Papa's Coming Home...........

On Wednesday, our HMO decided that Papa could be discharged from the hospital and sent to a "skilled nursing facility" to regain some strength, through physical therapy and continued medical care. Nothing had really changed in his medical condition, and in some aspects he was worse. But, apparently they considered that he was tying up an expensive hospital bed at his "level of care." Although, his head was finally clear of the effects of the narcotics and his white blood count was down, which showed the infection was getting better with the course of prescribed anti-biotics.

The HMO said that they contracted with the facility and had one wing that was devoted entirely to their patients, to include a full-time HMO doctor and registered nurse-case-manager. The "skilled nursing staff" are not employed by the HMO and that became very evident. From the outside, the place looked wonderful and modern. It was set back in a tree-lined, shady business area of town, but away from the busy main street .

In this section of the valley, the heat can be excruciating and right now we’re having a terrible heat wave with an average daily temperature of 108 degrees. I think it was at least that hot in the facility’s lobby as we wheeled Papa in the door. To give them the benefit of the doubt, it was nearing 7: 30 p.m. when we arrived, so it was likely that the facility shuts down it’s air conditioning in the areas not used, after business hours. There were two, 200 gallon fish tanks in the wall of the waiting area, and I cannot believe that the water was not boiling. The fish appeared pretty sluggish, but I hope for their sake that the aquariums are temperature controlled.

We were told that Papa’s room was 323B, and we followed the young man pushing my dad’s wheelchair down the long hallway that was probably just 20 degrees "cooler" than the main lobby. Of course, since I am menopausal, anything above 75 is too hot for me. The attendant wheeled skillfully through the maze of dazed looking people in wheelchairs, many babbling and asking for assistance, which was generally ignored by the staff. Later, while I rushed down the hall for a quick potty break, I made friends with a frail 93 year old lady named "Polly" and I held her soft, bony hands while she told me about her breathing difficulties, her lost address book and how "they" wouldn’t give her vitamins. For that few minutes, my bathroom business could wait.

In the mean time, the attendant got Papa settled in his bed. He was fortunate to get near the windows and an air-conditioner, of sorts. The room was warm and crowded with all the medical equipment, used by his roommate, Pierre. Pierre; a double amputee just below the knees, looked to be about 65 or 70. He laid in his bed, clothed only in a diaper with his oxygen machine next to his bedside table. His "legs" complete with shoes and socks, were standing at attention, across the room by a wheelchair. For some reason, Pierre thought I was a staff member and he repeatedly asked me for help wanting to be "cleaned" or his water handed to him, etc. The water was not a problem, but I explained that I’d get one of the nursing staff to deal with his other issue. I’m pretty helpful, but sometimes I have to draw the line. Besides, we hadn’t even been introduced yet! J

Papa laid in the bed and I had his chart in my hand for about 45 minutes, until the intake nurse came in, hooked up his IV and took the chart from me. At that point he began asking for his Reglan, (a medication for his acidic stomach) and something for the pain, but they had to call the doctor for authorization.

Repeatedly Papa had to use the toilet, and we’d have to maneuver his IV stand through the crowded room to the restroom on Pierre’s side of the room. He’d then have difficulty getting up off the stool, which did not have a raised toilet seat, so we’d have to call for help. Finally, they showed us the portable toilet seat/stand that he was supposed to place over the stationary stool. Ohhhhh. I think I missed that part in my 30 minute nurse’s training.

We stayed with him until about the time we felt he’d be able to finally get some much needed sleep, thinking he was in fairly good hands and then we headed home.

To be continued…………………