Sometimes a patient interaction leaves you speechless. In my experience, that most often occurs when a patient refuses to acknowledge any responsibility for their condition despite massive evidence to the contrary. This is compounded when dealing with caregivers of patients who don’t just drop the ball, they kick it into the next county on purpose.
Here is an actual phone conversation between a fellow physician and a son of her two elderly patients. Names have been left out for obvious reasons. When you are finished – and the “punch line” is at the end – see if you agree this qualifies for Personal Responsibility Deficit Syndrome or PRDS for short.
On the phone:
MD: Hi Mr. So and So. We spoke a couple of months ago about looking for nursing home placement for your parents. I was calling to find out what’s been going on.
Son: What do you mean, what’s going on?
MD: I mean, what progress has been made in finding a home for them. Your mom told me to call you, and that you were taking care of everything.
Son: I got a few applications and gave them to her to fill out, but she lost them.
MD: That’s because her memory is bad. You need to fill them out.
Son: What do you mean, I need to do it? I don’t know their social security numbers!
MD: Ask them.
Son: You know, it’s not my job to do this.
MD: Then whose job is it?
Son: Some administrator should do it.
MD: They are your parents. If you don’t do it, no one else will.
Son: Well, they don’t even know what nursing home they want to go to.
MD: You need to take them to see some.
Son: So what, I’m supposed to take off from work to drive them to a bunch of different nursing homes? That’s a waste of my time.
MD: Your parents lost their driving licenses, so, yes, they have no other way to get around.
Son: They can take a taxi or the bus.
MD: (suspended somewhere between disbelief and fury): Look, if you don’t take care of this, I’m going to have to call Adult Protective Services and start proceedings to have the State take guardianship of your parents. They are no longer safe at home. Your dad wandered off this week and the police had to go find him.
Son: Someone else should take care of this. I don’t have time. Why is it such a big emergency all the sudden? How did you let them get so bad?
MD: How did I let them get so bad? Look, I’ve been treating your parents’ dementia , but I can’t fix it. I’m sorry to tell you, but it is your job to take care of this. If you don’t, no one else will.
Son: “You know, it really sucks how the healthcare system treats old people in this country.”
Dike Drummond is a family physician and provides burnout prevention and treatment services for healthcare professionals at his site, The Happy MD.
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