Non-Compliant Patients

My father-in-law who lives with us is on 2 L O2 continuously and has a  pulse dose system he uses when out and about.  We had to take away his driving privileges since he did not recogonize when his sats were dropping and he also did not think it was a problem to leave the concentrator in the car while  visiting and being out with people.  I have found that the elderly DO NOT want to be percieved as "ill or chronic" instead of  healthy and active.  Education is the only thing to keep repeating over and over every time they make a repeat visit to the ER.  It finally has worked with my father-in-law, and he now wears his O2 all the time and also carries a charger everywhere.  good luck with all your patients.

I am the home care therapist who has to break it to the non-compliant patient of which you speak . . . I just had a lady this very week who was satting 85% on 2.5L continuous.  She refused to give up her pulse-dose (aka conserver) regulator.  She pointed her finger at me and said, "Lady, I don't want to discuss this with you."  I had to verbally request that she acknowledged that she was putting herself at risk, then wrote it dutifully on the delivery ticket for her signature, so I have it in writing, also.

It is an extremely frustrating experience.  I, too, wonder what else I can do for these patients who want to maintain mobility but are not saturating properly on these items that are advertised as convenience products (and please, don't even get me started on POCs).  

The biggest thing for me is helping the patient understand that a pulse-dose system does NOT emit O2 in liters per minute.  They are more like milliliters per dose.  I try to explain to them that they are essentially getting 2000 ml/min on their O2 (if they are a 2L/min pt), and w/ a pulse-dose, it is usually less than 30 ml per dose.  For some patients, this helps them, but then when they see how quickly their tanks empty on continuous flow, & how they must use a larger tank, they get upset.  

Thanks for sharing your experience.  I am on the "other side", trying to do the same things as you, but trying to keep them from going to the hospital :)  It is not easy.  We need better products out there to address this problem.