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Kooky Korky 31,578 Views

Joined: Feb 12, '10; Posts: 3,975 (53% Liked) ; Likes: 5,505

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  • Jul 19

    I have a soon-to-be- former patient who can walk short distances with walker, has hard time getting back into bed.
    Can toilet alone. Cannot do even the lightest cooking because she can't let go of the walker long enough to, for instance, make a sandwich or heat a can of soup. She can't reach out to the porch to get the mail.

    When you take longer to heal than Medicare allows, when you are fast going through any reserves you had (to pay for utilities, food, mortgage, a helper for a couple of hours per evening for a couple of times per week, what do you do?

    What do people in this situation do? Go live with friend or relative? Sell whatever they can sell and then become homeless and live under a bridge?
    Get arrested and be grateful to be in jail? Say you're suicidal and get admitted to Psych?

    How do the 100 days allotted by Medicare get renewed or extended?

    I have suggested trying to learn resources, if there are any, by talking with a Medical Social worker and with a Case Manager but don't really know how to find these people except to start calling hospitals and insurers. Kind of hit and miss, no?

    Pt could probably rent her spare bedrooms and her garage space, sell a car, sell jewelry, guns, furniture, or whatever she might have of value.

    Any thoughts on this? Like why America, the greatest country on Earth, stinks when it comes to health care. I already know the answer - $$$$$.
    Insurers' profits. I guess. Or am I missing something in my cynicism?

    She never even offers to reimburse for food that people go out of their way to bring her, or for some small but nevertheless real expenditures at WalMart on her behalf. Does she conveniently forget or what?

    The County I live in has an extensive Senior Services department, her County does not. I've thought about checking with various religious organizations and homeless shelters.

    I doubt she qualifies for Medicaid and she says she can't afford to enter a facility. That seems to leave the old cardboard over the heating grate or the park bench.

    Any help you can think of would be much appreciated.

  • Jul 19

    Quote from elkpark
    Doesn't your agency have a social worker who would be knowledgeable about the answers to your questions and be able to direct this individual?
    Yes, there is one. I have spoken with her about this pt and she is planning to do a reassessment visit with her soon. She's working on getting a doctor's order for the visit.

  • Jul 19

    Short answer: yes, I think so.

    Probably depends on circumstances, such as self-defense vs. drunk as a skunk and provoking someone else, history, and what state, maybe more factors.

  • Jul 19

    Quote from Rocknurse
    I'm glad to see us oldsters ruling the roost!
    Yes and no. Will there be enough replacements with adequate experience when we sail off into the big R?

  • Jul 19

    Since right after The Flood.

  • Jul 19

    Quote from Rocknurse
    I'm glad to see us oldsters ruling the roost!
    Yes and no. Will there be enough replacements with adequate experience when we sail off into the big R?

  • Jul 19

    Since right after The Flood.

  • Jul 18

    Quote from JKL33
    Your actual role in this scenario is to request a SW consult through your agency. Maybe visit SSA or other agency to gather information. If you have extensive senior services in your county, I don't think it would be out of line for you to visit some resources there and find out information that could apply to an individual in a different county (info about M'care, SSD, recommended lawyers, stuff like that) - - if you wish to volunteer time in this way.

    I have sort of chastised a few coworkers before for being really angry that family members declined to come to the aid of some of our elderly ED patients. Coworkers can't imagine what kind of a sick, selfish individual doesn't come to the aid of their elderly family member when needs arise. Well - - sometimes it has to do with what all has transpired in the past 60+ years. It's very sad to witness but sometimes it is just no one's fault. Sometimes it's actually due to relationship choices the patient freely made earlier in life.

    You can't allow yourself to be guilted into putting yourself in the sort of position you're talking about. As the sometimes "resident warn-er" I will add that these situations are often not safe for parties such as yourself in the midst of family dysfunction. What happens when you volunteer time and possibly personal funds to continue helping this lady and they find fault with what you do (or don't) do? What happens when it's not enough and they make a complaint about something? What happens when she deteriorates under your (unofficial) watch? Or her needs conflict with your/family's needs? You're still an RN and that will sensationalize whatever way this goes wrong.

    I say you take a few steps to gather information and present it to them; names, entities, etc., where they can consult for help with their situation. Don't forget her PCP office (or the office of whomever ordered the services you are currently providing)!!

    After these efforts, leave with a clear conscience.
    You are so right. No good deed goes unpunished, that I have already learned in life, LOL.
    And yes, we are often not knowledgeable about how relationships have gone in the past, what grudges have been existing for decades. And sometimes people truly want to help but time and other obligations, like work, kids, one's own health, just don't permit. I don't blame Burnout. She has a lot of other obligations and she has, as far as I know, been a tremendous help for the past few years when this pt had another long course of illness and during this current illness.

  • Jul 18

    Quote from Rocknurse
    I'm glad to see us oldsters ruling the roost!
    Yes and no. Will there be enough replacements with adequate experience when we sail off into the big R?

  • Jul 18

    Quote from JKL33
    Your actual role in this scenario is to request a SW consult through your agency. Maybe visit SSA or other agency to gather information. If you have extensive senior services in your county, I don't think it would be out of line for you to visit some resources there and find out information that could apply to an individual in a different county (info about M'care, SSD, recommended lawyers, stuff like that) - - if you wish to volunteer time in this way.

    I have sort of chastised a few coworkers before for being really angry that family members declined to come to the aid of some of our elderly ED patients. Coworkers can't imagine what kind of a sick, selfish individual doesn't come to the aid of their elderly family member when needs arise. Well - - sometimes it has to do with what all has transpired in the past 60+ years. It's very sad to witness but sometimes it is just no one's fault. Sometimes it's actually due to relationship choices the patient freely made earlier in life.

    You can't allow yourself to be guilted into putting yourself in the sort of position you're talking about. As the sometimes "resident warn-er" I will add that these situations are often not safe for parties such as yourself in the midst of family dysfunction. What happens when you volunteer time and possibly personal funds to continue helping this lady and they find fault with what you do (or don't) do? What happens when it's not enough and they make a complaint about something? What happens when she deteriorates under your (unofficial) watch? Or her needs conflict with your/family's needs? You're still an RN and that will sensationalize whatever way this goes wrong.

    I say you take a few steps to gather information and present it to them; names, entities, etc., where they can consult for help with their situation. Don't forget her PCP office (or the office of whomever ordered the services you are currently providing)!!

    After these efforts, leave with a clear conscience.
    You are so right. No good deed goes unpunished, that I have already learned in life, LOL.
    And yes, we are often not knowledgeable about how relationships have gone in the past, what grudges have been existing for decades. And sometimes people truly want to help but time and other obligations, like work, kids, one's own health, just don't permit. I don't blame Burnout. She has a lot of other obligations and she has, as far as I know, been a tremendous help for the past few years when this pt had another long course of illness and during this current illness.

  • Jul 18

    Quote from MunoRN
    If it this point she cannot live independently and requires some level of nursing home placement and has too many current assets to qualify for Medicaid coverage for nursing home then she would have to do a "spend down" until she qualifies.
    Being single, she is allowed to keep her house, she says. She has no car. I don't know and don't want to know what other assets she has.

    I am not nearly as involved in her life as I might have seemed to be at first. It's just that she keeps c/o how hard it is on Burnout. I do think I need a different assignment.

    I have never given or lent her money, have no intention of doing that. I am not involved in her finances whatsoever. I think that is not a good idea at all. And I don't run errands for her, like pick up stuff at the store even if I am going there. I just don't think it's good to get into these habits. It is hard, though, to resist, as previous staff have done this for her, she says. Now, with me there, poor Burnout has to do it all.

    And I feel guilty, despite knowing I needn't feel guilty, wondering if it would be wrong to pick up her Rx or food or whatever if I'm going to that store already for my own personal biz. My job does discourage but not forbid this behavior.

    I think they hope we will just do it and not mention it because it does help the clients. However, it exposes the workers to accusations of mishandling monies, might even bring driving liability if an accident occurs while we are running errands for patients.

    I really appreciate all the good advice I have been given so far. Many thanks to all!

  • Jul 18

    Short answer: yes, I think so.

    Probably depends on circumstances, such as self-defense vs. drunk as a skunk and provoking someone else, history, and what state, maybe more factors.

  • Jul 18

    Quote from Rocknurse
    I'm glad to see us oldsters ruling the roost!
    Yes and no. Will there be enough replacements with adequate experience when we sail off into the big R?

  • Jul 18

    Since right after The Flood.

  • Jul 17

    Try to test out of a class or two.

    Go to school outside the US, like the Caribbean.


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