Over one hundred million Americans have one or more chronic illnesses. These clients may lack the financial resources to pay for needed rehabilitation. Rehabilitation cost of services is increasing and may be covered by “Medicare, Medicaid, worker’s compensation, private insurance, and social security disability benefits” (Larsen, 2016, p. 582). The process of applying for needed coverage, timing …show more content…
Due to the long term nature of end stage renal disease (ESRD), many of the marriages have diminished quality and inreased tension. Often a spouse “checks out”. I have a client, (I’ll call him Bill). He used to work at the Sherriff’s department and met his wife there. They were married shortly before he was diagnosed with ESRD. His wife is never present at his clinic visits or home visits. He is open about not being in a good place with his wife. When I did a routine annual home visit on Bill, I asked him to show me his glucometer. He couldn’t find it. When probed, he admitted to giving himself his insulin based on how he feels. He also made up numbers on his home record sheets. The team of the social worker, dietician, RN, and physician made little difference in changing the status quo for Bill. Then, Bill had to have a cardiac stent and follow up cardiac rehab. Exercise was now an overseen physician order. Bill responded well to this program. The increased interactions with people and the physical exercise impacted every part of his health. His albumin, which usually sat at 3.5 rose to 4. He was more positive, had an improved weight, and better gait. When the caregiver of the dialysis patients disengage, it results in patients demotivation, depression, and decline in adherance to the treatment