Does Anyone Care?
Ms.’s Obtuse’s neighbor, Red, was admitted to the hospital with a high temperature and delirium. He was elderly, lived alone and had many chronic medical problems. Dr. Kildare received permission from Red’s adult daughter to treat. Initially the neurologist wrote Red was not competent to make his own decisions. Case Manager, Kegan, approached Red’s adult children about applying for guardianship for Red. Red’s daughter reluctantly agreed and started the process at the courthouse.
Meanwhile Red was responding to treatment and the delirium was clearing. He did not want his children to be his guardian. Finally the neurologist agreed Red was once again competent to make his decisions.
When Red was almost stable for discharge, Kegan presented him with discharge options. Red could go to a nursing home for rehabilitation or home with assistance. Red’s adult children rarely visited. They had jobs and were busy with their lives. They could not commit to helping Red at his home or Red staying at their homes. Red was competent to make his own decisions but not safe to return alone to his home and handle his care. He even had to go to and from outpatient hemodialysis. He refused rehab at a nursing home even for a short time. Therefore, at great cost he remained in the acute care hospital (rather than a sub-acute setting) receiving therapy until he was stronger and safe for discharge.
Before leaving, Red stated “I guess I’ll just get a mail-order bride”. Is this an idea whose time has come? How strong is your support system?