I was wrong, the Referrals lady called me back at 3:15 to say that she had just sent the form back to the doctor’s office. I expressed my dismay – I’d thought she was sending it late this morning, and the clinic would be calling me this afternoon. I told her we felt it was important for Mom to be seen today, and she said, “Oh, that was never going to happen.” So all that’s left now is to wait till next week or take her to Emergency, a decision I have to make purely because of inefficiency and miscommunication by various members of the medical community. The HHN is apparently jumping up and down about how serious this is, but at the same time says ER is not necessary. Neither the aide nor I know what to make of that. Brother is coming in for the weekend, I think I’ll let him share this. Ugh.
Oh man,LasMa.So sorry. Wound care IS important. Why’d that idiot HHN cancel the Dr appt yesterday? They should have kept i, let the Dr. treat the wound and if the Dr. felt another referral was indicated he/she could have made it then. I’d complain to the HHN’s agency.
As a primary caregiver, I suspect the wound clinic was the correct call as not much the doctor will do in the clinic besides making the referral. I think the HHN probably saved a wasted visit to the doctor. For treating wounds, wound clinics have much more knowledge and resources available. I suspect the wound needs urgent but not emergency evaluation.
But if the Dr. saw it and felt it was in need of urgent attention, wouldnt they have either helped facilitate an urgent appt to be fit in that day, or sent the pt to the ER, not left it to the following week, to fester over the weekend?
The ER will not take care of the wound directly. The most they would do is culture it if necessary, dress it and try to get her to be seen by the wound clinic for debridement and care. If she does not have a fever and the wound clinic could not fit her in, she would have to wait for Monday and it could mean many exhausting hours in the ER and a possibility of the bill not being covered. It is so frustrating that this could not have been taken care of more quickly. I am the one in the family to do all the communicating with health care and I call and followup with what has been promised and still there are delays and problems.
Re: lift chairs. Mom has one, she is short and it has been a blessing. She has lymphedema and spends most of the day and night in the chair. She still is very much able to sit in other chairs at tables, sofa, etc. without a problem and she has advanced dementia.
Thanks for the helpful input. Brother and I will be seeing Mom (and the aide) in a little bit, and I’m going to lean toward waiting until I hear from the wound clinic on Monday, fingers crossed. I’m really hoping to avoid ER. Dad and I were frequent visitors. It’s a regional trauma center, and usually was 8-10 hours to get processed there. Not how I want to spend my Saturday,
It does sound like the HHN did the right thing, except that she didn’t communicate with me, and she didn’t stress the urgency when talking to the primary, so the referral sat around all week.
The HHN has much more experience with a wound than a typical primary care physician does. I would trust her assessment of the wound that is not necessarily getting worse, but just not better and therefore needs to go to the specialist. Seeing the patient in the office does not typically facilitate a faster referr
My MIL had a lift chair and yes, she had trouble with other chairs and a toilet. But, this may not be due to the lift chair but the reason she needed it.
On lift chairs, my father, who is frail with severe memory loss loves his and it does help him get up. He is in skilled nursing care at this point and usually is getting up with an aide in the room. He can shift the chair to having the feet up independently, which works well for his always swollen feet. He can not position the chair to sit from his wheelchair. If he could, he would likely need neither.
My mother tried a lift chair as her health was failing and she had severe problems getting up due to both lung and bone issues. She really could have benefitted from one, but the lift feature, no matter how we demo-ed it in the store, made her feel vulnerable to being “tipped over” by the chair itself. Her cognition was fine, though she was an epic faller…
I know that there are down sides to pre-maturely using lift chairs and wheel chairs. In my experience, if you are at the point where they are on the table, there is usually a good reason to consider them. If they may be needed for a shorter time during a recovery, the elder can have “safe” PT to try to keep their muscles working and assess their strength/progress, while benefitting from the security of the right device and greater access to their routines. Sometimes, there is resistance to a chair within a family that is more based on ignorance of specifics or denial than the actual clinical status of their relative. It can be pretty hard to predict exactly how elders will rebound from each challenge; I have been surprised in both directions.
Thinking of everyone and sorry for these systemic communications issues on top of all the “real work” of eldercare.
Defer to those of you with knowledge and experience in wound care, but IMO the HHN should not have cancelled/changed appointments without telling the aid and/or the family. Thats just not ok in my book. It can lead to a whole lotta confusion, not to mention major annoyance. And LasMa, what was the original appointment that was scheduled for yesterday for? Does it need to be R/S too?
What’s R/S? Agree that this has been a whole lot of unnecessary confusion and trouble and wasted time.
I’m sitting in ER. We took Mom to urgent care this morning. The doc there prescribed antibiotics, and confirmed that further care really has to be done at the wound care clinic. She wrote me another referral, just in case it might help speed things up.
But she was concerned that the swelling and redness could mean DVT, so we are here to test for that.
Too bad you couldn’t avoid the ER. I’ve experienced it enough with my mother to know that it’s never a quick and easy visit, but better to know what you’re dealing with. Good luck.
Sending good thoughts and a hug too! They, (ER), should move more quickly when ordering a d-dimer to rule out DVT. I hope they can see her in the wound clinic on Monday.
I hope the referral and visit to the wound clinic happen on Monday. You really don’t want to play around with wounds and healing.
Mom is in the AFH, but so far it’s a disaster. She seems to have chronically low sodium levels and perhaps UTIs that are playing with her mind. She says she hates it, that the operator is a witch. Their attempt at showering today was a mess - mom yelled and fought. We are calling her PCP on Monday to get a HHN to come out and do a blood draw and run a catheter for urinalysis.
The past two weeks have been a mess for me professionally - major employment issues - and personally - with Mom. My sisters and I are at the point where we can’t be with her from 9am to 9pm every day and we are trying to come up with a path forward that works for all of us. We know the care is good, so the next steps are to get her stable and hopefully coherent, then taper on the visiting hours. We will talk with mom and get firm understanding of what she wants…more than the no CPR and heroic methods. Does she want to start the dying process? What does she want us to do if she doesn’t want to take her meds? Etc, etc. fortunately for us, the operator has seen this all before and is able to provide insight. We’d be lost w/o it. Bless her!
As an aside, I heard the end of This American Life today. It was a rebroadcast including Dan Savage talking about his mom’s passing. It was funny and sad and tragic…much like life right now. I’ll have to download the podcast and have another listen.
I’m taking a week off work and will spend the next 3 days by myself in our new vacation place. I’m hoping for no phone calls or emergencies, a chance to think about what kind of job for the next few years until I retire (I’m being kicked out of my existing job; the stress of mom on top of a high pressure job is prompting it), and time to consider what will happen with mom. A bunch of books and a couple of bottles of wine are making the journey with me.
Oh wow, zeeba. It’s coming at you from all sides. I hope a few days of solitude will bring a little peace.
Is hospice on the case with your mom, or is too soon for that? Or – don’t take this the wrong way – is it possible that you and your sisters are hampering her adjustment to the new place, by being there so much? Sort of like kids when they’re small, magically do better once Mom has left the preschool room, maybe if she didn’t have you as an “audience”, she’d be more compliant? I’m sorry this is so rough right now.
Re my mom – ER skipped right over the d-dime (?) and did ultrasound which thank goodness was negative for DVT. So Mom’s back home, with the two antibiotics prescribed by the urgent care doc (which the ER doc approved), and some compression hose because apparently the insufficient blood flow is preventing healing. The hose made her feel immediately more comfortable. So I’ll be on the phone first thing Monday, to push hard on an ASAP referral to wound care, then undoubtedly will have to push hard for an ASAP appointment. Ugh, I hate this crap.
But there was one good thing today; my brother was along for the whole ride and he was wonderful, supportive and cheerful and diverting. And helpful. He played errand guy, saving me from all of the extra trips which always come with these emergencies. When we got to urgent care, I realized that we didn’t have Mom’s med list; he ran back to the care home to get it. Once we were checked in at ER, he ran to CVS to pick up the Rxs, and then to Subway because we were all hungry. Then he ran to the medical supply store clear across town to pick up the hose. All of this while I was dealing with Mom and hospital stuff. It was just so great to have a partner. And then late in the day Mom was getting fussy, so he whipped out his phone and started playing [funny animal videos](https://www.youtube.com/watch?v=fl38Lm06234) for her. Genius.
@zeebamom massive hugs. I hope you do get some time to breath and gather peace. Can you do yoga or meditatie?
@LasMa Yay for the partner brother. My brother is awesome when he shows up, too. But we try to alternate so Mom gets more family time. I am still a bit on edge that he didn’t go see her when she broke her arm, even though there was nothing concrete he could have done. It would have comforted Mom to have him there though. But after just 5 or 6 weeks ago, rushing up to her bedside and then she was fine, it is understandable. Understandable to the head, but not to my heart.
Lasma,
R/S means rescheduled. Glad you decided to have her checked out. Glad there was no clot, as they can break free and go to the lungs, heart or brain. Not good.
My mom is still in rehab. One thing she’ll do is tell me no one comes to visit. A huge lie. She must have a minimum of 3 people visiting a day for hours a day. But when I talk to her she says everyone is busy and she’s all alone. I believe her expectation is that someone should be sitting next to her 24 hours a day. You truly can’t do enough for her. I just blow it off, I’m just trying to make conversation, she really is difficult to talk to as she doesn’t participate in the conversation, but she wants to hear from me every day. Not that much happens in a day for me to have a one sided daily conversation. So if I ask if anyone has been by, no, who would come here, I’m alone all day…sigh
She’s in a big pickle, she has bronchitis and pneumonia but needs this test done asap on her heart valve. She’s so weak because of the valves so she can’t do much pt which would clear her lungs. I’m not sure how long she’ll be allowed to stay on the rehab floor before they move her to the nursing home floor.
LasMa - Glad to hear no DVT and that your brother was helpful and supportive. Hope all goes smoothly when you call the wound clinic tomorrow.
zeebamom - Hope you find the peace you need at your vacation home. You’ve had quite alot of stress and really deserve the rest, relaxation, and time to clear your head.
FIL had a stroke (after mini ones and docs missing his nearly 100% occluded carotid artery which prompted the more serious stroke on his right brain which most affected sensation on left foot) - surgeon said he was amazed that any blood got through. So he qualified for a lift chair. It is comfortable. No heat/vibrating. I think those add ons may be overpriced and not necessary.
If an elderly person on medicare needs a lift chair, I would get the paperwork done to obtain, but really get the right one. It is probably like a wheel-chair, once you get it can’t get a better model for X years.