My 97 year old client's family members live out of state. While I try to keep good communication with them concerning her needs and current behavior issues as well as medical needs, it’s becoming quite difficult. My client actually needs 24 hour supervision but the family is resistant on providing that.
We are all in agreement that her last days should not be spent in a nursing care facility. However the family is unwilling to provide me with authorization to take care of all of her needs the way she needs. Example: The responsibility of her care is divided amongs a few of her children. One of them pays me to take care of them. One of them authorizes medical as needed. One of them pays all of her bills. And then she is responsible for paying Dr visit co pays, grocery expenses, day trips etc.
The problem is her cognitive function is limited. She has dementia and is sometimes very uncooperative. An example of that would be a simple grocery trip. I will take her to the store for staple grocery items such as milk, bread, toilet paper. Once at the store she will refuse to buy anything other than ice cream, cookies, milk, and cereal. Never proteins, never soap, never anything healthy. Mind you my client is not on a fixed income in fact she is more financially blessed than most people I know. However she chooses to exist on PB& J sandwiches, ice cream and cookies and dress as though she sleeps under a bridge.
The problem with these things is it appears as if I’m not properly caring for her because her family lives out of state. My concern is and has been that the credit card her family provides her with to pay for her own needs is actually more freedom than she should mentally have. It gives her the option out of seeing a doctor when she needs one, buying healthy food rather than junk, and is even unfair to me after I have driven her to the store (many times without being reimbursed for gas) only for her to decide she doesn’t need anything that badly.
The last point I would like to bring up is the fact that she doesn’t have someone with her 24/7. She lives alone and while she is able to walk on her own, she sleeps with supplemental oxygen yet consistently refuses to keep it on. She paces around the house from 3:30 am to 7:00 when I arrive. But has on rare occasions decided to take a stroll around the neighborhood. The questions I am asking myself at this point is how fair am I being to myself for worrying about her well being and trying to help her achieve the best quality of life she can have while her family appears to be perfectly happy not knowing there are problems with this system we have in place. I apologize in advance for the rant I’m just looking for a resolution that doesn’t involve her being placed in a NH.