Thursday, July 5, 2018

LPS-01 - Lanterman Petris Short Conservatorship – Performance Driven Success – Keith Torkelson, MS, Pathology


-
Lead Image – Picture Selection
[DOCTOR SINGH Composite]
-
-
-
Parent Document(s)
Righting_Conservatorship2006121701_LPS-01_V2018
-
Core belief: I am Incompetent > Evidence or experiences that suggest that the core belief is not true 100% of the time.
-
Naivety – As Is Up Front (AIUF)
-
Charter Information
-
Blogger
LPS-01 - Lanterman Petris Short Conservatorship – Performance Driven Success – Keith Torkelson, MS, Pathology
-
Google Plus
Patient’s Rights and Ethics in Health & Human Services – Clozapine - Deinstitutionalization – LPS Conservatorship – Keith Torkelson – M.Sci. – Domain Approach to Fixes and Solutions
-
Follow Up Article – LPS-02
-
Abstract – Executive Summary
When we were released from Westminster Therapeutic Residential Center (WTRC) in February 2007 we set out to address nine (9) major Performance Outcomes.  By the close of 2007 we had successes across all nine (9).  We had to surrender to a Lanterman Petris Short (LPS) Conservatorship in order to get “Respite”.  Upon admission to Westminster Therapeutic Residential Center (WTRC an Institute for Mental Disease) in Orange County California we asked the Doctor On Hand (DOH), Dr. Belman: What was the average stay at WTRC?  Dr. Belman told us “two years”.  WTRC gets a lot about their “Programs” correct such promoting and providing about individual and group Activities of Daily Living (AOLs).  Yet, when it comes to “Recovery” we could see they were going to fall short.  Later this year (2018) we plan to author a standalone about WTRC.  Locally in Orange County we  are promoting the establishment of a Housing Advisory Committee (HAB).  Personally our lived experience with successfully navigating out and away from WTRC an Institute for Mental Disease (IMD) might come in handy when we commit time and effort for our HAB.  While at WTRC we promoted our own recovery module.  It was centered on working diligently a workbook called: The Anxiety & Phobia Workbook (Bourne, 1990).  The WTRC Service Chief approved of our module and offered us two (2) hours a day for working own “Program”.  When we were on outings and overnighters we also puzzled through our workbook.  We are a keen advocate for Bibliotherapy and working workbooks.
-
Protective Value
In addition to Bibliotherapy (Cognitive Behavioral Therapy) our program included Self-assessment.  We designed two assessments: Assessment for Functioning and Assessment for Anxiety.  After about three and a half (3-1/2) months Sue Beck PhD a forensic psychologist interviewed us.  We had regained a bit of confidence about managing our own life again.  Sue took our case to a local probate judge.  Immediately upon a judgment to release the court the court forwarded its’ decision via Fax to WTRC.  WTRC staff, including Diana Shipley, were a bit alarmed concluding that we must now be competent enough to place ourselves.  And so began our Performance Challenge of 2007 to resolve our Conservatorship.  Our stability As Measured By (AMB) no hospitalizations lasted five (5) years or until 2012.  In 2012 we suffered catastrophic losses (A Fall) that included at least two (2) hospitalizations.  If asked to surrender to LPS we probably would have agreed again for whatever it took to get respite and secure our safety.  Sharing this information does not overtly “Protect” us from future “Falls”.

-




-
Our FAV









-


-
Figures - Community Partners
List of Tables and Figures
Table – Post Charter Information
Table – Decisions - Temporary Conservatorship Team
Table – Performance Indicators About Self-sufficiency - Performance Outcomes (2007)
Figure – LPS Metadata
Table – Resolving (Solving) an LPS Conservatorship
Matrix – Updated Behavioral Health Doctor Reviews – Objective
Table - Assessment – Subjective - Quickly Evaluating Your MD On-Call
Rate Your Conservatorship Associated Doctors (MDs and PhDs)
Matrix - Cast of Characters (Chronological) – Associated with LPS Window
[APPENDIX – FYI – Objective INCLUDES SOME CALCULATIONS]
-
[PLAN UP FRONT METHOD – Article A]
We are placing our LPS Confidence and Recovery Plan up front so as to reflect our level of naivety for the period 2006-2007 when we surrendered to “going on” an LPS conservatorship.  We have learned much since this time.
-
[PLAN UP FRONT METHOD (PUFM)
[COFIDENCE & RECOVERY PLAN - UNEDITED OR REVISED]
-
Interpersonal relationships – I have modified my relationships with the primary people in my life.  The result being less stress when transacting with all ((Relationships) Lanaii, Joan, Roxanne, Etc.)
-
Appointments – I make greater than 95% of my groups at WTRC.  In addition I have always returned before my deadline.  I intend to make all of my aftercare appointments with and without the help of Lanaii.
-
Food > need – I have an appetite that I did not have before September 17, 2006.  In addition I manage my caloric intake such that my weight gain is reasonable.
-
Anger management – My irritability is reasonable and I am not suppressing my anger nor masking it with fear (Anxiety).
-
Housing – I recognize that I most likely need Lanaii’s help in finding a room else I will take up residence with her during my aftercare adjustment period.  When I do get a room Lanaii with help my security deposit and me with initial payments such as first months rent.  I intend on living with another that I may maximize my Reality Testing.
-
Reality testing management (RTM) – I am at an all time high in my Reality Testing since the summer of 1988, the period before my first psychotic episode.
-
Work relationships – I am looking forward to doing my part in managing our employees, on site.  In addition I wish to pick up where I left off mentoring our employee, Antione.  Due to my time away the other partners have picked up a good deal of my previous duties.  Thus, the demands on my time are significantly less.
-
Medications – I have been stable on my new medications, Seroquel and Clozaril since October 15th, 2006.  The negative effects of my previous medication, Haldol, have been completely reversed.  I recognize the fact that I need medication to help me cope with schizophrenia.  I am on no anti-anxiety medications at this time.  This is an indicator that Dr. Bellman (My WTRC psychiatrist) feels I am managing my anxiety adequately.
-
Tele-Links legal – I know it is in my interest to support Lanaii and Candace (And our current attorney) in resolving the stressful Brown versus Torkelson (Tele-Links Exchange, LLC) legal issues.  At the same time engage in positive self-talk with regard to our legal fiasco, for example “We can work this out so both parties win”.
-
Workability – After being on the Westminster TRC schedule and fulfilling tasks I feel confident that I can work if necessary for another supervisor without undo stress or issues.
-
Confidence – I have outlined what anxiety free future will present itself.  I feel that I have a bright future and will begin again to actualize my goals without the need for excess stress and or hospitalization.
-
Panic – My anxiety survey indicate that I am about 90% healed.  At this time I am focusing on the problematic symptoms.  I have not had the urge to call 911 or commit suicide since September 15, 2006.  This change correlates to being taken off Haldol.
-

Need for 911 – The reasons under which I repeatedly called 911 have all but past and I am becoming more confident that I will not lose control again.  I attribute this progress to medication and the Anxiety/Phobia Workbook I am working.

-
Phobias – I have been overcoming my phobias through imagery and actual exposure to previously fear evoking situations.  I face them mostly on my passes and overnights.
-
Security – My stay at WTRC has given me the time and environment to significantly get over my insecurities.  This especially applies to financial insecurity.  I am relying on Lanaii and Candace’s financial help to initially set me up with my needs: Housing, medical, food, etc.
-
Independence – As evidence of my impendent ability, I have been granted by WTRC staff level 3 (The highest, solo, and most accountable level).  Again I govern my movement in the community and I always return on time.
-
Exposure – This means facing my fears in imagery and actually.  I have no urges to harm myself.
-
Substance abuse – I have little urge to drink and thus become light headed at this time.  In my follow up I intend to attend regular Alcoholics’ Anonymous meeting while engaging in prolonged sobriety.
-
Caffeine – I have been reducing my caffeine intake because it brings on symptoms of anxiety.  In my follow up I am considering eliminating all caffeine and other stimulant intake.
-
Finances – I recognize the fact that I will need financial help to the tune of $1000.00/month from my business partners, Candace and or Lanaii.  When I get adjusted I am planning on supplementing my SSI with income from Remedy Temp (I am a Remedy Associate at this time).  I intend to do Clerical or Warehouse work.
-
Remedy – As I stated above I am a Remedy Temp Associate.  In addition I am in good standing.  I am confident that I can find part time work with Remedy (The Irvine office).
-
After care – This is very important for me.  I need to switch my Medical from Kaiser to Medi-Cal.  I need to get a Medi-Cal card, a psychiatrist, pharmacy location, and information on any ancillary services Medi- Cal provides such a counseling.
In addition, I recognize the fact that I will require Lanaii or Charley to help me with my aftercare including finding a room (Whether it is here in Orange County) or at their home in Los Altos.
-
Keyboarding – As I type this I recognize that my keyboarding skills are up to par.  In this manner I may perform my work for ABC and Remedy.
-
Sleep – I get enough restful sleep.  When I was being hospitalized I was having nightmares that drained my energy.  I attribute my sleep difficulties with Dr. Chandler (Kaiser psychiatrist) cold turkey taking me off Ambien.  I have an as needed benzodiazpine [MIS-SPELL] at this time to help me get restful sleep.  I very rarely require it though.
-
Relaxation – Due to the noise of other roommates at WTRC and the intercom, I intend to get more relaxation after I am released.
-
Self-help – The WTRC staff commends me on my self-help and progress.  At the current time I am working a good selling Anxiety/phobia Workbook.  According to a survey I am about 90% free of symptoms.
-
Skills & product- I have written much regarding schizoaffective disorder.  I am hoping on publishing my work, in that it may help others heal.
-
Quantities – I have gone from 50% well to 90% well with regard to anxiety/phobia.  I am approximately 75% well with regard to depression.  And due to logical and rational reasoning I am 100% over my delusions.
-
Community - Through my (And my business partners’) efforts we have contributed 3 full time and 3 part time jobs to the community of Tustin.  I am hoping that by resuming my work for ABC and growing our client base we may provide even more jobs.
-
Dr. Bellman and staff – over the past view weeks Dr. Bellman and staff have concluded I am “ready” to challenge my Conservatorship and engage in independent living.  In addition I found out from the Public Defenders’ office that Dr. Bellman might initiate a DDT (?, Dismiss, and Terminate) at any time and thus facilitate my release.  Before I ask him to do so I must have my Medi-Cal in place.
-
Overnights – Overnights have been difficult to get used to because I spend them with Joan and our relationship is less that excellent.
-
Relations continued – I am sharing a room with a noisy roommate.  At this point he has stimulated m to tolerate others more.
-
Depression – Based on my results of a standard survey I have to admit that my depression is increasing a bit (25% depressed).  Good news is that I score 0 (or never) for the categories involving harm to self.
-
“What ifs” –I am successfully addressing my catastrophic thinking (increased the intensity of panic).  I have come a long way since 9-15-2006 or the last time I dialed 911.
-
Reasonable risks – My workbook indicate that it is necessary to take reasonable (ethically sound) risks in order to heal.  Yet at this time I would like to make clear that this does not mean altering my medication without my psychiatrist’s instruction.
-
Environment – I a working today and I feel the environment is much less stressful that it was earlier this year.  In addition I am staying nights with Joan and the environment at her (our) house is less stressful.
-
Stressors of daily living – I took a standardized stress survey and found that I score high in stress even though I do not feel stress right now.  In the next few weeks I am going to focus on categorically reducing my stress.
-
[BEGIN BODY OF REPORT]
-
Table – Post Charter Information
-




Element
Primary
Secondary
Note

-




Blog
Clozapine
HEALTHMAN
[PENDING]
Housing
[PENDING]

Publication Host
Blogger



Date Chartered
20180706-F



Date Finished
20180708-SUN
[EXPECTED]


Nature
Non-living



Author
AVEY



Editor
Keith E Torkelson, MS








Mock School
Cypress College
Orange County
California


Mock Course
Health & Human Services
Ethics
Patient Rights

Mock Teacher
Gary Zager



Theme
Housing & Respite

OCHCA
Westminster Therapeutic Residential Center

Institute for Mental Disease (IMD)

Population
SPMI
Seriously & Persistently Mentally Ill


-




Table – Post Charter Information: Last Reviewed: 20180706-F:
-
-
Table – Decisions - Temporary Conservatorship Team
Keith E Torkelson, MS (2006).
T-Con Votes (T-Con Team)
-




Character
Role
Tendency


-




Dr. Singh (Ravinder P)
Doctor in charge
Surrender & Succumb


Michael Merryman
OCHCA
Patient Right’s Advocate
Surrender & Succumb


Dr. Leino MD
Doctor on outside – Kaiser
Surrender & Succumb


Keith E Torkelson, MS
Self & consumer
Changing day by day


Lanaii Kline
Sister in charge
Undecided


-




Table – Decisions - Temporary Conservatorship Team for Keith E Torkelson, MS (2006).
-
Respite
In order to get Respite support we needed to Surrender & Succumb (S&S) to LPS Conservatorship.  While in the Temporary Conservatorship (T-Con) phase we collected the positions daily from our T-Con Team above.  We think that T-Cons fall under Welfare and Institutions Code section 5352.1 (WIC 5352).  Basically, it appeared Dr. Singh could not help us unless we were on Conservatorship.
-
-
Naivety – As Is Up Front (AIUF)
When we read back about our work efforts and Performance Outcomes to stabilize back in the community we conclude that we were very naïve.  We got the job done by delivering on the major work efforts we put before us.  We have already shared our task list (plan) now let’s address Project Performance Outcomes (PPOs).

-
Table – Performance Indicators About Self-sufficiency - Performance Outcomes (2007)
-





##
Performance Outcomes

Prior
2007
Fixes & Solutions

-





1
Argue for Competency

1990 Error (*)
2007 Via Sue Beck
Forensic Psychologist

2
California Driver’s License

LPS Suspends
Awarded Back

3
Find New Health Insurance

Kaiser
HealthNet

4
Help with Family Business

Tele-Links
ABC

5
Least Restrictive Housing

Rent Apartment
W MSO
Rent Room in House
Irvine California

6
Make at Aftercare Appointments

2004
2007 - OCHCA

7
Manage Whole Budget

2006
2007-2011

8
Release From Lockdown

2004
IMD – WTRC

9
Save LPS Legal Costs

Never rewarded LPS before
System does not have to manage this Conservatorship

-






Performance Earned Value
(PEV-LPS-01) =


9/9 = 100%

-





Table – Performance Indicators About Self-sufficiency – Argument Against Permanent Grave Disability: Last Reviewed: 20180706-F:
-
1990 Error (*) - Risks
In 1990 we made a costly error.  We were at Woodland Memorial Hospital (WMH) in Yolo County.  We didn’t know that everything we said could be used against us.  Back then the process was a bit different.  On the day of our Conservatorship Hearing three of us gathered in a private room at the hospital:  The Judge Advocate (JA), our hospital representative (Social Worker) and we.  The advocate asked the social worker to present our case.  She only presented our deficits resulting in a violation for our trust in her (Dual Antagonistic Relationship).  We testified for the JA that on the outside we have: Income, a place to live, a role in Davis as registered Veterinary Student, could feed ourselves, etc.  The JA voted in our favor.  We were released still not knowing what was causing our Anxiety (Panic).  About ten (10) day later due to panic we were back.  Because we had in a manner of speaking released ourselves our insurance did not cover the second stay.  Eventually our father took us home for respite.
-
XENONET – An LPS Moment
XENONET is what we call elements of medication therapy and pharmacy for which we have personally garner little or no control.  In 2006 Dr. Ravinder P Singh (MD) made a huge decision for us.  She semi-fast tracked us through the Clozapine Decision Chart (algorithm) and began the process of stabilizing us on Clozapine.  Actually the chart indicates that we might have best been tried on Clozapine as early as 1993.
-
[INSERT CLOZAPINE ALGORITHM]
-

-
Position on LPS Conservatorship
Since our first contact with the Conservatorship process back in 1990 we have listened to many people discuss LPS Conservatorship.  We find there are more reasons to stay off Conservatorship than to surrender.  Conservatorship interfered with our working, recovery investment spending, and our transportation to name just a few.  Some people feel a consumer may never make progress towards recovery.  For us Conservatorship impaired our primary recovery by creating secondary recovery tasks.  In a manner of speaking Conservatorship gave us the opportunity to recover from more losses that expected.
-
Placing First Things First
While immersed in WTRC we soon earned an Overnighter.  The first thing we did was go to our office at the family business and draft a Cross Domain Recovery Plan (CDRP).  At WTRC we were approved to work our own program for two (2) hours each day.  As stated earlier we created an Social Functioning Assessment (SFA) to build confidence and not overly fear that we would not “Freak Out!” on the outside.  This assessment was based upon WTRC Appropriate Consumer Behavior (ACB) policies posted on the wall in one of the up front rooms.  We found a record somewhere that the WTRC consumers’ had voted us to be President.  So what we shared earlier is Mr. Torkelson’s Naïve Recovery Plan (CDRP).  Not perfect yet it served our purpose over more than three (3) years.
-

-
Major Milestone – Getting Your License Back - DVM Safety
DMV Hearing Offices – Driver Safety Offices (DSO)
FYI – “The California DMV’s Division of Driver Safety is the enforcement branch of the California DMV.  The Division of Driver Safety is authorized to deny, suspend or revoke any California driver license if they determine just reason.  The Division of Driver Safety holds and processes administrative hearings to determine to suspend or revoke licenses of California drivers at designated offices referred to as Driver Safety Offices.  Commonly called a DSO, the Driver Safety Offices are large offices regionally spread out over the State of California.  DMV DSOs are not the traditional “field offices” where one goes to register their car, or process normal DMV transactions.”
-
Table – Resolving (Solving) an LPS Conservatorship
Original Contents and Order – LPS Naivety
-



Effort
Effort
Effort

-



Interpersonal relationships
Phobias
Relaxation

Appointments
Security
Self help

Food > need
Independence
Skills & product

Anger management
Exposure
Quantities

Housing
Substance abuse
Community

Reality testing management (RTM)
Caffeine
Dr. Bellman and staff

Work relationships
Finances
Overnights

Medications
Remedy
Relation continued

Tele-Links legal
(Family Business)
After care
Exposure

Workability
Keyboarding
Depression

Confidence
Sleep
“What ifs”

Panic

Reasonable risks

Need for 911

 

Environment

 



Stressors of daily living

-



Table – Resolving an LPS Conservatorship: Last Reviewed 20180706-F:
-
Treatment Planning – Consumer Driven
Basically what we did ourselves was devise an Anxiety Disorder Treatment Plan (ADTP) and a Plan for Aftercare.  We ended up placing ourselves in a rent-a-room located in Irvine California.  On two occasions we shared our room with one of our friends Mark B.  The rent was $450.00 per month.  Conservatorship warrants the DMV to take away your CDL (Just Reason).  One of our biggest achievements was earning our CDL back after passing three DMV Safety Division’s Hearings.  On the final Hearing our Hearing Office said we did such a good job presenting our position that we should write it down and share with others.
-
Matrix – Updated Behavioral Health Doctor Reviews - Objective
Doctors Associated with LPS Window & Dangers
-






Initials
Name
Date
Means
5.0 is Best
Reviews

-






DRC
David Royce Chandler
20180216-F
Vitals
3.0
2

RPS
Ravinder P Singh
20180216-F
Vitals
3.3
14

AEI
Andrew E Inglis
20180216-F
Vitals
1.0
3

AEI
Andrew E Inglis
20180216-F
Healthgrades
5.0
1

-






Matrix – Rate Your Doctor – Objective – Scored 20180216-F:
-
Table - Assessment – Subjective - Quickly Evaluating Your MD On-Call
Rate Your Doctor – Rate Your Behavioral Health Doctor (BHD)
-





Assessment

Singh
Before
Belman
During
Inglis
After

-





1-Objective

Above
Above
Above

Accountability

Low
Low
Acceptable

Bed Side Manner

Acceptable
Low
Good

High Stakes – Catastrophic Losses

Potentiated
Neutral
Ameliorate

Problem Solving Value (PSV)

Acceptable
Poor
Very Good

Quality Of Care (QOC)

Average
Average
Good

Contribution
Quality Of Life (QOL)

Good
Poor
Very Good

Ratings-Subjective

3 Stars
2 Stars
4.5 Stars

Satisfaction

No
No
Yes

-





Assessment – Subjective - Quickly Evaluating Your MD On-Call
-
Rate Your Conservatorship Associated Doctors (MDs and PhDs)
-





Professional
Objective
(Source Vitals Online)
Subjective
Satisfaction
(Q*M)
Subjective
Quality Of Care
(Q*M)


-





1-David Royce Chandler MD
20180216-F
3/5 * 2 (V)

2.0
2.0


4-Sue Beck PhD
As of 20180216-F
Unrated
5.0
5.0


3-Belman MD
No digital presence
2.5
2.0


2-Ravinder P Singh MD
20180216-F
3.3/5 * 14

3.0
2.0


5-Andrew E Inglis MD
20180216-F
5/5 * 1
4.5
4.0


-






Matrix – Combined Objective & Subjective Ratings for Doctors In Charge: Last Reviewed: 20180706-F:  In Chronological Order
-
Doctor Matching Held Over
Right Doctor for Me (Match)
-
Matrix - Cast of Characters (Chronological) – Associated with LPS Window
Subjective
-







Character

Initials
Q*M
QGM

-






1
David Royce Chandler MD

DRC
2.0
D

2
Sue Beck PhD


5.0
A

3
Belman MD


2.0
D

4
Ravinder P Singh MD

RPS
3.0
C

5
Andrew E Inglis MD

AEI
4.5
A

-






Matrix – 2006-2007 – Satellite Doctors – Last Reviewed: 20180706-F:
-
Q*M=Quick Star Method
QGM=Quick Grade Method
-
[APPENDIX – FYI – Objective INCLUDES SOME CALCULATIONS]
Healthgrades & Vitals
-
Vitals
DRC
20180216-F: 3/5 * 2
-
RPS
20180216-F: 3.3/5 by patients. 14 reviews
20180216-F: 3.3/5 * 14 (Transformed)
-
AEI
20180216-F: 1/5 * 3
20180216-F: 5/5 * 1
-
Ravinder P Singh MD
Doctor Bum Soo Lee’s (BSL’s Take) – Doctor Singh is “Unremarkable”
-
This Is The End
Next Installment LPS-02

 
-
A Legacy Assignment for Us from Doctor RP Singh
-
-
Our Roommate After We Placed Ourselves
-
-
Promotion for WTRC
-
-
Another Partner
-
-
Consumer Art While @ WTRC
-
-
What it is all about
Causation & Prevention
-
-
Experimental Bunny Rabbits Rule!
-

20180706-F: FYI - Stats for This Paper
-

-30-