Problem
Manuel del Pozo (he, him, his), a 52-year-old man, is with his older sister, Angelita Martin (she, her, hers). Angelita reports that Manuel has autism and doesn't talk much. During the visit, he doesn't talk at all and mostly stares at the wall behind you when you attempt to engage him in conversation.
Angelita tells you that Manuel has been living in a local residential facility, but because of state funding changes, the facility is being shut down. The nearest place with space is 3 hours away. So instead, Angelita is taking Manuel into her care.
Manuel appears calm, euthymic, and well-kept.?He weighs 270 pounds and is 5' 9". His current medications are:
Depakote 2000 mg at bedtime
Risperidone 1 mg PO BID
Sertraline 150 mg PO day
Trazodone 100 mg PO qhs
Would you change anything on Manuel's medication list? If so, what? Include your rationale for each change. If you wouldn't change anything, explain your rationale for that.
Angelita says,
"I'm quite a bit older than Manuel, and I'm in good health right now. But I am concerned about who will take care of him when I no longer can."
How would Angelita get a psychiatric advanced directive for Manuel?
Angelita is also concerned about what to do with Manuel during the day while she's at work. She's heard about adult day programs and asks if you know about any.