Carer Quandary

[iloveglee]

My neice is a qualified mental health nurse, although she does not practice nursing now, and has given up her registrations.  She currently works as a carer 2 days a week through an agency, and a private arrangements 4 hours a week.

The lady she sees privately has incurable cancer, although her physical state currently is pretty good.  A few weeks ago, after having been diagnosed with this cancer, and having one round of chemotherapy, she was, as they thought at end stage of her life.

Since then she has improved remarkably.  She is however, having bouts of feeling dizzy and disorientated, and a little confused.  My neice has been helping her and her husband complete an attendance allowance form, and when learning of the medication she is currently taking was horrified.  Her meds are an end of life regime, and seems not to have been reviewed since she was very ill a few weeks ago.  

This lady's family seem to be intent upon her being an invalid, even though three of them are nurses themselves, and one of them is closely involved in her care, as she works closely with the consultant the lady is under.  I think this is a conflict of interest but that's another side to it.  The lady is not on very good terms with her husband, who she lives with, and he appears to be very cowed by her family.  She believes her family can do no wrong, so goes along with everything they say.  She was living with them initially but has since moved back into her own home, but I am not aware that her care has been transferred to, or shared with her GP.  They have not been requested to call.  

My niece is unsure what to do about this.  Had the lady been asssigned to her through her employer she would have reported this to her manager but as this is a private agreement she doesn't know exactly where to go.  She is reluctant to go to social services, although in my opinion this is a safeguarding issue. 

She has had a quiet word with the husband and advised him at her next consultant appointment, next week, a medicine review should be requested, as this appears to be an entirely inappropriate regime for her current state of health, and is almost certainly adding to her symptoms of confusion and disorientation.  Had she been a practicing nurse, who to take this to would have also been easier.

If anyone has any advice to offer, I'd appreciate hearing it.  

[Old_Geezer]

I think she has given best advice and it is now up to the husband. Appreciate you seem to imply he may not have what it takes to push the issue, but unless she has access to the doc and can express her concerns I'm unsure what the next best option would be.

[barry1010]

If she really is concerned for this lady's welfare she has no choice but to refer it to social services and the lady's GP - she does have a duty of care. 

[iloveglee]

Much has happened since my original post.  This lady was in mental turmoil about having more chemotherapy.  This was how it was the last time my neice saw her.  She had a long talk with her, using her mental health nurse skills, and basically said there is no need to decide now, to see what the consultant had to say, and take some time to think about it and decide.  

Since then, her family have swooped in and have taken her for a wig for when she loses her hair.  This took place on the day that my neice is scheduled to visit her.  They knew this, and could have come any day, but it appears that they are very unhappy that someone from outside of her family is seeing her on a professional basis.  My neice is now on holiday for the next week, so is waiting to see what happens after her consultant appointment and what her decision has been.  

It looks to me, from the outside, that there is some coercive control going on from her family, she is neither physically or mentally strong enough to withstand it.  My daughter who works  with gp's believes this is a safeguarding issue, and my neice agrees with her.  Once decisions are made about her treatment and where she will live while undergoing it, my neice is going to have to consider her position and what she is going to do.  This lady had one round of chemo, and the plan was she would live with her family during the 6 months of treatment.  It was only once she began to feel, and be in better physical health she returned to her own home.  So time will tell this time.

[Old_Geezer]

Let's hope all works out well.