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TILTING AT WINDMILLS
30 March 2010
Well, today certainly had its twists and turns! Kind of like sliding down a corkscrew and wondering who was going to be screwed in the end!
It started out innocently enough. Norm packed up all his stuff and raced out of here by 7:30 so he could get to the hospital in time to talk with their mother's doctor before he got on the road to head home.
Walt and I followed around 10 a.m. When we got to the hospital, we could see that Norm's car was still there. I told Walt I would wait in the lobby and post my journal entry, since I knew the hospital had wi fi and since 3 in that tiny room was very crowded. So I did.
I sat there for about half an hour, posting the journal entry and doing some catch-up on the internet, since I've been without access for two days, and waiting for Norm to come out so I could tell him goodbye before going back to their mother's room.
Pretty soon, it was WALT who came out, not Norm. There was a problem, it seems.
The discharge person said the hospital wanted to discharge Alice, but they didn't know where they were going to send her. Welcome to the wonderful world of insurance! Buena Vista Care Center is a nursing home which is about 2 blocks away from the hospital. Alice has been there several times, but you see she had this terrible daughter. Alice Nan has the misfortune of being a conscientious family member who loves her mother enough to check and make sure she is getting the proper care.
She stops in at the hospital or care center every day, she notices when things aren't right and she tries to make sure they are right. She had the audacity to complain when her mother's clothes were taken away to the laundry before they had been marked when Alice Nan always washes the clothes for her and without a marking, nobody would know whose clothes they were. She made herself a problem by repeatedly asking if they had found the clothes yet (for three days) and then went to the laundry herself and found them right away in the "whose clothes are these?" stack. She complained when her mother sat for 6 days without any rehab, when Blue Cross will only pay for 14 days and will only tack on an additional 7 days if they can show she has made progress. She complained when her mother's oxygen level, which should be at 1/2 was turned up to 2--not once, but twice, which makes her lethargic and unwilling to participate in rehab activities. She complained when her mother's catheter bag overflowed because someone forgot to empty it. She complained when they neglected to have her remove her dentures before going to sleep, only to have them fall out onto the floor during the night, roll under the bed, and chip off a piece of a front tooth.
In short, she's made a real pest of herself. She has the audacity to care. She has the audacity to question. She has the audacity to demand the care that her mother is there to receive.
How dare she?
SO, Buena Vista Care Center has decided to refuse to treat Alice any more. It would be a simple matter to move her from the hospital to Buena Vista, which is next door to her orthopedist's office, and thus very easy for her doctor to follow up on her surgery. But no, she can't go there because Alice Nan cares about her mother too much. The discharge coordinator actually said she thought Buena Vista might consider taking her if the family promised never to visit during her ~6 week stay!
There are several care facilities in Santa Barbara, but Buena Vista is the only one which Blue Cross will cover. Blue Cross's policy is that as long as there is another facility within seventy miles, they will not cover her at a different facility and there are three other centers, each 40-60 miles away from here. This means that her surgeon will not be able to follow up because she has to be transferred by ambulance and the surgeon will not drive 60 miles for a follow up exam. She will also have to have her care transferred from the physician who has been her primary care physician for all the years she has lived in Santa Barbara.
We discussed other options. Paying out of pocket for something in town for the ~6 weeks (or more) that she will need care, even if split three ways would be astronomical.
They discussed sending her back to her own apartment in Assisted Living and hiring a nurse, but there were all sorts of reasons why that wouldn't work, even if we could afford it. The big problem is that Alice has her times when she is lucid and with it, but she has lapses when she's kind of out of it, and if she decides in one of her lapses that she can walk to the bathroom herself (which is how she broke her hip in the first place), it would be worse than it was before.
The whole day was taken up with phone calls and text messages and conferences and all the while the discharge person tapping her pencil on her clipboard asking where she could send Alice because she needed to be discharged today.
Walt and I went to lunch at the hospital cafeteria about 1:30 and I got out my computer to look at the medical options locally. None of them looked good.
In the afternoon, while waiting for calls to be returned (Norm had gone to Buena Vista to talk to the head honcho and they promised to have a "meeting" about the situation and get back to him, but he never did and when we called back late in the afternoon, they said he had left for the day).
While Norm was gone, one of the hospital aids got Alice in a wheelchair and when he returned, we took her outside for a bit.
She seemed to enjoy what little she could see of the outdoors and even comandeered Norm's cap when he finally had to leave.
It was finally apparent that there would be no moving today. Ultimately it seems they have decided to send her north to Lompoc, since the other two centers are full. But Alice Nan will now not be able to stop by during the day, or go to the hospital at bedtime and say prayers with her, which always seems to settle her down.
I decided to stay down here an extra day while we get her moved, but I can't stay longer than that because I have a feature article which is due in a couple of days and I have to finish researching parts of it--and everything I need is at home. Walt may stay down here for a couple of days more. We have no way of knowing if this move will be good or bad. For all we know it will be worse than Buena Vista, but no family member can be there frequently to find out. All we can do is hope. Maybe it will be a lot better.
Walt actually turned to me today and said "I miss Polly." I've just finished reading a book about therapy dogs (and met one in the hospital lobby) and I think that having a warm little body in your lap who only wants to love you would have been great therapy for him.
We finally left the hospital at 5:30 to meet Laurel and Bri at the new house (photos for Jeri)
We went to see the school Bri is going to go to in 3 years...and it's great. Looks like a wonderful school. Bri raced through the playground, climbing things, sliding down big slides, hanging on bars and having a great time. She's fearless. Jeri had dared me to spend time with Bri without my camera, so I left the camera bag in the car. Laurel had not brought one either and both of us were in withdrawal. But it was fun to just play with Brianna, who was a delight.
We ended the day with dinner at Chili's with Laurel and Bri (Tom had flown out to Detroit on business at 5:30 a.m.)
PHOTO OF THE DAY