I am writing on behalf of my mother who is a HHA, she is having a dilemma with one of her patients. My mom works for an agency. So she is scheduled to bathe this patient, so my mom works 2 hours per day with her. But this is through the senior alliance, that's where the patient gets her hours from, so it's not like there is a nurse there to re-assess her and stuff. It's not like a typical HH private agency.
Background: The patient is an elderly female, with COPD, Type II diabetes, Urinary and bowel incontinence and IBS. She also recently had a stroke and since then, her cognitive processes haven't been all that great.
My mom is scheduled to work in the evening with her, every single day that my mom comes, she has not taken any of her meds. Her blood sugars run through the roof. She's been in the hospital twice the last 6 months for DKA.
She is on oxygen. She smokes, and not only does she smoke but she will chain smoke, oxygen tank next to the couch.
She has several holes in her couch and her bed where she has fallen asleep with lit cigarettes. Small fires have had to been put out because she leaves food burning on the stove.
She falls at least 2-3 times per week. She keeps her cell phone in her pocket to call my mom in case of emergency. My mom usually goes to go help her up, if she can't make it, she'll call the fire dept and they come pick her up.
Every single time my mom is there, she spends AT LEAST 4-5 hours there because the patient moves at a snails pace and my mom ends up getting out the carpet cleaner and cleaning the turd trails on the carpet and pee spots from her incontinence (patient refuses to wear depends, saying that she doesn't have a problem.) My mom isn't paid for the extra hours (and the agency can't get any more approved), but it is just against my mom's ethics to leave her there sitting in excretement.
The patient has 2 sons and 2 daughters. Both of the sons won't speak to her. One of the other daughters will call ONCE in a blue moon. The other daughter comes every now and then to re-fill her meds and drive her to dr's appointments. The daughter that does see her is so stressed out because she's taking care of kids and working 2 jobs... one day she was at the apartment with her mother and just got so frustrated, she was giving her a shower, and leaned over to her and said "I just don't know what to do anymore. I just wish you would die!".
That daughter does the little that she does and only has power over her finances. She does not have medical POA.. she can't make medical decisions for her mom.
The patient thinks that everything is fine and dandy and that she can take care of herself... that's how "off" she is.
She currently lives in govt subsidized housing, so they are senior apartments, but it is not assisted living.
I told my mom she needs one of many things, either assisted living, LTC, or those kids and her need to put money together and get her AT LEAST a 12 hour per day private aide.
I don't really know what is going on with the docs, but I'm wondering what can be done in this situation? could a doc get her approved for an LTC? Can this patient really be allowed to smoke with oxygen tank? Isn't this putting OTHERS in the building at risk? Would it be appropriate to call adult protective services? The agency won't do anything, they don't feel like meddling into the family issues.
