I work for an elderly couple. The husband is perfectly normal but the wife does have dementia. I have been there for a year now and she is deteriorating fast. She can no longer walk or stand on her own and only says yes and no every great while. In the last 6 months she has been having seizure like episodes but the doctors can't figure out what's going on. She is deteriorating fast but the husband does not want to do palliative care. She has been in the hospital multiple times in the last 2 months for dehydration and UTI's. Would I be wrong to call Adult Protective Services because she needs some type of extra care?
Do you accompany her to the doctor’s? Next time, ask for a family member to go with you. As “just” a caregiver, you do not have the power to make medical decisions. If you aren’t on the HIPPA (privacy act) form, the doctor can’t even discuss her condition with you.
Who pays you? Speak with that person. Or, if you are employed by an agency, go to your supervisor. If you are privately employed and have no luck making voice contact with their family, find an address for the person who pays you and send a registered letter. Tell them your lady is declining rapidly and you feel she either needs Palliative Care or even Hospice. Share this with the doctor as well. Leave it to the doctor to make the first contact, it share everything you’ve observed. If
I want to add that people have the right to make medical decisions that you or I wouldn't agree with, even ones that might cause pain or suffering. As a paid caregiver you must be able to go along with those choices, if you can't then it might be better to let someone else step in.
It might be helpful to talk to the palliative care agency yourself about the situation - they will surely have had experience in similar situations and may have good suggestions. Even some printed material from them might be a help.
If you think husband is losing patience with you bringing this up, can you find someone else to do it? If finding 'family' is too hard, perhaps a letter to her doctor could explain what you are seeing and the difficulty in dealing with it. The doctor can't talk to you about it, but it could alter what questions they ask and what they actually see. You could even make the letter anonymous if necessary. But Ahmijoy is right - you don't want to appear to be talking about abuse and neglect.
Good luck!
If you work through an agency this should be brought to the attention of your supervisor, manager or other person that can contact the husband and have a "care plan meeting" When I was using an agency for caregiver for my Husband they would come at least 2 times a year to discuss his level of care, how he was doing as well as how the caregivers were doing.
If you are working privately you might want to have a discussion with the husband that you think that more help is necessary. For her safety as well as yours. If things continue the way they are that you will have to submit a resignation. Tell him you will give him time to find another caregiver. I think wording it this way he may realize that you are serious and that it may be a safety issue for his wife.
If you know of a Hospice group tell the husband you can call in a "friend" that will discuss options. Tell him that the service will be free (Hospice would be covered by Medicare) and that the supplies and any equipment would also be covered. Palliative care is not free although some may be covered and not all the supplies and or equipment would be covered.
It sounds like he may be not just overwhelmed but also in denial about how ill his wife is.
If there is family close you might want to talk to them as well or they may be caring for Mom after Dad has died, many statistics show that caregivers die before the person that they are caring for due to stress and not caring for themselves.
But where's the hospital? The woman has been in hospital multiple times in last 2 months. I'm assuming that she's a Medicare patient. Hospitalized are penalized if patients are readmitted within short periods of time with the same diagnoses. She should be getting home health nurse visits at least weekly. Where are those who should be helping this woman?
That said, it doesn't sound like the right step in this poster's situation. The elderly lady is already under close supervision from healthcare professionals, for one thing; and for another it would be better to think specifically about what additional care is needed.
What is not being done for her at the moment that you would like to see done? What has the husband got against her being assessed for palliative care? A rose by any name would smell as sweet - rather than pushing the whole package, concentrate on particular tasks and see if you can get him to accept more help with those.
And is it clear that the health care workers, doctor, hospital staff, are actually aware of the true situation?
When they ask the husband about the situation at home, is he honest and accurate? Wife may not be getting the care she needs - many men of a certain age are clueless about this.
The APS mission is not make sure that elders receive a specific coarse of treatment. The APS mission is to ensure elders are not neglected (which clearly this woman is not) and receives medical treatment. The doctor, who should/could know a lot more about this couple and the wife's medical condition than the caregiver, is the person who does any mandated reporting.
BTW - the husband does not owe this caregiver any explanation of his decisions either. He has a right to privacy and so does his wife.
However, with all due respect, I wonder if you know what "extra care" you think the government is going to provide? And at what cost to the couple...finanically, emotionally and health wise
Everything in life has a price.
Are you aware of what "palliative" care is?
Its bombing people out with a very potent cocktail of narcotic drugs...to the point that they are passed out. This old couple have spent their lives "together"...loving each other. They share a home together.
You say the husband is healthy. And he hired you to help out.
So perhaps a good approach would be to help keep the lady hydrated and healthier
Apply the Golden Rule
Be the change you want to see.
My Grandpa often tells me "Get it done yourself"
There are a couple of simple inexpensive things you can do to help her
a. Distilled Water. Buy some $1 bottles of distilled water. And find out what her favorite fruit is...ask her....or her husband will know. And put a few pieces of the fresh fruit &/or a few sprigs of fresh mint into each mug of water. And keep giving her the fluids. Count the cups the days you are there. At least 6 cups.
This will make her urinate more...of course. However, the body is 98% water and in dehydration the brain shrinks so her problems will be much worse.
B. Herb teas
Corn is in season now. You can buy a few cobs of organic corn for little money.
Im sure the husband will pay for it if you explain
Strip off the silks...(the long hair parts). Bring 2 pints of distilled water to the boil
Add the silks of 3 or 4 corns. Let sit 20mins or more. Strain off. And give to the lady to drink. This taste of almost nothing & is very soothing to the inside of the body. And will soothe the bladder & help prevent & treat bladder infections.
C.
Nutrition is very very important
The key is ORGANIC foods. You will find when you go to the farmers market in your area..especially towards the end of the market day you can get good deals on fresh produce
A CROCK POT is a cheap and wonderful investment. My friend found one at a thrift store for $12. Its just a matter of chopping up lots of fresh vegetables, rice, beans, chicken cover with chicken or vegetable stock (avail at Trader Joes ) Turn on low & leave for 12 to 24 hrs. Then they will have a nutritious and tasty fresh food that will last a few days. Store in fridge or freezer in boxes they can heat up as needed.
These simple inexpensive ideas will improve the quality of life for this dear couple (& yourself if you use the ideas) more than you can imagine.
I work in medicine. Now only practicing holistic medicine