The doctors are also checking the heart; his is enlarged, with a-fib. The VA sends a caregiver 3x weekly for 3 hrs each time; she's marvelous. Naturally, he pushes to come home; he's desperate. If he does make it home, he'll need to use a manual wheelchair. I am 68 with a hernia and have stated I can't push his 230 pounds around, so tomorrow I'm notifying his PCP that his would not be a safe release back home. To complicate matters, he's 100 percent VA covered but the EMTs took him to County General because the nearest VA hospital is 100 miles away. At the moment, I'm considering what to write in the note: "unsafe discharge," "I'm unable to help with his mobility," but does anyone have other suggestions? Thank you.
Also look into other programs the VA has . I had my Husband on a program called VIP (think it stands for Veterans In Place) but they keep changing the programs and the names of them but I am sure he/you can get more help. Also you can get equipment that will help you. A PT and OT will help with anything they think you might need when he is ready to come home.
Quite honestly for the future you may be looking at a need for placement simply because of the weight problem. They will do all they can to get him home as anything else costs them. They will say they will get you more help and help you "make this work". Really you already KNOW that will not happen.
I would make you letter on unsafe discharge start with the sentence that you cannot and will not accept your husband back into home care; that at least rehab and possible placement is necessary due to A) your own condition B) his weight and debility.
Good luck.
I was in the hospital earlier this year with new diagnosis of Diabetes and I stayed for 8 days, The medical team wanted to monitor and check m diabetes to get it under control.
If he was there for 3 days, wouldn't he be eligible for rehab straight from the hospital?
1. Most important, the daily insulin injection.
2. 16 sorts of daily meds prepared in pill tray and given to him
3. MOBILITY WORSENED RE L. KNEE COLLAPSE
4. R hand bad sprain (no fractures per Xray) because he fell on it on 9/1. Stated last night "when my R side is touched or moved in a certain way it hurts".
5. Changing Depends infrequently.
6. Hoarding snack packages around bed, computer, etc., which the EMTs noticed last night and commented on.
It's important to say he handled #1 and #2 himself for many years now to his great credit. I do not know how I would handle all these issues for myself.
Of course he wants to come home. I would, too. New developments are 1. somehow ER missed the broken rib he incurred on Sept. 1 and which hurts him now and 2. A-fib developing into V-tac (SP?)
Just one comment on his latest fall. You might want to eventually switch from a walker to a rollator. He could sit down on the seat; being 4 wheeled, it provides much more support than a walker. After we got one for Dad, I realized how unsafe a walker can be.
I certainly agree that the hospital is now the safest place for him, especially given the latest cardiac DX, which needs to be addressed, and the fact that it's challenging for him to realize how much more challenging it would be to come home.
I complement you and your family on your care and strength.
I'm doing my best to care for him from 15 miles away. He said on the phone "yes I have a new heart issue I discussed it with the MDs it's nothing" and I believe that to be untrue. He pulled out all the stops yesterday to convince me to bring his scooter so he could scoot out of there and come home: tears, 'why don't you help me,' and so forth. It was awful. He sounded hoarse and slurred from pain meds given for his broken rib and sprained R hand. It goes against all I have inside me after 36 years of us being together in the family business and regular living together not to respond. The rest of the hr. long talk was the usual sports, politics, upcoming family birthdays, etc.
I think if I say "you had a heart attack" which is one of the V-tac descriptions, he would understand a bit more and perhaps I'll use that simple phrase rather than V-tac, which would be new to him. I dread talking to him because of his obstinacy re where he needs to be for his best care.
I stated earlier that the 9/1 fall was due to low blood sugar, which it may have been, but this whole new V-tac puts a new slant on the reason, as does his statement 'my left leg doesn't work anymore' on 9/5.
Years ago my mom told me that "when someone is sick, you have the lying down person and the standing up person. The lying down person is in no way able to ask the right questions or make important decisions". She already had some cognitive decline going on when she said this, but it is such a nugget of wisdom!
Wishing you both the best.
Can you get a psych consult? It doesn't sound like he's acting in his own best interest.
If the Cardio appointment today?
Cardio administered a stress test to confirm the V-tach findings; he had a Zio monitor for 1 week that got sent for evaluation yesterday; he's well cared for.
I'm unsure about discharge; I've reiterated to nurses, dr.s and case mgrs. "I cannot care for him in this unsafe environment" due to all the stuff I've stated before. He needs skilled nursing and it looks like he'll get it. After the 100 days, who knows?
Also, did the VA Social Worker tell you about the various support functions available to caregivers? From what I've read in their newsletters, they've expanded beyond what was available when we were involved with VA care.
You probably are aware of this, but his first day home will be a challenge, including re-adjustment, and possibly relief mixed with fear over his recent episodes and challenges.
Make sure you take some downtime for yourself.