Thursday, December 17, 2009

A SAD STORY (begun 12/17; finished Sat. 12/19)

This situation may not be all that uncommon, although I hope I'm wrong. It involves a retired, respected professional in the health care field and his independence; and his capable, caring adult daughter with an extraordinarily busy life. And stuff that can happen, but shouldn't.

Rodney, divorced, and in his early 80's, was living happily by himself in a condo in a very nice southern California suburb. Because of his profession he had many friends who valued his wisdom and kind ways. But he was increasingly seeming "spacey,"-- "dementia-like" to those who knew him well. He appeared unsteady on his feet at times. Close friends obviously noticed this and may have attributed it to his age. (We've discussed how people hesitate to "rock the boat" in a previous post.) So the reasons for no one questioning this physical and mental change could be many.

One day Rodney took a bad fall in his apartment. A neighbor heard his call for help and phoned 911. At the local hospital where supposedly they did a full evaluation to determine the cause of his fall, his daughter was told he needed assisted living. She quickly and efficiently made arrangements for assisted living, but it was soon evident that Rodney needed even more help so a private aide was hired to be with him. More falls, more trips in and out of the hospital. No one understood the cause, only the effect as Rodney became more and more frustrated and, at times, unruly.

Assisted living could not provide the care Rodney required. So his daughter located a group home with adequate staff to watch him and prevent more falls. The superviser of the home, a thorough person, had a hunch... that medication could be causing Rodney's problems. It then surfaced that Rodney (who could legally write prescriptions), had prescribed a medication commonly used to aid sleep for himself. Rodney had no primary care doctor (unrelated specialists treated him). And evidently prior to the "hunch" no one was aware Rodney was taking this medication and that it could produce the side effects Rodney was experiencing.

The good news: the group home's superviser put Rodney on a new medication. He's himself again; he's much steadier on his feet. The bad news: he has nothing in common with the residents at this group home. He doesn't like living there. But during these many months his efficient daughter quickly sold his condo because, she was told, he could no longer live alone and because funds were--and would be--needed for his care. Rodney has no condo to return to.

Initially his daughter was glad to see him cared for, didn't wanted another upheaval, and thought she would have peace of mind. But with new medication, Rodney made it clear he had no reason to stay in the group home.

A bad start, lack of information, incomplete knowledge, inaccurate assumptions, and a busy, caring daughter's well-meaning quick fixes. Upon rereading this story, it makes sense that people, who have--or have given--power of attorney and/or health care proxy responsibility, reread and share the "Key Thoughts" (see sidebar at right). In addition:
1. It would make sense for adult children to have a current list of parents' medications.
2. Getting help from an experienced geriatric social worker would most likely have reduced stress on the busy daughter and led to well-thought-out changes with a quicker, better outcome.
* * * * *
Oh yes, Rodney did move from the group home, but much time had passed and other problems arose, so he moved to an assisted living facility.

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