One of my worst fears was recognized today.
My patient fell. On my watch.
She likes to have some privacy in the bathroom - as would anyone - so I normally help her in there, help her get her underthings down, and then leave her in peace. She hollers when she's ready to get up, and I'm never far away (usually in the bedroom or kitchen, both of which are on either side of the bathroom). I go back and check on her every few minutes, knocking on the door and asking if she needs anything and is 'ok in there'.
This morning was no different. I helped her in there - she was walking no differently than any other day - got her squared away and went into the kitchen. She hadn't been in there but 3 minutes when I head a crash.
I knew as soon as I heard it that she'd fallen. I rushed in there and found her face down on the floor, wedged between the tub and toilet, unresponsive and making not attempt to try to get herself up. I clambered over to toilet, got her extricated and then carried her into the bedroom.
By the time we got there she had somewhat come to her senses and was able to answer my questions about where it hurt. She had a small abrasion on her forehead and an obvious cracked rib (I could feel it under her skin).
I wanted to take her to the ER. Her husband said no. So, she didn't go.
He said no, I think - no, I KNOW - because the doctors would have kept her in there until they figured out WHY she fell and was unresponsive. There's also a very good chance that they wouldn't have let her come home again, not until there was a better care system in place, anyway. Her husband doesn't want that, and he's made it very clear that HIS wishes reign supreme in that home.
She simply doesn't have adequate care at home. This morning proves that.
So, she's no longer allowed to be alone in the bathroom, not when I'm there at least. This is just another stop on the downward slope for her, and that makes me sad.
It makes me very sad.