Compassion and Persistence in Patient Care

Compassion and Persistence in Patient Care

If you were to ask me what I am most proud of in my work, it would be my strong advocacy for patients and their families. I never accept "no" for an answer, and I work until the job is done. As the saying goes, "If you want something done right, do it yourself." This week, I successfully assisted a patient in transitioning to a care facility where they will receive the high-quality care and support they deserve. Sadly, two different case management teams dropped the ball on helping this patient over the last year. While I am proud of the assistance I provided, this case highlights significant issues within our society.

This patient suffered from a rare neurological disease and accompanying dementia, resulting in significant behavioral changes and a difficult journey that, in its darker moments, included homelessness. Fortunately, this patient was lovingly cared for by an incredible homeless shelter in Wyoming. In fact, when every Medicaid care facility in the state of Wyoming turned this patient down for admission, a homeless shelter came to the patient’s rescue. If you’re considering end-of-year donations, I might recommend your local homeless shelter; homeless shelters provide services to which society readily turns a blind eye.

The patient spent the last year living at the homeless shelter, during which time the patient’s guardian contacted care facilities in the tri-state area, only to be denied time and time again. Two different case management agencies also got involved to help; both dropped the ball. In the end, the patient’s guardian hired me to help. Although the work required was mostly case management and social work, I eagerly set out to help with the fierce determination and all-things-are-possible attitude that I believe is an asset in my work. I contacted several facilities, most of which denied the patient.

Someone mentioned a facility out of state that cares for many patients with the same rare disease as my patient. I contacted the facility, spoke with a compassionate admissions coordinator, sent a referral letter, and crossed my fingers. When the answer I got back wasn’t “No,” but “We are meeting to discuss a way to admit your patient,” I guarded my optimism while following through on every request for information the facility made. At some point, “We are meeting” changed to “We can accept on such-and-such date.” I was ecstatic. The facility agreed to accept the patient without a pay source, generously providing care until their state’s Medicaid would kick in. Sometimes, good things do happen.

The sorrow in this situation is threefold: the length of time this patient was homeless, the fact that two different case management agencies dropped the ball on supporting this patient, and the number of Medicaid-funded care facilities that turned this patient down for admission. This patient's rare disease is just one variation of a common theme; I know that many other families face similar situations with various other diseases.

As the move-in date approached, I helped with the transition planning. The attention to detail by the care facility team members during our conversation about the patient’s arrival reassured me that the facility is staffed with very compassionate individuals. This final conversation cemented my confidence that they would welcome this patient with the tender, loving care the patient deserved.

When I look back on my work as a PA over the last ten years, this case is certainly one of my proudest moments. Receiving the news from the patient’s guardian that the patient was in their new room and looking forward to dinner brought tears of joy and relief to my eyes; I can only imagine the relief the patient’s guardian felt. The facility sent me a kind message afterward: “Thank you so very much for getting this done. I have never had such a smooth transition from another state, and I am so thankful for all your help.”

This is the kind of can-do, never-take-no-for-an-answer advocacy that patients and families deserve. It’s the standard of support I expect from others and the level of assistance I aim always to provide.