Gaps in the system

What are some of the biggest gaps you come across with your clients?

Do any of them make your job more difficult because you find yourself having to take on certain responsibilities to an extent that really should NOT be yours to take on?

Or do you find yourself just spending more time in general on one client with an issue and as a result, neglecting others on your caseload?

For my clientele, the biggest problems I've been running into are no one to help manage a person's $$$ who cannot do so when they first come into the community (we can refer to APS but that's a big long drawn out process) and this also happens because family does not want the responsibility (which I totally get), lack of funds when a client first comes into the community setting from a nursing home (pantries only go so far, especially if you are on a specialized diet) and a HUGE gap.....there really are no agencies left anymore who are accepting clients who need weekly pre-pours and medication monitoring.

We've been referring to pharmacies to do blister pack deliveries but this can still be tough for many a client for a variety of reasons. Our staff are also not allowed to handle meds.

Some of our case managers have been dipping into their own pockets to help clients out financially when they first are discharged, but they can't afford to do this for long (even if our agency reimburses them), and not only that, it sets up a dynamic of dependence and entitlement from the very start which is NOT good.

It has also been suggested that our agency be a rep-payee for many a client, but that is highly unethical.


Regarding the pre-pours, some of our nurses have gotten stuck with that responsibility too, and it often creates problems and takes away from their regular duties and clients.


I always say that way back when some person designed the program I work for, they never thought of these needs to be implemented into the program and now they have exploded, sometimes making the job impossible, and also putting the client at risk.

In order for any major change to go through, it has to go through the government too, and you all know how fast that will happen......

Do you have any of these same issues? How have you dealt with them?

All suggestions (and venting too!) welcomed!