Abuse in the home

SoCalRN1970 · Jun 25, 2011

Hello there..

I have been very fortunate to have had pretty good outcomes when it comes to issues with abuse. Not always physical, but rather emotional, financial or neglect.

APS for the most part has it's hands full. Often they open a case and may follow up, but only in extreme cases are actions taken

I have had a few cases of abuse that I had to deal with as a Hospice RN.

#1.) This patient was under a conservatory as she had no family. Her court appointed conservator has arranged 24/7 pcg with a lovely lady who was caring for this little lady in her big gorgeous home. The patient had dementia, but was on service for another issues. I had witnessed nothing but wonderful care for this patient that was until I found a sort of an issues that triggered a Red Flag. One afternoon I showed up a bit early to my appt and found my patient on the patio with another dementia patient ( unknown ??) while the two caregivers were visiting in another room. I decided to make an un announced visit to the home next time around. The court conservator relied upon my reports to assure all was taken care of in the home.

I showed up later one day to find extended family members in the patients home.. having a party. I also decided to walk through the home and assess the rooms I never looked in on. You got it.. multiple family members lived in this home.. rent free.. while the hired pcg got paid for caring for the patient. The conservator was notified and the pcg and family were immediately asked to leave the home.. APS would of been of no use here.

#2) I had an eldery man with CHF end stage new on hospice who had a wonderful full time pcg in his home caring for him. This young man came from an agency as well. The patients family lived out of the area and was indeed involved but by telephone only.

I was caring for this man and the agencies "owner" took it upon herself to "talk to me" about what she felt was needed for the patient including a hoyar lift and a wheel chair "to go out to the garden". Mind you this man was actively dying. To turn him took his breath away. I had to set the boundaries with the agency who in the end backed off.. But that wasn't the end.

I got a call from a "neighbor" of this patient who wanted to "talk to me " about his care. I returned the call to find out that she wanted confidential information on the status of this man, which I would NOT give. She then informed me that she noticed "pink" eyes and decided to call me about this. I thank her and moved on to the visit.

I found my patient with no signs or symptoms of conjunctivitis, but found a weird bottle of "restasis" on his bedside table. This was not part of my patients med profile and I found out that the neighbor told the patients care giver.. DO NOT GIVE MORPHINE.. and here, use these eye drops of mine for his pink eye.

I notified the next of kin. I explained the situation and advised that she contact this over stepping agency and neighbor that they are NOT in charge of the patient.. APS? could of been involved as the agency was instructing their pcg to go against our careplan. The neighbor was interfering with the plan of care. But getting the family involved even if from afar was the answer.

Sorry to ramble on, but patients are really vulnerable. There are many ways to stop abuse short of APS.If family is available even if by phone.. get them involved. If not APS is your only solution at this point