Health problem hits earlier than projected for

[michelek]

Health issues can really mess up retirement plans. Unfortunately my DM has encountered complications from diverticulitis surgery plus mental health issues that have landed her in an “acute” long term care facility post ICU. She has no desire or will to make progress to return home. Facility is designed to milk as many days out of her insurance as possible. So in effect, it enables her to act helpless. DF says after June 02 it costs him $700/day out of pocket in perpetuity. DF (age 77) says he never expected such a health issue to arise until well into their 80s. He’s in a quandary. Financially and emotionally. This facility will suck the money fast and change all financial projections he thought were golden.
I don’t even know the questions to ask to help at this point. I think DF would rather have DM home, then he can have a nurse come over to help with the stoma bag and daily hygiene. How can we inspire DM to do what she can (like get up and walk ) to leave the hospital? A home nurse won’t cost nearly as much as the facility she is in. Plus she’ll have a better quality of life at home. Lying in a hospital bed is a sure way to develop blood clots, bed sores, infections

 

[braumeister]

Can you bring in an outside doctor or nurse to examine her and tell her she's well enough and free to leave?

 

[Bryan Barnfellow]

You mention mental health issues. I am assuming depression due to the major health challenge and her view of a life now as bleak. Is she being treated for that? It could make the difference.

-BB

 

[Moemg]

Get the social worker from the place involved . They will work with you to help get your Mother home with a visiting nurse .

 

[Bestwifeever]

Sorry to read this--we expect our future to go on a certain way but we cannot always control it. Hope the in-home care works out for her. My late MIL always had hallucinations and other issues when she was prescribed a certain antibiotic--perhaps your DM's meds can be looked at for mental health side effects and possibly adjusted?

 

[Amethyst]

How good is their relationship? It seems odd that she'd prefer lying in a hospital, which no one enjoys, to being with her life's companion.

Using an anecdote to illustrate, when my great-Aunt had a stroke, around age 80, that took her speech (and she'd been a talker!) her devoted husband threw himself into the caretaking role. As a result, she made amazing progress, given her age, the stroke's severity, and her own awful frustration (which even as a kid, I could perceive and empathize with).

Fortunately, she could still get around. Although life was never the same, they established a life together once again, that lasted until his death from a car accident. After that, she lost the will to thrive, and basically did what your poor Mom seems to be doing. The ending was grim. I wish much better things for your Mom.

 

[MichaelB]

Get the social worker from the place involved . They will work with you to help get your Mother home with a visiting nurse .

This is excellent advice. Your parents need an advocate who is experienced and knowledgeable dealing with health care options and situations like this and will work with them to find a home care option.

In older folks, surgery and anesthesia can cause dementia. In many cases it is temporary or can be treated. It wouldn’t hurt for her to be evaluated.

 

[Human]

Get the social worker from the place involved . They will work with you to help get your Mother home with a visiting nurse .

I’m so sorry. From a somewhat similar experience, a social worker (from the place or the hospital) can be very helpful.

Also, if things progress poorly, consider contacting a local hospice organization. For me, they ended up being invaluable. I couldn’t have done the home care without their help and guidance. They can also be an advocate for bringing her home.

 

[MarieIG]

With regard to my DF, to get him out:

a) I was there morning & night;

b) I coordinated visits so that I was there when the doctor made his rounds;

c) I reviewed his meds/ chart daily (when in hospital or temporarily in the nursing home) and I also researched the meds so that I could query as to side effects (caught and error one time and insisted the nurse contact the doctor immediately while I was watching her);

d) I fought for daily PT;

e) Checked his sheets morning & night to make sure they were clean (and if not I would wait for them to be changed);

f) I encouraged visitors and arranged for telephone calls to cheer him up (I would hold the phone for him);

g) I did sit with him, talk to him, hold his hand, watch tv with him, etc.,

h) Brought him treats,

i) I was never nasty to the employees, but I was there; I believe that they were [-]happy to get rid of me[/-] willing to assist in arranging his discharge when he no longer needed IV meds, and I was able to present a plan for his home care.

j) I arranged for the house to be set up for him (hospital bed with a special mattress that moved after he became paralyzed), fixed up a large room for him that had a very nice view from the bed, and room for visitors/ company; got scripts for home PT, visiting nurse to the extent possible, got a room ready for a home health aide and found agency which would provide one;

k) The discharge plan was coordinated with the aide of a social worker;

g) Hired home health aide 24/7, Monday - Friday, out of pocket since Medicare only provided for a few hours a day (which was not enough), coordinated medications/ doctors visits, transportation to doctor visits, insurance - AND was at the house everyday - AND had help from DH AND help from grown sons.

As an aside, my mother, who was ill first, had a stoma. The nurse just came to teach us how to take care of it, not to change the bag on a daily basis. DF ended up doing that.

With my parents, the "dementia" would wax and wane depending on their physical condition/ medications. It got to the point that I knew when DF was getting a UTI by his confusion. Your mother may be depressed at this time, still weak from the surgery, or influenced by her meds.

The social worker should have information as to what type of services you mother would be qualified to receive at home.

Your father may want to see an elder care attorney to help shelter some of his assets.

Be prepared, arranging this is not quick or easy, it is time consuming and emotionally draining. Good luck.

 

[michelek]

How good is their relationship? It seems odd that she'd prefer lying in a hospital, which no one enjoys.

Well that’s the crux of the mental illness piece. She has always been a demanding, manipulative person and the hospital staff is feeding her attention seeking behavior.
In a way she is a hoarder. Not of things but of drugs and attention. When the nurses come in and ask what her pain level is it’s always a 10. No matter what. She wants more drugs. They are giving fentanyl- the drug that killed the artist formerly known as Prince. She knows when she goes home she won’t have so many people doting on her. Even in this pathetic situation she’d rather stay in the hospital than go home.

Now she has developed extreme anxiety and is so afraid to get out of bed that she described a nightmare she had last night where she “fell out of the hospital bed”. DF tried to assuage her fears by showing her the guardrails. She is petrified of standing up. She won’t do it. Even when the PT came in and tried to get her up she flat out refused. She still has bedsores on her back and her muscles are wasting away from inactivity.

The other problem is that the stoma bag keeps leaking. Totally gross. DF can’t understand why the staff can’t connect the bag so that it doesn’t leak.

I mentioned to DF that she be evaluated by a psych. And also to get a couple other opinions like the thoughtful responses on this thread have advised. He is planning to speak with doctors tomorrow. A former engineer and CEO, he is not used to being at the mercy of the hospital pecking order.

 

[Texas Proud]

I am a bit surprised they do not kick her out.... refusing to participate in PT is a reason for the insurance to stop paying...


I cannot believe that it cost $700 per day.... I would move her to a skilled nursing facility (our was $270 per day) or even a assisted living... both would be much cheaper and from our experience they would not be coddling her... they say they will, but they do not....

My mom was in a SNF until a month or so ago... they kicked her out... we moved her to a memory care facility and she has actually blossomed... actually walking and participating in activities...

 

[Moemg]

Now she has developed extreme anxiety and is so afraid to get out of bed that she described a nightmare she had last night where she “fell out of the hospital bed”. DF tried to assuage her fears by showing her the guardrails. She is petrified of standing up. She won’t do it. Even when the PT came in and tried to get her up she flat out refused. She still has bedsores on her back and her muscles are wasting away from inactivity.

Some of that anxiety may be from all the medications she is taking .As for the leaking stoma bag whoever is putting them on is not sealing them properly . You have to go around the seal and make sure it is firm . It is like fitting a tupperware lid .Good Luck with your DM I hope it gets better .

 

[candrew]

Social Worker!

Previous posters have given the best possible advice. Get a social worker involved ASAP. The situation you and your family find yourselves in can be overwhelming. A good social worker can help you with sorting out various options, assist with coordinating care and cutting red tape.

 

[michelek]

Hello again: update DM has been given the speech from the acute long term care facility where she has been staying after overstaying her welcome in the hospital ICU. They told her that if she didn’t comply with PT that insurance wouldn’t pay and they would move her to a nursing home. So she mustered up the energy to walk 5 whole feet. Then the docs also conveyed that if she “walked more than 100’ that insurance wouldn’t pay for rehab since she could easily go home and recover.” The ironic thing is that DM walked more when she was in ICU than she has since she was moved to the new place.
DF had a meeting with the docs today and they are moving her now to a rehab facility. Both docs that work at the current facility also go to the rehab place. At least she won’t be connected to all of the oxygen, heart sensors, oxygen sensors, catheters etc... in the new place. It is really hard to see yourself as healthy enough to get up and walk when 50 tubes and lines are connected to your body. Someone also figured out how to make the stoma bag work. Apparently the bag is very close to the surgery incision so the tape overlaps and causes leaks if it’s not sealed.
Thanks everyone for all of the advice. I’ve been conveying it to DF everyday. He doesn’t know how many people are behind the scenes helping me sound so smart and thoughtful!

 

[MarieIG]

Good luck to you and your family. I am hoping the services at the new facility is more in line with what your DM needs.