The Nudist Who Wore His Heart On His Sleeve – Part 2

If it hasn’t been 24-hours since the last time you saw a person, the police won’t let you file a missing person report.  And if the only thing you know is their cell phone number to their trailer in a nudist community, it turns out the police don’t really have a policy in place to help you.

Danny Greene wasn’t answering his phone but he had barely agreed to be my client. My gut told me he was somewhere he didn’t want to be but I didn’t have enough intel for traction on a missing person’s report…and this left me worried that my phone call to the police would shake down something like this:

Police: What was he last seen wearing?  

Me: Well, see…here’s the thing…he doesn’t exactly wear clothes most of the time.

I tried to reach Danny all day on Wednesday and even drove to his trailer where his truck was parked out front.  The nice ground’s manager said he’d been gone since Tuesday. Yesterday.  I called Danny’s cell number but no one answered.  When I finally called the police they suggested just waiting.  Could he be with family?  No.  Could he be with a friend?  Maybe just out of town? I had no idea but, by gum, his truck was still there.

After an afternoon of phone calls, I tracked down the cell phone number to the do-gooder friend from the senior center who had originally referred Danny to me in the first place — or at least told me that Danny needed help.  The friend didn’t pick up on my initial call so I used an old social worker trick and called him three more times in a row without leaving a message. On the fourth try, he picked up.

“I’m the person you connected Danny with at the senior center,” I told him.  “You thought he needed more help and I was working on that but now he’s not at his trailer.  Do you know where he is?”

The friend (enthusiastic as all get out) responded, “Yes!  He’s down at the VA hospital.  They admitted him.”

Note: In social work, the phrase is, “What-the-what?!” but we often respond with: “He was admitted?  How….?”

“I told them he had Parkinson’s,” said the amigo.  “And they admitted him into a study.”

Enter social-work-reflective-listening-in-order-to-perhaps-spark-reflection

“You told them what he had and they admitted him…okay.  To what?”

“To a Parkinson’s study they’re conducting…they wanted him inpatient so they could assess him,” said the voice on the other end of the line.

Leaving it at that, I called the VA hospital two hours away and told them I was trying to reach a client.  Of course, they could neither confirm or deny that Danny was there. I updated my case notes with all the calls, furiously thinking, “What kind of friend decides to admit someone to the hospital?”

Just before the 24-hours since anyone’d seen Danny, I tried his cell number again.  Miraculously, he picked up.

“Danny, it’s Jill.  You’re there!”

Danny was having a hard time putting together words so I simply told him I was coming over.  There is a high tolerance, it turns out, for social workers who impose on clients by scheduling random home visits.  I drove to the clothing optional community.

Danny opened the door in the nude.

“For God’s sake, Danny.  Put some shorts on.”

“Hu-hu-hu-hu-hu-huh!” he chuckled, then backed away from the doorway to go find clothes.  With shorts on, Danny slowly came down the steps and motioned for me to sit in one of his folding chairs.

The story Danny proceeded to tell me was like James Bond.  Earlier in the week, his “friend” drove him down to the VA hospital which was fine until said “friend” decided to tell the doctor that Danny wanted to be part of a “study”.  Without asking Danny, they admitted him into the hospital and the friend left for home. Ditched him.

Stuck in a hospital bed and hooked to monitors, Danny asked to make a phone call but was told he wasn’t allowed to and there was no phone in the room.  After a few hours of realizing his was trapped in a situation that wasn’t going to help him, Danny somehow figured out how to make an outbound call from the nurses’ station.  The one number he remembered was his friend-slash-girlfriend who immediately drove a few hours south to pick him up.

According to Danny, he was just wearing his hospital gown (amazing that he even had that on!) and had to run out of the hospital AMA (against medical advice) right as she pulled up.  He jumped in her car and they zoomed off for home, taking the back-roads to make sure they weren’t followed. I can only imagine their conversations:

“Do you think they’ll come for us?”

“They’re probably on their way…drive faster!”

And so they made their way back to our county and the clothing optional community that was home.

Reflecting back, if hospitalization was the only way to treat Parkinson’s, Danny was out.  Now he was back in his trailer and keenly proud of himself: “Hu-hu-hu-hu-hu-huh!”

During my time in the clothing-optional community, however, I’d had time to do my fair share of healthy sleuthing.  Danny, it seemed, had a nasty staph infection on his left buttock and was banned from using the hot tub at his community.  There was a friendly but curt note saying, “Danny — until the staph infection on your left side is healed, we ask that you please do not use the communal hot tub as this could pose a public safety risk.”

Could I help with that? I asked him, knowing that getting in-home care into Danny’s trailer was going to be the sales job of the century, both on the side of the provider and the agency.  Astonishingly, Danny agreed. The next day, a coworker and I set up a folding table outside of his trailer and proceeded to organize all of his paperwork. We applied for in-home care through Medicaid — the COPES program — that very same day.

With Medicaid, most states have what are called waiver programs.  They’re called waivers because the states “waive” the income requirements to be a little higher and then create programs meant to help people get the care they need in the “least restrictive” (AKA “less expensive”) setting.  For example, care in your home is likely going to be less expensive for the state than 24/7 skilled nursing care in a skilled nursing facility.

In Danny’s case, getting on a waiver program would give him someone to be there while he took showers, extra help for that staph infection on his rump, and help dressing…. should he so decide to wear clothes at some point.

The key to all of this, I told Danny, is that when the social worker comes out to ask what you need help with, you have to answer the questions as if it was your worst day.  I worried that Danny would say he didn’t need help in which case the state would say, “Great, we won’t put you on this program!”

When I finally heard from the local Department of Health & Human Services that he’d been approved.  Now the big sell was to get an in-home care agency on board with a client who

A.) chose to not wear clothes,

B.) lived in a rural area

C.) and (I just found out) fired the VA nurse who came to his trailer to give him a vitamin B shot — standard Parkinson’s disease management at the time.  In other words was a “non-compliant patient”.

I started making calls, laid bare the facts (so to speak) and set the ball in motion to try to get Danny some help.  At this time, his neighbors had found out about me and called regularly with updates on any tiny supposed decline. Little did I know (and was too young to realize), the next chapter in our choose-your-own-adventure of Danny’s life would bring its own challenges.

To be continued….

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