And so, in the never-ending roller coaster that is my professional life, last week I had 2 patients and this week I have 5. I would have had 6 but…

She was a nice enough lady to begin with…her recent medical history didn’t have much to do with Occupational Therapy but who am I to question a hospital doctor’s bad judgment? Besides, an Initial Evaluation is an Initial Evaluation – I get paid to do it and there’s always a chance I may find *something* to work on.

Anyway, the house was filthy and the son was…weird. He stayed in the room with us and talked on the phone most of the time, loudly accusing family members of not doing things for him, asking why he wasn’t informed of such and such. Since my back was turned, half the time I couldn’t tell if he was asking something of the person on the phone or of me – he used the same fishmonger-esque white trash tone of voice for both of us.

She had history of Alzheimer’s but still talked a good game – well enough where most laymen or untrained people wouldn’t even be able to figure out she had Dementia. Hell, she was good enough where even I was convinced she was in the very early stages of the disease (and I worked on a Dementia unit for 11 years; I’m GOOD at figuring out their level of confusion). I mean, she even knew how old she was (95). But her son described a different lady…one who thought her husband was still alive but referred to him as her father and who sometimes thought her son was her husband, one who would eat breakfast and then demand dinner two hours later. There was other stuff too, mainly behavioral, but it didn’t really matter…she was still good enough to get dressed by herself (granted, every drawer was labeled: “shirts”, “bras/panties”, etc., but with that little bit of a crutch she could DO IT.), feed herself, comb her hair, brush her teeth, etc. And her arm strength and ROM (Range of Motion – all the different directions her arms could go) were really awesome for a 95-year-old lady. But when she went to the bathroom, she left her walker outside the room (it wouldn’t fit – the doorway was too narrow) and held onto the door knob, towel bar and sliding glass shower door for support – definitely not safe. She held onto the glass door to help her get in and out of the shower too – equally putting herself at risk of falling. I recommended a commode to put over the toilet, and grab bars for the shower and maybe even the walkway from the entry to the toilet/shower area but the son, who had Power of Attorney, was completely against it – even if Medicare paid for the commode, it would be too inconvenient when anyone else had to pee and how DO they find studs in the walls to install grab bars? I told him that a professional would have to install it and they know how to do those things. He said he didn’t think those stud finders were all they were cracked up to be…he’d used one and couldn’t find a beam so he didn’t want someone coming in and smashing all of their bathroom tiles in order to find a stud. I tried to make him understand why his mother was at risk for falling without this equipment, but he kept insisting she was fine. “And those shower doors are fine to hold onto – they don’t move much at all.” Um…yes they do. As sometimes happens, you can lead a horse to water but you can’t make him drink. Usually the horse is a little more quiet about not following through, though – they’ll yes me to death and then just never do it.

With nothing else that would warrant my services, I prepared to discharge her, with recommendations to the son to contact the Alzheimer’s Association for support and education (“I don’t need that. we’re doing fine. I’m here with her all the time. 24/7. I live next door but I never go into my own house because I’m always stuck here with her.” Yeah, no support systems needed there…sigh) and a reminder than he can ask the nurse or the physical therapist with assistance in getting the commode, should he change his mind. And that was the end of Patient #6 for me.

The other 5 patients are fine – Bidet Lady is still on my roster for one more week – she’s a crabby lady and her whole family is afraid of her but, despite herself, she’s improving. I have a lady with a spinal cord injury who I had last year – she’s a nurse by profession and keeps me on my toes, LOL! I just got a lovely lady in her 70’s who has Degenerative Joint Disease – her shoulders are shot and she gets tired quickly so we’re going to work on bunches of adaptations to  make things easier for her. Another 70-something-year-old lady has Multiple Myeloma (a type of cancer) and muscle weakness from several hospitalizations. And I have another lady who I should see after her doctor’s appointment today – she has a badly broken arm from a relatively recent car accident and if the doctor decides that now is a good time to start moving her wrist, she will be mine as well. Never a dull moment, huh? Watch…next week I’ll be down to 1 patient, hahahaha!

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