Pear-shaped

It's days like these where I remember why I am an OT, and why I love being an OT, but it's days like these that also burn me up. We had a patient come in for a Continuing Care Assessment...which essentially means, someone is petitioning for the person to be admitted to a nursing home. As in the US, this requires the person's consent if they are mentally competent. So he would need to be informed at some point that his wife and social worker are trying to place him in a nursing home. Actually, he is supposed to be informed that the interdisciplinary assessment process he went through today is one to assess whether he cannot be cared for other than in a nursing home. But he had no idea that he was being assessed for a nursing home! As far as he is aware (because we didn't bluntly say, oh well, we're trying to see if a nursing home would be appropriate for you), there are no plans for him to live anywhere but at home with his wife.

I did my assessment in conjunction with the physios, or at least, the functional part (and yes, this is unusual unfortunately)...and discovered he was able to do sit to stand transfers from his wheelchair independently, and stand independently with a rolling walker! Beyond that, he could move about 5 feet with a slow shuffling gait, a rolling walker, and contact guard assistance. The difference between nursing homes here and those in the States is that a nursing home here is for people who are totally dependent for all care, and once they enter a nursing home, they will pretty much be bed-bound (that's how it's been explained to me).

Meanwhile, this man told us he hasn't walked in about 18 months- ever since he broke his leg. He does have a degenerative neurological disease, but the physios and I definitely see room for functional improvement! He deserves a trial of rehab at least, and as he only has carers twice a week for 30 min (crime), no wonder his wife feels like she can't cope! They don't have the support they need. While I'd like to call up and scream at the social worker, what I will do is discuss the case with his assigned doctor at the day hospital on Monday, and ask to make a referral to inpatient rehab ASAP- meaning Monday. Hopefully they will accept him for rehab (those therapists have to do their own assessment first), and hopefully he will improve with some intensive rehab. Meanwhile, his wife can get some needed respite.

Blast the social workers who always take the easy route, and assume we will rubber stamp people into nursing homes if they're sent to us for continuing care assessments!!

Phrase or word of the week: "Pear-shaped" as in, this poor man's world will go all pear-shaped (upside down) if he realizes someone is trying to place him in a nursing home, and that his wife is aware of the possibility.