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Monday, June 18, 2012

Seven Layers of Hell....

I thought we knew what we were doing. Really, I did. Mom, who is ninety-one, fell...hurt her back and was in terrible pain. Of course, we called the doctor..who sent her to be exrayed - showed arthritis in her hip and degeneration of her lower spinal column. Pain meds were prescribed something with codine - it didn't help. Ice, heat nothing helped...she laid in bed and screamed.  We couldn't stand to see her in pain, the doctor was useless.  We called an ambulance and she was admitted to Bayfront, a very good hospital downtown.

They put her on Morphine, then graduated her to a pain patch that slowly releases the medicine into her system.  She was in there seven days and they only tried to get her up maybe two times, so at the end of seven days she could not sit or move herself on the bed. One day before they transfer her to a Nursing Rehab they start giving her Oxy-codine...we notice she's a little "off" not quite right. But in the rush of getting her transferred we chalk it up to age and a change in routine.

Mom was admitted to the Rehab facility late in the evening of June 17th...her doctor (let's call her Dr. Irdgas...stands for I really don't give a shit) tells us that this Rehab is her best choice and should suit Mom well. The doctor also stated that she didn't believe that Mom would benefit too much from the Rehab and that she was going to review her staying there on a weekly basis. I found that ridiculous given that she is 91 and had not moved for over a week..to put a week time period on her progress was very insulting. Barb & I got her settled in, left for home.  Next day we took Dad up to visit around 2 P.M. Mom was not herself, she was angry, upset and quite hateful to myself and then Barb.  We questioned the Nurses station as to when she had her meds and told them what was going on.  The response we got was "Oh, her age I've seen them turn like that in only one day..it's dementia"..of course, we found out that Mom had been without the Oxy=codine for over ten hours they had forced her into a physicked break.

This happened over and over...she would make progress in the PT part and get killed in the nursing end of it.  She also had a Fentinal Patch on and three times the old one had not been removed when a new one was put on...very dangerous.  Even with all of this going on Mom did well in PT she stood, she walked the parallel bars, she was able to transfer from bed to wheelchair..the exercises were making her stronger.  Now we proceed through the seven layers of hell....

June 7th....again the nurses do not get the pill into her and they let her go to Rehab in an awful condition.  So, of course, she bites the PT person - thinking she is attacking her when she tried to get her to stand up. This person  puts a call into Mom's doctor and my other sister in Washington state gets a phone call from the doctor's office telling her all about this and that the doctor wants to put Mom in "custodial care" removing her from "skilled (such as it was) nursing".  Barb and I go flying up to the home to find out what the hell is going on and Mom is so off the wall my sister goes hysterical, I go after the nurses....I get the dam pill and get Mom to take it. It took an hour before she came back to her senses.  Yet, these freaks are still denying that it has anything to do with the meds.  


We couldn't make sense of the whole thing...we went to rehab but were told to come back the next day to talk to the director.  We were up at the Rehab every single day for at least 3 hours every day for the last three weeks. Mom made progress from being a vegetable to be able to on Friday June 8th to take ten steps with a walker. To us this was huge.  Not so to the fly in the ointment....the dreaded HUMANA NURSE....she flits around spying on people in Rehab making sure that they are indeed making progress or she cuts them off at the knees..NO MORE REHAB FOR YOU!! Sort of like the Soup Nazi on Steinfield...except when she is called on it all she does is squeal..."It's documented, it's documented!"  Well, we are requesting the documents and they had better hope that their records match ours...because we wrote down each day what she was doing, how she was, what progress she made.


On June 7th we called the doctor's office and got her assistant...the girl repeated the doctor's viewpoint about Mom and I told her in no uncertain terms that we - my sisters and my Dad had to discuss the in's and out's of whether to bring Mom home with hospice care or to leave her in the Rehab for the time being...told her we would get back to them. This call took place at 3:30 PM.  Remember the time, you'll get it later.


We go up to the Rehab on June 7th, can't talk to Rehab so we figure let's see if Social Service is open maybe we can get some additional info there.  Yes, the lady is in, we had to wait for about 1/2 hour for her to finish a phone call. The time is now 6 PM.  We finally sit down and start talking to her she starts to tell us the difference between skilled and custodial care. Hmmm...Mom would be in the SAME room, SAME inane nurses, SAME crappy food, oh but there is one big change..NO PHYSICAL THERAPY!! oh, and by the way..Humana doesn't do custodial..it has to be self pay and it runs estimated $350.00 per day.  Mom's plans calls for 100 days of rehab with a co-pay of $50  per day....we told this woman right there and then "Oh, no..my Dad not going to do this...not when we are having as many problems as we have had" Now get this...we never signed anything in there, the woman never, ever said oh by the way its already been decided to do it...without any regard to your wishes. We walk out at 6:20 figuring we had to talk to Dad.


On Friday June 8th, Barb and I go up to Rehab and met with the director of the Rehab..this woman maintained in agreement with us that Mom was actually doing well and improving with each session. She arranged to have the head of nursing and also the nursing supervisor sit with us in her office and hears our concerns about the medication slip ups.  They were all very concerned and had helpful ideas about meds and such. The head nurse said she was going to send a fax to the doctor suggesting changing the oxy to a lesser pain med.  While we were there Mom was exercising and doing very well.  We tried calling the doctor again and was told that there was an emergency and that the doctor would not be available neither would her assistant.  So our hands were tied as far as reaching anyone.  We figured okay it's the weekend....doctor's office is closed...no orders can be written.


Saturday, Sunday....I took off for my mobile home..it's the second anniversary of Joe's passing and I needed time to myself for memories, pictures and lots of music for the soul.


Monday....Barb & Dad went up every day..Mom is still mixed up a bit, it's hard seeing her like that.  Barb spoke to the doctor's office about getting the back shots from the pain management doctor....nothing else was said to her.


Tuesday, June 12th....I find out that Mom has not been to therapy since Saturday. Checked with the nurses and her record..no new orders had been received. We are, at this point, scratching our heads.  We had gotten a call from the woman in their accounting office so we proceeded to go down there.
This woman hands us a post prepared bill, showing $900 up until Saturday the 9th and then under it a monthly charge of $7,200.00 for custodial care! Can you say WTF? I did.  And I normally do not curse..this situation called for it.
We explained everything precisely as they happened and she said No that is not how it happened....I have a paper documenting exactly how is happened and all of this was explained to you and YOU agreed to it. I said "What paper, what the hell are you talking about?" We never, ever agreed to anything..with my sister concurring.


The woman is sitting there holding a piece of paper, I asked her aren't we going to get a copy of whatever that is since we never saw that document to begin with.  She says to me, doesn't matter you gave verbal permission according to this...again I ask for the paper, again she does not give me a copy to read, again I asked this time a little more loudly and my sister wants to walk across her face bigtime. Finally she stands up holding the secret paper close to her chest, she says "ok, but I have to get permission from your Mother to show or give you this paper"....the lunatics are running the asylum I was looking for hidden cameras by this point. We had just explained to this moron that Mom is out of her mind, not able to digest any info or agree to anything.


So the three of us march down the halls, headed to Mom's awful room, avoiding walkers, wheelchairs..trying not to see the unhappy residents of this pitiful facility..a large majority of them just lay in the beds with their mouths agape..just waiting for the end.  No one smiling, no activities....just plain awful.  We reach Mom's room, the woman stands at the foot of her bed and tries to talk to her..Mom reacts as if the devil incarnate had just dropped in...finally the woman just shoves the paper in front of her and says "is it ok for me to give this to your daughters?" You know, doesn't a husband have some rights in this frigging state? Because he is 95 he is being ignored too? This woman pissed me off bigtime. So the woman turns and hand the paper to me....then she says "listen, tomorrow Wednesday the Humana Nurse will be here for a meeting...why don't you girls come up about noon and we can all sit down and discuss this"...so we agree to do that.  She leaves, I sit down to digest this secret paper....what I find has me shocked.  It is a form from Medicare saying  that we had met with social services at 6PM on June 7th.."I met with both daughters this afternoon and they are in agreement to place their mother into custodial care as of June 9th" Then there is a place where it states she had been in to see my Mom and show her this paper at 5:30 pm..(1/2 hour before we sat in her office!) Oh and get this "resident declined to sign the paper just giving verbal agreement"....can you say bastards?

Can it get any worse?  It sure could and did. Barb & I got up early, dressed..we took Dad and went directly to the doctors office to confront the doctor over these decisions. Guess what doctor had decided to take a week's vacation and her assistant was unavailable too. We told the receptionist how unhappy we were.  We took Dad home and then ran up to the Rehab hoping to catch the meeting...we got up there early around 11, went to the accounting office to find no one, another lady said they were in a meeting for all the heads of departments and to come back at noon.  We passed the witch from social services and she smiled, catlike, at us and said "oh, girls I have good news for you...have to run right now but I will catch you later!" Barb & I looked at each other and good news would be nice.  We were so stressed out from all of this...my blood sugar was up more than 50 points higher than it should be and my blood pressure unreal.

Well, we go into Mom's room and the final piece of straw lands squarely on my back....she has another patch on and the old one is not removed. She is beyond herself crying she wants to go home...again the oxy pain pill was withheld for hours beyond what it should have been...I go after the nurse, I get the pill into her. The nurses go right into her face, she feels under attack - I put the pill in her hand, hand her the water and tell her the doctor wants you to take this its important....easy...she takes it. Meanwhile, we are still waiting for a meeting that was never going to take place...I went and sat in the hall outside Mom's room just for a breather.  A rather large and pompous middle woman walks quickly by me, carrying a clip board clutched to her breast. A flash of her badge registers with my brain...I yell out to her.."Are YOU the Humana Nurse?"  She turns, sizing me up and down...I think she was trying to determine if I was a patient or visitor there...because of my walker.
She "Yes, I am" I say "You had a meeting today about my Mom Mary Schick?" 
I start to ask her how could you put down that she wasn't making any progress when out of nowhere the witch from social services rushes to us as if she would be the Humana reps personal defender.  She starts talking at full voice, I answer in kind....I called her a liar to her face over the "secret" paper..she stands there and lies more. My sister hears the commotion and brings Dad out into the hallway.  The Humana Rep looks like she would like to slink away and just keeps saying "it's documented, it's documented"....My Dad, 95 years strong, drew himself up looked them in their eyes and told them..."THIS WHOLE THING IS BULLSHIT" social services says "why Mr Schick what do you want to do?" Dad says "I want her home NOW"!


Social services says I will get right to work on that...I say the doctor is out of town how can you write a discharge? Social services, very smugly, says "Oh, I have their cell numbers I have already spoken to the doctor today and she is upset because you all upset her office this morning!" I really wanted to spit..my folks have been patients of this doctors office for over twenty years and have been treated so shabbily.


So we have her home...she is eating better..she had lost 15 lbs in 12 days there was dehydrated also.  We still have mood swings and depression but we are hoping that we can find someone in the medical field who understands the ins and outs of medicating a 91 year old.


Needless to say, we are kicking this inept doctor to the curb I already have them assigned to my great, caring, wonderful doctor....as of July 1st. It will give me great satisfaction to know that they will be cut from the other doctors list from Humana.  Does everyone know that these managed care programs pay the doctors monthly and the more you don't use the doctor the more money the doctor gets to keep in his pocket? I'd really like to know the dollar amount and times it by twenty years....years where they had nothing wrong with them except blood work....years where this office talked my Mom out of doing anything for her bad knee...not even shots. I'm not even sure whether they did a bone scan to see if she has osteoporosis.


Well, the nursing home, the doctor have not heard the last of this..I have a list of places to call to complain and if I can figure a way for this to go viral on the net ,,I would do it.