Friday, April 09, 2010

Thursday update

I spoke today with Kristin. She reported that the doctor approved changing Dad's meds to Tylenol with codeine. This did not change Dad's alertness during therapy, but unfortunately it did not seem to make any difference in his willingness to move. She now feels that his cognitive state may be the biggest factor holding him back. She thinks he is afraid perhaps. At the same time, she says he enthusiastically engages in upper body exercise involving throwing/catching a ball, so I wonder if pain is in fact real. She did however raise the issue that they expect patients in this rehab centre to be progressing more quickly in their therapy - the average stay is 10 days. If he is assessed to be 'plateauing' (or not progressing), they will recommend moving him out. She is very sympathetic and wants to keep working with Dad if she can. She hopes the new meds will help in the next few days. She suggested that one of the issues is that the policy about 'plateauing' is governed by the insurance coverage. She suggested talking to the Case Manager (Suzanne - hope that's a good sign) more about this area, when I said I thought Dad's coverage would be better than most. Suzanne will not be available until Monday, however. I also spoke with Haydee tonight. She said Dad was more sleepy today than during her previous visits. He didn't finish all his dinner, and she had to help him eat most of it. She said he did take the ice cream and fed himself to finish it off though. She confirmed that he does not want to move much, and she thinks he may not be able to get back to walking on his own as before. If he does it will take quite a long time of therapy. I know this is not really what we are hoping to hear, and it is still early days yet. I think we need to take one day at a time and continue to work toward full recovery, but may need to accept that Dad could be entering a different stage of ability and consider mainly how to ensure he is as comfortable and happy as possible.

2 comments:

Catherine said...

I think most hospitals only keep patients for a week or so--that was the case with Mom--then she had to be moved to a rehabilitation place (Brian Center). Unfortunately, the care at the rehab was not not as good as the hospital care was!

I hope Dad does well wherever he has to go.

Justine said...

Sorry about the confusion. Dad was only in the hospital for 5 days, then he was moved to his current location which is TCU - a rehab centre. I know that Mom spent a lot more time in the rehab centre she went to, so I was a little surprised they were expecting Dad to progress more quickly. THis may all be premature though. I think they will work with him a few more days, and there will probably be a team conference next Monday. Barb should be able to be there and she will get more detailed feedback and options for future care.