Quote from AtlantaRN
I was wondering that myself. I had a nursing home patient admission the other day, and the daughter (who was power of attorney said), well "we want as much as we can get). I explained a home health aide can come 5 days a week, but as he is stable, it is normal once a week, but of course the nursing home can call me at anytime to see him. She kept saying "we want as much as we can get."
I see this occasionally too. Usually with people either not able to accept the hospice concept and the idea the patient is dying, or, as in my most recent case, the person had been sick all their lives, married a person who had recent extended hospital and rehab experience due to trauma, and the latter was used to drawing lots of attn to himself and the patient.
I could be there for two hours, leave, and five minutes after the evening crew came on, there would be the call. The RN would go out, and the patient would be peaceful, comfy with no signs described by the CG.
The best spin I can put on this is, anxious about the course of the patient's care.
The more realistic is, related to that unfortunate attitude we see sometimes where people are used to getting lots and lots for free, whether they need it or not, and by damn they are going to get lots and lots from you too.
In the latter situation, explain clearly and gently that more is not always better, that we cannot and should not be in the home more than is necessary to support the family and friends and the patient, that the kind of nursing they envision might be more "hospital" and "hospice," and that the constant intrusion of staff undermines the peaceful process in the home.
Good luck. When it is personality, you are pretty much jammed. Be sure to be gentle and caring, and document in as much detail as you can. These are the ones that will fire you as soon as look at you, and you have to cover yourself, liability wise.