I spent several hours Saturday with my aunt  in the local emergency room.  I did the same the  weekend before. It is exhausting. She calls 911 whenever she gets discomfort in her chest…and chest pain means you end up in the ER.

Is she ill? There is nothing wrong with her heart – although I doubt she is truly convinced.  The hospital believes she may have a reflux issue – that will require some additional follow up investigation.

Will she follow up with her primary care provider, like she was told to? I don’t know.  I will call her and remind her to make the appointment, but I can’t be sure she will really follow through. The last time she made a follow up appointment, she didn’t show – because she wasn’t feeling well – which is precisely why she should have gone to the appointment.

My aunt is  mentally ill.  She struggles, making illogical decisions and ignoring sound advice – even advice from the emergency room staff. They have been very kind and patient with her at the ER, even when she complains it is taking too long to get her test results or too long to be released.

I listened with her as they explained what she should do – and she could repeat it back. If she looked confused, I asked for further explanation.  I struggle, wondering whether or not she has the capability to  schedule and keep her follow up appointments, or even follow the ER staff’s directions.  I know she can make the phone call, but if she feels better Monday, she may just decide not to… you can’t make her schedule or keep an appointment because she is an adult.

I recently had a conversation with a social worker – he expressed that adults who suffer from mental illness or developmental issues have the right to make bad decisions, just like anyone else.  The difference is this:  If I make a bad decision, I have to deal with it myself.  If my aunt makes a bad decision,   our family , her social workers or the paramedics end up working to straighten things out on her behalf…again.



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