A resident with a history of trauma asks for help finding a female dermatologist who accepts both Medicare and Medicaid so she will not have any out-of-pocket expenses – but not with this particular county medical group or any of their satellite clinics because they give horrible service. I run my Google-fu and find a couple of possibilities, but only if the resident’s primary care doctor can get prior authorization from Medicaid for the referral. I pass the information on to the resident and wish her the best of luck. 

When an aging veteran’s rep payee/caregiver takes the battery from his motorized wheelchair for three days as “punishment”, leaving the veteran unable to get to the grocery store or any food place to feed himself after previously only being able to carry 2-3 days’ worth of food home on his wheelchair at a time, I make the call to adult protective services. I also advocate with this resident’s external case manager numerous times over several months for a higher level of care due to the resident’s inability to meet his own needs in fully independent living and decreasing quality of life. The day before Thanksgiving, a substitute case manager filling in for the holiday week sees what I see and transfers him to the hospital, then finds him a place in hospice. My resident is literally dying while his primary case manager ignores or placates me for months; it took a substitute to hear and believe. The resident passes before the turn of the year but at least his last bit of time is comfortable.