Question

Ms.B is a 85 y/o Italian who immigrated to America 50years ago with a 6 grade education from Italy. She was admitted to the hospital with exacerbation of CHF. Her co-morbidities are diabetes and osteoporosis. While in the hospital her daughter - primary care giver suffers a MI and is now recuperating at home. Ms. B lives with her daughter Barbara and son-in-law, John Barbara is requesting you the Case Manager to arrange for her mother to be sent to a rehab center. The request is so Barbara may recuperate from the MI and not place a double burden on her husband You call a team meeting and announce the request. You inform the team that Ms. B has traditional Medicare, is eligible for Medicaid. The family has not completed a Medicaid application because they were unaware of Ms. B's eligibility. You also inform the team that there are no Health Care Proxies signed. Can you grant the family's request? Identify 2 reasons why the Health care Proxy should be completed 2

Answer 1

1.The patient who are elderly with chronic diseases like CHF needs care in home if discharged.Here the patient will be in informal care. The caregiver in home are the family members who has to provide care.They may ar risk of injury and illness because of caring and they are considered to be in secondary care.Here the patient's daughter Barbara is herself sick and needs rest and care .Neither she not her husband can give a complete care to the sick elderly women practically. On the grounds of patients Medicare eligibility the requests can be granted for limited time frame until the daughter is well and can be a care giver.

2.The main reasons for completion of healthcare proxy are

• The patient when they are ill or cannot make decision or not in a sound mind to take decision in regards to their healthcare can appoint or fix an agent for making decision.This can help the patient by getting a medical service as per their wish .(like treatment in regards to end of life care,COR,feeding, etc.,)
• This can prevent a lot of ethical and legal issues in making decisions both for the family members and also the healthcare professionals .