If you work in physical therapy, sooner or later you're going to encounter a patient, friend or relative who is making secondary gains off the patient's illness. In my experience, this usually revolves around money or special attention. I have a patient now whose wife is behaving this way. We all get the behavior but no one has figured out what her payoff is.
She is demanding and demeaning to the staff. She insists her husband be seen three or four times daily. She constantly lowers his oxygen to a level that causes his breathing to be labored. Until this week she has refused to allow a wheelchair in his room, stating he doesn't need to rest. This is a man who gets short of breath moving in bed. He had major cardiac surgery and tolerates very little activity.
The wife is a retired nurse who believes she knows more than everyone else about her husband's care. She refuses to discuss anything with anyone but a physician. I am the lone exception because I walk with him. She will speak to me long enough to clarify her expectations for the day and then ask how he did. I think he would do much better in general if there was a way to prevent her from entering the building.
In the course of one week, more time was devoted to managing her behavior than therapy spent with the patient. Even when she gets her way, she isn't happy. She simply makes an even more outrageous demand. I believe she has had only one telephone conversation where she didn't hang up on the caller and that was with the rehab doctor. No one wants to go into the room when she is visiting. No one understands what she is getting out of this.
My first thought is an underlying psych diagnosis. My second is that she is used to bullying people to get her way. Every demand includes a statement along the lines of, "He won't get better unless you do this." Either she is in denial about how sick he really is or she needs him to be even more ill.
I feel sorry for the man. He works hard with therapy. Today we didn't accomplish anything because she turned off his oxygen before leaving for the day. He couldn't even stand up, he was so worn out from trying to breathe with no air. This is one of those situations that makes you want to call Adult Protective Services. I ran into a similar situation one time previously. Then it was the wife of a patient with TBI who did the opposite of everything we recommended.
Everyone in the facility is aware of her. The OT and I watch over him while he is in therapy. The nursing staff checks on him regularly. I hope it's enough.