Jack's Story

Inquiry

We were asked to care for a 90 year old gentleman (Jack) who was thought to have Alzheimer's and urinary incontinence. Jack's Elder Law Attorney told us that Jack continued to report to work despite being retired for many years. This situation posed a liability exposure for the employer given Jack's age and overall condition. Unfortunately, Jack had no living relatives and the only daily structure, routine and opportunity for social interaction came from his job.

Aging Well Consult

Jack was told by his attorney to expect a visit from two community based nurses who would be checking blood pressures in his area. Jack presented as a gracious but guarded gentleman who showed evidence of a major thought disorder and poor personal hygiene. After a brief interview guided by Jack's tolerance for conversation, Jack agreed to allow a return visit in one week. He also agreed to allow us to contact his primary care physician for coordination of care.

Plan

Jack had been seeing two separate primary care physicians for his medical care needs. We consolidated his care to one doctor. We also referred Jack for a geriatric psychiatry evaluation to address his thought disorder. Findings from this evaluation revealed a gentleman with undiagnosed schizophrenia with no evidence of any Alzheimer's disease. His urinary incontinence was a function of poor personal hygiene so home health services were arranged to assist with bathing, do laundry, provide home cooked meals, new clothes and transport Jack to and from church services. Jack began to attend his "new" full time job at a local Adult Day Program to provide social stimulation and daily structure.

Outcome

Jack no longer reports to work at his former employer. He now attends a "job" which addresses his need for social interaction, structure and activity.

"What did I ever do without you?" (Jack)