAPE, THE SUICIDE OF TWO FRIENDS, AND DOMESTIC ABUSE BY CAREGIVERS. SHE MUST NOT BE SUBJECTED TO EITHER MECHANICAL RESTRAINTS OR INVOLUNTARY SECLUSION* AS THE USE OF THESE HAS BEEN DEEPLY TRAUMATIZING. FORCED MEDICATION SHOULD BE AVOIDED. SUCH METHODS NOT ONLY DO NOT HELP, WHEN USED THEY HAVE INEVITABLY PRODUCED RE-TRAUMATIZING AND INJURY, REGRESSION TO PRIMITIVE STATES SUCH AS FECAL SMEARING, AND SEVERE WORSENING OF HER PSYCHIATRIC SYMPTOMS.

 

 HOW TO INTERVENE IN A CRISIS:

  • DE-ESCALATION IS ESSENTIAL
  • DO NOT TOUCH ME OR GRAB AT ME.
  • DO NOT LAUGH OR MAKE FUN OF ME and DO NOT FORCE ANYTHING…
  • I WILL CALM DOWN IF YOU REMEMBER THE FOLLOWING THINGS:
  1. I AM SCARED AND LIKELY TO BE PARANOID. I ONLY FIGHT IF I FEEL UNDER ATTACK. DO NOT USE A SHOW OF FORCE, AS THIS WILL FRIGHTEN ME MORE.
  1. DON’T ISSUE ULTIMATUMS…That will push us all into a corner and serve nothing
  1. AN UNRUFFLED PERSON SHOULD ASK ME TO TAKE A DEEP BREATH, and try other verbal calming techniques. I am always grateful for people remaining calm when I am upset.
  1. NEVER LEAVE ME ALONE IN A BARREN (seclusion) ROOM. Even if I am mute, someone talking to me or being with me should help.
  1. COVER ME WITH A WEIGHTED OR WARMED-UP BLANKET. SOMETHING ICY TO EAT LIKE A POPSICLE CAN ALSO HELP.
  1. PLEASE LISTEN TO WHAT I HAVE TO SAY. Medication may not be needed if you hear what the problem is.
  1. WHEN NECESSARY, YOU MAY PERSUADE ME TO TAKE ORAL MEDICATION, but only if you negotiate this with dignity and kindness. Keep speaking to me calmly and explain your reasoning.

****BUT REMEMBER****

8.  MUSIC HELPS EVERYTHING. If Pandora radio (not broadcast radio!) is available, Carole King, *Bruno Mars, *Adele, my own HipHop playlist on iTunes, Jim Croce or James Taylor “stations” will calm me better than any medication. Any 60s-70s soft rock or folk music is better than nothing.

*I cannot reiterate enough that if you utilize 4-point restraints or seclusion, it is virtually guaranteed that you will see regression to primitive states, increased hostility and aggressiveness as a result. Please don’t do something everyone will regret.

 

8 thoughts on “Advance Directive”

  1. You are very welcome, Pam. I believe that a change is coming. Do I dare share what I think with others? Faith is a touchy subject online or otherwise,right?

  2. Yeah, you are darned straight about needing a new system of things…I have a world to say on that! But where to begin…I wish I knew. Even though I am a sort of expert on these matters, of course no one actually listens to me. Why should they? I am just another MP. and no one listens to mental patients even though they should, both when ill and when well. Anyhow, thank you so much for your heartfelt comment. Pam

  3. Dear Pam, I’ve just begun reading Divided Minds and am saddened and appaled at the way you were treated during your breakdown in 1999. It shouldn’t be necessary to even have an advance directive. The intervention instructions you’ve laid out should be standard procedure for dealing with anyone who is upset or in crisis, regardless of their mental state. I’m going to share this with my husband and remind us both to utilize its steps with Pebbles whenever she has a meltdown.
    Much love, Mai ❤

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