Friday, September 18, 2015

We’re in Lynden, Washington



Today was moving day for Lorraine, she was moved from Shuksan in Bellingham to Christian Health Care Center in Lynden.  Basically, this move was because of insurance and therapy coverage, sure wish insurance companies would leave the doctoring to the doctors/therapists.

Last night was pretty emotional for Lorraine, she was doing lots of things for the last time at Shuksan ie, last dinner, last time with her nurse and aide.  Her favorite nurse and favorite aide were both working swing shift, both came by to let her know how sorry they were that she couldn’t stay there. 

When I got there this morning she was angry at me because she had been awake for hours and I got there at my normal time (6 am).  I think most of it had to do with the stress of her having to make this move today. 

We were scheduled to get transferred at 11:00 but they had their monthly pancake breakfast this morning so things were in a bit of turmoil and confusion.  But the breakfast was nice although Lorraine has been getting the early breakfast and was hungry way before they were ready.  They pancakes and eggs were cooked to order and had plenty of fixing to go with them. 

All morning long, people were stopping by to see Lorraine and wish her luck and hoping for a good recovery.  They all said she was a great patient and they hated to see her have to leave.  Sure wish they could have talked to the board or owner or whoever it was that made the decision to force her to leave.  

I think there were four residents leaving this morning so they were busy doing the paperwork for all of them.  There were three moving to different facilities and one moving to her daughter’s home.  But about 10:45 or so, the head nurse came in with the paperwork for Lorraine and we were able to get the 11:00 bus.  There were two ladies going so they dropped the first lady off at a place in Bellingham then headed we North on the Guide. 

I was following the van, had to get our car there with Lorraine’s stuff and if I rode with her, I would have had to just turn around and go back to get the car and I wanted/needed to be to get her through the first few hours in the new nursing home.  And as it turned out, I wouldn’t have left with the van, I needed to be there for sure. 

Lorraine said the ride was really rough, the wheelchairs are all the way in the back of the van and she felt every bump.  We pile pillows under her left arm to keep it in place and they had fallen out so her elbow was hitting the side arm and it hurt. 

Once we got here, there was the usual paperwork hassle, the gal said they didn’t send the right paperwork.  I told them it didn’t really matter, we weren’t leaving and Lorraine was tired and needed to lay down, NOW.  She tried to tell me they had to have the paperwork but I managed to convince her to change her priority to the patient vs the damn paperwork.  Not a good start at this place for sure. 

But once we got to the nurse’s station and they took over from the paper pushers, things started getting better in a hurry.  Her room was ready and waiting, they only had to find the proper lift to transfer her into bed, they use a completely different type here. The nurse said all the paperwork could wait until Lorraine was moved and comfortable.  Now we’re talking. 

The therapists showed up to check her out but decided to return later after she was more settled in.  The nurse and aide stayed with her for awhile to make sure she was doing ok. 

The therapists did come by later and did their initial assessment of Lorraine’s condition.  They were both pleased to see Lorraine had more muscle control than what the notes from Shuksan described.  The did range of motion and found where the movement caused pain, saw how much she could move her leg and arm and were really pleased to see how much muscle control she had over her left knee, very important in order to stand. 

In fact, they wanted to get her to stand before they were done.  Lorraine was able to sit on the side of the bed but still had trouble with falling over to her left.  I explained how they had worked it at the other place, they tried it and it worked again.  From a sitting position on the side of her bed, she was able to stand without a huge amount of help.  The therapist did have to brace her left leg so her knee didn’t fold but she was able to stand and hold her head up.  They had her sit back down then got her to stand again the second time. 

The physical therapist said she was pretty certain they would be able to get Lorraine standing and maybe even taking a few steps soon.  I must admit, I got a bit teary when she said that, luckily I was standing behind Lorraine at the time.  She is working so hard to get better, I haven’t (and don’t want anyone else to either) told her the therapist didn’t think she would ever walk again.  So it was really uplifting to hear a different opinion and this one was better. 

The therapist at Shuksan said one reason they thought it would be a good thing to move was to get a different set of eyes on Lorraine and she what they thought, really glad we did it.  It made the whole moving thing much better, for sure. 

I realize most people don’t know where these nursing homes are located so I will put the address and some directions here.  I think she will be here for quite awhile, months at least I’m guessing, so if you want to visit, here you go.

Christian Health Care Center

855 Aaron Drive

Lynden, WA 98264

Heading North on the Guide Meridian, go past Lynden and turn right on Badger Road (road to Sumas)

Go to the second roundabout and turn right on Bender road (at the mini-mart)

Less than a block later, turn left on Aaron (right after the mini-mart), it’s a small residential road

About 1 1/2 blocks, arrive at Christian Care Center on the left, just before the new senior care apartments.

Lorraine is in room 208B, bed next to the window.  She is, obviously, in a shared room so it may take some getting used to having someone else around but so far, the lady has not been in her room since we’ve been here over the last 5 hours or so. 

I’ll try to write a regular blog next time, really just wanted to let everyone know that Lorraine has moved and all is well, at least as well as can be at this time. 

Thanks  Chuck


Sunday, September 13, 2015

We’re in Bellingham, WA



Probably time for another update although there isn’t too much progress to report.  There are, however, a couple of road blocks in front of us that I’m working on with/for Lorraine, here’s hoping they work out well. 

Lorraine has improved her swallowing ability to where the speech therapists have upgraded her to a regular diet, no restrictions except to slow down and check her left cheek for pockets of food when she’s finished eating.  She remembers the feeding tube she had at the hospital in Seattle and certainty doesn’t want one of those again.  The speech therapists have actually signed off on her care, she is done with that therapy discipline. 

She works hard at her physical and occupational therapy but isn’t showing much improvement on that front.  Although she has stood up twice, it is only with lots of help and control from the therapists.  Most of her therapy has been trying to sit upright on the side of her bed or on the platform in the therapy room.  She still can’t sit straight, she will fall to her left quickly most of the time.  They are working on getting her to know and control what is straight while she’s sitting before they try going to the standing/walking stage.  Yesterday she was able to sit on the side of her bed, put her right elbow on a pillow and sat up straight for about 10 minutes, yea.  She was also able to lift her elbow without falling completely but she is really unstable and would fall over easily. 

The head therapist has made the decision that her last therapy will be next Friday as she isn’t showing enough signs of recovery.

Now an explanation about that, at least as I understand.  We have Medicare part A plus supplement part B as most retired folks have.  Medicare is good about paying for recovery after surgery or incidents like Lorraine’s stroke.  They will pay for up to 100 days of care as long as the recovery is going per their guidelines.  After Medicare benefits are finished, she will either have to go to private care or Medicaid. 

But to qualify for Medicaid, the family can only have $40,000 left in assets, that is in their savings, checking, IRAs, retirement accounts and such but doesn’t count their house and one car.  They even say you have to cash out any insurance policies that have a cash payout too.  That may effect whether we sell the house or not, if we sell it, they can take that money too.  Boy, the rules are complicated and I get different information from different folks so this is something I have to tread through carefully.  

The money is a big part of this for the nursing homes, I’ll use this nursing home as an example.  They charge $300/day for some one to stay here for long term care if they are paying for it privately.  After the family runs out of money, which doesn’t take too long in most cases, state Medicaid takes over and they get paid $158/day. 

But Medicare pays the nursing homes $600/day for the time the patient is here going through therapy and recovering per their guidelines.  So this place has made a decision to not allow anyone to go into long term care but have them leave after their Medicare benefits has been exhausted.  That means they get $600/day vs $158/day, at that rate, they can afford to have empty beds for a time.  The resident turnover will be much greater here and they will need to have more therapists but they are after the dollars per bed per day. 

So Wednesday we were told Lorraine will be finished with recovery therapy next Friday and just have therapy to maintain her status.  This is because she isn’t showing enough recovery even though she isn’t anywhere near the 100 day maximum allowed.  That means she will not be receiving Medicare benefits but will revert to private pay.  But if we can get her into a different nursing home before she has her last therapy here, she can continue with Medicare therapy and benefits at the new place.  I think these places are working together to get the most Medicare money as possible, it is a business after all but I hate the way they work it.  I would prefer the patient’s care comes first but those days are a thing of the past for sure.  

So, as I see it, not allowing any more long term care patients is just a money/business decision at this place.  Between that and the insurance companies’ rules, the doctors and therapist have to make decisions they don’t really agree with.  Everyone here says they would like for Lorraine to be able to stay but the decision was made “up the ladder” so I can’t talk with them. 

For the last three days, I’ve been checking out new nursing homes.  I’m finding most don’t have an empty bed right now but we are on the waiting list at two places.  I’ve found two places I really liked but they are only long term care, not nursing care and at this time, Lorraine needs round the clock nursing care.  I’ve also found three places that I wouldn’t move into for one or more reasons. 

Lorraine is still having some confusion yet and really doesn’t understand why we have to find a new home for her now.  I’m sort of pissed at this place and probably won’t stay here now if they changed their minds and gave us the OK to stay.  I am working hard to get her a bed at the new place before Friday next week and will update this blog to let folks know where she is when we move. 

The steps Lorraine has to go through is to continue with skilled nursing care until she is able to move from her bed to a wheelchair by herself.  Then she can go to long term care until she is able to go home with a home care nurse coming by once a day for a couple of hours or into a senior living place.  This will be a long process for sure but that’s just the way it is.  The therapist I talked with yesterday said Lorraine may never be able to move into a wheelchair by herself and may end up in skilled nursing home for the rest of her life but I don’t have any plans to give up. 

I sure haven’t given up on Lorraine’s recovery, that’s for sure.  Yesterday morning I was doing her range of motion exercises on her leg, arm and hand when she complained about pain when I moved her fingers.  That was something new, she hasn’t had any pain or feeling in her arm or hand.  I asked the therapists about it, hoping it was a good sign of recovery, being able to fell her hand.  They aren’t sure if that is the case or not but I’m saying it is. 

She is still moving/lifting her leg on command and I say that’s getting better too.  She is trying hard to get better and as long as she has that attitude, I won’t give up on her!  The experts say she isn’t meeting their guidelines but I’m with her much more than they are and I know her better too.  I’ve come to the conclusion she will not recover back to 100% of where she was but that’s what we’ll work towards. 

It’s hard for us to get used to this nursing home care, that’s for sure.  We both take showers every morning but most of the places I’ve checked only have showers for the residents twice a week.  At least that’s for those who are wheelchair restricted.  But this place, and the others that I’ve checked into, have a good kitchen and serve a good meal, not what I expected.  And this place also gives me a free guest meal too.  And all of the ones I’ve checked are clean and didn’t have the bad “hospital” smells. 

The nurses seem a bit overloaded but they take the time to know the residents and show they care.  The aides are busy too but they are also friendly and care.  Lorraine has a call button and when she pushes it someone shows up fairly quick even is they are busy somewhere else.  If they can’t work with her right then, they explain why and let her know they will be back when they can.  This works out pretty well but a few times she has had to wait longer than I liked. 

She has to have two people help her in order to get into/out of a wheelchair using a lift.  She also can’t get dressed by herself and requires assistance from an aide for that. She is still getting regular pain meds every four hours for her terrible headaches.  Items like these are why she needs to stay in a skilled nursing home vs going to a long term care place.  The LTC places don’t have as much help for the residents, they are more mobile and able to care for themselves than what Lorraine can do. 

I have been leaving every night, Lorraine is getting better with that.  One of the therapists explained to her that she can’t be calling me in the middle of the night unless she needs to, not just because she wants to.  But she is really glad to see me when I get here in the mornings.  I still try to be here for all her meals, she gets into her wheelchair before lunch and we go to the dining room for lunch and most of the time for dinner too.  But she still still has her breakfast  in her room. 

We had signed Lorraine up for an outing to the mall yesterday.  This would be her first outing except for a quick visit to see her doctor when we first got here four weeks ago.  She was really looking forward to shopping with her sister there.  But Thelma couldn’t go to the mall so she stopped by to see Lorraine here before she left for her outing.  Her daughter (our niece Kerri) stopped by too.  While they were having a nice visit, Lorraine still wanted to spend the afternoon with them so I asked if it would be possible to have the driver take Lorraine to the casino instead.  Lorraine’s therapist and nurse both said they thought it would be good and the driver said he would just stay until we were ready to return.  Both her sister and our niece agreed to meet us there too, winner. 

So that’s what happened, no mall but she did get to the casino.  Of course she was in her wheelchair but I was there to navigate around the place with her.  She was able to play the slots without any problem, anyone who knows her well would understand that, ha.  They all had a great time, I’m glad that’s the way it ended. 

But more important, she had a good time and when we were riding back, I asked about her pain level and she said she didn’t have any pain, yea.  It was a good outing for her, especially with the pain being gone. 

One thing this place has is a shuttle bus that they use to run the residents around, including wheelchair bound folks and some of the other places don’t have that benefit.  I understand it has an added cost but after yesterday, I’m a believer in getting out and about as therapy.  The city bus system does have specialized transportation available, only $1 one way I understand, but it can take much longer to get a bus and I don’t think you can reserve one. 

Lorraine is still getting lots of facebook comments, emails, phone calls and people stopping by to see her.  These help lift her spirits and when she is having a down moment, I remind her of all the family and friends thinking of and praying for her.  So thanks for all you do, I know how easy it is to forget someone if you aren’t around them often, I am as guilty as the next person on that front.   

I haven’t had any more work on the house, the guy doing the work was on vacation for a week.  Unfortunately, he pulled a hamstring while on vacation and had to take off this week too.  But it is listed for sale and a couple of folks have toured but no one has made an offer or anything yet.  As I said, I may have to rethink the idea of selling the place now but I’ll work on that this week, in my spare time.  And I’m keeping the option open that we may have to move back into our house, it’s a large house and with a little bit more work, it could easily be handicapped/wheelchair accessible on the bottom floor. 

Ok, guess that’s enough for now.  I tried to record how Lorraine’s recovery and prognosis is going so this may blog may not be as upbeat as the others but be aware, she is working hard and I’m here  by her side to help her all I can.  Plus with all the prayers and good thoughts from family and friends, we’ll accept whatever recovery she had get. 

Thanks   Chuck and Lorraine



Friday, September 4, 2015

We’re in Bellingham, WA



I guess it’s time for another update, at least I’ve had some people ask me for one.  I’ll try to keep this note shorter than the last one.

Lorraine’s condition is almost the same as last time, she still has no control/movement on her left arm and very little on her left leg.  She can sometimes move/lift her left leg on command and we continue to work on that. 

The speech therapists are pleased with her ability to swallow better.  She has a number of exercises she does to work the muscles in her mouth and tongue, say the vowels slowly, click her tongue, purse her cheeks and whistle.   We do these exercises a few times a day and I think her speech is getting better/stronger too. 

The therapists have upgraded her allowed food once again, this time she gets basically ground vs pureed.  She does get some whole foods, they said if it is fork mashable  that she could have it.  Plus she is now able to have bread although it does take much more chewing for her.  

She is learning how to better move food from the left side of her mouth to the right side.  She does still get some food hiding on the left side but has learned how to sweep that out with her finger.  And she has learned to take frequent sips of liquid and swishing it around her mouth, that helps to clear any food hiding in the left side too. 

Her occupational and physical therapist have been working with her every day too.  They are still getting her to sit upright without falling over to her left.  At first, she would lean over so far that she would fall unless held.  Then she was using her right arm to assist but her new normal upright was still leaning way to the left.  So they positioned a mirror in front of her to show her how she was sitting and that seemed to help. 

The last two times she worked with them, they said she is doing much better, using her stomach and back muscles more and not relying on her right arm so much.  She was able to sit upright for about 1/2 hour on Wednesday with less assistance but still not where she wants/needs to be.  The therapist told us she has to master this before they can move on to standing then to walking. 

She is still having a constant head ache on the right side of her head, where the stroke happened.  Her doctor has ordered enough pain medicine that she is able to bear the pain, sometimes she said it’s down to a three.  She has a standing order for the pain meds with the option of getting more anytime she needs it.  Of course, these meds cause other problems so it’s a balancing act to control the pain without causing the other issues. 

Lorraine is still in good spirits most of the time although she does have some bad moments too.  Yesterday she was having a bad time, feeling bad about being here and not out doing things we like.  She was really sad that she missed being with her sister for her 50th wedding anniversary. 

One of the toughest times for her was when our niece got married on Tuesday night.  I explained to her many time that we wouldn’t be going to the wedding but a few minutes later she was doing some sort of planning for us to attend.  She wanted to make sure I had her clothes ready and wanted to make sure mine fit.  She really cried when she asked to call her sister and I told her she was at the wedding and couldn’t talk on the phone while the wedding was going on. 

As I mentioned above, sometimes she gets confused.  I’ve been able to spend most nights in her room since her stroke but I got to where I had to go home and get some uninterrupted sleep.  So Tuesday I kept telling her I was going to leave her at night and would be back in the morning.  She seemed ok with that throughout the day but when it came time for me to leave, she tried getting up to get dressed so she could go also.  Once again I had to explain that she couldn’t walk therefore she had to stay here. 

I did stay around until she was asleep before I left and when I got back in the morning, she was fine.  I attempted to go home on Wednesday night but it was raining really hard and I found the streets downtown were flooded.  I guess after the big windstorm we had, all the leaves were plugging the sewer drains and the water was getting deep.  If it was that bad in town, I didn’t want to see what it might be on the roads back to the house so I turned around and went back to the nursing home and spent the night there once again. 

Last night I was able to go back home once again, I think Lorraine is getting better about me leaving her.  But when I do leave in the daytime, she thinks I’m gone way too long.  The other day she said if I am out gallivanting around, she was going to go to the casino, funny but sad. 

I haven’t been leaving too often during the daytime because I want to be here when she has therapy and I help her at mealtimes.  But we did just get the house listed for sale and I have some work I have to complete before we get prospective buyers through so I need to be leaving more. 

Lorraine does work hard on her therapy and is pretty tired when done.  She can sit in a wheelchair pretty well although she does tend to lean to the left then too.  She likes for me to push her around the place, it’s built in a big U shape with a patio/garden in the center.  It’s been too rainy and/or cold to spend much time out there but she can see the flowers and such through the windows. 

I talked with the activities director and her therapist when I heard they were planning another outing to the casino later this month.  The therapist said she could go if she could increase her stamina in the wheel chair and the activities gal said she could have one of the two spots in the van for wheel chairs. 

You should have seen the smile on her face with I told her I set it up for her to go to the casino.  She immediately started planning on what she wanted to wear and even wanted me to get her cloths out of the closet, even though there aren’t any there at the time.  She wanted to call her sister and ask her to meet her there too and it isn’t even happening for three weeks yet.  I know she will enjoy the outing and sure hope she is able to go, it would be a huge disappointment to her if she couldn’t go for some reason.

Another time she smiles is when she gets visitors.  She does like to have folks stop by for awhile although it does tire her out if there is more than one conversation going on in the room at one time.  So we really try to limit the number of folks in the room at one time. 

We were both surprised to have my brother from Missouri walk into the room the other day.  He had surgery in early August but he’s doing well enough to travel.  His daughter and son-in-law are at Fort Lewis in Tacoma and he drove out to visit with them.  They decided to make a day trip up to Bellingham to see Lorraine, very nice.  It was a complete surprise when he called and told me he was just a couple miles away from our house and wanted to know if I could “do lunch”.  Thanks for the visit Brad, Dude, Rachael and the two little ones. 

Lorraine also gets some emails and facebook notes and I read all the comments/notes to her.  She really appreciates everyone’s contact, it lifts her spirits.  When she is having a down moment I remind her of all her friends and family that have visited or sent comments and she starts to feel a bit better. 

On our house repairs saga, I did part ways with the contractor that was working on restoration after the clean up was complete.  I was unhappy with the painting job they did, the painting was ok but they didn’t even pull the nails left behind or spackle the holes.  When we got here they hadn’t even been to the house for three weeks and when I had the project manager meet me at the house, he told me they hadn’t even ordered the material needed to complete the work.  He said he didn’t have any work scheduled for the next few days.  So we agreed on their payment and they are out of the picture. 

But I did get a call from them yesterday saying they didn’t want to pay me the portion of the check from the insurance that we had agreed on.  I reminded him that we both signed the papers and I expected to get the check for the agreed upon amount.  Just what I need to worry about now, some contractor being an a - -. 

But on a good note, the guy I hired to do some other work at the house has agreed to take on and finish the fire restoration work.  We’ve made a couple pickups at Home Depot to get all the material needed and he is a good worker.  But he did have time off schedule for this week so when he gets back he’ll get going once again.  He is in great demand for others, especially our realtor who told me about him.  But I’m glad he’s getting it done and it’s done correctly too. 

Guess that ‘s enough rambling for now, I’ll close this and get it posted.  Lorraine wants to proofread this so I’ll pass the laptop over to her and see how that goes. 

Thanks   Chuck