Mom (88) fell and broke the head off the femur bone. She already had a broken fibula on the opposite leg for which she was wearing one of those big, awkward walking boots. She had a new ball and rod put in her hip during surgery last week. She suffered really bad delirium the second night after surgery but seems to be better now.
Her hemoglobin has dropped to 7.1 and they decided to give her one unit of blood which brought it up to 8. I think that is still way too low. She has been in the hospital for a week now and the case manager is starting to make noise about wanting to dismiss her even though Mom's hemo level is severely low. I keep asking her hospitalist to figure out WHY her hemoglobin keeps dropping. You would think I was asking him to come up with a cure for cancer!
Mom has to go to rehab after she leaves the hospital, especially since both limbs are now affected. She is weak and having difficulty getting out of bed. Each time she gets up to go to the bedside commode or to walk for PT, I have to put on her boot, get the walker, get the belt they put around her waist to help hold her, and set up the bedside commode. I do this all after I have pushed the button to call for a nurse or tech to come help her since it takes so damn long for them to get to the room.
My brother and I went to visit SNFs last Sunday and were underwhelmed with what we saw. One place even had a community shower with one stall! Yikes! We talked to some friends who had been in acute in-patient rehab at a place near the hospital where Mom is now. They require 3 hours a day of rehab or 15 hours a week. They are in the top 1% in the nation in success in returning people to the community. They truly have impressive stats. We have talked to admissions there and they reviewed Mom's hospital file and said she qualified for care there. Mom's insurance company denied her request to go to that rehab facility and said she should go to a SNF where she will maybe get 1 hour a day of rehab. Since she was independent and walking with a cane and dressing and bathing herself before all this, we want her to get back to that level or as close as possible.
I have filed an expedited appeal with the insurance company and it has been accepted as of today to be put before the decision-making committee. We will know within 72 hours. But the hospital may not let her stay that long (although she needs blood). Our Plan B for a SNF has not been approved yet as they have some "questions" about Mom's hospital file. Apparently, during the delirium episode, the doctor ordered Haldol which she never got. Now the SNF wants to know if she is violent or is "sundowning". She never took the dang pill! They may deny her admission for something that is absolutely irrelevant. She can not come home. I can not lift her or transfer her. I wish I had planned for this starting years ago instead of days.
Why is this rehab situation so difficult?