Wednesday, March 31, 2010

Watching Paint Dry

My plan had been to drive home today, but with Walt's brother back at home again and Alice Nan not able to leave work, Walt was left with the whole weight of his mother alone and I just couldn't leave him here to deal with that, so I made arrangements for the dogs for another day (thank you, Jessica and Ashley!) and I decided to stay here.

It was probably a good thing. I think Walt appreciated the support, but most of the day felt like we were watching paint dry. She did sit in the wheelchair for about 15-20 minutes, but seemed to be in a lot pain at that point. Walt tried to keep her calm.
It's amazing how yesterday's "emergency" totally dissolved today. The woman who was so insistent at getting Walt's mother out of the hospital Right. This. Very. Minute. was nowhere in sight today.
Part of it may have been that Blue Cross denied her coverage at Lompoc, the place about 50 miles away, which seemed to be our only option. Their dismissal was because she is trying to get approved for therapy and they didn't feel, based on the clinical notes, that she did not have the strength to do physical therapy. The chart notes showed that she couldn't brush her teeth, couldn't brush her hair, and wouldn't get into the wheelchair.

Well. Not exactly. I watched the staff at the hospital and today was a down day for her. Perhaps too much stimulation yesterday with her trip outside and with three people to talk to. She pretty much slept all day today, except for a brief 20 minute sit in the wheelchair and eating dinner (she hadn't eaten lunch). But attendants would come in and say "Alice? would you like to sit up?" and she'd say "No" and they would leave her alone. I didn't hear anybody try to encourage her to sit up, or tell her she had to sit up for a bit. Then they would write in the reports that she "wouldn't" get up. So Blue Cross thinks she can't do therapy.
What do you do with a 96 year old woman (who is too old for Medicare, since she never paid into the system) whose insurance doesn't cover recovery, but only physical therapy--when the hospital determines that you no longer need hospital care and wants to sign you out?

This was the lengthy discussion among all of us tonight, including a phone conference with Norm.
As it turns out, tomorrow is probably the day I could really be of help here, but I have to get home to finish my newspaper article and I just can't. Had I known, I would have brought it with me, but who knew all this was going to blow up?

There are several options, none particularly good. In what may be a "cover your ass" move, Buena Vista has now graciously accepted her as a patient, if the family will promise not to interfere with the nursing staff. BUT now it may be Blue Cross who will deny her, figuring that she won't be able to actually do any therapy (I'm not sure if learning how to pivot on your good leg to get yourself into a chair qualifies as "therapy").
So that's one possibility...see if Blue Cross will cover a short stay at Buena Vista.

Second would be to check into the possibility of moving her back to her apartment at Maravilla, and that will involve renting a hospital bed, removing the bed she has now, getting some sort of either restraint or a table to block her from getting out of her recliner if she forgets she has a broken hip.

It will also involve hiring nursing help, possibly around the clock, though Walt will probably come down here again next week. When she was recovering from pneumonia, he lived in her apartment for three weeks and, as he puts it, never left except to go buy screw-top wine, because there was no corkscrew in the house.
There is no way that can all be set up in a day, obviously, so she may have to go somewhere for a few days and if Blue Cross won't cover her to go anywhere, we will have to pay out of pocket for that time (at something like $600 a day).

I'm beginning to understand how people lose their homes over medical conditions!

Through all of this, Alice sleeps, totally unaware of how absolutely amazing her children are being, how much they love her, and how hard they are working to help her get through this crisis with as little discomfort to her as possible. Her job is to get well. We'll handle the details, even if it sometimes feels like watching paint dry.

Update, 11:30 P.M. Alice Nan just got off the phone with Maravilla and they had wonderful suggestions for her, telling her how to get the hospital bed, whom to call for nursing care, etc., etc. Alice Nan told the gal "I didn't realize you did all that" and she said "Alice, that's why you pay so much here!

Things are looking brighter than they did an hour ago.


1 comment:

harrietv said...

Thank goodness for her assisted living! You have greater geographical problems in California than in Connecticut, but it's really hard when you get nurses who don't think the patient is worth a little extra effort. I haven't run into that so far.