Uninformed Families
Sometimes family members of some of my patients are so clueless it really makes me wonder what they are thinking. Some seem to think therapy is a magic bullet, and we can cure any problem. In the past, there have been a couple of real backward thinking people I've dealt with, but just recently there has been a couple people that have really made me scratch my head.
Case one: the person is near comatose, follows no verbal directions, totally dependent for transfers, dressing, feeding, and personal hygiene. On eval, this person resisted even the simplest tasks. Yet the daughter wants to take this person home. She even asked the doctor to write orders for a second therapy eval about two weeks after the first which ended up with the same results. My thought is if she does take this person home that within a week she'll either be exhausted or have them back in the hospital.
Case two: the person is late stage dementia, a recent fall at home ended with a hospitalization and a possible patella fracture. On eval this person resisted everything, scratched and swung at the therapists, and screamed out with just being touched. This person is totally dependent for hygiene, dressing, bathing and transfers. Again, the daughter thinks she can take this person home and take care of them even though she works a full time job and has her own medical issues. Do you have the same thought as I do? It will be just a matter of days before there is another incident.
Why do families want to do this? Sometimes it almost seems like abuse, and I feel terrible that these people are going home to an environment that is probably unsafe and the needed equipment to properly care for the person is most likely unavailable. I cringe at stories heard on the news, like the one a few years ago of the lady who's son used to leave her on a mattress on the garage floor while he went to work for the day. She was left no food or water, was incontinent and had to lie in soiled briefs all day. Of course the days he decided to hang out with buddies after work she was left to wait longer for care. I'm so glad he got caught. Want to know what reason he gave for doing this? He needed the extra money from his mother's Social Security check to pay off his bills and child support so he couldn't afford someone to watch mom during the day. Did I mention that this was mom's house he was living in rent free?
It's sad that money is the main motivation for trying to keep these people at home. I have run into several situations where I assume that is the case, the family was living with the parent or grandparent and didn't want to sign the house over to the state to enroll the person on Medicaid. Unfortunately that is the situation in both of the fore mentioned cases. These families are making poor medical decisions just to benefit themselves. I am sorry for some that this means losing a place to live and losing income, but the bottom line is proper care for the elderly. I know this is not what always happens, but situations like this sure seem to be coming up more frequently. The worst part is there seems to be no way of educating these families of the risk they put their relative in.
Until next time, hope all your "Thoughts" are Good-
Tim