adult "child" in home care - who is in charge?

Specialties Pediatric

Published

I recently worked a home care case where the patient was an adult "child" who never aged out. He is completely dependent physically but mentally is functioning quite normally. Parent's instructions are to take his computer away (that he uses to communicate - as his only form of communication) at 130 am turn off lights and tv and make him go to sleep, yet the patient is 31 years old. He prefers to stay up all night and sleep all day. Any home care nurses out there encountered conflict between parents and children (adult child in this case) and how did you handle it? Personally I think it's cruel to take away someone's only form of communication, yet this same patient will keep asking you for treatments all night long at about 4x's the rate indicated on their chart.

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I feel for you. It's confusing. If the man is 31 and can make his own choices, leave it up to him.

If he's willing to take responsibility in case there is a disagreement, then go for it. If not, do what you think is best.

Not sure why he is asking for so many treatments though.

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Specializes in NICU, PICU, PCVICU and peds oncology.

This is a very sticky situation. Who provides consent? Is this man legally competent to consent to treatment, procedures and so on, or are his parents in possession of guardianship? If his parents have that piece of paper from the courts saying they are in control, then you could be getting yourself in serious trouble if you flout their direction. On the other hand, if he's competent to provide consent then you could be justified in doing what he wants. Why is he asking for treatments more often than indicated? That's easy. He has control over his requesting care at that moment. It's also a little passive-aggressive way of fighting against the plan his parents are imposing. Perhaps a little contracting would help you out with that.

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Specializes in Pedi.
This is a very sticky situation. Who provides consent? Is this man legally competent to consent to treatment, procedures and so on, or are his parents in possession of guardianship? If his parents have that piece of paper from the courts saying they are in control, then you could be getting yourself in serious trouble if you flout their direction. On the other hand, if he's competent to provide consent then you could be justified in doing what he wants. Why is he asking for treatments more often than indicated? That's easy. He has control over his requesting care at that moment. It's also a little passive-aggressive way of fighting against the plan his parents are imposing. Perhaps a little contracting would help you out with that.

^THIS. If the parents are the man's legal guardian his numerical age is irrelevant.

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Specializes in Peds/outpatient FP,derm,allergy/private duty.

Yes, I guess you need to find out the legalities there because a disabled person with normal cognitive function for his age is not a child.

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