So many things have changed for the better since FIL got to rehab. He has been doing PT, OT and Speech. His murmurings have become words...lots of words. Lots and lots of words. Our conversations have been long, funny, arduous, and serious. They have him up and walking in the halls, and his PT therapist, Joe, is fantastic with him.
He still doesn't sleep well. Apparently TBI's cause sleep disturbances, and FIL has them. Up until the past night or two he was clocking about two hours of sleep a night. They started him on an anti-anxiety/depressant and that appears to have kicked in, and he slept about 6 hours last night. However, when he is up, he is busy. Busy. The staff has to keep him close all the time, because he has no common sense when it comes to staying in his wheelchair. He thinks he can hop up any time and walk. He can't. We've had more than one fall now. First they kept him near the nurse's station. Now they keep him IN the nurse's station. He can be found rummaging through drawers, tapping on keyboards (computers are off), and chatting up the nurses. He always has a mission. Always has a story.
Yesterday when we were by he was in the nurse's station. He was needing all of us to get busy. It was time to pack up. We were moving. Where were we moving? Charlotte? Raleigh? Atlanta? Charlotte it was decided. Steve, the nurse and I would ride together, and he would ride with Scot and Joyce. We needed to get moving. He'd never seen such an unorganized mess. What were we doing? Where were the boxes? The longer we took the more ornery he became... There was another resident behind the desk with us...he grabbed the guy's wheelchair and spun him around..."Bill, where are the boxes? Do you know who is organizing this arrangement?" Of course, the resident wasn't Bill, and he wasn't involved in the move. LOL.
Later we went outside and I was trimming his nails. We mentioned he needed a haircut, and it then became his obsession. He'd been waiting two days at this barber shop for a haircut, and yesterday it was so busy they did 1000 haircuts. He was tired of waiting. How much longer would it be?? We told him it'd be tomorrow b/c I needed to get the scissors and clippers, but that wasn't good enough, b/c tomorrow no longer means anything to him. How much would it cost? A dollar? When we said that sounded good, he wanted it in writing. We had to go to the nurse and get a one line contract written up that says his haircuts would be $1 for the next 100 years. I could go on and on.
The facility called MIL to get her to agree to a "sitter" because he is so busy and never stops moving. She agreed they could hire one for the weekend, and then as needed other weekends when they didn't have enough staff to keep someone with him one on one all day. This morning when we arrived he was being walked by his sitter, so we were chatting with his nurse. Apparently the sitter wasn't with him at 6 am when he got up, b/c his alarm went off. By the time the nurse got down there, he had peed in the trashcan, put on his roommate's shoes, and was sitting on his roommate's bed (with his roommate sound asleep in it!!) The brain is such a crazy, complicated thing.
While yesterday the facility was UNORGANIZED, and a few days ago the place was CROOKED, today it was a resort. He hoped we'd stay another day, so we said we would. Shortly thereafter he was once again ready to go home...which is how visits typically go. He is ready to leave. He wants to go home. He wants to leave.
If we can get him eating food, and using the restroom and sleeping...it might just happen.
Sunday, June 17, 2018
Monday, June 11, 2018
You can't make this shit up...
FIL was transferred to rehab on Saturday. Sunday morning at 6:30 a.m. he pulled his PEG tube out. I kid you not...less than 24 hours.
Did you know that rehabs and nursing homes don't allow restraints? I get that they shouldn't be for everyone. You shouldn't go into a facility and see everyone tied down. BUT...when you have a man who is struggling with a brain injury and will not stay still, restraints are a good idea. Apparently he was in and out of his bed, and eventually pulled his PEG tube. Thankfully his bed was as far down as it could be.
When we went to visit, they had him by the nurse's station so they could keep an eye on him. I'm not at all surprised by this...he has been busy and not sleeping for a month now. He had a language explosion overnight, however.
FIL: Are we going or not?
Us: Where do you want to go?
FIL: Let's go get a beer.
FIL: I have a suggestion. This is a pretty nice place, but I have a suggestion that they could make this a place where people could go to change Like her. She could come here to change.
Outside...near the parking lot.
FIL: That's a good place to park right there mister.
Then, of course, he started trying to get out of the chair/bed he was in. It is like a chair/bed hybrid, b/c he kept getting out of the wheelchair. This lays him back some to make it more difficult for him to get out. BUT.......last night, rehab called again...
FIL fell out of the chair, by the nurse's station, and was on his way to the hospital. Luckily, he was xrayed and discharged with nothing broken. BUT...seriously? WTH?? Why doe residents have the "right to fall" but not the right to be kept safe? Belt his ass into the chair. Keep him safe.
Did you know that rehabs and nursing homes don't allow restraints? I get that they shouldn't be for everyone. You shouldn't go into a facility and see everyone tied down. BUT...when you have a man who is struggling with a brain injury and will not stay still, restraints are a good idea. Apparently he was in and out of his bed, and eventually pulled his PEG tube. Thankfully his bed was as far down as it could be.
When we went to visit, they had him by the nurse's station so they could keep an eye on him. I'm not at all surprised by this...he has been busy and not sleeping for a month now. He had a language explosion overnight, however.
FIL: Are we going or not?
Us: Where do you want to go?
FIL: Let's go get a beer.
FIL: I have a suggestion. This is a pretty nice place, but I have a suggestion that they could make this a place where people could go to change Like her. She could come here to change.
Outside...near the parking lot.
FIL: That's a good place to park right there mister.
Then, of course, he started trying to get out of the chair/bed he was in. It is like a chair/bed hybrid, b/c he kept getting out of the wheelchair. This lays him back some to make it more difficult for him to get out. BUT.......last night, rehab called again...
FIL fell out of the chair, by the nurse's station, and was on his way to the hospital. Luckily, he was xrayed and discharged with nothing broken. BUT...seriously? WTH?? Why doe residents have the "right to fall" but not the right to be kept safe? Belt his ass into the chair. Keep him safe.
Tuesday, June 5, 2018
We had a conversation today. It was short, but it is the best we've had so far.
Me: Hey!
FIL: What are you doing?
Me: I'm visiting you. What are you doing?
FIL: I'm doing nothing.
Baby steps.
We heard from the case manager that we can't send him on to a rehab facility until he is restraint free for 24 hours. The tech told us today he'd been without gloves briefly, and that he'd sat in a chair while they changed out beds for him. That's big news. He also tried to wiggle out of bed the whole time we were there tonight, and the only thing that kept him in was restraints.
Baby steps.
His new favorite word is "What?"
While we were touring rehab facilities, it was hard to see the people there...the loneliness. Our tour guide at one place took us to a semi-private room to show it to us and was pointing all kinds of things out while we stood outside the door. In the room was a naked man standing there looking at us. Just because he may not be in his right mind doesn't mean we shouldn't still respect that he is a person.
Baby Steps.
Me: Hey!
FIL: What are you doing?
Me: I'm visiting you. What are you doing?
FIL: I'm doing nothing.
Baby steps.
We heard from the case manager that we can't send him on to a rehab facility until he is restraint free for 24 hours. The tech told us today he'd been without gloves briefly, and that he'd sat in a chair while they changed out beds for him. That's big news. He also tried to wiggle out of bed the whole time we were there tonight, and the only thing that kept him in was restraints.
Baby steps.
His new favorite word is "What?"
While we were touring rehab facilities, it was hard to see the people there...the loneliness. Our tour guide at one place took us to a semi-private room to show it to us and was pointing all kinds of things out while we stood outside the door. In the room was a naked man standing there looking at us. Just because he may not be in his right mind doesn't mean we shouldn't still respect that he is a person.
Baby Steps.
Saturday, June 2, 2018
Rehab facilities
Today was a long day. MIL, my mom and I went to tour nearby rehab facilities, as the hospital said it was time for us to choose one. This is all well and good. We can go look at them, see what they look like, chat with tour guides and patients. But is he ready for rehab? I'm not so sure.
My biggest issue with rehab right now is that in the hospital he is still trying to wiggle out of bed constantly. He has bed rails and restraints to keep him from doing so, and in the rehab facilities they are not allowed to use either. No restraints. It's illegal. So, what happens then? They can't sit in his room 24/7. So when he wiggles out of bed, and he will, what happens when he falls again and breaks his leg? Or hits his head again? What then? And there don't seem to be options in between the hospital and rehab/long term care.
We toured 4 facilities and while all were adequate, they were not at all equal. Our favorite was one called Royal Park. They were bright, clean, cheerful, and didn't smell near as bad as the others. There was a courtyard in the middle where residents could go and be outside but NOT leave as they were surrounded by 4 walls. The lady who gave us the tour, Pat, was incredible and gave us so much information. As a nurse she was able to tell us that yes, others were also on feeding tubes, and all about the rehabs. They also had the nicest rehab rooms.
The worst we saw, which was adequate as I said, was S.O. S.O. was dark and gloomy. There were not enough windows, and then in addition the walls were painted dark, dreary colors. You wouldn't want to visit long, much less live there.
At C.P. all was bright and nice, but one thing turned us off... the tour guide took us to a room where we were to be shown a semi-private room. She opened the door wide and was pointing things out to us in the room...all while a naked man stood on the other side of the room. She didn't even acknowledge him, much less take us to a different room to give him some privacy. It's possible he didn't realize he was naked, or even that we were there...but we did. Who does that?
The question now is, can they meet his needs? Can they help him gain back some skills? We don't know. We need to speak with case workers again. Palliative care again. Doctors again.
My biggest issue with rehab right now is that in the hospital he is still trying to wiggle out of bed constantly. He has bed rails and restraints to keep him from doing so, and in the rehab facilities they are not allowed to use either. No restraints. It's illegal. So, what happens then? They can't sit in his room 24/7. So when he wiggles out of bed, and he will, what happens when he falls again and breaks his leg? Or hits his head again? What then? And there don't seem to be options in between the hospital and rehab/long term care.
We toured 4 facilities and while all were adequate, they were not at all equal. Our favorite was one called Royal Park. They were bright, clean, cheerful, and didn't smell near as bad as the others. There was a courtyard in the middle where residents could go and be outside but NOT leave as they were surrounded by 4 walls. The lady who gave us the tour, Pat, was incredible and gave us so much information. As a nurse she was able to tell us that yes, others were also on feeding tubes, and all about the rehabs. They also had the nicest rehab rooms.
The worst we saw, which was adequate as I said, was S.O. S.O. was dark and gloomy. There were not enough windows, and then in addition the walls were painted dark, dreary colors. You wouldn't want to visit long, much less live there.
At C.P. all was bright and nice, but one thing turned us off... the tour guide took us to a room where we were to be shown a semi-private room. She opened the door wide and was pointing things out to us in the room...all while a naked man stood on the other side of the room. She didn't even acknowledge him, much less take us to a different room to give him some privacy. It's possible he didn't realize he was naked, or even that we were there...but we did. Who does that?
The question now is, can they meet his needs? Can they help him gain back some skills? We don't know. We need to speak with case workers again. Palliative care again. Doctors again.
Friday, June 1, 2018
What Happened?
The truth is, we wish we knew exactly what happened.
My father-in-law (hereafter called FIL) and mother-in-law (MIL) had arrived home from my FIL's doctor appointment. It was a check up, and the doctor was impressed, once again, at how fit, mentally and physically FIL was. He was given as clean a bill of health as an 83 year old could get, and after having lunch out, they went home.
My MIL noticed FIL was absent from the house, so went outside to find him. She found him trimming the hedges, which is not unusual. FIL is an outdoors man. A former marine, he can't be stopped from taking on new challenges. Build a retaining wall at the lake house? No problem. Build shelves? You bet. Cut down trees? Sure...in fact he was cutting one down at the lake the day before. What I'm saying is, FIL was active all the time. He couldn't stand to be cooped up on a rainy day. He was always going and doing, so hedge trimming, even on a hot day, was nothing new. What was new, however, was him saying to MIL when she came outside, "I feel dizzy."
MIL told him to sit down while she swept up his trimmings, and she turned her back to him to do just that. When she turned back around she found him in a fetal position on the driveway, with blood around his head.
Judging from his injuries, he must have passed out. There is absolutely no sign that he tried to stop his fall. His entire left side seems to have taken the brunt of the fall. An ambulance was called, and he was taken to Novant hospital. Several hours later we were allowed to see him in the ICU, where he was unconscious.
He had a lump on the left side of his head. While originally MIL thought the blood had come from his head, we discovered that it had actually come from his nose, which had several fractures. His left eye was completely swollen shut and bruised, and his eye socket, too, was broken. He has a foot long bruise on left leg to this day. We were told he had bleeding on his brain. This is when we learned we were dealing with a Traumatic Brain Injury.
TBI's come in all shapes and sizes. There are apparently different levels of severity, and FIL's, we finally learned on Day 17, was considered severe. It was Day 17 when a doctor finally showed us his scans. My first lesson for you is you must demand to see scans, and demand for explanations at each turn. Could we do anything at Day 1 differently? No. But being informed helps you make decisions. Being informed helps you understand what you are dealing with.
FIL was in a coma. Not the kind of coma you think of where the person lies still and quiet. FIL was in a noisy coma. He didn't lay still after the first two days. He moaned, he groaned, and he tried to get out of bed. His eyes were closed, the left swollen shut, but his arms and legs were moving. Kicking. Hitting. They had to restrain him. They put what we call "boxing gloves" on him to keep him from pulling out tubes. They were mesh with big cushions where his palms were, and even with his arms tied down, he was able to do damage.
He had a tube down his throat. He knew it was there and he worked tirelessly to remove it. Flailing hands went again and again to try and knock it out. He groaned around it. He made faces. He also had a neck brace on. "Pull my neck! Pull my neck!" he shouted early on. "Pull my neck over my neck." He wanted it off. Still, all of this was random. He was not conscious, and he did not follow commands or answer questions.
After the fall he threw up. Apparently he then got some of that vomit into his lungs. It turned to pneumonia, though no one told us that...we only learned it later. After I had mentioned several times his chest sounded congested and I was concerned about pneumonia around day 5 or 6. We weren't told about the pneumonia until about day 14 or 15. When he was finally about over it. AGAIN...ask every question. Demand to see lists of meds!
Today is Day 22. I will try and catch up to this day as quickly as possible.
My father-in-law (hereafter called FIL) and mother-in-law (MIL) had arrived home from my FIL's doctor appointment. It was a check up, and the doctor was impressed, once again, at how fit, mentally and physically FIL was. He was given as clean a bill of health as an 83 year old could get, and after having lunch out, they went home.
My MIL noticed FIL was absent from the house, so went outside to find him. She found him trimming the hedges, which is not unusual. FIL is an outdoors man. A former marine, he can't be stopped from taking on new challenges. Build a retaining wall at the lake house? No problem. Build shelves? You bet. Cut down trees? Sure...in fact he was cutting one down at the lake the day before. What I'm saying is, FIL was active all the time. He couldn't stand to be cooped up on a rainy day. He was always going and doing, so hedge trimming, even on a hot day, was nothing new. What was new, however, was him saying to MIL when she came outside, "I feel dizzy."
MIL told him to sit down while she swept up his trimmings, and she turned her back to him to do just that. When she turned back around she found him in a fetal position on the driveway, with blood around his head.
Judging from his injuries, he must have passed out. There is absolutely no sign that he tried to stop his fall. His entire left side seems to have taken the brunt of the fall. An ambulance was called, and he was taken to Novant hospital. Several hours later we were allowed to see him in the ICU, where he was unconscious.
He had a lump on the left side of his head. While originally MIL thought the blood had come from his head, we discovered that it had actually come from his nose, which had several fractures. His left eye was completely swollen shut and bruised, and his eye socket, too, was broken. He has a foot long bruise on left leg to this day. We were told he had bleeding on his brain. This is when we learned we were dealing with a Traumatic Brain Injury.
TBI's come in all shapes and sizes. There are apparently different levels of severity, and FIL's, we finally learned on Day 17, was considered severe. It was Day 17 when a doctor finally showed us his scans. My first lesson for you is you must demand to see scans, and demand for explanations at each turn. Could we do anything at Day 1 differently? No. But being informed helps you make decisions. Being informed helps you understand what you are dealing with.
FIL was in a coma. Not the kind of coma you think of where the person lies still and quiet. FIL was in a noisy coma. He didn't lay still after the first two days. He moaned, he groaned, and he tried to get out of bed. His eyes were closed, the left swollen shut, but his arms and legs were moving. Kicking. Hitting. They had to restrain him. They put what we call "boxing gloves" on him to keep him from pulling out tubes. They were mesh with big cushions where his palms were, and even with his arms tied down, he was able to do damage.
He had a tube down his throat. He knew it was there and he worked tirelessly to remove it. Flailing hands went again and again to try and knock it out. He groaned around it. He made faces. He also had a neck brace on. "Pull my neck! Pull my neck!" he shouted early on. "Pull my neck over my neck." He wanted it off. Still, all of this was random. He was not conscious, and he did not follow commands or answer questions.
After the fall he threw up. Apparently he then got some of that vomit into his lungs. It turned to pneumonia, though no one told us that...we only learned it later. After I had mentioned several times his chest sounded congested and I was concerned about pneumonia around day 5 or 6. We weren't told about the pneumonia until about day 14 or 15. When he was finally about over it. AGAIN...ask every question. Demand to see lists of meds!
Today is Day 22. I will try and catch up to this day as quickly as possible.
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