Thursday was the day! Mom was able to come home from rehab.
On Wednesday, the physical therapist did the final evaluation measuring range of motion, etc. She had mom sign forms to say the therapy was completed,
Since I had already talked to the Social Services director, she didn't have to do an in-home visit. We already have a commode chair(if needed), a wheelchair and two 4-wheel walkers with seats. (One I bought years ago at a yard sale, and last year because of leg injury, home health ordered a second, light weight model. We keep the heavier one in the house and the light one in the car.)
Thursday morning, the discharge when relatively smoothly. The duty nurse went over all her medications and gave me what was left of the ones I didn't have for her at home. We signed a couple forms and we were free to go.
At Home
The effort of getting in and out of the car and getting settled in the house was a lot for her and the first thing she did was go take a nap. Her endurance level seems lower than when she was in the rehab, but that is partially their fault. She caught a bod cough at rehab. The chest x-ray the doctor ordered was negative, but the two medications (the generics of Musinex and Robotussin) just weren't enough. She stayed awake most every night in rehab and her first night home. Large numbers of patients and guests in a confined facility can make it hard to prevent illnesses, like this upper respiratory thing, from going around through patients.
SUGGESTION: monitor your patient's health when in a hospital or rehab, and make sure that they get timely medical care. I should have been more conscientious about asking her about the cough each day, and then insisting that the medication be increased or changed when she didn't improve.
On Friday, her endurance dropped even more, especially since she had been coughing most of the night. I phoned our doctor and he called in both a stronger cough medication but also a 5-day treatment of antibiotics. We have an appointment with him on Monday. We're going to discuss her weakness and lack of endurance, her shortness of breath and whether or not she needs oxygen at home at night to help her improve, and her lack of appetite. If the later continues, she may end up back in the hospital for IV fluids, so I try my best to get her to eat and drink, a little at a time, every hour. I have been making milkshakes with Boost and Ensure.
MILKSHAKE RECIPE: 1 cup ice cream, 1/2 c milk or Boost/Ensure or other supplement drink, 1/2 tsp vanilla extract (or almond or mint), and 1 tbs sugar. Blend well. This makes one serving.
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Home Health visit
SUGGESTION: In our case, the rehab assigned a home health agency to us and sent them her paperwork. We didn't have a choice. But you may have an agency in mind and want to use them (see side bar for suggestion on hiring home health agencies and aides). If so, be sure you discuss your choice with the social services person several days before you are scheduled to leave so the referral will be sent to the correct agency.
The Home Health nurse came on Friday to do the initial evaluation. She asked a lot of questions about mom's background health as well as her current condition (her personal medical history came in handy again - see side bar under pages). The nurse took her vital signs and asked us to call her after we saw the doctor on Monday. We signed the papers saying we agree to their services. Fortunately, they accept what Medicare deems normal and acceptable, so there is no out of pocket cost.
We discussed what mom had for durable equipment at home (walker, wheelchair, etc.), how often we'd see the nurse, and what the plan was for continuing physical therapy. We also went over mom's lack of appetite and what I could do to help her regain her strength, though it will take several weeks.
Home Health will be providing a nurse's visit a couple times a week, physical and occupational therapy. That all starts on Monday, so I'll let you know how it goes.
Take Care
Kathy
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