I was thinking back to a case I had and a debate I had with my director.
Elderly woman with end- stage dementia max 80lbs. Reddened sacrum. Daughter took ExCELLENT care of her. Changed her 4 times a day, turned her often, says its not a problem as she is so light. Our associate director did her admission and sent me in as the case manager on the second visit . Told me to go with a foley as she is having the daughter consider one. I go into the home, meet them, assess the patient and the daughter and I am finding no reason for a foley. None. Patient is clean and dry and a little fidgety and can't communicate much , especially unable to communicate discomfort. I speak about the foley anyways, thinking, well I've been hospice nursing for a year and she is the director and has been doing it for 16 years...... The daughter refuses, doesn't feel a need to introduce infection when she states she has no problem keeping her clan and dry.
I couldn't argue with her. I completely agreed and I told her that. When I get back to the office, I told the director she refused the foley and I wasn't quite grasping the need for one. She says she disagrees with me the daughter would benefit and it would make it easier on the daughter to have one. I felt the daughter was having no issues and it would cause discomfort to the patient and her skin is fine.
I'm getting long winded here, but am I right or wrong? Whydo something invasive to someone at end of life if unnecessary ?