Wednesday, October 23, 2013

Social Work in a nursing home

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Social Work in a nursing home can get tricky at times.    Many, many times, even the Administrator gets confused as to what is right and what is legal.  

For instance, one place I worked had a man living there who was a flaming alcoholic.  He would periodically decide to leave, go on a drinking binge with his old cronies and simply walked out of the nursing home to do so.  He was prescribed medications to curb his alcohol craving, but sometimes the cravings proved to be too great and he wanted a few drinks.
One evening, just before dinner, he walked out of the place.  One of the nurses noticed him missing and came to my office.  The next thing I knew, the Administrator was in my office, demanding I 'call the police' to have him brought back.  I tried to explain to the Administrator that since the guy was coherent, which meant he knew exactly what he was doing, the police would not drag him back, kicking and screaming.  Sometimes you have to explain that nursing homes are not prisons.  Some staff members think all residents have to adhere to all rules, like a jail, not so.  Now a nursing home can, and sometimes will, kick out a problem resident, but they cannot just kick them to the streets without making arrangements for their safety.

The Administrator didn't like that I refused to call police to drag him back.  She picked up the phone in my office, called them and then hung up a few seconds later.  I asked her what the police said.  Her reply: "They said what you just told me."  Uh Huh.  The best they could do was a well being check, not much more.

I would get told, often, by other staff that: "So and so cannot call a cab to go shopping, go home or for other reasons."  I beg to differ.  I'm telling you that they can do that.  The nursing home is supposed to be their home, not a prison by a long shot.  

If anyone does go home, AMA, against medical advice, Medicare can cut them off for services for a time and all you can really do is call Adult Protective Services to check on their well being.  Not much more if that elderly person is coherent and knows what they are doing.  

When a nursing home tries to act like a resident does not have the same rights they have in their own house or apartment, you must explain to staff that they do retain those rights, like it or not.