Catch-22

How’s this for a Catch-22? (Do you know where this expression comes from? Ask Joseph Heller …)

My mother has been diagnosed with early stages of dementia (apart from metastatic cancer) which means that her shrink has prescribed Ebixa (much like the Aricept my Dad was on for his Alzheimer’s). This is not only to delay the onset of Alzheimer’s, but to improve her current mental health, and also to protect her from rapid deterioration.

BUT – the medical aid has deemed this to be ‘Acute Medication’ … like what – she’s going to get better next month and not need it anymore? As it is fairly expensive and my mother’s Acute Medication limit has already been exceeded, we are hoping that the medical aid will reconsider their decision, and move this on to Chronic Medication.

Since my mother will need to take this for the rest of her life if she wants to maintain some independence and limit her confusion – and since this medication would be prescribed as Chronic Medication if she had already deteriorated to the point of being diagnosed with Alzheimer’s (which comes with plenty of other medical costs – such as full time care), one would think that the sensible thing to do would be to agree to fund this protective and delaying prescription. One would think …

Her psychiatrist has motivated for this previously, but the request was rejected. So yesterday my mother went to him for a re-assessment. Here’s where it gets really odd. On one hand we were hoping that her mental state had declined sufficiently for the medical aid to deem her need “Chronic” – but at the same time hoping that she has actually retained her mental faculties, and that the medication has, in fact, been working.

I tried to tell her to mess the tests up … but you try telling someone who is already confused that she needs to purposefully come across as confused – when she is trying hard to prove that she isn’t! The shrink called me after the appointment to report that she was actually better than last time – which is great news! Only he fears that now our chances of getting the necessary medication covered by medical aid are slender-to-nothing – but no one wanted the results to be worse in the first place!

So like I said … a bit of a Catch-22, or what? In order get the medication required to stop my mother from losing her marbles, she actually has to lose them first … and since she has only lost a couple of them, she is not capable of convincing anyone that she’s lost them all already, and thus get the marble-retention meds!

[Wikipedia says: The archetypal Catch-22, as formulated by Heller, involves the case of John Yossarian, a U.S. Army Air Forces bombardier, who wishes to be grounded from combat flight. This will only happen if he is evaluated by the squadron's flight surgeon and found "unfit to fly." "Unfit" would be any pilot who is willing to fly such dangerous missions, as one would have to be mad to volunteer for possible death. However, to be evaluated, he must request the evaluation, an act that is considered sufficient proof for being declared sane. These conditions make it impossible to be declared "unfit."
The "Catch-22" is that "anyone who wants to get out of combat duty isn't really crazy."[1] Hence, pilots who request a mental fitness evaluation are sane, and therefore must fly in combat. At the same time, if an evaluation is not requested by the pilot, he will never receive one and thus can never be found insane, meaning he must also fly in combat.

Therefore, Catch-22 ensures that no pilot can ever be grounded for being insane even if he is.]

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