Sometimes a person will do something and they know it’s not on the up-and-up so of course they shouldn’t be surprised when they wind up experiencing repercussions. But sometimes you do everything according to the book and you still get your wrist slapped. Such was the case last week.

I had a brand new patient, “Anna.” Besides her physical problems (weakness, poor balance), she also had a diagnosis of Dementia. When I called the house to make an appointment to see her, the son answered the phone and, in the course of conversation, said that Mom would be alone in the house when I got there. Since I had never met her before and didn’t know the extent of her Dementia, I asked if she was “with it” enough to answer my questions accurately. The son asked what sort of questions I was going to ask and I said I’d need to know if she needed help with her daily self-care tasks and if so, how much help she needed. The son said she generally didn’t need help with taking care of herself but that yes, she would be able to answer my questions.

I got to the house and the son was right – not only was “Anna” able to respond appropriately, but she was generally self-sufficient and safe with her self-care – except for getting in and out of the shower.

Because her balance was only so-so, I saw that she lost her balance when stepping in and out of the tub shower under my supervision. As in “almost fell on me” type of losing her balance. As a matter of course, I asked if there was a walk-in shower in the home because sometimes it’s easier and/or safer to go in and out of those than having to, essentially, stand on one foot while shifting weight to step in and out of a tub shower. She said that there was a walk-in shower in her son’s bathroom but she didn’t want to use that one.

Tub Transfer Bench

OK, then I’ll change gears…well, they do make something called a tub transfer bench which is a very wide seat where part of it is inside the tub and part of it is outside, so you can sit on the outside, swing your legs over and scoot over but she said she had one of those when she had a stroke four years ago, she hated it and she didn’t want one of those.

Hmmm…now it was getting more difficult. I back pedaled to my original idea, to try to make it more appealing.  I reiterated that she wasn’t safe with getting in and out of the tub shower and the safest thing for her to do would be to try using the walk-in shower – was she sure she didn’t want to give that a try with me? She let me know, in no uncertain terms, that she had already spoken to her son about that when she came to live with him earlier that week (she had been in a nursing home for several weeks after winding up in the hospital. I think she had been living alone before then) and he had made it clear that he didn’t want her using his shower. Not aware of the family dynamics or how much the son comprehended the issue about Anna’s risk of falling, I asked her if she thought it might help if I, as a health care professional, might be able to talk to her son about this, so he would understand that her safety was at stake. She still adamantly refused. Well, just like the customer, the patient is always right and makes the final decision, so I let it go. I recommended that she get a grab bar for her shower and that she always have someone with her to help her step in and out, so there was at less risk of falling. I explained that it was not the best or safest way to do it, but if she wasn’t interested in the other recommendations, it was the best I could suggest she do. And then I documented it all, so if she ever fell in the shower, they couldn’t blame me for not doing my job correctly. Rule #1 in healthcare is to CYA (cover your ass). There weren’t any other needs for Occupational Therapy so I left it at that, without plans to come back.

About an hour later, I got a phone call from the son. He sounded quite angry and spoke very sternly to me, asking how dare I suggest to his mother than she use his bathroom? It was very intrusive, he continued, to do that and I should never, ever again suggest that a patient go through someone else’s bedroom and use a bathroom that does not belong to them. Well, of course at this point I started wondering what was in this bedroom-that-led-to-the-bathroom of his that he didn’t want me to see. I tried to explain to the son that I was only suggesting it in the interest of his mother’s safety because she wasn’t steady, that we never actually went into his bathroom because she said no, and blah blah blah. He continued on that his partner was a registered nurse and was well aware of the safety needs of his (the partner’s) mother-in-law. He then reiterated that I was intrusive for merely suggesting she use his bathroom and I should never do that again. Well, I had no intention of ever seeing his mother again anyway because she had no other issues that required an Occupational Therapist and the guy obviously had something to hide so I just said, “Yes sir, thank-you for the suggestion” and left it at that.

I called my boss to let him know what happened, in case the son decided to call him to pursue the ridiculous situation any further. At one point Bossguy said, “Wow, what are they hiding in their bedroom, a tiger?” but once I told him about the son’s partner being a nurse, he changed his tune…”Oh, I get it. It must be some sort of sex toys, then. That’s more fun than a tiger.” Personally, I had visions of something hanging from the ceiling, probably made with leather, but that’s just me…

But wow, what a hissy fit! Welcome to my world…

 

Advertisements