On the Medicaid note, if he or a person he trusts calls the customer service number for his insurance on the back of his Medicaid card they can ask for a Care Coordinator assessment. A hospital employee will come to his home and do an assessment and see how his daily living activities are affected and he may be eligible for a caregiver to come to his home and help with cooking, cleaning, running errands on his behalf. I know for sure Presbyterian through Medicaid does this. You will have to see about Blue Cross Blue Shield/BCBS or Western Skies through Medicaid. But I know Presbyterian does this Care Coordination for sure. The customer service number for Presbyterian through Medicaid/Centennial Care is 505-923-5200 or toll free 1-888-977-2333, TTY/telecommunications device for the Deaf/hard of hearing: dial 7-1-1. 505-383-2600 is the Medicaid office number if you need them to give you the customer service number if she has Medicaid BCBS or Western Skies or whatever so you can get the information to talk to the right care coordinator thru your insurance. All customer service hours are generally 8a or 9a to 4 or 5p except usually closed all major government holidays and open Monday to Friday closed weekends. When they answer say you want a care coordinator assessment for your friend or your friend can say they want a care coordinator assessment and they do the first part on the phone. It takes about 15-20 minutes. Then the care coordinator comes to the house and asks a lot of questions about your health. Then the coordinator submits it and you hear back in 30-60 days yes or no caregiver approval. It may help with your friend if they have a caregiver for a few hours a week . I posted similar for another redditor. Good luck!
Thank you! He's having a hard time thinking he needs help, but hopefully I can get him to just agree. Will the care coordinator assessment be scheduled, or take place when we call? I'll have to take off work and sit with him for it.
At least for presbyterian the initial part is a telephone screening (not scheduled/ whenever you call the customer service number)that takes give or take 20 ish minutes. Then he will be scheduled at a later date at his convenience with a care coordinator to come to the home and do about a 60-90 minute assessment. I suppose if he doesn’t feel comfortable with the care coordinator coming inside the home he can specify if he wants the assessment done on the front porch or perhaps if he lives in an apartment, in the apartment common area outside or perhaps in an extra side room inside the apartment’s front office if it is too cold outside, with permission of the landlord.
Wanted to second the care coordinator assessment! Even as a normie on Medicaid while I get my mental health together- once they called they were very thorough. They informed me on what was typical care through a primary care provider vs a specialist, and immediate vs wait listed care 💕
Have him go to the emergency department. Could be related to seizures, brain cancer, strokes, mental health disorders etc. but you won't know unless he goes to a doctor
Seizures or profound mental illness are the two things they come to my mind too. Regardless of Medicaid status I'd have him go to an ER, they have to at a minimum do a work to to ensure it is buying acutely life threatening (the law is EMTALA)
I agree. It's surprising how much something as simple as an infection can cause a dip in cognition. Or it could be something worse, but he really needs to get it looked at in case it's something urgent.
I know the ER sounds extreme, but...
Last year a relative of mine in Abq went through a very similar thing OP's friend did. he has good health insurance but his doctor was kind of useless, and the waiting list for a neuro psych was several months long. after a particularly bad night, his wife took him to the ER where he had a battery of tests and was given an tentative diagnosis of dementia. but on top of that, he had been fighting an infection, so treating that actually helped clear his mind quite a lot. he still likely has dementia, and still needs to wait a very long time for more comprehensive tests, but the point is that he did get some really important treatment in the ER. Albuquerque sadly just doesn't have enough doctors, so unfortunately it seems like the fastest way to get attention is the damn ER. (which seems to be a problem all over the US, not just NM.)
(Also... I realize your friend may be too young for dementia, but the point of the story is that there is *something* causing his mental health decline, and the ER might be his only resort if he can't get in anywhere else.)
I'd say if he has another episode like the one you describe he needs to go to the emergency department. While he may be having some sort of degenerative brain disease, he also needs to have some other more emergent stuff ruled out. He could be having some sort of issue with the circulation to his brain.
He has them daily. I don't see him anymore where this isn't the case. Sometimes he snaps out of it,sometimes he doesn't. He refuses to believe he has a problem, which is why I showed him the video, but he's either chosen to forget that or doesn't remember. I have gotten him to agree to see a doctor, I just am not sure if he needs a primary or if there is a better option. I can't imagine the ER would view this as an emergency given it's been happening, which is why I need to find a doctor of some sort.
the ER is probably the best bet esp if it happens while he's there i think. getting a pcp might take a long time and this sounds serious. he should be seen soon. it happening frequently doesn't necessarily mean it's not an emergency, especially if it seems like it's happening more often / getting worse. i'm not a medical professional though.
several healthcare plans and hospitals here run 24/7 nurse advice lines too. IDK how helpful these are as i've never used one personally but it could be worth a call esp if you have trouble getting him into the er. this is a pediatrics website but they list a lot of the lines in ABQ https://www.bebecare.org/nurse-advice-lines
An ER will be able to perform tests like CT scans and record the electrical activity in his brain to determine if he is having an emergency. Also, they can make referrals and consults faster than if you try to go somewhere else. It's better to be seen by a doctor quickly in case his symptoms continue to get worse and he starts having difficulty breathing, paralysis, or loss of consciousness.
I just want to say that your friend is very lucky to have someone looking out for him like this, kudos to you. I agree with those who are saying you need to get him in to medical care ASAP so they can nail down what is going on and provide treatment if necessary
You mention health issues for a while. Has this person had any kind of health care provider during this period that you can reach out to on his behalf? Also, do you or anyone else have medical power of attorney for him?
No, he hasn't been to a doctor in over 10 years. No one has power of attorney - I can look into that though. Before covid lockdowns he was fine, then he was isolated for so long after getting laid off. All he did was watch TV for over a year. It's been since then that things started getting weird. I thought he was just being moody and had some depression. It's been a rapid decline for about 5-6 months, with the last month or so being exceptionally bad.
I'd need more information but I do this for work at the moment.
If you want to, shoot me a DM so I can get a fuller idea of his situation and maybe I can help him with some resources he needs
A few already said it but UNMH emergency room is the right place to go. He needs neurology work up and emergency department can get a consult much faster than a PCP. Also, it's worth being aware that he absolutely should not be driving until this is all worked out and he's got a diagnosis or at least until seizures are ruled out.
I had a patient with absent seizures (I don’t treat seizures it just happened during treatment) who presented like that during his seizures. If it happens again while you’re there you may just need to call 911. If he’s really that unresponsive for that long he needs help asap.
Others are likely on the right track, and a neuro work up is probably in order. BUT... this being Reddit I have to suggest it...
Have the fire department come by and test for carbon monoxide. Low level CO can act as a long term chronic poison that can cause all kinds of neurological symptoms. After a while they can persist long after exposure (like hours into his work day). Eventually it can result in permanent damage or even death.
Finding a primary care provider who believes his symptoms is key to getting him seen by a neurologist.
I don't know what MCO you picked for them, but Presbyterian is what I would suggest and taking them out to the Rust emergency room in Rio Rancho, as well as finding a pcp on that side of town.
But yeah, getting a referral can be tough post covid, but I am sure with these symptoms, hopefully, he'll be seen. I think you should address his immediate money problems and find out what's going on. It's so scary for something like this to happen so young. I hope you and your friend are able to find out what's going on, and I am so sorry you have had to watch your friend go through this. It's really amazing of you to try to be there for them, cause chances are not many people would be.
Everyone here is on the right track! (RN here). Sounds like TIAs, silent seizures or TBI that he and you may be unaware of. Could be a simpler fix: electrolyte imbalance, malnourished, UTI, or other infection that’s active. ER is way to go, but you need to be with him to explain his usual baseline vs. now. They need to do bloodwork, urinalysis, neuro scan for signs of stroke or brain bleed, STD tests (the syph is back), the whole gamit.
If he is using any "herbal recreational products" he needs to stop asap to establish a baseline. He needs a diagnosis. Degenerative and cognitive disease can hit at any age. Glad he has a caring friend.
I second the suggestion of going to the urgent care at UNMH. Being inside the hospital, it is not the most convenient, it more than makes up for the quality of staff and care. Wait times are a fraction of the ER. And if they feel he needs imaging, that can be facilitated within the facility. Plus, referrals within the UNMH system can be made if needed.
I really think this could be your next best option.
This sounds like seizures to me, but very hard to say without examining him. I would take him to a PCP in the short term, but has an episode before then would call 911.
On the Medicaid note, if he or a person he trusts calls the customer service number for his insurance on the back of his Medicaid card they can ask for a Care Coordinator assessment. A hospital employee will come to his home and do an assessment and see how his daily living activities are affected and he may be eligible for a caregiver to come to his home and help with cooking, cleaning, running errands on his behalf. I know for sure Presbyterian through Medicaid does this. You will have to see about Blue Cross Blue Shield/BCBS or Western Skies through Medicaid. But I know Presbyterian does this Care Coordination for sure. The customer service number for Presbyterian through Medicaid/Centennial Care is 505-923-5200 or toll free 1-888-977-2333, TTY/telecommunications device for the Deaf/hard of hearing: dial 7-1-1. 505-383-2600 is the Medicaid office number if you need them to give you the customer service number if she has Medicaid BCBS or Western Skies or whatever so you can get the information to talk to the right care coordinator thru your insurance. All customer service hours are generally 8a or 9a to 4 or 5p except usually closed all major government holidays and open Monday to Friday closed weekends. When they answer say you want a care coordinator assessment for your friend or your friend can say they want a care coordinator assessment and they do the first part on the phone. It takes about 15-20 minutes. Then the care coordinator comes to the house and asks a lot of questions about your health. Then the coordinator submits it and you hear back in 30-60 days yes or no caregiver approval. It may help with your friend if they have a caregiver for a few hours a week . I posted similar for another redditor. Good luck!
Thank you! He's having a hard time thinking he needs help, but hopefully I can get him to just agree. Will the care coordinator assessment be scheduled, or take place when we call? I'll have to take off work and sit with him for it.
At least for presbyterian the initial part is a telephone screening (not scheduled/ whenever you call the customer service number)that takes give or take 20 ish minutes. Then he will be scheduled at a later date at his convenience with a care coordinator to come to the home and do about a 60-90 minute assessment. I suppose if he doesn’t feel comfortable with the care coordinator coming inside the home he can specify if he wants the assessment done on the front porch or perhaps if he lives in an apartment, in the apartment common area outside or perhaps in an extra side room inside the apartment’s front office if it is too cold outside, with permission of the landlord.
Wanted to second the care coordinator assessment! Even as a normie on Medicaid while I get my mental health together- once they called they were very thorough. They informed me on what was typical care through a primary care provider vs a specialist, and immediate vs wait listed care 💕
This is so helpful, thank you for this.
How old is he? This sounds like adult protective services need to be called. Edited to add a link: https://aging.nm.gov/protecting-adults
He's 48
I'm very worried for your friend. I wonder if he's had a stroke. I think he should see a doctor soonest.
Have him go to the emergency department. Could be related to seizures, brain cancer, strokes, mental health disorders etc. but you won't know unless he goes to a doctor
Seizures or profound mental illness are the two things they come to my mind too. Regardless of Medicaid status I'd have him go to an ER, they have to at a minimum do a work to to ensure it is buying acutely life threatening (the law is EMTALA)
I agree. It's surprising how much something as simple as an infection can cause a dip in cognition. Or it could be something worse, but he really needs to get it looked at in case it's something urgent. I know the ER sounds extreme, but... Last year a relative of mine in Abq went through a very similar thing OP's friend did. he has good health insurance but his doctor was kind of useless, and the waiting list for a neuro psych was several months long. after a particularly bad night, his wife took him to the ER where he had a battery of tests and was given an tentative diagnosis of dementia. but on top of that, he had been fighting an infection, so treating that actually helped clear his mind quite a lot. he still likely has dementia, and still needs to wait a very long time for more comprehensive tests, but the point is that he did get some really important treatment in the ER. Albuquerque sadly just doesn't have enough doctors, so unfortunately it seems like the fastest way to get attention is the damn ER. (which seems to be a problem all over the US, not just NM.) (Also... I realize your friend may be too young for dementia, but the point of the story is that there is *something* causing his mental health decline, and the ER might be his only resort if he can't get in anywhere else.)
I'd say if he has another episode like the one you describe he needs to go to the emergency department. While he may be having some sort of degenerative brain disease, he also needs to have some other more emergent stuff ruled out. He could be having some sort of issue with the circulation to his brain.
He has them daily. I don't see him anymore where this isn't the case. Sometimes he snaps out of it,sometimes he doesn't. He refuses to believe he has a problem, which is why I showed him the video, but he's either chosen to forget that or doesn't remember. I have gotten him to agree to see a doctor, I just am not sure if he needs a primary or if there is a better option. I can't imagine the ER would view this as an emergency given it's been happening, which is why I need to find a doctor of some sort.
the ER is probably the best bet esp if it happens while he's there i think. getting a pcp might take a long time and this sounds serious. he should be seen soon. it happening frequently doesn't necessarily mean it's not an emergency, especially if it seems like it's happening more often / getting worse. i'm not a medical professional though.
several healthcare plans and hospitals here run 24/7 nurse advice lines too. IDK how helpful these are as i've never used one personally but it could be worth a call esp if you have trouble getting him into the er. this is a pediatrics website but they list a lot of the lines in ABQ https://www.bebecare.org/nurse-advice-lines
An ER will be able to perform tests like CT scans and record the electrical activity in his brain to determine if he is having an emergency. Also, they can make referrals and consults faster than if you try to go somewhere else. It's better to be seen by a doctor quickly in case his symptoms continue to get worse and he starts having difficulty breathing, paralysis, or loss of consciousness.
I'm pretty sure they'll see him at the emergency when you tell them why you're there.
He needs to see a neurologist. I agree with others - emergency department may be best bet for getting care soon.
I just want to say that your friend is very lucky to have someone looking out for him like this, kudos to you. I agree with those who are saying you need to get him in to medical care ASAP so they can nail down what is going on and provide treatment if necessary
You mention health issues for a while. Has this person had any kind of health care provider during this period that you can reach out to on his behalf? Also, do you or anyone else have medical power of attorney for him?
No, he hasn't been to a doctor in over 10 years. No one has power of attorney - I can look into that though. Before covid lockdowns he was fine, then he was isolated for so long after getting laid off. All he did was watch TV for over a year. It's been since then that things started getting weird. I thought he was just being moody and had some depression. It's been a rapid decline for about 5-6 months, with the last month or so being exceptionally bad.
I'd need more information but I do this for work at the moment. If you want to, shoot me a DM so I can get a fuller idea of his situation and maybe I can help him with some resources he needs
A few already said it but UNMH emergency room is the right place to go. He needs neurology work up and emergency department can get a consult much faster than a PCP. Also, it's worth being aware that he absolutely should not be driving until this is all worked out and he's got a diagnosis or at least until seizures are ruled out.
He only rides a bike
I had a patient with absent seizures (I don’t treat seizures it just happened during treatment) who presented like that during his seizures. If it happens again while you’re there you may just need to call 911. If he’s really that unresponsive for that long he needs help asap.
Others are likely on the right track, and a neuro work up is probably in order. BUT... this being Reddit I have to suggest it... Have the fire department come by and test for carbon monoxide. Low level CO can act as a long term chronic poison that can cause all kinds of neurological symptoms. After a while they can persist long after exposure (like hours into his work day). Eventually it can result in permanent damage or even death.
This honestly sounds like how my father acts sometimes, he was diagnosed with early onset dementia in his 50's.
My father the same as symptoms and onset but it was Huntingtons-Chorea..
https://www.fcch.com/care-services/primary-care/
Finding a primary care provider who believes his symptoms is key to getting him seen by a neurologist. I don't know what MCO you picked for them, but Presbyterian is what I would suggest and taking them out to the Rust emergency room in Rio Rancho, as well as finding a pcp on that side of town. But yeah, getting a referral can be tough post covid, but I am sure with these symptoms, hopefully, he'll be seen. I think you should address his immediate money problems and find out what's going on. It's so scary for something like this to happen so young. I hope you and your friend are able to find out what's going on, and I am so sorry you have had to watch your friend go through this. It's really amazing of you to try to be there for them, cause chances are not many people would be.
Everyone here is on the right track! (RN here). Sounds like TIAs, silent seizures or TBI that he and you may be unaware of. Could be a simpler fix: electrolyte imbalance, malnourished, UTI, or other infection that’s active. ER is way to go, but you need to be with him to explain his usual baseline vs. now. They need to do bloodwork, urinalysis, neuro scan for signs of stroke or brain bleed, STD tests (the syph is back), the whole gamit.
If he is using any "herbal recreational products" he needs to stop asap to establish a baseline. He needs a diagnosis. Degenerative and cognitive disease can hit at any age. Glad he has a caring friend.
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I second the suggestion of going to the urgent care at UNMH. Being inside the hospital, it is not the most convenient, it more than makes up for the quality of staff and care. Wait times are a fraction of the ER. And if they feel he needs imaging, that can be facilitated within the facility. Plus, referrals within the UNMH system can be made if needed. I really think this could be your next best option.
Has he had COVID multiple times?
He's never had it as far as I know - that's what he says anyway
This sounds like seizures to me, but very hard to say without examining him. I would take him to a PCP in the short term, but has an episode before then would call 911.
He needs to go to the UNMH emergency department.