... we are making headway. Possibly in such small increments as to be not visible to the naked eye, but still moving in the right direction. A magnifying glass or possibly a microscope may be necessary to discern that there is some activity, but it is occurring. I am so thankful for the slightest signs of any progress at all.
The Dr./Hospitalist came in and picked up on all the right clues. I told him I understood she was still an inpatient due to her unwillingness to be transferred. But was thinking that the best way for her to get up out of the bed and on her feet was to get into someplace that would provide more assistance. The Dr., beautifully, thankfully read between the lines.
He began to tell her that the rehab. resources that were located here, in house, would not be the most appropriate place for her to transfer. That she was actually 'not sick enough' to be a good candidate for the program they run here in the hospital. But if she wanted to try some other places, the social worker here would try to find another facility that might accept her. The cantankerous auntie proceeded to laugh, smile, act coy and ask him how soon she before she could 'expect to be moved: today, next month?'
This is the huge roadblock we have been pushing against for a week. After a week of her being opposed to going anywhere except home (which is not an option) all it took was a man coming around. Whereupon she got profoundly cheerful, astoundingly agreeable, remarkably pleasant, effusive, and nearly instantaneously ready to make the move everyone has been encouraging her to make since this time a week ago.
Tuesday, September 6, 2016
progress report...
... or possibly a complete lack thereof. I was nearly speechless after the day nurse came in, was talking to the auntie this morning, to hear the obstinate auntie casually agree to be transferred. She has been so completely opposed to the idea of being sent to a facility that would provide some rehab. to help her regain mobility. The problem of what to do with her is likely the biggest reason she is still here in this bed for over ten days. The perfect scenario would be for her to go into nursing care long enough to get on her feet, though at this point it appears she will be using a walker indefinitely.
I asked the nurse if she had documented the fact that there was this sudden, surprising, completely unexpected cooperative attitude. She laughed. So it does not take people who encounter the auntie very long to realize that agreeableness is not high on the list of desirable traits from this particular patient.
The sweet, good-humored nurse said that she had made a note in the auntie's chart to let other staff know she had been willing to accept a transfer. But unless there was a doctor and another nurse who had heard her say this: agreeing to go into rehab., it was of no value. So apparently not only do we need a spirit of cooperation, we also need witnesses.
At this point, I have been sitting here in this room with this argumentative person since before the sun came up. Waiting for the doctor, now called a hospitalist (Dr. who only works in a hospital, and does not have a free-standing office, or private practice) to come and have an opinion. I've been chatting up the idea of going someplace to get some help with getting up and practicing walking to regain ability. Hoping that when the Dr. comes, she will accidentally agree to relocating into skilled nursing facility.
I asked the nurse if she had documented the fact that there was this sudden, surprising, completely unexpected cooperative attitude. She laughed. So it does not take people who encounter the auntie very long to realize that agreeableness is not high on the list of desirable traits from this particular patient.
The sweet, good-humored nurse said that she had made a note in the auntie's chart to let other staff know she had been willing to accept a transfer. But unless there was a doctor and another nurse who had heard her say this: agreeing to go into rehab., it was of no value. So apparently not only do we need a spirit of cooperation, we also need witnesses.
At this point, I have been sitting here in this room with this argumentative person since before the sun came up. Waiting for the doctor, now called a hospitalist (Dr. who only works in a hospital, and does not have a free-standing office, or private practice) to come and have an opinion. I've been chatting up the idea of going someplace to get some help with getting up and practicing walking to regain ability. Hoping that when the Dr. comes, she will accidentally agree to relocating into skilled nursing facility.
Monday, September 5, 2016
in limbo...
...which is really surprising, as I know how difficult insurance companies can be when you are trying to get them to agree to paying for medical care. She is still in the hospital, in the same bed as when I left her a week ago. I've dreaded hearing my phone ring, fearing every call would be the nursing staff reporting they were putting her out on the sidewalk. But here she is, cantankerous and uninformative as ever....
At one point several days ago, I called her room hoping to be pleasant and agreeable in the manner of a 'friendly letter'. I told her how I was and proceeded to inquire as to her health - she said she was sitting in a motel room waiting for someone to come get her. I asked if she knew how much longer she would be there, and she said I would have to call the office and speak to the manager.
I had hoped the staff would keep her (safe or in the best possible place and circumstances if she were not safe!) through the weekend, to give time to formulate a plan for what will happen next. My best guess today is that she will be discharged soon, and we will have to find caregivers to stay with her in her home. She will be either thoroughly accomodating, highly agreeable - or - most unpleasant ever to people who are being paid to sit. Keep her in sight to be sure she is not in harm's way.
I can't imagine the her insurance will continue to pay for inpatient care just because she refuses to be transferred for rehab. But she appears to not be mobile - and the longer a person is inactive, lying in bed doing nothing the more difficult getting up and active becomes, with loosing muscle mass, mobility, agility and general stamina. Other than the inconvenience of having to get staff in place to help her get up and exercise, I don't know why she is still a patient, and surprised she has not exhausted the patience of everyone on the staff, causing some to threaten to do her grievous bodily harm. Even though as health care professionals, they are trained to relieve pain and suffering rather than be the cause.
At one point several days ago, I called her room hoping to be pleasant and agreeable in the manner of a 'friendly letter'. I told her how I was and proceeded to inquire as to her health - she said she was sitting in a motel room waiting for someone to come get her. I asked if she knew how much longer she would be there, and she said I would have to call the office and speak to the manager.
I had hoped the staff would keep her (safe or in the best possible place and circumstances if she were not safe!) through the weekend, to give time to formulate a plan for what will happen next. My best guess today is that she will be discharged soon, and we will have to find caregivers to stay with her in her home. She will be either thoroughly accomodating, highly agreeable - or - most unpleasant ever to people who are being paid to sit. Keep her in sight to be sure she is not in harm's way.
I can't imagine the her insurance will continue to pay for inpatient care just because she refuses to be transferred for rehab. But she appears to not be mobile - and the longer a person is inactive, lying in bed doing nothing the more difficult getting up and active becomes, with loosing muscle mass, mobility, agility and general stamina. Other than the inconvenience of having to get staff in place to help her get up and exercise, I don't know why she is still a patient, and surprised she has not exhausted the patience of everyone on the staff, causing some to threaten to do her grievous bodily harm. Even though as health care professionals, they are trained to relieve pain and suffering rather than be the cause.
making cheezy crafts...
... at Callaway Gardens today. I had signed up to volunteer for the day some weeks ago, and had actually forgotten what I was supposed to be doing. All I knew is that it would be indoors and air-conditioned, someplace cool and bug free.
We were making these awful tacky cheezy kites that I was almost nearly mortified to be associated with. The kid would get a sheet of copy paper with a hot air balloon design on it. After it was colored in with bits and stubs of broken crayons, it would be folded, hole-punched, taped and tied, then returned to the child who had to run around in circles to make it 'fly'. With a tissue paper tail and a three foot piece of yarn tied on for string, it would stay aloft as long as the child would dash to and fro to provide the 'lift' to make paper stay up in the air.
Making those flowers made from child's hand outline and rolled, taped onto straw for a stem look like a high quality art project. I wrote about making the little paper lily when I volunteered a day at the Gardens back in the spring. And now I feel very badly about poking fun at the process of tracing around their little hands, then cutting the shape out and rolling it to make a flower taped onto a plastic drinking straw. Not nearly as distressing as the day I spent folding and taping to make hopeless kites.
We were making these awful tacky cheezy kites that I was almost nearly mortified to be associated with. The kid would get a sheet of copy paper with a hot air balloon design on it. After it was colored in with bits and stubs of broken crayons, it would be folded, hole-punched, taped and tied, then returned to the child who had to run around in circles to make it 'fly'. With a tissue paper tail and a three foot piece of yarn tied on for string, it would stay aloft as long as the child would dash to and fro to provide the 'lift' to make paper stay up in the air.
Making those flowers made from child's hand outline and rolled, taped onto straw for a stem look like a high quality art project. I wrote about making the little paper lily when I volunteered a day at the Gardens back in the spring. And now I feel very badly about poking fun at the process of tracing around their little hands, then cutting the shape out and rolling it to make a flower taped onto a plastic drinking straw. Not nearly as distressing as the day I spent folding and taping to make hopeless kites.
Saturday, September 3, 2016
on the homefront...
...the man who lives there and has the television going at high volume was in a huge snit last night. It was sooooo peaceful and quiet, I really enjoyed being at home. Even though there was no internet along with the lack of cable for the tv. When he got home and could not turn on the news, he was hugely inconvenienced.
I suggested to him that it isn't really such a big deal. We were in a house that was comfortable and dry. Knowing there were people who were affected by the hurricane that blew into Florida and were flooded, stranded, without power, forced out of their homes, lost valuables, had lives completely disrupted. Even if not forced to evacuate due to flood waters, and camping out in emergency shelters, without power, or having trees fall on their houses, lives turned topsy-turvy. And here this guy is steaming about lack of cable service on his television.
He immediately got on the phone and called the toll free number to get his problem resolved. You can imagine how concerned the provider was about the fact that he could not enjoy having the television blast us out of the house. Concern level of Mediacom: zero.
He spent fifteen minutes (by his timing, so probably somewhat exaggerated) on hold while the customer service people were researching. Finally got irritated enough to disconnect the call, but called back immediately to complain about the wait time. And assured the second CSR he spoke with that he would be doing business with another company next week. I'm sure they are all worried about where their next paycheck will come from after that tongue lashing. Not.
Stewing and grumbling for the remainder of the night. Saying this sort of inconvenience happens all the time. And repeatedly announcing 'that is no way to do business'. I was sad with no internet, but all in all a small price to pay for an evening of peace and quiet with no television.
I suggested to him that it isn't really such a big deal. We were in a house that was comfortable and dry. Knowing there were people who were affected by the hurricane that blew into Florida and were flooded, stranded, without power, forced out of their homes, lost valuables, had lives completely disrupted. Even if not forced to evacuate due to flood waters, and camping out in emergency shelters, without power, or having trees fall on their houses, lives turned topsy-turvy. And here this guy is steaming about lack of cable service on his television.
He immediately got on the phone and called the toll free number to get his problem resolved. You can imagine how concerned the provider was about the fact that he could not enjoy having the television blast us out of the house. Concern level of Mediacom: zero.
He spent fifteen minutes (by his timing, so probably somewhat exaggerated) on hold while the customer service people were researching. Finally got irritated enough to disconnect the call, but called back immediately to complain about the wait time. And assured the second CSR he spoke with that he would be doing business with another company next week. I'm sure they are all worried about where their next paycheck will come from after that tongue lashing. Not.
Stewing and grumbling for the remainder of the night. Saying this sort of inconvenience happens all the time. And repeatedly announcing 'that is no way to do business'. I was sad with no internet, but all in all a small price to pay for an evening of peace and quiet with no television.
from bad to worse...
...with the auntie crisis: she is completely totally refusing to go to any rehab facility. Will not agree that she is unable to go home and care for herself. Even though when she fell last Sunday she cracked her pelvic bone and the femur where the artificial joint is glued in. I don't know what we will do. Or what she will do when she is discharged.
She is (thankfully) still an inpatient, at the medical center. We all know you should never go into the hospital on a Friday, or even Thursday. Nothing happens in hospitals on the weekend, so you are just paying for a very expensive motel room if you are there on Saturday and Sunday. Don't know how much longer her insurance is going to be willing to cover that expense. I desperately wish she could/would be talked into going someplace that would help her regain some mobility - as I am pretty sure she cannot get around independently at this point.
Here's what I can see, looking into my crystal ball. This is part of the conversation I had with the social worker at the hospital when I was there on Tuesday. As the next of kin, the cousins and I will likely approach this baffling situation in the same manner as one would go about eating an elephant: One bite at a time.
I know, we all know - your choice would be to go home to your safe haven. To be allowed to return to your comfortable, familiar little nest. So when she is obstinate and stubbornly unwilling to be transferred to nursing care, and therefore demands that she will go home - that will happen. But we will insist she must have someone come and stay with her. With two falls in a ten day span, it is pretty apparent that living alone would be very risky.
I expect it won't take long at all for anyone who provides home health care to have their fill of her demands and disagreeableness. So when it is impossible to find people who will go in and provide care in her home, then it will be time to make some changes. I look into my crystal ball and see 'relocation' in the future. Not some thing she will accept graciously, but there comes a point when you have to take the approach you use with teenagers: 'You don't have to like it, you just have to do it.'
She is (thankfully) still an inpatient, at the medical center. We all know you should never go into the hospital on a Friday, or even Thursday. Nothing happens in hospitals on the weekend, so you are just paying for a very expensive motel room if you are there on Saturday and Sunday. Don't know how much longer her insurance is going to be willing to cover that expense. I desperately wish she could/would be talked into going someplace that would help her regain some mobility - as I am pretty sure she cannot get around independently at this point.
Here's what I can see, looking into my crystal ball. This is part of the conversation I had with the social worker at the hospital when I was there on Tuesday. As the next of kin, the cousins and I will likely approach this baffling situation in the same manner as one would go about eating an elephant: One bite at a time.
I know, we all know - your choice would be to go home to your safe haven. To be allowed to return to your comfortable, familiar little nest. So when she is obstinate and stubbornly unwilling to be transferred to nursing care, and therefore demands that she will go home - that will happen. But we will insist she must have someone come and stay with her. With two falls in a ten day span, it is pretty apparent that living alone would be very risky.
I expect it won't take long at all for anyone who provides home health care to have their fill of her demands and disagreeableness. So when it is impossible to find people who will go in and provide care in her home, then it will be time to make some changes. I look into my crystal ball and see 'relocation' in the future. Not some thing she will accept graciously, but there comes a point when you have to take the approach you use with teenagers: 'You don't have to like it, you just have to do it.'
Thursday, September 1, 2016
sadly, things are not going well...
...for the auntie in Valdosta. She appears to have reached the tipping point the nieces have been anticipating and dreading. There have been several reports with people calling in to family services about her scare-y driving. Now she has had a couple of falls in her home. One a week ago, in the yard, with busted brow requiring a trip to the ER, and several stitches above her eye.
And another fall this past weekend, when EMS was called. She has been in the hospital since Sunday night, and will be transferred to a rehab facility when discharged. It is probably fortuitous that she has had both hips replaced with artificial joints over the past decade, or we would be dealing with a broken hip and a long recovery, learning how to walk again. Which, in the elderly, is often the beginning of the end who often do not fully regain mobility or recover completely from the surgical repair.
There are a couple of small fractures, so there will be a gradual process of putting weight on the injured leg, with hope that healing will occur in time. She is already getting some therapy in the hospital, with the assistance of a rehab specialist and a wheeled walker. The worst part is that she seems to be seriously confused, disoriented and often agitated. Even more than usual, and 'usual' is pretty daunting.
Sad for her, and frustrating too. For all the people who have tried to talk to her and get some understanding about what she would choose for herself if the time should come when she cannot live alone. That 'time' is upon us, and she has not been willing to have a conversation with the family members who will be responsible for making decisions.
So I guess this is a cautionary tale: Go ahead and talk about the future: Possibilities, options, choices. Decisions about the stuff none of us want to admit will happen, and do not want to discuss with the people who will be left to sort it all out. I've been threatening for some time to compose my own obituary. I think it is High Time.
And another fall this past weekend, when EMS was called. She has been in the hospital since Sunday night, and will be transferred to a rehab facility when discharged. It is probably fortuitous that she has had both hips replaced with artificial joints over the past decade, or we would be dealing with a broken hip and a long recovery, learning how to walk again. Which, in the elderly, is often the beginning of the end who often do not fully regain mobility or recover completely from the surgical repair.
There are a couple of small fractures, so there will be a gradual process of putting weight on the injured leg, with hope that healing will occur in time. She is already getting some therapy in the hospital, with the assistance of a rehab specialist and a wheeled walker. The worst part is that she seems to be seriously confused, disoriented and often agitated. Even more than usual, and 'usual' is pretty daunting.
Sad for her, and frustrating too. For all the people who have tried to talk to her and get some understanding about what she would choose for herself if the time should come when she cannot live alone. That 'time' is upon us, and she has not been willing to have a conversation with the family members who will be responsible for making decisions.
So I guess this is a cautionary tale: Go ahead and talk about the future: Possibilities, options, choices. Decisions about the stuff none of us want to admit will happen, and do not want to discuss with the people who will be left to sort it all out. I've been threatening for some time to compose my own obituary. I think it is High Time.
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