I am a social worker for low-income seniors. I work with a couple where the wife has to learn to walk again. She is currently in a rehab facility. While in the rehab, she began experiencing immense pain in her stomach, and it was so bad she was crying constantly, unable to sleep, and would call her husband in the middle of the night needing to be soothed to sleep.
The rehab center refused to provide anything besides over the counter pain relief, which was clearly not working. The facility also does not appear to have a doctor on site and just calls a doctor on the phone usually. Is this common? It feels crooked to me, but I do not have much experience with rehab centers.
I told my client he needed to get his wife out of there, or go speak to someone who supervises the site because his wife should not be suffering! Eventually, he asked a supervisor if it was okay to take her to the emergency room, the supervisor obliged, and when they went to the emergency room they found that her colon was completely blocked and were told by the doctors there that it was a very dangerous situation. They were able to give her something to unblock it, but now he reports that a week or so later she is still experiencing incontinence. She is also back at the previous rehab center, and they apparently are not responding quickly enough to her calling them and she is soiling herself. This puts a bad taste in my mouth, and I want to report the rehab facility.
I want to help this couple the best I can, but I feel out of my depth as I have never worked with rehab centers and have limited medical knowledge.
Have any of you experienced something similar? What advice would you give to this couple? We are in the state of Florida.
You say you are a social worker.
I was an RN. Social workers are skilled at and schooled in these situations, and they know well and understand the steps to take.
You say you "work with" this couple.
What do you mean by "work with". Are you their social worker? What agency do you work THROUGH as a social worker in working WITH this couple.
As I said, none of this makes sense at all.
You say that this woman was in severe pain (and trust me, a woman with a bowel blockage would not only be in severe pain, but would have a swelling stomach, and projectile vomiting at the LEAST and would in NO WAY be "soothed to sleep" by calling her hubby. She would be in shrieking writhing pain.
Again, I am having trouble with your question in a way that leaves me quite flummoxed. I would suggest that, as a mandated reporter, and as someone "working with" this woman, and as a licensed social worker, you know the chain of response in getting help much better than a bunch of folks on a Forum.
I wish you luck in resolving this sad situation for your client. But, it's time to call her doctor; you will know how to find out who that is.
The only problem in changing Rehabs is that you don't start over. It you have already been in one for 10 days your start the new one on the 11th day. Medicare pays 100% the first 20 days. The next 80 the patient pays 50% of the daily cost. Sometimes their supplimental will pick up the balance. Medicare only pays for 100 days. The patient can be discharged anytime within that 100 days.
I'm not sure how much I'm buying this story, if I'm being perfectly honest
And the advice I would give this couple is try like he## to find a different facility.
A rehab facility is not an Urgent Care, ER or a nursing home. The patients are there for 1 specific thing and only that thing: rehab. It is not going to coordinate care with another doctor for anything other than what is directly related to the rehab.
Since the rehab cannot solve all their health problems and this couple doesn't seem able to cope or manage well, maybe this is a case for court-assigned guardianship.
A doctor is not on site 24/7.
And unfortunately , long waits for a call bell to be answered is common . The woman is probably on some hefty stool softeners now to prevent another blockage , resulting in incontinence . Meds can be adjusted if needed .
However, the rehab definitely should have sent this woman to the ER for her severe pain . They also should have been keeping track if she was having bowel movements , to address constipation before it got to the severe blockage that happened .
That being said if the woman was toileting herself she may have told them she was having bowel movements , if they asked her . Many elderly lie because they don’t want a stool softener or laxative for fear of incontinence , not making it to the bathroom on time .