The primary purpose of obtaining an LPS conservatorship is gain power over the conservatee's medical and decision making abilities. This commonly is needed when the conservatee refuses to take medication, fakes taking medication, or believes he or she does not need medication. Conservatorship gives the conservator a solid ground to demand treatment even at the objection of the conservatee.
Enumerated in Welfare and Institutions
"The conservator shall have the power to order the conservatee to receive mental health treatment related specifically to remedying or preventing the recurrence of the conservatee's being gravely disabled."
What does this mean in practice
Conservators hold the power to decide which medications the conservatee will take. The conservator reserves the right to decide what medications the conservatee will take, route of administration, and when. Common medications that the conservator will order fall into three groups: mood stablizers, antipsychotics, and antidepressants. Obviously, there are far more medications when ordering involuntary medication treatment, but these are the primary ones the psychiatrist will order.
The first group, the most common, are the antipsychotics. There are several very common antipsychotic medications the doctor will order and the conservator will consent to. Hadol IM or Thorazine IM are two rapid acting medications that the psychiatrist can order to ensure compliance and deescalate a outburst. The doctor at the facility may observe violent or self harming behaviour that CBT behaviour fails to address. This may require medical intervention. If the patient is acting out of control, the doctor can order restraints and administration of medication. The patient can be retrained at five points, head, arms, legs, and stomach. This way the doctor can safely inject the medication in the buttocks; the ideal position for medication administration given the large muscle mass. Both of these medications immediately sedate the patient so they are no longer a threat to others or themselves. If they fail to demonstrate that they can continue to remain calm and sedate, the doctor can order further IM injections.
The next class of antipsychotics that the doctor can order are long term injections. The main three are Invega Trinza, Invega sustenna, Abilify Maintena [aripiprazole]. The first one lasts up to a three months. The doctor will need to titrate the dose for the first month and then can continue tri-monthly treatment once the patient has stabilized. With stabilization, the patient and doctor do not need to worry about compliance. since the medication is released through slow release delivery beads. Abilify Maintena is a monthly injections. With these medications even if a dose is missed for a few days there is enough medication built up in the bloodstream, the symptoms will not return soon.
Mood stabilizers such as lamotrigine, lithium carbonate, and carbamazepine are indicated for episodes of psychosis and as an anti manic. These medications usually do not come in IM form and therefore are a second class for treatment of immediate psychosis. These are commonly used in conjunction with an antipsychotic. to ensure stabilization of symptoms.
[address kinds of med , route, class, and for what dx]