Both mom's doctor's called me today about mom's condition. They both wanted to discharge her to go
back to her nursing home. Her WBC was 13 this morning which means she still has an infection. She is
not on any antibiotics. I thought she might have a UTI and they sent out a sample. The lab returned with
enough bacteria that I thought the ID doctor would start her on at least a mild UTI antibiotic before sending
her back to the nursing home. Not so. She says if we just keep giving her antibiotics she will become immune to more of them. While this is true it doesn't seem like a good idea to send her back with it unresolved. Since she wouldn't change her mind in a day or 2 it is wise to send her back I guess. They can treat a UTI at the nursing home. The strangest part of this is that most of these labs take 72 hours to return the full result that they prescribe the right antibiotics from. The test tells them which will work. It has been less than 48 hours since they took the sample so how she knows that she wouldn't want to prescribe antibiotics I don't know. Now the nursing home will have to test her urine and start the whole process all over again or wait & obtain the labs at 72 hours from the hospital. Like I say though if the facility can treat it when they want to what is the point of keeping her in the hospital longer & have the ID specialist say no we won't give antibiotics for it. When I asked if the colonization was over 100,000 she said yes but it was a mix of different bacterias. Don't know what that means but she is a little less responsive like she is when she has
a UTI.
Dorothy Harris (Mom) usually lives at Sandy Lake Rehab in Coppell, Texas but is in the hospital right now & Robert Harris (Dad) lives at Vista Ridge Nursing Home in Lewisville, Texas
Tuesday, January 29, 2013
Saturday, January 26, 2013
Friday, January 25, 2013
Mom - Friday, Jan. 25, 2013
Mom - Friday, January 25, 2013
Called the hospital today and her Hemoglobin is up to 10.? which is slowly climbing. This is good.
However her white blood cell count has risen back to 13. Not good so they were going to send her
back to the nursing home but will wait and collect a WBC count tomorrow.
When I saw her last night, 24th, she was showing signs of discomfort & I knew it had to be either
a passing stomach ache or the infection coming back & was looking for the WBC this AM to tell
me which it was but when I called no count had been ordered which was strange considering there
was one all week. This AM would have been the 72 hours since last antibioitic dose which would
be when any infection would return. So I called and as POA requested one & sure enough the
WBC is climbing back up. I figured the dropping WBC through the week was while she was
still having the antibiotics in the system. The funny thing is I expected it to be 13. I have gotten to know her so well I could predict the count.
No new ones have been ordered and the Infectious Diseases MD hasn't seen her today or made
new orders. Maybe they are waiting to see if the WBC is higher, same or lower tom. She has had
an awful lot of antibioitics in her system. Tomorrow we will see. I am glad her hemoglobin is going
in the right direction.
Called the hospital today and her Hemoglobin is up to 10.? which is slowly climbing. This is good.
However her white blood cell count has risen back to 13. Not good so they were going to send her
back to the nursing home but will wait and collect a WBC count tomorrow.
When I saw her last night, 24th, she was showing signs of discomfort & I knew it had to be either
a passing stomach ache or the infection coming back & was looking for the WBC this AM to tell
me which it was but when I called no count had been ordered which was strange considering there
was one all week. This AM would have been the 72 hours since last antibioitic dose which would
be when any infection would return. So I called and as POA requested one & sure enough the
WBC is climbing back up. I figured the dropping WBC through the week was while she was
still having the antibiotics in the system. The funny thing is I expected it to be 13. I have gotten to know her so well I could predict the count.
No new ones have been ordered and the Infectious Diseases MD hasn't seen her today or made
new orders. Maybe they are waiting to see if the WBC is higher, same or lower tom. She has had
an awful lot of antibioitics in her system. Tomorrow we will see. I am glad her hemoglobin is going
in the right direction.
Caregiving
Caregiving is some of the most difficult and
demanding work that we will ever do. It demands great patience and
strength of character. It is not a role for wimps or martyrs; it is a
role for the courageous and the optimistic.
You will probably have many moments of sorrow, even despair, but you will never, ever regret taking on this very difficult work. For the rest of your life, you will know that within you lives a hero.
You will probably have many moments of sorrow, even despair, but you will never, ever regret taking on this very difficult work. For the rest of your life, you will know that within you lives a hero.
Mom - Thursday., Jan. 24, 2013
Written January 24, 2013 AM
The WBC was down to 11 today which is great. The other place had really killed off all her good bacteria. It has also caused a new problem. Her hemaglobin fell to 5. She had to have a blood transfusion yesterday, Wed., and it brought up her count. Although her hebaglobin count has been around 9 something yesterday it was 5. Scared them. Anyway it was back up to 8.9 last night and today something like 9. But I am still trying to get them to do another transfusion or get a hematology consult & can't seem to get either even though the count is still low.
The WBC was down to 11 today which is great. The other place had really killed off all her good bacteria. It has also caused a new problem. Her hemaglobin fell to 5. She had to have a blood transfusion yesterday, Wed., and it brought up her count. Although her hebaglobin count has been around 9 something yesterday it was 5. Scared them. Anyway it was back up to 8.9 last night and today something like 9. But I am still trying to get them to do another transfusion or get a hematology consult & can't seem to get either even though the count is still low.
Mom - Wed,, Jan. 23, 2013
Written on January 23, 2013
I went to see mom tonight at the hospital. She is much better. She smiled alot. The doctors all called today & mentioned the new orders & dc'd orders. After her WBC was 21 Monday night, 19 yesterday - it was 13 today. They stopped the antibiotics since they weren't indicated in the sensitivity culture. She is more like herself. It is nice to have her back.
I went to see mom tonight at the hospital. She is much better. She smiled alot. The doctors all called today & mentioned the new orders & dc'd orders. After her WBC was 21 Monday night, 19 yesterday - it was 13 today. They stopped the antibiotics since they weren't indicated in the sensitivity culture. She is more like herself. It is nice to have her back.
Shut the closet doors
Dad has adopted a strange habit as his
alzheimer's has advanced. In his nursing home room every closet door has
to be completely closed (not even an inch open or ajar). The problem is
if he forgets to close it himself before he gets in bed he orders me to
close the slightly open closet door before I leave. He does not ask -
he goes "Hey close the closet doors" Well in the last place if the
sliding door was open a half an inch He
would order me so I would just do it even if it was a crack. Tonight he
was in bed & said hey close the door there & I said no you can
handle that & I don't work at the nursing home. On my way down the
hall I could hear him say - So you are going to make me get out of bed
to do that? It struck me funny. No one was making him do anything. Why
not just leave the closet doors ajar? He can either get up & close
them or leave them ajar. I don't remember him being this OCD or
persnickity? I have always wondered though if he is just used to barking
orders at the staff & having them followed. He can always close
them before getting in bed.
Dad's Mother in Law
Well tonight I went by to visit mama in the
hospital first to see what kind of shape she was in before bringing
Grandfather to see her. During her horrible night Tuesday night going
into the ER she kept crying out for him so I knew I had to but wasn't
going to put either of them through that if she wasn't in good shape.
She had her eyes closed but I turned on the lights in the room &
turned up the tv & started talking
to her. Nothing. Then I walked out to hand papers to the nurse &
walked back in & she was looking for me. I talked & sang a
while & when I could see she was comfortable I went & brought
dad to see her. I hadn't seen dad myself in a few nights because of all
the business of her illness & getting her in a different building.
He was doing well. They were each glad to see each other.
The funniest thing happened when we got back to his nursing home. There was a female patient in a wheelchair facing the front window sound asleep with her stocking feet on the wing chair. I said hey dad come look at the lady in the window. Now this is about 11:00 at night. So dad says oh yeah that's my mother-in-law. I just started smiling. He was very pleased with her & whoever she was. I thought - he is finally making friends in there. Anyway I said dad she cannot be your mother-in-law. That would be Nannie Mattison. Then he stumbled over his words & said she runs my ______ I had no idea what he was trying to say & I said activities & he said yes. Well I know she doesn't do that but maybe she helps him out with something. Anyway it struck me funny how she watched out the window in the dark. It didn't occur to me til later that she may have been watching for him to come back. I am just so happy he has made friends in there no matter who they are. The way he makes himself a stranger in these places as if he isn't there for long seems a shame. Even if you are only there for a short while why not enjoy the stay with friends. Maybe they just share a table in the dining room. I am just so happy he has someone that makes him smile. Even if he thinks it is his mother-in-law.
It made me smile to think of the talks I used to have with mom when dad was in rehab in FL. She would constantly ask to speak with her brother Bill & her father. When I would reply that they had died & were in Heaven she would say "Oh that is ridiculous - someone would have told me - why didn't I get to go to the funeral?" & I would say that she had been to their funerals & had gotten to say Goodbye and that she had forgotten about it. She accepted that. But we did have that conversation often.
The funniest thing happened when we got back to his nursing home. There was a female patient in a wheelchair facing the front window sound asleep with her stocking feet on the wing chair. I said hey dad come look at the lady in the window. Now this is about 11:00 at night. So dad says oh yeah that's my mother-in-law. I just started smiling. He was very pleased with her & whoever she was. I thought - he is finally making friends in there. Anyway I said dad she cannot be your mother-in-law. That would be Nannie Mattison. Then he stumbled over his words & said she runs my ______ I had no idea what he was trying to say & I said activities & he said yes. Well I know she doesn't do that but maybe she helps him out with something. Anyway it struck me funny how she watched out the window in the dark. It didn't occur to me til later that she may have been watching for him to come back. I am just so happy he has made friends in there no matter who they are. The way he makes himself a stranger in these places as if he isn't there for long seems a shame. Even if you are only there for a short while why not enjoy the stay with friends. Maybe they just share a table in the dining room. I am just so happy he has someone that makes him smile. Even if he thinks it is his mother-in-law.
It made me smile to think of the talks I used to have with mom when dad was in rehab in FL. She would constantly ask to speak with her brother Bill & her father. When I would reply that they had died & were in Heaven she would say "Oh that is ridiculous - someone would have told me - why didn't I get to go to the funeral?" & I would say that she had been to their funerals & had gotten to say Goodbye and that she had forgotten about it. She accepted that. But we did have that conversation often.
Facilities of Different Care Levels
PLEASE SHARE & PASS AROUND THIS STATUS TO
SAVE ANY FAMILY & PATIENT OUT THERE THE PAIN & MEDICAL HELL WE
HAVE BEEN THROUGH THIS PAST MONTH:
We need to help each other.
There are all different types of health care facilities.
There are skilled nursing facilities (nursing homes), there are Assisted Living Facilities (ALFs), Major Hospitals, & then there are LTAC hospitals (Long Term Acute Care Hospitals). The LTAC my mother has been in 3 times has an ICU but LTACs generally don't have ERs or Operating Rooms. The average stay for a patient at an LTAC is 28 days. The stay is covered by all types of insurers but getting admitted usually requires coming over from a major hospital. If an LTAC admits too many patients in a year that discharge prior to 28 days they pay a fine or penalty so for certain types of stays it is in the interest of the patient to go there. The problem is that if the patient is healthier a week after they go in there they will keep or make the patient suffer medically to justify the 28 day stay. There are ways to do this. My mother has stayed at this facility 3 times now. In March 2012 she went there to wean off a ventilator & onto a trache. They took good care of her & I was grateful to have her there because the major hospital had exhausted her days she could be there. W/O them she would have remained on a vent forever & had a lower quality of life since. When she got pneumonia the week of Thanksgiving in her nursing home we sent her to the major hospital. Then because she was getting IV antibiotics we sent her this same LTAC to complete her IV antibiotics. I did not realize that they would harm a patient to avoid that penalty for early withdrawal. I wasn't even aware of the early discharge fee. During the course of her stay they changed the course of very strong antibiotics 3 different times so that when she went back to her nursing home she was only healthy for 1 week & straight back to the ER. At this ER her bacteria was immune to 8 antibiotics so they had to put her on one that was $1,000.00 a dose. It was the only one left that would heal her. 4 doses a day. So before any other care costs she has had $4,000.00 a day of antibiotics going into her. Well a nursing home under nursing home medicaid cannot afford a patient on that price of antibiotic so where does that force her to go? Right back to the LTAC that made her immune to any cures
for future illnesses or suffering. And of course the 28 day stay again is going to force them to abuse antibiotics all over again. The 1,000.00 a dose Zosyn was supposed to be a 14 day course (not 28 days). The LTAC accepted her this time promising to only keep her the remainder of the 14 days while finishing the Zosyn. Then on the 14th day she looked great. Her WBC was 8.5. The pulmonologist recommended that they DC the Zosyn to get labs. The Infectious Disease specialist disagreed & the general attending did not have the power nor did the pulm. to overthrow the decision of the ID doc so they kept her on this powerful antibioitic past its normal course. By W-T her WBC was back up to 15, by F-S it was back down to 13 & she had been on Zosyn for 20 days. Past the 14th day she had new trouble breathing. This whole week her kidneys became comprised for the first time in 6 months & lungs took a hit. I tried to change her ID doctor & the place agreed but never did so which further harmed her. All of this was for the 28 day stay to avoid a penalty. My mother went to the ER with a white blood cell count of 21 & a BUN of 40. She is Severe Alzheimer's & is in medical hell because of a penalty for patients early DCs from LTACs. Be very cautious of admitting a frail person to a place that has an average stay of 28 days. And if you inquire of this to the admissions/marketing people at these places or to the discharge planner at a major hospital trying to get her out of the building (which is their job) they will most definitely lie to keep their job. You do not want to put your loved one through what my mother has been through this week. Also a POA, next of kin or legal guardian cannot get a patient out of an LTAC unless they want to do it AMA and pay the ambulance transfer costs & possibly the ER costs w/o insurance covering because it is AMA. I had to fight for 5 hours to get her out & almost couldn't get her out of there. The 5 hours further jeopardized her health. A POA or responsible party can always get a patient out of a nursing home or major hospital. Never at an LTAC. The patient can't even get themselves transferred or discharged. They keep you against patient wishes.
We need to help each other.
There are all different types of health care facilities.
There are skilled nursing facilities (nursing homes), there are Assisted Living Facilities (ALFs), Major Hospitals, & then there are LTAC hospitals (Long Term Acute Care Hospitals). The LTAC my mother has been in 3 times has an ICU but LTACs generally don't have ERs or Operating Rooms. The average stay for a patient at an LTAC is 28 days. The stay is covered by all types of insurers but getting admitted usually requires coming over from a major hospital. If an LTAC admits too many patients in a year that discharge prior to 28 days they pay a fine or penalty so for certain types of stays it is in the interest of the patient to go there. The problem is that if the patient is healthier a week after they go in there they will keep or make the patient suffer medically to justify the 28 day stay. There are ways to do this. My mother has stayed at this facility 3 times now. In March 2012 she went there to wean off a ventilator & onto a trache. They took good care of her & I was grateful to have her there because the major hospital had exhausted her days she could be there. W/O them she would have remained on a vent forever & had a lower quality of life since. When she got pneumonia the week of Thanksgiving in her nursing home we sent her to the major hospital. Then because she was getting IV antibiotics we sent her this same LTAC to complete her IV antibiotics. I did not realize that they would harm a patient to avoid that penalty for early withdrawal. I wasn't even aware of the early discharge fee. During the course of her stay they changed the course of very strong antibiotics 3 different times so that when she went back to her nursing home she was only healthy for 1 week & straight back to the ER. At this ER her bacteria was immune to 8 antibiotics so they had to put her on one that was $1,000.00 a dose. It was the only one left that would heal her. 4 doses a day. So before any other care costs she has had $4,000.00 a day of antibiotics going into her. Well a nursing home under nursing home medicaid cannot afford a patient on that price of antibiotic so where does that force her to go? Right back to the LTAC that made her immune to any cures
for future illnesses or suffering. And of course the 28 day stay again is going to force them to abuse antibiotics all over again. The 1,000.00 a dose Zosyn was supposed to be a 14 day course (not 28 days). The LTAC accepted her this time promising to only keep her the remainder of the 14 days while finishing the Zosyn. Then on the 14th day she looked great. Her WBC was 8.5. The pulmonologist recommended that they DC the Zosyn to get labs. The Infectious Disease specialist disagreed & the general attending did not have the power nor did the pulm. to overthrow the decision of the ID doc so they kept her on this powerful antibioitic past its normal course. By W-T her WBC was back up to 15, by F-S it was back down to 13 & she had been on Zosyn for 20 days. Past the 14th day she had new trouble breathing. This whole week her kidneys became comprised for the first time in 6 months & lungs took a hit. I tried to change her ID doctor & the place agreed but never did so which further harmed her. All of this was for the 28 day stay to avoid a penalty. My mother went to the ER with a white blood cell count of 21 & a BUN of 40. She is Severe Alzheimer's & is in medical hell because of a penalty for patients early DCs from LTACs. Be very cautious of admitting a frail person to a place that has an average stay of 28 days. And if you inquire of this to the admissions/marketing people at these places or to the discharge planner at a major hospital trying to get her out of the building (which is their job) they will most definitely lie to keep their job. You do not want to put your loved one through what my mother has been through this week. Also a POA, next of kin or legal guardian cannot get a patient out of an LTAC unless they want to do it AMA and pay the ambulance transfer costs & possibly the ER costs w/o insurance covering because it is AMA. I had to fight for 5 hours to get her out & almost couldn't get her out of there. The 5 hours further jeopardized her health. A POA or responsible party can always get a patient out of a nursing home or major hospital. Never at an LTAC. The patient can't even get themselves transferred or discharged. They keep you against patient wishes.
Caring
Did you know the people that are the strongest
are usually the most sensitive? Did you know the people who exhibit the
most kindness are the first to get mistreated? Did you know the one who
takes care of others all the time are usually the ones who need it the
most? Did you know the 3 hardest things to say are I love you, I'm
sorry, and Help me. Sometimes just because a person looks happy, you have
to look past their smile and see how much pain they may be in. I copied
this from a friends wall because I thought it was powerfully true. We
all need to pay more attention to those around us ♥ x
Singing to an Alzheimer's Patient
Singing
to my mom at the hospital or nursing home does calm her a great deal. I
will have to learn some new songs though because there aren't enough of
them that I remember the words to. I am still singing Christmas songs.
She does like the 12 days of Christmas. Good for my memory too.
Sleepless Nights
Coping With Sleepless Nights -
Write down all of your thoughts, concerns and to-dos before you go to bed. Since nothing is going to get accomplished in the middle of the night, you’ll feel some satisfaction knowing that everything you need to address is on that piece of paper waiting for the morning.
Write down all of your thoughts, concerns and to-dos before you go to bed. Since nothing is going to get accomplished in the middle of the night, you’ll feel some satisfaction knowing that everything you need to address is on that piece of paper waiting for the morning.
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