Better care than at home?

The other day I was able to visit an Old age home and was amazed at the care the inmates are getting.

It is a small venture run by a young widow, a trained nurse. She runs the institution in a small rented house.

She started by taking care of an old woman who was abandoned in the Hospital where she was working. She took the old lady to her house to take care. Soon the inmates began to increase.

Many were orphaned old women roaming around the streets, finally ending up in hospital wards. Some were abandoned by the family. Most of these women are in their 70s or 80s. They come from all parts of Kerala. They belong to many religions. Some are mentally not all right. Most of them are suffering from physical ailments. But it seemed all of them were happy living there.

Whenever I see old people as patients, I feel dissatisfied with the level of care they are getting in their homes. Medicines are never given as prescribed and doctor appointments are often delayed and missed. When the family is tight financially the old people's medicines are not bought for few days to weeks. Now this does not happen everywhere but in a large number of homes.

But I was happily surprised at the level of care given at this old age home. Though the inmates were only around 12 the nurse knew each and every detail of their ailments and medicines they were taking. They were given food and medicines in time. Their personal hygiene were well looked after. Whenever a doctor consultation is needed she will call me or someone else she know. She ensures doctor visits and sees the inmates at least once in 2 months.

The inmates were so happy to get such a level of care that they were not coming out to me with any physical complaint, though most of them were very ill.

Spending your last years in your house with the family taking good care of you is the best option any one can have. These women were not fortunate enough to get that. But they are lucky enough to have very good care and love during their final years, something many old people do not get even from their homes.

Too much work

I have not been posting in this blog for some time now. Thought I should revive it with more posts.




I left the Government service thinking I will be able to give more time, deserving time, to each of my patient when I work as a private consultant. 7 years as a private consultant and I am not happy with the amount of time I am able to give to each patient. This is particularly true during this busy Fever season. As the time I stay in the same place and see patients increases the number of Patients/families who have absolute faith in me increases. Thus a large pool of patients are created who just want an opinion from me. Many a time I am not able to give deserving time for each patient, still they are satisfied. I am now trying to consciously to reduce the number of patients I see, and it is difficult. I will have to make a large number of people unhappy with this, but I feel I do not have a choice. Let me see how it works.

Is 'honor' more important than your wife's health?

Few days ago a doctor who is well known to me called to ask the diagnosis of one of his distant relative who is under my treatment.
 I hesitated.
 I asked him why you were asking that question.
He said that the guy was admitted in a critical condition in another hospital.I asked further details and realised that the patient is in deep coma and not in a position to give consent  to reveal his diagnosis.
Then I told the doctor that his relative was under my treatment for last 5 years for HIV related illnesses. He was very surprised.Nobody in the family it seems know about it. But I was not surprised.

Let us call this guy Mr K.
He was referred to me 5 years ago by another doctor after he was found to be HIV positive while he was being investigated for recurrent fever. He came alone to me and was mentally a wreck. I could make out that he was thinking about taking his life.
It was very difficult for me to convince him that there is treatment for this and everything is not lost. I told him you can live as near normal life as others if you take proper care and regular medicines. Then I told him that his wife has to be tested.
 He said he cannot tell this to his wife as she will be shattered and the family life will be doomed.
" It is better for me to take my life than to tell this to my wife".
"OK you should tell this after some time.But meanwhile do not have any sexual contact,I warned".
He agreed.
Every time he come to me I used to ask him about informing his wife and he was adamant that he cannot.
I continued to prescribe medicines and monitor him. He was doing fairly well continuing his job and doing everything he need to do as the head of the family.
He did not attend my OPD for last few months and I was wondering what happened to him. I was afraid he was not taking medicines properly and his illness must have exacerbated.
What I was afraid of happened.
Just now I received a more dreaded news. His wife was also tested positive for HIV, though she appears relatively healthy at present.
Was she positive at the time of her husband's diagnosis? Or did Mr K broke the promise he gave to me and had sexual contact with her even after knowing he is positive.I hope it was the former.
 If she was already positive and I knew it I would have been able to manage her health better.Should I have insisted on bringing the wife and telling the truth before prescribing medicines for Mr K?
Why Mr K refused to tell the truth and test his wife?

Is 'honor' more important than your wife's health?