Hi all
Another week on the gerontology ward and another lesson for me about just how difficult life can be for some of my patients. Last friday i discharged three patients. They had a number of different issues, some of them still with medical rather than mobility issues. I'm pretty conservative, so no patient gets my ok to discharge without me being well and truly satisfied that they are safe to go. Anyway, two of these patients were re-admitted (one through ED) the very next day. It was reported that one of them had suffered another fall. The other had another cardiac event. Obviously, to hear that one had fallen again so soon after DC left questions as to her safety for DC in the first place. Questions were asked. This patient was admitted to another ward, but my supervisor (who is very supportive) went and did some investigating. The truth of the matter was that the patient was re-admitted with a UTI, and in fact the hostel that she had returned to (she has been a resident there for 10 years) had decided that they were unable to provide the level of care she requires, so had her sent back to RPH. There had been no fall. This is not just a story about me being in the clear regarding discharging a patient. What was annoying was that we had done alot of rehab with this person, so much so that her mobility on DC was better than her pre-morbid status. Also, her mobility was much better than that required by the hostel as part of the criteria to return to their facility. But, somehow the facility must have changed their criteria overnight.
I think you can see a theme running through my last few posts. It has to do with the fact that gerontology is so much about finding somewhere to put someone. Sadly, it is not a very consultative process, and the wishes of the patients seem rarely to be taken into account. While this is in some ways unavoidable, the attitude of the hostel in question takes the cake. I hope bureaucracy has something sorted by the time I get old(er). Am I getting a warped view of the way our aging population is (mis?)managed? or have some of you felt the same way on your gero clinics
M
M
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Hi Martin
I agree. In the gerontology prac so much is about the team meetings and 'where can the person go' because the hospital admission often seems to be the stimulus for either the family to say that they cant cope or for the care facility to say that they can no longer care for hte client. With the current shortage of placements for elderly people needing care the hospital seems to be a place where they stay until something else can be sorted out, which obviously isnt great for the bed situation. Sounds like you're doing a great job with it all though, keep it up! Is this 3K? If so tell Frances I said hello.
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