Protecting a patient at risk for abuse or neglect

[Lynx25]

I work in a LTC facility, and I have had one resident for quite a while, who seemed to be one of those who just gets dropped off by the family, and never thought of again. From the records, it doesn't seem like they had been to visit in about a year. The contact numbers were disconnected, the certified letters we sent out were returned... I even went to facebook and other social sites trying to match up the contact name, with some photos of the family left with the patient. No such luck. I have personally replaced her wardrobe as needed, bought her snacks, stocked her fridge, etc etc.

In the mean time, this patient contracted C-diff, multiple pressure sores, and had a tremendous change in function. During her latest stint at the hospital, I went to medical records and went through the things that had been thinned out of the chart, and somehow found a new phone # listed on the bottom of a 3 year old page from the hospital.

When contacted, the patients family sounded angry that I had contacted them and bothered them with all of this information, wanted to know why their mother was in a different state than they had left her a year ago... etc etc- you've all had difficult family members.

NOW- here's my problem. They want her pulled out of the nursing home, out of the hospital, and they want to take her home. This woman is incont, with pressure sores to the sacrum that's forever being irritated by the Cdiff stool. She doesn't walk, she can't sit up by herself, and she's on honey thick liquids and a puree diet, and I am suspecting she even aspirated on that.

There is no way this family can take care of this woman. She'll be dead in a week. I find it highly suspicious that you go from not seeing your mother for a year, to suddenly wanting to take her home with you. In a perfect world, I suppose they have learned their lesson, but it's not.

I've pushed and pushed our social worker to get DFACS, or adult protective services involved, but it's been a week, and she's done nothing. The hospital social workers seem to think I'm causing a scene because the family wants to sue my facility.

Is there ANYTHING else I can do to protect this patient?

[tyvin, BSN, RN]

If the patient is a ward of the state, why does the OP say,

"I've pushed and pushed our social worker to get DFACS, or adult protective services involved, but it's been a week, and she's done nothing. The hospital social workers seem to think I'm causing a scene because the family wants to sue my facility."

The family also pulled the patient out of the facility, which they would not be able to do if the patient was a ward of the state.

Also, in another post the OP goes on to say,

"I thought that something might have happened with the family- and before she became a ward of the state- I wanted to make sure."

Therefore, the patient was NOT a ward of the state and, as unfortunate as it seems, unless the patient was competent enough to consent they should not have been moved without the family's knowledge.

The lady apparently is not a ward of the state; that was my misinterpretation ... sorry.

[Rob72, ASN, RN]

Anonymous call to Adult Protective Services. IIRC, 5 years is abandonment, in most places.

For future reference, if you have any suspicion that the facility is not interested in allocating care decisions (i.e., your SW person was making calls), do your digging inconspicuously, and make the call (APS)anonymously. It sounds like your name is aaallll over this. Generally not good.

Edit: as was said to my wife by a PI, before she decided to divorce her ex:"You don't need me to check. You already know this. That being the case, why would you want to pay me...?" A case for abandonment didn't really need to be "built", nor did family need to be contacted.

[tyvin, BSN, RN]

I thought that something might have happened with the family- and before she became a ward of the state- I wanted to make sure.

Then again, I work 16 hour shifts on the weekends, so I suppose I might have been bored.

Is she or isn't she ... I thought I was going nuts when someone asked why my I thought she was a ward due to a sentence in the original post but I didn't go through this whole thread until this morning because I was thinking "How could I have got it so wrong" ... bingo. Anyway she's a ward of the state according to the OP's words and the nurse had absolutely no business contacting the family. Then again is she ... please clarify for us OP.

[Lynx25, LPN]

I took 'in a different state' to mean 'in a different condition'.

Yes.

I suppose it's all a moot point now.

Apparently she didn't make it through the week.