"Who's Falling Through The Cracks?" January 12, 2007 "Who's Falling Through The Cracks?" Topic of CVMC's January 'Conversations in Ethics'

Catawba Valley Medical Center invites healthcare professionals and the community to attend the next 'Conversations in Ethics' to be held from 12 noon to 1 p.m. Thursday, Jan. 18 in the Northwest AHEC Lecture Hall, Room 112. This monthly, no-charge meeting provides an opportunity for discussion of some of the most important issues facing the healthcare profession today. Topic for the January session is "Who's Falling Through the Cracks?" Ms. Frank, a 72-year-old widow hospitalized for dehydration and pneumonia, presents with poor hygiene, poor mobility, and difficulty expressing herself verbally. After making progress in the hospital, she is discharged to a nursing home where she can receive the 24-hour care that she needs. Ms. Frank does well at the nursing home for about 3 months when her 37-year-old great-nephew comes to town. He decides, against medical council, to take Ms. Frank out of the nursing home. A Home Health referral is made and Home Health responds and makes visits. Concerns arise when, on several occasions, Ms. Frank is found dirty, incontinent, and with a communicable skin disease. The nephew expresses a desire to do better, yet he does not follow through on Home Health nursing recommendations, such as applying medication to his aunt's body. In light of various areas of neglect, Nurse Kathy makes an Adult Protective Services referral. A visit is made and the great-nephew does make some effort to do better. But the care is still below par. The last straw for Nurse Kathy occurs when the nephew neglects to get a glucometer and keep check on Ms. Frank's blood sugars. (She had been diagnosed with diabetes while hospitalized.) Nurse Kathy wonders how much she should do for this family. The great-nephew fires Home Health the day before Home Health was going to fire this family from their services. The concern now is that Ms. Frank will only deteriorate and need hospitalization again before she can get back on track with the care she needs. Questions that could be discussed at this session include: What does Adult Protective Services have to offer in such a case as this? How much intervention should Home Health be offering when families do not do their share? Is "firing" an ethical option when follow-up care is not clarified? If Ms. Frank is agreeable to the care she is receiving, is there really an issue here? If Ms. Frank is not clearly agreeable to this substandard care, what action can be taken? A free lunch will be served to those who register no later than Tuesday, Jan. 16, 2007 by calling Glenda Fowler at 828-326-3365. Completion of this activity provides 1.0 contact hours of continuing nursing education via CVMC, Department of Organizational Learning, an approved provider of continuing education by the NCNA, an accredited approver by the ANCC-COA. Catawba Valley Medical Center is a not-for-profit, public healthcare system providing and promoting the physical, mental, emotional and spiritual well-being of the public in addition to serving as a center for health education, wellness services, preventative medicine and acute care. CVMC, recognized by the American Nurses Credentialing Center as a Magnet facility, was recently named a Hospital of Choice by the American Alliance of Healthcare Providers.