I haven't yet begun to recover...
...from what was supposed to be my "respite" and, yet, yesterday afternoon I hit the ground running to keep up with the rehab stay that began around 1430 at the Sniff. And, yes, I know, I know, I could have stubbornly insisted on claiming my "respite" fully and left my mother alone to the whims of the care home, insisting on our isolation from one another "in my best interest"...or, actually, no, I couldn't have. We're too close for that and our interdependence ensures not only the best care for her that I can manage to wrangle from the variety of medical systems occupying, for awhile, the forefront of our lives but their effect on her outlook and "quality of life".
    It is obvious that I am going to have to work very hard to make sure that she is not lost in this new system. There are several sub-systems in place at her facility of excellent structure and intention but, as is normal now in U.S. medicine, they are all understaffed and all staff is overworked. Just one instance: As of the time I left my mother tucked in for the night at the facility only one of her meds had "come up from the pharmacy", the metaclopramide, which is no longer necessary and which I refused on her behalf. Today I am taking her meds with me and threatening to medicate her myself if this situation hasn't changed by the time I arrive there.
    I have already, diplomatically, established myself as a force in the management of her care and this is being well taken by the facility; so much so that I suspect I will be, once again, operating as an unpaid employee.
    Sometime within "the next 72 hours" a meeting will convene, including her facility doctor, nurse-case manager, a PT overseer, the administrative supervisor of her "case", some mysterious others, probably, and me in order to "establish a care plan". I like the idea. I hope it works well in practice. I'm not sure when the actual rehab will begin.
    Everyone, so far, is well intentioned, everyone is very knowledgeable, if not yet about my mother at least about what has been proposed to happen for her, and everyone is surprised, pleased and respectful at how well prepared I was when we walked in, how much I know about my mother and how prominent I am in her care. I doubt that there will be any major conflicts between the facility procedures and my observations, questions and desires on my mother's behalf. I expect, as well, I will, again, be availing myself of their food service, just because it looks like I'll be "there" through many meals. I already have an "employee meal ticket" and ate my first facility meal last night. I am pleased to note that my mother is finally on a diabetic diet...and, it tastes good, too!
    Still haven't found the time to get my computer into the shop. Still have a few loose ends (notably, lost pajamas and socks and some stuff I have decided to donate to the center) to tie up at the "respite" care center. Still have a major supply run to make to Costco but that won't become urgent until we are closer to Mom's discharge from the facility.
    Mom continues to improve, even without formal rehab, on an hour to hour basis. Last night she was able to easily stand and shuffle about from bed to wheelchair to toilet to wheelchair and back to the bed, even as tired as she was, well enough so that she and I handled her bed routine almost completely alone. Halfway through our routine the nurse came in to do a skin assessment [Much to my horror, my mother developed a pressure sore on her coccyx over the last week and a half; luckily, the nurse assured me it is, at this point, minor and should heal completely without a problem] and helped us make sure Mom was in a comfortable position for sleep. As this was happening I mentioned to the nurse that Mom's feet were swollen. She checked them and said they weren't bad. I added that my mother's feet are almost never swollen. Much to my relief, the nurse made a note of this. So, essentially, the heavy strategy will probably be moment to moment as well as hour to hour and day to day. Uppermost for me, of course, will be making sure my mother's spirits remain high and her will strong.
    Gotta go: Shower, dress, down some yogurt and hit the road.
    Later.
- posted by Gail Rae @ 06:56   email  this post