Can you pick the doctor's and home care provider's race and sex?


My 87 year old FIL is probably in stage 6 or maybe stage 7 of dementia. He thinks is living in the 1940s or 50s. He has always been a sociopath, but with this stage of dementia he has become very sexist and racist. His body is healthy but is mind is almost gone. He refuses to see anyone that isn't male or white. He also refuses to go outside of our home so we must have Doctors Making House Calls give him medical attention. We have requested a white male doctor and nurse but have been refused. We have also requested a white male home provider (we need help giving this man a bath) but have been refused. So, what is happening, this man, who due to his illness of not knowing any better, is being refused medical and home care treatment. He still has rights so I cannot just tie him up and force him to see a black nurse or home provider. Doctors Making House Calls have suggested we drug him so he doesn't know what is happening (she said they made a cream we could rub on his skin to drug him). The result is he is going without proper medical treatment. One last comment, we live in the South, and from what I can tell, home providers in this area do not hire white males. They have told me this, so they as employers are being racist and sexist. I say this is not right - any comments or advise.

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Magnum makes the key point, I think: that although this is distressing and embarrassing, it can't possibly be unique.

I know a patient used to be able to specify the sex of a doctor or nurse; and as far as I know you still can though usually this happens for religious reasons. But your father is then restricting his own access to healthcare, in that broadly speaking he's reducing the availability of staff by 50%.

The racial issue is another matter; and I'm not aware that there has ever been any provision to give patients the right to reject a practitioner on ethnic or religious grounds. But what I am more certain of is that a practitioner is free to refuse to treat a patient who is abusive.

I suggest you try calling your father's bluff and just taking what he's offered. If your father becomes abusive, the practitioner may walk. Or, if he's lucky, the practitioner will put his or her vocation first and be sufficiently dedicated and skilled in treating your father's ilk to be able to work round his prejudices regardless. Your father has dementia. People with dementia are not always a joy to work with, and they should know that. Just make sure you warn them about this behavioural issue in advance.

This bit, though: "Doctors Making House Calls have suggested we drug him so he doesn't know what is happening (she said they made a cream we could rub on his skin to drug him)." Nonsense. On too many levels even to bother explaining.
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Jackjack, your Dad is at a point in his life where he can no longer make clear decisions. Sadly it is like like dealing with a child who is in their terrible 2's. You might need to wait for a medical emergency where 911 is called and trip to the hospital to get Dad his care. Boy won't Dad be surprised how hospitals have changed when it comes to their Staff and their different ethic backgrounds, which I think is great.

My Mom [who was in her 90's] was extremely against anyone who wasn't of her own ethic background and religion. She had learned that from her own parents.

Mom really disliked any doctors who were women, Mom's stock answer was "what do they know, they should be home having babies".... [sigh]. It didn't matter if that woman had outstanding credentials.

When it came to caregivers, many caregivers were of other nationalities, ethic backgrounds, etc. and Mom wanted no part of it. Mom even turned down someone of her own race because the caregiver was as she call it "fat".... [sigh]. Thus my parents had to manage on their on in their home. Until an emergency.

Once Mom passed away, Dad had me call the Caregiver Agency, Mom would have been horrified to know whom Dad picked for his weekday and weekend caregivers. It was great match as they both had a lot in common growing up, and had the same crazy sense of humor as Dad. Yes, one of Dad's favorite caregiver was the one Mom had called "fat", and that caregiver was with Dad for over a year.
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No, your father in law is the one refusing care, not the agencies, who are offering care, just not caregivers he will tolerate. I find it difficult to believe an agency told you they don't hire white males- as said above they can only hire people that apply for the job. Perhaps you misunderstood.

No one is saying "no services until an emergency" - unfortunately your FIL is the one forcing that outcome. What is another solution if he won't cooperate?

This is a tough situation for him and your family.

From what you say, he needs assistance bathing; I guess the family can do that. But when you say he is not receiving the medical care he needs, what care does he need? He has a doctor that makes house calls to treat him so that is an important need that is being met. You say his body is healthy but his mind is gone. What would you do if he needed tests like CT scan or chest X-ray? You may need to sedate him, as his provider suggested.

In this situation there is not a lot of options. I hope it works out and wish you luck.  
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Frankly, it sounds like he needs to be in a memory care unit regardless of their sex or race. I'm sure they have had to deal with men like him before.
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Jack, a person loses their right to make choices once they are are in a stage of Dementia where they are unable to think clearly. That is when the medical Power of Attorney steps in. I had to step in a few times for my Dad as he wasn't make the right medical choices. My Dad's  mind would frequently slip back to the 1940's, too.

As for caregiver providers, the companies can only pick employees from the applications they receive. If a certain ethic group doesn't apply, there isn't anything the providers can do. The providers need to work with the employees that they have. Finding male caregivers is not easy from any ethic group.

I know for my Dad, he was very uncomfortable having a male caregiver ask if Dad wanted a shower, to which my Dad would say no. Dad also said "no" to having a female caregiver give him a shower due to shyness.... well she put her arms on her hips and said "Mr. Bob, I raised a houseful of boys, there isn't anything I haven't seen". That got her and Dad laughing, and he never had a problem with taking a shower after that.
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If your family/FIL is willing and able to pay out of pocket for all of his medical care including house calls so that he has a white male doctor and a white male home care attendant then you/he can pick. It's called private pay and you would be hiring them directly to provide your FIL with services.
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Jack, it's your dad who is refusing the care. If you can find white males who are willing to do the work, I'm sure you can hire them. But if you go through an agency of some kind, then you know they are bound to follow the laws forbidding discrimination. Hard for me to feel much sympathy for people like your dad, who have probably been abusing people all his life, with his racist, sexist attitudes.
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I agree with Countrymouse above regarding this so called skin cream to drug your Dad-in-law. That would make it extremely difficult for the doctor to check him out. Such as it could lower a normally high blood-pressure result.
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I find the issue about drugging through a cream to be implausible and not realistic. Beyond the issue of applying narcotics through a cream, there's the issue of using narcotics in the first place, for what really isn't a medical need.

It's my understanding from someone who is a medical professional that there's been a crackdown and effort to discourage doctors from dispensing controlled substances. Recommending it as if it was a hand lotion raises the plausibility factor to very questionable.
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Jackjack, I think that as a consumer you can pick your providers on any basis you care to, but the burden is on you to find what you want. If you had a long-standing superstition against being waited on by a bald person you could decide not to go to a drug store that employed several bald people. You could drive an extra 20 miles to another place where you haven't ever seen a bald person. If you walk into a coffee shop and the cashier is bald you can walk out again and perhaps try the next shift. You can chose not to be served by a bald person, but it is up to you to make that happen. You can't expect a drug store to not have a bald pharmacist on duty when you need a prescription or a coffee shop to do their hiring to please you.

You can't expect a medical clinic or caregiver agency to only send you redheads or never send you a bald guy, etc. That has nothing to do with the service they provide. If they have a website with pictures of their doctors, you may be able to apply your own criteria, but don't expect the company to do that for you!

I really feel sorry for you, jackjack. What a tough position to be in. Naturally you want to keep FIL calm and avoid confrontations, and yet it is difficult (impossible?) given current laws and social attitudes to arrange for care providers who meet his prejudices.

Your FIL's world has changed dramatically since his formative years. He was taught not to drink out of the same water fountain as a Negro. He heard adult men being referred to as "boy." And maybe as his world changed he learned to accept the change or at least not fuss about it. But now he has dementia. The social filters he had that kept him acting like a gentleman are gone. He is back to where he was when he was 10 years old and his prejudices were the norm where he lived. Sad situation.

Of course your father still has rights. But it is not his right to tell agencies (or drug stores or coffee houses) who they should hire and make available to him.

If the healthcare agencies are deliberately not hiring white males, that is wrong. And it is against the law. But if few white males apply for the jobs their hands are tied.

I am sorry that you are in this situation. I hope you find a resolution.
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