Maybe rehab won’t be so bad after all

March 29, 2018. Mom left home for the hospital shortly after 8:30 AM., and I followed her in my car about 15 minutes later. By the time that Mom arrived at Dad’s room, he had been visited by Mike (today’s physical therapist) and a nephrologist. According to Dad, Mike had had him walk around the bed. He seemed to like Mike and was eager to have another session with him.

When I arrived, Dad was finishing his breakfast of hot cereal, pancakes, eggs, and a few cups of apple juice. Dad looked much better today and had a healthy appetite. He was still a little confused about the dreams and hallucinations that had occurred during the night, but he seemed to be in a good mood. Unlike Dad’s previous surgeries, I had been able to warn him about the potential for hallucinations and confusion after this surgery. yoRehabCatI was encouraged that he shared his events with me so that we could sort out what was real. During the day, he asked me about a cat that was sitting in the corner of the room. Although it seemed real to him, he believed me when I told him that there was no cat in the room, although he could still see it.

noRehabCross3The morning’s happy mood took a nose dive when Alisa, the nurse, tried to give him a doxycycline capsule. He insisted that he would not take this pill because it had made him vomit. Alisha said that she would give him a Zofran for nausea to take with the antibiotic.  I reminded him that he had had problems with this antibiotic when he took it on an empty stomach, but he had just eaten breakfast. He eventually calmed down and agreed to take it, but I was not hopeful that he would take the second pill after dinner.

Sara, today’s physician’s assistant, stopped by at 10:15 A.M. to tell Mom and me that Dad could be discharged to Cornerstone as early as today. Mom told her that we wanted to meet with a Cornerstone representative and tour the facility before Dad was discharged. Sara thought that our request was reasonable and would relay our request to the case manager. When I asked her if we were responsible for Dad’s meds, she said that the hospital would send Dad’s list of medications to Cornerstone and that they would obtain them through their pharmacy.

yoRehabCross1At 10:30 A.M., I went to the cafeteria to get some coffee for Mom and me. When I returned, Dad was in the bathroom. Being able to get out of bed to use the bathroom was a significant and welcome milestone after hip surgery. With his movement at glacial-speed, the short trip took quite a bit of time, but Carrie, the aide, eventually got him back into the bed at 11:10 A.M. After watching the process that was required to get Dad from the bathroom to the bed, Mom was convinced that we had made the right decision to have Dad discharged to a rehab facility. Dad had insisted that he could have out-patient therapy, but Mom and I together could not have safely transferred him from home to the rehab facility.

Shortly after Dad was settled back into his bed, Dr. Bolanos and Dr. Duran, the nephrologist, and her entourage arrived. Dr. Duran said that Dad’s kidneys were back to where they were before this surgery, whatever that meant. Dad hadn’t seen a nephrologist or had a blood test since early December, so I wasn’t convinced that his kidneys had been in great shape when he entered the hospital. I knew several of the Scott & White nephrologists and was disappointed that one of them was not working at the hospital this week.

When the nephrologists left, Dr. Bolanos spoke with Dad again about rehab, and he was still very resistant to her recommendation and dismissed her reasons why he should have in-patient therapy, insisting that Mom needed him at home. After a few minutes of unsuccessfully trying to change his mind, she left the room.

yoRehabCross1After the doctor left, Dad started talking about how he wanted to extend his hospital stay so that he could get the physical therapy here that he needed before he went home. I explained to him that his insurance didn’t allow patients to extend their hospital stays for physical therapy. I also reminded him that hospitals were germy places and that he didn’t want to stay any longer than necessary. I added that the hospital wanted to discharge him either this afternoon or tomorrow morning and that there was no way that Mom could take care of him. Because Mom seemed to be Dad’s primary concern and his stated reason for not going to rehab, I had told her that it was up to her to convince him to go to rehab. When she started telling him about her appointment at Cornerstone this afternoon, I excused myself and went to the waiting room so that they could talk in private.

Shortly after I returned to his room at 11:45 A.M., Brenda, the occupational therapist, and Carrie, the aide, arrived for a therapy session with Dad. The goal of an occupational therapist is to prepare the patient to become independent in the job of daily living, and today she wanted to get him into the bathroom. Brenda and Carrie had him practice sitting on and standing up from the commode. She also had him stand at the sink and brush his teeth.

yoRehabCross2During Dad’s therapy session, Mom told me that he had agreed to go to Cornerstone and complete his therapy as fast as he could. The doctor and therapists had estimated that he would require two weeks, but he planned to be ready to come home in half that time. I was thankful and encouraged by his change in attitude. I left the room to find Dr. Bolanos to let her know that we were all on board with his rehab plan at Cornerstone.

I needed to return to Houston today, but Mom wanted me to join her for her appointment with Marie at Cornerstone. Because we wanted to spend as much time with Dad as possible, I picked up a soggy sandwich from the cafeteria for us to split and eat in Dad’s room. At 1:00 P.M., I woke Dad from a nap to tell him goodbye. It was a good goodbye, and I felt optimistic about his prospects. Mom and I left the hospital together and drove in separate cars to Cornerstone for our 1:30 P.M. appointment. After Mom signed a huge stack of papers, Marie provided us with a tour of the facility that ended at what would be Dad’s semi-private room. The current occupant was due to be discharged tomorrow morning, which meant that Dad would have the room to himself for some time. Everybody was very nice, and it seemed like a nice place. I hoped that Dad would do well here.

yoRehabCross2After our meeting, Mom returned to the hospital and I drove to my parents’ home, where I worked for another hour before driving to my home in Houston. Five days ago, Mom called me with news of Dad’s fall. Because of his severe osteoporosis, I feared the worst for him. With Dad seeming to be inspired to get back on his feet, I now felt optimism that I hadn’t thought possible.

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