I think I'm right, but..

[Purple1234]

About 6wks ago I took a private-pay job which basically was just every day giving patient meds and visiting with patient. Within 2 weeks my opinion was that she needed to be placed in assisted living or have live-in help (one fall that led to her being transported to ER--nothing ended up broken, and then two instances Im aware of that involved her driving while in a confused state). She previously had a home health agency nurse tell her the same which is why I was hired--patient didnt like them.

I contacted the daughter (only child who is several hours away) and told her my concerns, but she is either in denial or just feeling overwhelmed because she did not share my concern. Three weeks ago I gave my resignation letter due to I don't think it is safe for her at home alone (I'm only there 20 min a day). Now the patient is refusing to go to assisted living, the daughter claims she can't find anyone to come in and help her mother and wants to know if there is any way I will continue to care for her mother--she will pay me whatever I want.

I am feeling torn between that if I dont continue to work for this family, this lady (90+ years old) may not have anyone to make sure she does take her meds correctly and that maybe this may be the step needed to get the patient either into assisted living/live in help.

Any advice appreciated!

[SDALPN]

Don't use your emotions to make your decision. Don't be manipulated by family. Stand firm on your decision. Call adult protection services if you feel like she is not capable if caring for herself independently and her kids refuse to handle it appropriately. I'm a peds nurse, and don't normally work with adults. So there may be other resources as well that I'm unaware of. Maybe you can speak with her pcp or social worker about your concerns as well. You sound like you are trying to do the right thing. Just make sure you protect your license.

[mariebailey, MSN, RN]

I understand your concerns. I think part of our job as nurses is to refer/link people to other services when needed. I know some states have programs that will actually pay for things like adult daycare, home health services, transportation to medical appointments, residential care, & the list goes on. Call your local social services or health department if you want to inquire about them; you could also just google "Virginia (or whatever state) Medicaid long term care" to see what's out there. Good luck.

[Purple1234]

Thanks for your reply. I gave the daughter the contact info for local area on aging agency and told her that they could help with referrals on who could possibly help. She said her mother doesnt want government involved so that it wasnt an option.

I'm at a loss and am afraid contacting adult protective services may be the only option

[SDALPN]

Thanks for your reply. I gave the daughter the contact info for local area on aging agency and told her that they could help with referrals on who could possibly help. She said her mother doesnt want government involved so that it wasnt an option.

I'm at a loss and am afraid contacting adult protective services may be the only option

Either she gets help or the gov will step in anyway. And then she could face legal problems. Our job is to look after the best interest of the patient. If the patients basic needs aren't being met, other interventions are needed.

[caliotter3]

Do not submit to manipulation. You are right. Perhaps you refusing to work under these circumstances will be the impetus needed to get the lady the assistance she so sorely needs. Go back and you are asking for consequences you may not like.

[Purple1234]

Thanks everyone--I feel better about sticking to my decision now

[NutmeggeRN, BSN]

Thanks for your reply. I gave the daughter the contact info for local area on aging agency and told her that they could help with referrals on who could possibly help. She said her mother doesnt want government involved so that it wasnt an option.

I'm at a loss and am afraid contacting adult protective services may be the only option

Don''t be afraid that Elderly Protective Services may be an option, be thankful!

[ktwlpn, LPN]

Assisted living,long term care or live in help will not prevent her falls. It's likely she will fall and suffer an injury with life ending complications.

Why not assist her and her daughter with getting the services in place to honor her wishes and help her remain in her home as long as possible? Maybe they are willing to expand your hours?

If she is in a detached home and not going to burn down the block with her,why shouldn't she stay as long as possible? It seems they are willing to take the risks (not taking meds regularly,safety,etc)

Driving is another issue,that needs to be stopped asap. If the daughter won't take the keys and stop her you need to call adult protective services. They can also help with services in the home.

Set her meds up for her, call her to ask her to take them (and get paid for doing it)

Help her shower

Take her to the grocery store,beauty shop etc.

When the inevitable happens it will NOT be your fault. She is making the decisions.

[amoLucia]

I also have serious concerns about this lady's unsafe driving status. I think State Motor Vehicles Depts can help if someone is reported as unsafe.

I don't know which community you come from, but I would hope that none of my family, friends or me are on the road when she is!

[poppycat, ADN, BSN]

I also have serious concerns about this lady's unsafe driving status. I think State Motor Vehicles Depts can help if someone is reported as unsafe.

I don't know which community you come from, but I would hope that none of my family, friends or me are on the road when she is!

I don't know about other states, but on Illinois, the DMV will NOT help with this even with a doctor's letter.

[poppycat, ADN, BSN]

In my area, Catholic Charities has a lot of resources for seniors. If they don't have what someone needs, they can usually find sources that do.