Hoolahan, sympathize with you---had 3 or four visits like that. Draining, exhausing re communication time spent all because NOT set up properly at hospital discharge or DME company dropped the ball. I' ve been on both sides and as intake RN am constantly amazed at piece meal info given to us. Barbara and I in my office pride ourselves over orienting via phone all the NEW case managers on the Rehab and SNF units at our local facilities, ESPECIALLY Social Workers, LOL. Keeping up with the insurance changes each year and which ones will pay for which supplies can be daunting for a new CM with no homecare experience.
Ross cheap plastic bags WILL NOT RUN on a flexiflo pump, I've tried it too.
A PATIENT can almost ALWAYS request a change of DME company if non-responsive to your pt's needs.
My longest case tops you by an hour. Had a 92yo bedbound confused, man (foley, COPD/Pneumonia and small stage 2 sacral decub) with 68 yo wife...both were on home care (wife developed pneumonia too). Living in one bedroom apt was 19 yo granddaughter who had just had baby taken away by Children and Youth two weeks prior to this visit and had mental health problems (suspected drugs too). NEVER saw any of 6 children in area despite late afternoon visits.
Arrived at 11:45 AM with HHA. Saw wife asleep on sofa with back to us in LR--no lights on. Husband in Dining room hospital bed complaining of being hungry...course had BM too so aide proceded to wash him while got hot lunch cooking. Could hear 19yo in back bedroom. I'm walking in and out of apt carrying in bag, chux and diapers, Ensure ( DME would supply to patient thru insurance but NOT deliver to patients area, no car for wife, so of course I hoofed it for past two months).
Been in the home 20 minutes when 19yo comes in LR, turns on light talks to grandmom and shakes her, starts screaming "She's dead, she's dead" and is hysterical. Quick check of VS---DEAD and cool, slightly stiff at least two hours. Call PCP, agency and then coroners office as not suspected. 19yo freakin out, calls her friends. I call Office of Aging (COSA)-Cl MGr (who I already conferenced with re lack of food) and Protective services. Located daughter 10 min away who now has SECOND child of this 19yo daughter in her posession and says she can't take in her DAD nor can any other family member.
Minister to husband, gently break news of wife's death while police arrive and await coroner. Went in cabinet to get clients nebulizer meds, and see wife's iron pills and FULL bottle of antibiotics, 7 days old. 19yo says Pt. was afraid to take "death pills". Aide pulls me aside and quietly admits that she stumbled over COLT 45 QT bottle next to sofa upon entering home and she placed in trash can.
Give report to police and coroner while attempting to quiet granddaughter who is now accusing me of her grandmoms death due to those pills doctor prescribed (thank God same PCP....another call to him). COSA Cl Mgr arrives and situation reviewed---daughter agrees to meeting in one hour to discuss case, I'm asked to participate as I have all clinical info in case SNF placement needed. Police recalled to home to have funeral home remove body as 19yo refusing. AIDE extends visit time stay with client---ok'ed by agency.
Quick visit client in area (20 min) then go to Daughters home for meeting---cannot convince her/find another member to take client in. Confirmed 19 yo was treated on PSYCH unit for Drug withdrawal and unsafe to care for grandfather. Lucky, call by Protective can get client moved to SNF in 1 hr as I have all clinical info including recent labs I drew in field chart.
Go back to apartment with COSA CL Mgr. to pack up patients possessions --warned by family that POLICE called a THIRD time that afternoon as 19yo picked fight with neighbor and stranger in car that drove up. CL Mgr. wants my big bodily support, I agree as I need her to pull strings for my other patients. Aide (not afraid of 19yo) relieved from case at 3:45. Emptied foley and gave another nebulizer treatment. Police called +stay in apt with us and subdue 19YO screaming she will care for grandfather, we cannot remove him, as ambulance crew picks up patient. Left at 4:30PM
Irony was wife would repeatedly say to me, her husband would only be placed in a nursing home over her dead body.
NEVER went on that block again.