• Dr. Nader Amer

Home Health Stories #1

To supplement my income, I do per diem work for home health agencies. I have been doing this for about 5 yrs either full-time or per diem in northern and southern California. Here is the first of a series of stories. Feel free to share your own. I love to exchange "war stories."

This one happened recently:

I had trouble scheduling an evaluation for my patient with a diagnosis of a CVA (Cerebrovascular Attack). They were wheelchair bound, required moderate assistance (caregiver/therapist helps with 50% effort from you and the patient), and dependent on family for most daily needs from the H&P. I called multiple times to schedule but still no answer with a full voicemail box. I had multiple patients in that area that day and decided to do a drive by before heading home.

I pull up and park in front of the duplex. Dogs from all around the neighborhood begin to bark. I cannot distinguish from which direction the dogs barks because they were coming form everywhere, this is common for me. I am afraid of dogs to begin with so I push down that fear and focus on task on hand and knock on the metal security gate while the actual front door is open. I cannot see through the gate because of various reasons including small holes, sun reflection, fear of dogs(barking), and overall anxiety of entering another persons home.

The patient tells me to enter. Hindsight, I should have known his judgment was impaired because he had a CVA affecting his frontal lobe (decision-making part of brain) and leaving the left upper and lower extremities hemiparetic (minor--severe weakness of one side of the body). I open the gate an immediately see a dog from the opposite side of the room full sprint coming toward me. I immediately begin to run away stupidly forgetting to close the security gate. This minimum 60 lb muscular dog is charging at me. The only thing I thought of doing was jump on top of my hood and luckily the dog didn't jump up with me. The dog continued to bark for felt like an eternity (30 sec. max) until he just turned around walked to the door. At this point my patient yelling at me from his wheelchair 15 yards away "Did he bite you?" At that point i realize this dog has bitten someone before. My next challenge in my head was how am I going to get this re-evaluation done. So stupidly, I slowly get down from the hood, walk over to the door saying "good-boy", and sweating with fear. I get about six inches from the door and dog pops out and I slam the security door yelling to my patient I am coming back tomorrow 10 AM, with the dog in another room!

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