What to do?

[mysticalmoonray]

I'm a home health nurse for an elderly woman who lives at home with her husband. He gets very jealous over her health issues and tries to gain attention away from her by complaining about pain, difficulties breathing, and feeling that he 'has pneumonia'. I do however try to take a few minutes to remind him of medication that he has at home to help with his pain, to take his inhalor as directed which is why he's wheezing, and I've listened to his lungs, there are no wheezes. However I tell him if he feels that his health is at risk to seek a physicians care.

While caring for the elderly lady and her various ailments, I've noticed a severe change in her mental status. On three seperate occasions, the more recent being today she's made reference of wanting to die. I've talked to the physician about this however when he talks directly to her she states shes fine. She's recently injured an old shoulder injury due to 'tasks around the house' where her husband directs her to do heavy lifting outside instead of waiting to call her son who is in his 30's to help. Her husband gets very upset and throws tantrums if she doesn't do what he wants her to do whenever the idea arrises to him. Now she is small framed and petite while he is well over 350lbs. She's voiced a bit about distress of his words and ordering her to do things. She is in charge of all household chores when I am not there to help her, he will not assist. She in turn also has to help him stand, dress, bathe, and other ADLs. Again when its brought to the doctors attention she denies it.

I've seen such a drastic change in her character within the last month. She's a proud woman who does not like to complain or ask for help, however she's been stating how she wishes the pain and misery would end. The light in her eyes is dim, and she seems like she's just existing doing whatever her husband orders her to do.

Now I'm in no way questioning the physicians call, however I'm asking for advice to what possible things I may be able to do to help this poor lady. I'm tired of seeing her health fail more each time I visit, and the abusive verbalization from her husband are the worst I've ever heard. I've asked my work place and they tell me to just continue to do my job. However I feel that as looking out for my patient's well being that I should seek out whatever I may be able to do I'm just not sure of what paths to take.

[nursel56]

It sounds like this case merits a call to Adult Protective Services. In my state we have mandatory reporting, which means that notifying the doctor isn't enough. We must call them ourselves if we suspect someone is in an abusive environment. To me the shoulder injury is a huge red flag unless you actually saw it happen. I feel for the elderly lady - how frightening must her day be under such circumstances! She really needs you to advocate for her. Very best to you, it's awful for all concerned.

[HmarieD]

If you are a mandated reporter, you must report this to social services.

[tinyRN72, BSN]

I was just about to make the same suggestion, but two have already beat me to it.

[jammycakesRN]

I've made several reports to APS. They've never done anything to help. And if they interview the lady & she denies the treatment to them (like she does the doctor) they won't help her either.

[mysticalmoonray]

Well I reported it, I'm just hoping they do something about it. I'm thinking of even trying to get proof from family that comes to see her, he still is verbally abusive in front of them. Thank you so much for your help.

[St_Claire, ADN, RN]

Well I reported it I'm just hoping they do something about it. I'm thinking of even trying to get proof from family that comes to see her, he still is verbally abusive in front of them. Thank you so much for your help.[/quote']

You don't need to get proof but you can give them contact info for all people that may support your case.