dear old man in his nineties who had lost most of his marbles due to Alzheimer’s — was nevertheless sharp as a tack when it came to beating me at dominoes.
“He’s in his thirties—”
“His thirties?” I interrupted, then cleared my throat. “Sorry, go ahead.”
“From what I understand, he’s active military and was injured in Afghanistan. Shrapnel from an IED or something. He fractured one lumbar vertebra and received severe muscle damage to his back and one side of his hip and thigh. He’s spent two weeks in the hospital. He’s recuperating at home now, was discharged about a week ago, and has been receiving regular physical therapy at the hospital.
“He’s supposed to be going to outpatient rehab, but he’s not shown up for his last two appointments. The surgical incision is still seeping, so he has a dressing over it. It will need daily attention, and you’ll need to daily chart the status of the other wounds and how they’re healing. Make sure you take accurate measurements of the wound edges.” She paused. “I’m warning you ahead of time, he’s been noncompliant with a number of issues regarding his treatment.”
“How noncompliant?”
“Well, let’s just say that getting him to take his medications can be quite a challenge. He’s on pain pills, antibiotics … he’s not following the schedule provided by the physical therapists, and while he should be in a wheelchair or using another mobility device, he’s insisting on getting up and walking.”
I thought about this. A live-in situation with a patient in his thirties, and a medically noncompliant one to boot? I wasn’t sure about this. In fact, it was a first for me. I didn’t have a problem with twenty-four hour live-in care. After all, I was a home health care nurse and had performed such services dozens of times, but never with such a young man.
“Let me explain, Angie,” Nancy said. “The man’s name is Jackson Andrews, but he prefers to be called Jax.”
“Jack?” I interrupted her, not sure if I heard her right.
“No, Jax. J-A-X. He was injured during his fourth combat deployment to the Middle East. One in Iraq, three in Afghanistan. He’s Army Delta Force.”
“Why isn’t he receiving care at Fort Bragg?” I asked. I knew the home base for Delta Force squadrons was in Fort Bragg, North Carolina. They operated under the oversight of Joint Special Operations Command or JSOC. I knew enough about the military to know the mindset. All of a sudden, the things Nancy had said about the client began to fall into place.
“He’s on medical leave, recuperating at a home in Hilton Head—”
“Hilton Head!” I interrupted again, surprise ringing in my voice. Everyone around here knew about Hilton Head, a resort community located on an island just off the banks of the Savanna River. It was a rich man’s getaway for sure, but to own a home on Hilton Head? “How does a guy from Delta Force afford to live there?”
“Not my place to ask, Angie,” Nancy gently scolded. “Maybe he’s got family, or a friend who’s letting him recuperate there. It doesn’t really matter, does it?”
I sighed, wishing I could back out of the job. I had a feeling that Jackson Andrews would prove to be quite a handful. “Oh great, so what you’re telling me is that he’s going to be a pain in the ass, is that it?”
Nancy laughed gently. “Give it a chance, Angie,” she said. “This is a private pay job—”
“No Tricare?” I asked, surprised and more than a little excited. Military medical and health insurance was provided by Tricare. I had provided care for a couple of older Vietnam vets since I arrived in Charleston and knew that squeezing money out of military or veterans benefits could be a long-term and headache-filled endeavor.
But private pay? I knew that the health care agency normally received the bulk of the payments for the care I provided, and it was not often that I made more than twenty-five to thirty