Good morning.. I have looked over bits and pieces of this specific topic, and gleaned some advice that I have put in place. The one area I am spinning my wheels on is the actual "transfer". I am shooting for around the 7th for transfer. My DH still knows his home, his routines, his aides. He is also VERY strong in his upper body.
No Dr I have run across will do an admittance to hospital for a day or two. They say Medicare will not approve it as it would be considered a "social" admittance, whatever that means.
I could use a transport from the NH, but DH has never been on one of those and I am pretty certain he would freak out.
I am going to ask our local ambulance service about a non-emergency transport..strap him down, get a sedative in him, I think he would be confused but pleasantly destracted by the ambulance.
His neuro's hospital has no beds and are not allowed to admit at this time. She did say we could sit thru the eternal wait at an ER, see if they will admit or transfer.
Once again..I am the one with no friends or family, his in home aide will be angry at me as she hates the NH I will be sending him to.
I just cannot envision having the strenght to drive him there and check him in by myself. I am also uncertain as to his reaction. He has faint memories of last summer in the ALF. I am afraid he is going to fight.
any ideas?? or how u guys did it? None of his caseworkers are jumping at the chance to accompany me.
i am not sure why you just dont use the sedative the morning of transfer and take him youself and have the NH there at the entrance with wheelchair and help ready. i know its very hard to do this yourself but if you are all there is as far as family/friends then so be it. i feel its the last thing we can do for them as we know in the long run its the best option for the them and the burned out caregiver. once it is over come home and take a sedative yourself. in my opinion it will be less stressful on him having you take him. but i would definately do it under sedation of some sort to avoid conflict. also having his room set up before then with familiar objects will be of benefit to him. i am so sorry you feel so badly having to make the decison. we all know from posts here how painful it is. we are stronger than we think when it comes to paimful decisionsif no other options hire the caregiver or a hired nurse from an agency to accompany you. divvi
Thanks Divvi, It is one of those scenarios that plays over and over in your head and you just cant visualize being able to do it. This is the last piece of the puzzle I am putting together. The deception and betrayal are soul-crushers, I cant discuss this with him, as I normally would. The betrayal comes from long ago promises of no NH, Ever. Little did any of us know.
I agree with Divi...if it's too stressful for you to bring him by yourself, hire an aide or a nurse from an agency to accompany you. I know how heartbreaking this is for you - I was advised by his doctors and the geriatric manager I hired not to do the transfer myself because they thought it would be dangerous. I know the hospital gave him Ativan before they transferred him to the ALF in an ambulance. My thoughts and prayers are with you during this very difficult transition. <<Hugs>>
I found the best way in my case was to tell my husband the advantages of the move for him and the advantages of the move for me. I'm not saying any of it sunk in, but I told him in a matter-of-fact way; it was not a discussion. On the day of the move, I took him there around the main meal of the day, ate with him, stayed with him until it was time for him to go to bed, tucked him in and told him I'd be back in the morning. I repeated this until I saw he was adjusting. He adjusted surprising quickly. I've always thought that the caretaker suffers much more than the loved one. We suffer for both of us.
sheltifan, An admittance to the hospital without a real diagnosed reason other than to get him placed is considered a social admittance and is as your Doctors say, not payable by Medicare, also a transfer to the NH if admitted to the Hospital as a Social admit will not be covered in the NH under the Medicare 20 day etc. rule. You would incur a large expense payable out of pocket if you did it in this way.
argh..any ideas jane? it would be so much kinder to all of us if an admit to hospital was done first. Maybe I could push him over? j/k can i just call an ambulance and say he has stroke symptoms?
I really don't know. My doctor must have come up with some diagnosis to put DH in the hospital as quick as he did.However he did it, I can be thankful for how it went. He went right from the hospital after three days into the NH. Medicare and his supplement paid for everything except the ambulance that transported him to NH, which I paid for.
Sheltifan, it's one day out of your life, and you can do it. If it's for your husband's well being, you can do it. Ask your church's minister for someone there to be with you. Or hire someone for the day from an agency. "The deception and betrayal are soul-crushers, I cant discuss this with him, as I normally would. The betrayal comes from long ago promises of no NH, Ever. Little did any of us know." Some promises can't be kept, like "no NH. Ever." I'd like the same promise myself. But that promise was made "in health." Now you're dealing with "in sickness." You have to do what you have to do. You husband no longer has the ability to see the whole picture.
I will hate this day. I'm sure you're not alone in having a wrenching time. You can do this. I'm thinking about you and hope you get through it.
I hear in your 'voice' that you aren't questioning the decision but can't bear to face doing it. I will be exactly the same when my day comes. I wish you strength.
thank you all, for your arms in cybre-space, holding me up. I know I am not alone. Chris, in her trials right now, is not alone. none of us are. and thank Joan for this sight. Right now, it is my lifeline. Literally.
Having accompanied friends as they have placed their LOs, having some one with you is key. Do you have a friend, minister, someone from church to assist? Does he feel comfortable with CNA so she could assist? Contact Alz Association in your area and see if a volunteer is available. The social worker/admitting person at NH can also give you some assistance in the admitting process
As for the CNA why doesn't she like this NH? Is it that she is losing employment at your house? Or does she know something you should know about? Even if she does not like the home and you have done due dilligence, professionally she can assist you and keep her thoughts to her self..
You can always call an ambulence service for transport, especially if mobility is a problem. Not sure about your insurance coverage. Again, social worker at NH can answer that question. Hope this helps.
Many of the CNA's that have worked with us do not like facilities in general. They have experienced working in facilities and were turned off by things they saw happen; that's why they went to work for a home health agency doing one-on-one inhome care. Based on my experience so far, I would say it's not unusual to have a CNA criticize a particular facility.
I have been away for awhile now.... it is too painful for me to be here, yet just as painful when I am not. I tend to only read and not comment these days.... but, your post tugged at my heart….. Keep in mind everything you have learned from your caregiving. Distraction and "comfort lies" are kind and helpful. I think each of us knows our loved ones the best and knows what will work best for them. With Lynn what I did was tell him we were going for lunch, that way there was no fighting about going. When we got to the nursing home, we did indeed have a private lunch in the dinning room there. I had prearranged it with the nursing home. It all went well until one of his sons decided to explain that he would be staying. It was a day straight from hell after that!!!!!
In hindsight, I wish I had not insisted his children come. They made a bad situation much worse. What Lynn needed, is what he was accustomed to, and that was me at his side. His children were strangers and brought him more distress. He wanted what he knew, and that was me, and the comfort that brought him. In fact the ONLY way I was able to get him to stay was to tell him I was sick and needed to stay, and would he please stay with me? His whole demeanor and attitude changed. .... I had to tell him that every single day for months ... and when I left the room I had to tell him I was going for testing or to see my doctor upstairs. I have a history of illness, and it still triggered something inside him when I said I was sick.....That is what worked for Lynn, he would only stay for me.... you will have to figure out what will work best for your DH. Go with your gut instincts....
To save yourself some of the heartache and learn from my mistake, the biggest thing you need to do is to MAKE SURE there are medicine orders on hand at the nursing home BEFORE he is even placed. They could not increase Lynn's seroquel until a doctor came into see him. They told me I could not give him any that I had brought with me!! Pffffft, I was NOT about to watch him suffer anymore, so I gave him some... but I did not dare increase it too much. He was only on 25mg of seroquel, and he needed A LOT more than that to calm down. Not enough to sedate him, but enough to prevent him from being overly stressed. Also have orders on hand for the nursing home to increase whatever medications he is on as needed. Also, for you and your husband, please make sure you also talk with your doctor about what dose you should be giving him to make the transition easier for him the day he goes, BEFORE you go there! Hell, I wish I had taken something for me lol
I am not going to lie, it is the single hardest thing I have ever done! It was 2 years on Feb 17th that I had to place Lynn. Two years later and it still has the power to bring me to my knees!! placement was harder, and still is harder, in many many ways than caring for him at home ever was. ..
But I will tell you, it was done in love, with Lynn's best interest at heart. That, and that alone, is the only thing that got me through this. I love him enough to want what is best for him. Just keep reminding yourself of that ♥
Not everyone has a hard transition, I see new people placed all the time. Some go very smoothly!! I hope this is the case for you! Keeping you deep in my thoughts ((hugs)) Nikki
I have placed my DH last week and it was also the hardest thing I've ever had to do and I have been called upon to do some pretty hard thing in this life, but that was the worst. He went straight from hospital (think I may have written this in another blog)in hospital transport, but for the entire time he has been at the N/H they have been on shut down with gastric. This has made the seperation all the more painful for both of us, and he hasn't settled, I think he still needs me to be around. It has been a black ten days filled with tears and what if's !!
sylvia - how horrible that you still have not been able to see him. I agree that he needs to see you and you him. I took vacation the week that my husband was placed and spent nearly every waking moment there for several days. I think it made his placement easier and I know that it gave me peace of mind. Hope you get to see him soon.
sylvia its gutwrenching to hear you havent been able to visit DH after placement. i hope the sickness clears soon in the facility and when you see him hes at peace and adjusted well. divvi
Sylvia I can't imagine not being there, it has to be very difficult for you to say the least! I am wondering what this shut down is all about? I have never once been told I couldn't go see Lynn. When different illness were going around they have hand gel and face masks at the front door for people to use. Maybe you could ask if that is an option? You need to talk with someone in managment, I do not believe they have any right to tell you that you can not see your husband!! I too think it helps the adjustment period to have us with them, and it helps OUR transition to be there with them. Please keep us posted, keeping you both in my thoughts ♥