Tis a puzzlement

So, here's an interesting tidbit. A patient of mine "Sally," was recently released from the nursing home rehab center after having surgery on her back. After her surgery, her family, which consists of a sister and some nieces and nephews really pushed for her to go into an assisted living home. Sally didn't want to leave the home that she owns and worked hard all her life for. So she went back to her home and has been under the care of our home health nurses for the last few weeks. Her nurse referred me to her after she started talking about how she doesn't have any food or money.

Sally is an interesting woman. She likes to have people take care of her, and she is very limited in what she can do, yet at the same time she insists that she does not need help. It's kind of a puzzlement to me. Sally was also very affluent in her earlier life, and she is used to having all kinds of luxuries that she does not have access to anymore. She is frustrated with herself for not being as independent as she used to be. Her family is frustrated with her for not listening to them and moving to an assisted living facility. Her nurses, occupational therapist, and I are all a little frustrated with the whole situation because she has a right to stay in her home if she chooses, but we can see how enhanced her quality of life would be if she chose instead to move to a place where she could get the care she needs. The nurses and therapists are ready to dscharge her, and once they are gone, I can't continue to see her. But I can't in good conscious leave her alone in her home with no assistnce or care. I don't think she'll realize how much help she really needs and make an effort to get it until we discharge her, but I don't feel good about discharging her until she has that help. But she won't ask for it until we're no longer making visits.

Posted in: hospice,social work ethics