My patient Rose who I wrote about recently was deemed legally incompetent on Friday due to my reporting her to Protective Services for the Disabled. Although I have mixed feelings about making such a report, I felt I had no choice based upon her deteriorating state, her children's inability to properly care for her, and the increasing risk that she and the entire building would eventually go up in flames (her bed is covered with cigarette burns from Rose nodding off while smoking).
I have been aware for months that Rose is not long for this world and I have been doing my best to put appropriate services in place. Given her untreated Hepatitis C and HIV, seizure disorder, anxiety disorder, history of trauma, and Xanax addiction, Rose's chances of survival in her current situation are next to nil, and I seemed to be the only person ready to step up and make the call that would legally change her status.
I have called the Department of Social Services once when I felt a patient's children were being neglected, and my hope was that this would lead to a better life for these children. I don't think it worked, but this has alot to do with the relative inefficiency of our state programs. In Rose's case, my hope is that a court-appointed attorney will become her legal guardian, and that she will be placed in an environment where her addiction, HIV, and anxiety can all be addressed appropriately, not by the band-aids that I continually attempt to put in place, often to no avail.
Tomorrow I return to work and hope that this situation can improve, that her life can be qualitatively improved and quantitatively lengthened, and that I won't suffer any negative consequences from taking action.
I sit here in the steamy heat and ruminate on my work, but now I must return to my regularly-scheduled Sunday afternoon.