The hospitalist pronounced my mom medically stable but the PT/OT department said she couldn’t go home yet. But first, I read the hospitalist’s report in her portal. Holy wow. Her urine was clear (no), she denied any pain (no), she has SVT (no) and he put her on metroprolol. I asked for how long, he said incredulously, this will not go away, she will take it always. Her wbc count is high (15) but lower than yesterday (18). There is no plan to continue antibiotics. She is incontinent (no) and that was the last straw. I said what about her wbc count and he WAVED HIS HAND AT ME and said “she’s fine, it’s coming down”. Behind him, the patient advocate rolled her eyes. I entered the field of battle with “she’s not incontinent” and explained, again, the problem (TMI ) and when I trailed off HE LEFT THE ROOM. The nurse went and got him to come back and when the patient advocate suggested maybe a urology consult , I said absolutely.
Consult was last night, doctor is wonderful. She doesn’t have a uti. She has a mass in her bladder…They’ve moved her to the step down unit for observation and PT, that’s where the uro consult happened. Same day, same unit my late father was in for his last hospitalization a year ago. I went back to the house and ate a bowl of ice cream.
It sounds like the staff are aware of the failings of the Hospitalist. A facility is going to be very reluctant to do anything drastic with a MD.
All I can say is a Hospitalist lead FIL to a wrong health choice when no family was at the hospital (BIL had cataract surgery, so when transfer from skilled care to hospital was before DH could get there with 850 mile drive) - ‘comfort care’ versus treating his Covid with just standard meds that any younger person would have been given. The only reason this was proposed to FIL was due to his age. FIL did not fully understand. Have to be totally aware that some hospitalists are ingrained with some ideas that may not be best for a patient, especially an elderly patient who still has some QOL left with the right care, and has a right to die with dignity embracing their own faith beliefs. In FIL’s case, hospitalist thought he could foresee a quick death with FIL with ‘comfort care’; after so many days, FIL was transferred back to skilled care to die, never regaining consciousness.
We had the absolute worst experience with a hospitalist at the end of my mom’s life. She refused to acknowledge my mom, speaking only to my dad. She wouldn’t listen to him, and I ended up basically forcing my dad (from many miles away) to tell her that she had to test my mom for a staph infection. She made it abundantly clear that she was only doing it because he insisted - intimating that insurance may not cover it because she didn’t believe it was medically necessary. Lo and behold … MRSA. It was one of the combination of things that killed her. I was not a pleasant person when I flew to see my mom & gave that hospitalist an earful. I complained to her boss, but a nurse told me that he was her brother …
When I reflect on my BIL’s passing in the hospital…that was the mantra–send him to hospice–it’ll be cheaper. I can’t relate the details. Just never get sick with no advocates.
We’ve now authorized about $6k of work on the exterior to get it back into shape.
The inside needs updating, but mostly it needs a good cleaning.
We have suggested to StepMom (92+; in a wheelchair) that we/she sell her car — and you’ll love her answer: She wants to keep it so her friends can drive her around in it!
We haven’t yet shown her the budget — one of us needs to do that in person. The house is costing about $30K year to sit vacant, a bit more with fixing it up.
I would also like the house sold, because if my father passes first, StepMom will need the cash for her care (her pension and SS will only cover her care at AL, but not any higher level). AND she can’t handle the carrying costs of the house.
We are on round 3 for updating StepMom’s will. We never make it past updating the list of beneficiaries (so we can’t yet give the list to the lawyer). Once she agrees to the beneficiaries, she’s going to get a POA, which she does not currently have.
Aside: if you go through the house, you will find many “notes” — with changed intentions for her will. These notes, written over the years, are not admissible in NY. (They don’t meet the criteria of having two or more non-beneficiary witnesses).
Beds: Both seniors are back in AL, where they have been in twin beds previously, and StepMom has pushed for a shared bed. (In January, she would only sleep with her husband in a king). Only a Double will fit in the AL room — who could have predicted they are not sleeping well in a Double?
I am helping our DD/Gkids while SIL is helping his parents clear out a storage rental they have not been to for 2 years, clear through stuff in home office and garage - to transport some items to his brother, maybe transport some items that they want to have ‘family move’ (they plan to move to their other son’s city, which is 6 hours by car from SIL), and some of the things SIL wants to keep. SIL flew out and will drive back; using 2 weeks of leave time. DD is getting SIL to focus on specific tasks every day, which is also keeping his parents focused.
Once he is finished, parents can hire someone to clear out their on-site garden shed, and whatever doesn’t get done in this time period.
DD is in health care management, and has been very good with guiding his parents along with their medical issues. They both need a physician sign off for the community they want to get in near their son’s – and DD is having them get it very directly to get things moved along. His parents were on DD/SIL’s cell phone plan, and evidently they need to get on another plan during this month. DD has begun a daily communication including SIL/BIL so everyone is aware of how things are going with the process - throw away, give away, keep.
The 4 grandchildren need a second adult during one parent’s absence (ages 1 - 6). M - F DD will take them all to summer day care and day camp at the same place (older two just finished 4K and K) and pick them up after work, so leaving the house at the same time as they do during the regular school year. They all get breakfast at day care/day camp, so just need to give them a breakfast bar for the drive. The older two just finished school last Thursday, so it will be interesting to see what they say about day camp - but I am sure they will have a blast. The day care has some cute stuff coming home with arts/crafts. With me here, DD got the things done she needed to get done while I handled a lot of child care as well as kitchen and laundry chores. M - F I will have daytime ‘off’.
Once SIL’s parents get moved, we can stop by to see them in their new city on our drive to DD/SIL/gkids which we go over Christmas/New Year’s – it helps with child care when DD and SIL both can’t take off work. IDK if they will get moved in this calendar year, but they need to.
SIL/parents are reminiscing some while going through the house and storage areas - and the daily phone calls DD has with her DH help keep the focus and getting a lot of things accomplished and the plan for the next day.
Tomorrow my mom will have a cystoscopy to see what is going on with her insides; it might be a cancer, it might be blood clots, either one is pretty treatable. She had seemed particularly confused these past few days and we were worried. She isn’t eating particularly well or much, but then again who really wants to when you are stuck in a hospital room, with a catheter , cranky bladder, and unpredictable GI?
She has a roommate now so things are even more cramped and she is trying to not use the bathroom so she doesn’t “bother” the nurses (she is not allowed out of bed without help, not even mine alone) or “use up” the bathroom. Roommate’s children asked if we minded that Thursday evening their friends are coming to set up a livestream of a grandson’s graduation ceremony starting at 7 pm. I was appalled, but decided to let nursing handle it.
They have been giving her some painkiller that the pharmacy report warns can cause falls and delirium; that explains the confusion of the past several days. The nutritionist report says she doesn’t eat quite enough so please supplement with Ensure; it started showing up yesterday but NOBODY told us she was supposed to drink it and she just skipped it. She can order half a sandwich and 8 oz of milk without any pushback about her tiny meals.
I found most of this out searching through her online portal for documents and notes. I am home now, about to go see S1 with siblings’ blessing to go. We come back in 8 days and will stop at my hometown to see how it is going but by then we should have more info. I just can’t believe they think putting a carton of Ensure on a tray without comment is gonna get more protein into her.
Sounds like she is getting conscientious care after earlier situation. Even if she has bladder cancer, it is highly treatable. Due to having a little blood in our urine, both DH and I at different times have had in-office uroscopy by urologist.
Hope the urologist gets whatever bladder/urinary issue your mom has resolved - then your mom will be feeling better, and perhaps her appetite will improve.
The psychological aspects in addition to the physical aspects are most likely affecting her, and being in a space compromised hospital room.
Limited visitors in a shared patient room is for a reason…
One can live stream on a phone or tablet and not have a room full of people…
The cystoscopy was supposed to happen at 2, it actually didn’t happen until 7 and they put her back in the main hospital around 8:30. She had been npo since the previous midnight so bless the nurse that made food a priority as soon as Mom was coherent and cleared. We had a different hospitalist this time.
Biopsy will take a week. Urology says they don’t expect it is cancer (which my FiL has been treated for , for about 4 years) but instead a complication of the overall infection. She is feeling a bit better.
They want to keep her several more days, maybe a week, for PT and OT. Siblings and I had thought this might be a good time to transition to the (only) AL facility in town and Mom was reasonably okay with that. Don’t need to sell the house anytime soon, and that comforted her.
Found out today that the facility is in lockdown with a raging COVID wave. So next week I will likely go back so my siblings can take care of their own things if Mom is discharged to home. She has two unrelated appointments with her other doctors that I am trying to get rescheduled. Meanwhile, S2 was part of a large layoff and is trying to secure interim healthcare before his next ( $$,$$$ without insurance) drug infusion. He is talking to pharma about qualifying for help, with his doctor’s assistance.
Apparently I’m the Trustee for my dad’s irrevocable “Life Insurance Trust.” I asked him what that meant, and he said he didn’t know! Can anybody tell me anything about it?
I don’t think it’s rude for the trustee to ask about beneficiaries. It would be rude if you made negative comments about the beneficiaries once informed of who they are! (Of course, I realize you wouldn’t do that.)
My parents have a second-to-die policy in a life insurance trust. Dad is still alive so it hasn’t paid out yet.
I have a copy of the trust — and I get all correspondence with the insurance company.
Due to an early/extra/audit check that was paid to us, I have already set up a checking account in the name of the trust (with the named beneficiaries) for the eventual insurance check.