Letters from the Bedside

This comment was made by a son of my patient who went and checked out the local nursing home/skilled facility where the hospital wanted to send his mom after her stroke and fractured hip for rehab. Unfortunately, it’s one of two in town and the other one isn’t any better. It’s a truly sad state of affairs in this country when it comes to our elderly & people in need of Skilled Nursing care. We don’t honor or respect them and the choices given to them concerning their rehabilitation are like a bad nightmare for the most part. There are a few exceptions and I don’t want to discount them, but they are the rare exceptions. Nursing facilities that have both long-term patients and interim patients are mostly horrible to say the least. They are warehouses.

One Saturday I was working on the skilled wing as the only therapist that day. By skilled I mean the folks that were there temporarily for various reasons like hip & knee replacements, strokes, cardiac surgery etc. They needed to be more independent before returning home. That Saturday there was one CNA (certified nursing assistant) for 18 people. Most of these folks were wet from urine and unable to get out of bed on their own. I spent most of the day calling the nursing staff to help the people get cleaned up and out of bed. There was little time to do the needed therapy to return people to their independence.

We as a country are very generous sending lots of money to Africa and donating to various causes but we offer very little to people here at home in need of care. It’s a very big picture with lots of regulations from Medicare and insurance companies concerning coverage. Some people know about it to some degree and just shake their head but don’t know what to do to help. I suspect the majority of people don’t really know what’s aren’t raising hell to get legislative changes made in Nursing & rehabilitation facilities.

Is it our selfishness that prevents us from seeing?

They’ve been married 66 years.  He’s 87 & she’s 85.  He’s been taking care of her for years.  She’s got lousy circulation and diabetes and had her left leg amputated below the knee last week.  The other foot is half gone and she wears a special black shoe made for the foot that looks a little like it belongs to a little girl.  She lays there passive with her eyes half closed drifting off not saying anything.  He is tall and slim with a upright posture not appearing to have any mobility problems and looks great for his age.  He answers all my questions and talks about the details in taking care of her at home.  How he transfers her to the toilet and the recliner where she spends most of her time.  He recently ordered two ceiling hoists that will be installed in the bathroom and bedroom so he can more easily transfer her.  He is her primary and only caregiver and wants it that way.  I asked him if he ever got any respite care for her so he could get a break or do errands and he replied, “I can handle all the things that need to be done.” He will not allow her to go a nursing home.  When he talks to her to encourage her to participate with me, he is kind and you can tell he loves her.  Some people amaze me and leave me with a feeling of awe at their integrity and committment.

Claire is the pen name of a rehab PTA who will write about life in the hospital.