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Maryland offers "The New Directions Waiver" as a means of self-directing state and federal Medicaid dollars for individuals who qualify for supports due to their disability.

This offers the disabled individual the opportunity to use those dollars to best meet their own unique needs. However, it comes with the responsibility to create a plan, a budget, and find your own resources to make the plan a reality.

No centralized source of resources exists. The purpose of this blog is to direct others to resources in our communities and to provide one example of a self-directed plan. (*Caution: The self-directed plan described at the beginning of this blog is for an individual with a 5/5 needs rating, the highest possible rating in Maryland, and therefore the highest budget possible. Most will have a lower rating and a lower budget to work with.) It is also to share firsthand knowledge of experiences that may assist others who self-direct services.

Comments are welcome. Please share your knowledge with others.

Tuesday, September 18, 2012

NAC Tolerance?

Over the years, some medications have helped to control the irritability and agitation that V has struggled with since she was 3 years old. So many times we have gained temporary relief and glimpsed hope, only to have it fade away within 2 or 3 months. Usually the decline in effectiveness has resulted in adjusted dosages to higher levels to regain benefits. But, there are upper limits to safe dosages with all meds, and a point at which side effects outweigh benefits. We always seem to reach that point with each med, and the hope slips away.
I suspect that V has become tolerant to the effects of NAC, although it is not a medication. I have not increased the daily dose above the 900 mg tablets, but I can no longer see a difference in irritability levels compared with what they were before we began to give her the NAC.
It was always a subjective evaluation of effectiveness. I didn't keep detailed behavior data beyond the usual behavior reports that support staff turn in. It is possible that I saw the improvement that I wanted to see in the beginning. I will use the remaining NAC tablets that I have, but I probably will not order it again.
I am disappointed.