I work in home health, and I would not consider discharging for this 
reason - I have seen many patients where there were problems: trash 
everywhere inside and outside the house, old food lying about, or dirty 
dishes in the sink week after week. As an OT I want to enable the pt to 
make their own decisions about how to make changes, and to help the 
patient affect that change. Our whole home-health-care team tries to 
help the patient, not judge them. I sometimes get an MSW referral to 
assist in providing information about resources for the patient. 
Sometimes (often!) the patient is not willing to change - that is their 
right. Even in a clean home patients can be unsafe and ignore my 
training in safety. I definitely think it is not just unethical to d/c 
for this reason, but also against everything we stand for as therapists. 
While the company I work for is committed to providing clinicians with a 
safe environment I don't consider dirt or bad smells unsafe (to me). The 
only reason I d/c is when the patient has met their maximum goals:  or 
if I really, really cannot show progress (and even then I keep trying 
different strategies). . . .
Sue

-- 
Sue Hossack MOT, OTR/L, ATP 

Occupational Therapist    
http://www.ot-care.com



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