Robbin Miller

This week, my client’s sister passed away peacefully in a nursing home under hospice care. My client questioned when her sister would ask for her support over the last twelve months. When she did talk to her sister either in person or via telephone, my client said that her sister always asked how she was doing and did not talk about her illness at all. My client visited her twice a day for the last two weeks, seven days a week. As her sister laid in bed in a conscious state, she continued to ask my client the same questions about how she was doing. A few days ago, her sister became congested in her lungs where she needed increased dosages of morphine to decrease her pain. While morphine decreases pain, high dosages will suppress your breathing. Three days ago, her sister lapsed into a coma. Under hospice comfort measures, intravenous fluid treatments for hydration and medicinal purposes are withheld.

Last week, I saw a client who is vent-dependent and has a chronic muscular disease. This individual uses round the clock personal care attendants and lives in her own apartment. The client informed me that her sister is dying from numerous brain tumors and from lung cancer. Her sister is receiving hospice care in a nursing home. The client also talked about her family grieving about the inevitable since her sister was born able-bodied and healthy.

I heard about a very sad event that an adoptive single parent endured this past week. She had to relinquish her 17 month old preadoptive son from the state foster care system to his biological father. Apparently, the birth mother told the state who the father was after a year in which she refused to identify him at birth. The birth mother held back the information due to her belief she would get custody back of her baby after she cleaned up her act in a drug rehabilitation facility. When the birth mother found out her parental rights were terminated this year, she decided to identify the birth father so she can still see her son in his custody. What a tragedy for my colleague and for this baby.

Massachusetts passed new reforms for children’s mental health in 2008 as a result a federal lawsuit known as the Rosie D case. Three families sued the state due to their children not being able to access community based services for their psychiatric disabilities/disorders. The federal judge ruled in their favor and stated that Massachusetts was not in compliance with other states such as Florida who have services and programs in place for the above populations. Also, Massachusetts was also not in compliance for administering the Children and Adolescent Needs Strengths scale known as the CANS to children and teens on Mass Health only. I say, “only,” because the new services and programs in place in Massachusetts are targeted to children and teens on Mass Health (State Medicaid program).

The below information in quotes was posted on a blog entitled, “The Conscience of a Liberal.” “Poverty in early childhood poisons the brain.” That was the opening of an article in Saturday’s Financial Times, summarizing research presented last week at the American Association for the Advancement of Science. As the article explained, neuroscientists have found that “many children growing up in very poor families with low social status experience unhealthy levels of stress hormones, which impair their neural development.” The effect is to impair language development and memory — and hence the ability to escape poverty — for the rest of the child’s life." (Paul Krugman, 2008).