Amy’s Life in Brief


When is enough enough?
November 25, 2008, 3:31 am
Filed under: Uncategorized

I’m dealing with a tough case at work.  And I’m wondering if there is anything that we can do about it.  In this particular case, it is a patient and a family member who has provided care in the past.  There is no question that this person provided good care.  At this point, though, the patient probably actually qualifies for hospice.  The family member is wanting very, very aggressive treatment.  The doctors who have been handling the case (there have been at least three or four as the hospitalists go through their shifts and rotations) have essentially bowed to every wish of family member due to this person’s very confrontational manner.

The family member’s wishes have shifted about as often as the wind has shifted.  I’ve made the determination not to speak with this person one on one.  I’ve listened to this person twist the words of other staff members and flat out lie about what was said.  So, I will not meet with this person unless I have a witness.  This person strikes me as either having a personality disorder and/or a substance abuse issue.  As I watch what is going on with this patient, I’m left to wonder if there is some measure of financial exploitation going on.  In spite of the patient’s wishes of not receiving certain forms of treatment the family member is demanding these things.  The doctors have bowed to this family member’s wishes, I think, due to fear of litigation.  These treatments are extending the patient’s life.  I feel the family member is wanting to extend the patient’s life because the patient’s social security check is going to the family’s checking account.  

While I can understand the problems faced by family members when they take care of a loved one who is ill and disabled, I am having definite misgivings about this situation.  The patient is refusing what they can (which is very little) and this is what has precipitated the additional treatments demanded by the family member.  But, I don’t know that it could ever be proved that the family member is demanding very aggressive treatment due to the financial aspect of their relationship.  One doctor suggested it is because of the family member being unable to accept that the patient will die.  I don’t entirely discount this, however this family member spends very little time at the hospital.  They come to the hospital only when it appears that the patient will be discharged to a nursing home (which would necessitate a redirection of the patient’s funds to help defer the costs).  I am at a loss as to where to go.

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4 Comments so far
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Well, you can’t accuse the family member outright of financial abuse. Perhaps an adult protective services referral? I’m not sure they can do much, but at least it will be some action you can take.

Comment by Reas

Almost everytime there is an unreasonable family member there is money involved, or some sort of skeleton in the closet that hasn’t been addressed. Almost everytime. It’s hard to take isn’t it? That said, if there isn’t some sort of evidence that can be presented to protective services they aren’t going to do jack. I feel so bad for these patients with their wackadoo families that can’t get their heads together enough to see that they are causing suffering and the white coats that can’t say enough is enough.

Comment by lcswmom

I doubt that we’d be able to come up with enough proof that this is all driven by finances. And after dealing with this person I don’t think that is the only thing driving their behavior. I definitely think the finances are a big portion of it but I really think there may be some sort of mental illness going on. I’m on by myself tomorrow, Friday and Saturday, covering the whole house. So, at this point, I’m just hoping that nothing stirs them up between now and Monday. And it’s entirely possible that the patient may take care of all of this by having a celestial discharge.

Comment by oregonamy1972

You know, I have to do some of these investigations and often find my gut shouting a lot louder than any proof. It’s hard because obviously the action you can take is very limited in that circumstance except making sure than your own supervisors are aware of your doubts. I hope it all settles for you in any case.

Comment by cb




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