I had just started a rotation in geriatrics yesterday and it has been rather interesting. Much like paediatrics, the patients you interact with sometimes do no understand what you are talking about, they might be disorientated, delirious, they might not be able to speak or understand what you are saying. So like in paediatrics, you often have to rely on partners or family.
I was sitting in a discharge meeting today. What happens is that the family and health professionals sit in a room and discuss what happens next to the patient upon discharge. On one side of the table, was the consultant, social worker, occupational therapist, 2 nurses and myself. On the other side, was the patient, her 2 daughters, a son in law, husband, interpreter and 2 representatives of the community carers. It reminded me of a board room meeting or a deposition or something. I didnt realised that a situation like that happened in medicine.
They were discussing what the next step for the patient should be. If she should go to a nursing home or if going home was possible. When you put family members in the same room, you can come to expect some sorta conflict and conflict was what we got. To cut a long story short, they finally made a decision and it was a fair compromise.
What struck me at first was that they needed a whole room of people to decide if she should go home. I came from Malaysia and you don’t have the privilege there, if you cannot afford healthcare privately, thats it. You have no opportunity to choose between home care of nursing home in the public system.
Next was that they were deciding on something as simple as going home. Being young and fairly healthy, I cannot imagine they day when people have to decided if I get to go back to my own home or not. The thought of it is fairly scary, such a basic human right in the hands of your family members and a bunch of health professionals. A bulk of their problem was the insecurity the family felt in the whole situation. On top of that, the poor husband, if the patient’s children cannot spare some time to care for their mum, there will be a huge burden on the poor man.
I guess thats part of my motivation to succeed financially in life. When I am old, and family cannot look after me, at least I can afford to pay for home care or private nurses. Security, afterall is what we all are after.