Read on Twitter
1) A social worker's response to 'Granny dumping', a term used to describe behaviour of a family who take a clinically well person to hospital and refuse to take them home. With minimal assessment, the family are usually labelled as Granny Dumpers in ED & it sticks for admission.
2) The term immediately conjures up an image of the classic 'difficult family'. Off socialising, holidaying, blatantly ignoring phone calls from hospital teams, enjoying life to the full, possibly quaffing champagne, having abandoned their older relative to the care of staff.
3) Having worked in ED for many years, I received countless referrals of so called 'Granny dumping' from frustrated, overworked & tired medics & nurses. Looking past the label, health policy, care burden and family dynamics inevitably explain the presentation.
4) Health policy: To get additional home care hours or emergency respite, you must present in hospital. That is literally the policy of the State & has been for many years. So medics, please don't be surprised when desperate carers who need that support attend ED for it.
5) Care burden: Carers are usually older spouses, or women with multiple responsibilities. Our 1950s care model & hospital system expects families to provide the bulk of 24.7 care, despite women now in workforce. Basically, Be Superwoman is the message, with minimal support.
6) Care burden: Closure of day support services, home help and often home care over Christmas pushes people past their tipping point. Carers can't do it alone, but we somehow expect them to juggle Christmas, children & caring while cutting all existing supports.
7) Family dynamics: Family members are very conflicted about caring for someone who was abusive/neglectful or unloving to them. Social workers are skilled in understanding relationships. 'Granny dumping' takes a simplistic & paternalistic view of 'good older person' 'bad family'
8) Everyone knows how frustrating & risky it is to bring an otherwise well person into hospital. Social workers are the experts within the team in family work & care burden. Perhaps check in with them, before rigidly applying a family label that originated at point of admission.
(9) I have never been unable to track down a family to discuss a presentation. I have inevitably found stressed carers who are at their limit without support, historical family pain & conflicted carers. It takes time to build a relationship with a family and hear that narrative.
10) So as many medics & nurses do, look beyond the label. Labelling is fundamentally saying 'my family would never do this,' yet many families may lack the resources, supports, loving relationships or emotional capacity of your own. Just an alternative perspective..
