I have a question....I have a patient who in april had a colostomy put in...it will hopfully in around 6 months be reversed....but for now she has it. Her family brought her back here to from another state. The family if very rich. They have a non-speaking maid that does everything for the family....and the most important thing...take care of the patient. This maid is leaving. This family is losing a wonderful lady....I know little spanish...but she is very smart, and does wonders. She actually does the colostomy care. She actually did the care today...and changed it for me...while her family sat there and watched. This patient has two daughters. One right now is fighting cancer...on chemo/radiation...so she cannot do this. The other daughter has scleroderma...and states she cannot do this. The family I will repeat is VERY rich. I think it is more that they do not want to do. The patient daughter can open small jars, sew purses together...(here in the south they like to make purses from the hi-c, capri sun packets? is that everywhere?) But all the sudden when it is time for the bag change...she cannot do it. She got very upset with me today when I told her Colostomy bag changeds are not a skilled nurse "need" medicare will not pay for us to go out there once a week for 6 to how ever many months to do it for her.
any suggestions? The patient is wonderful. she is too confused to learn to do it herself. Is there a way we can help this patient out? or am I right in saying this is not a skill for medicare to cont to cover? Any information would be great.....I want to help...but at the same time I know the patients daughter just does not want to do it. It is like when I first arrive....she is fine.....when I then say lets do the change.....he cannot....then when I leave...Oh...I am feeling better again. I know there is pain with scleroderma...but I am not sure what to say or do. sorry I went on so long here.....anyone that made it through my whole post here! thanks! and any info! THANKS!