Systems Understanding and Intervention, and Ethical Issues

A 67-year-old woman with a hip fracture was referred to the psychiatrist, as she wished to leave the hospital against medical advice prior to surgery. The patient was described as being hostile, agitated, and irrational by the nursing staff. On interview, the patient insisted that she had to go home, but upon further questioning, it was found that the patient lived alone with three cats, and she was concerned about not being able to care for the cats. When the consultant called the social worker, she was unaware of the patient’s concern about the cats, as she had only asked whether the patient had a home and family (human family!). The consultant explained to the nursing staff why the patient was so agitated: she was worried about her cats. They empathized with her concern. The social worker was able to contact a sister who lived in another city, who was willing to care for the cats while the patient was in the hospital. The patient was now willing to stay and have the necessary surgery.