GP Stage 3 Simulated Consultation - Relative 13
You are an SHO on a geriatric ward, and Jacquie the private carer for Mr Alfred Hodgson has asked to speak to you for an update. Mr Hodgson is a pleasant gentleman with early dementia who was admitted with a urinary tract infection last week. Mr Hodgson has improved well and is expected to be medically stable for discharge in the next 24 hours, with a view to returning to his usual residence. Your colleagues have previously spoken to Jacquie, and Mr Hodgson has consented for you to speak with her regarding his care.
You are Jacquie, a private home carer for Mr Alfred Hodgson. Mr Hodgson has been admitted to hospital following a urine infection and you have arranged to meet the doctor for an update. You would like to know how Mr Hodgson’s condition is progressing and how he has behaved on the ward.
On being advised that Mr Hodgson is due to be discharged tomorrow, you are surprised and wonder if he may benefit from a slightly longer stay, especially given his recurrent previous re-admissions following premature discharges. If advised that this is not necessary, you are keen for Mr Hodgson to remain an inpatient for even one day longer. If further probed, you reveal that you are struggling to look after Mr Hodgson alone at home, and feel that he needs additional care support. However, Mr Hodgson is not keen to pay for additional carers and when you raised the issue with the care agency they were not keen to discuss the matter further for fear of losing the care contract. If asked about additional concerns, you also report that Mr Hodgson has been verbally and physically aggressive towards you on occasions, and you do not feel safe caring for him. On one occasion, Mr Hodgson pushed you against a door after forgetting ‘mushy peas’ with his fish and chips.
At home you live with your partner and two children. You are otherwise well, although financially require your income in order to support your husband with the mortgage and household expenses.
This consultation commences as a routine relative/carer update request. This swiftly progresses towards what appears to be managing health resources and the wishes of a ‘work shy carer’. On further probing, it becomes apparent that Jacquie’s concerns are very pertinent and require addressing at the earliest. As such, it would be unsafe to discharge Mr Hodgson with the current care arrangements. Furthermore, investigating whether appropriate action was taken by the care agency and other relevant authorities following Mr Hodgson’s previous physical and verbal aggression would be appropriate.