Hospice and APS
Case Study
Adult Protective Service (APS) worker Fay Stalnaker receives a referral from the Hospice social worker on patient, June Fortney.
Ms. Fortney (78), is terminally ill with pancreatic cancer. Her adult daughter, Kelly Grimm, and adult grandson, Jason Grimm, live in the home with Ms. Fortney.
Ms. Fortney’s adult granddaughter, Terri Grimm, does not live in the home but is there nearly every day.
Hospice has been providing services for Ms. Fortney for the past several months. During the course of that time, there have been several instances when the pain medication for Ms. Fortney has come up missing or has ran out long before it was time for a refill.
It is suspected that Kelly and Terri Grimm have been using the pain medication for their own use. However, the hospice care team wants to respect Ms. Fortney’s desire to remain in the home, even if that means going without much needed pain medication.
Ms. Fortney is aware that her daughter and granddaughter have been taking her medication but will not speak out against them.
Hospice has provided a lock box for the medication with a key and has designated a family member to have the key. nfortunately, the medication has still come up missing and Ms. Fortney continues to suffer in pain.
There has also been some family violence in the home, typically between Kelly and her son Jason.
Hospice is notifying APS because they are terminating services due to the conditions in the home and the missing pain medication.
When APS investigates the situation, they are appointed as the temporary guardian for Ms. Fortney by the court.
APS finds a nursing home that will accept Ms. Fortney for care and have agreed to supervise visitation with the family. The APS worker talks with Ms. Fortney about her wishes for care. Ms. Fortney only wants comfort measures, she does not want any life sustaining measures such as CPR and she wants to be with her family.
The APS worker wants the family to be together during this end of life period, however they are charged with protecting Ms. Fortney.
Despite the supervision by the nurse, during one of the visits with her grandmother, Terri, takes the Fentanyl patch from her grandmother’s arm for her personal use.
Ms. Fortney died later that evening.