Undertoad |
05-23-2012 10:08 PM |
We finally found out:
Acute care: 3-4 hours/day
Sub-acute: 2-3 hours/day
Skilled nursing: 1/2 hours/day
~~~
That's why a cardiac patient doesn't get into Bryn Mawr. Bryn Mawr is acute-only.
Mom certainly didn't need anything but skilled nursing -- except that it needed to be actually skilled, in which severe a-fib should be recognized as a problem, monitored as closely as possible, and referred to the hospital immediately and perhaps not left up to the patient's decisions.
But at the shitty rehab, none of that was really available -- and thus...
It was eventually the patient who decided that she should be taken to Pottstown Memorial's ER. By ambulance, so that she could remain on oxygen. Once at Pottstown she was evaluated as truly at risk, and far enough from surgery that she could get blood thinning meds, which reduced her stroke risk by half [citation needed]. She was admitted and then told she had to stay for 3 days.
That allowed J the time to germinate the idea that mom didn't have to go back to the shitty rehab facility, and that the local retirement community/assisted living facility Shannondell had attached to it a skilled nursing facility. And although it was said to be hard to get a bed there, they had one available -- which mom was slotted for.
What a difference! Shannondell's private rooms have wall to wall carpeting, walk-in showers with benches... everything is clean and smells ok! Her nurse met us right at the door with a wheelchair and told us jokes as he explained that every day would get better. The next day's menu was taken and it was top-notch: pan-seared duck breast and green bean casserole. Within two hours of admission another nurse was fighting to transfer the meds that the Pottstown doc hadn't put on her list.
And then she went into AF again, and this time she had the right meds to keep it in check. The S-dell staff was authoritative: you'll stay here, now that you have the right meds, and our doc has read all fifty pages of your history and will see you on rounds. And she did stay; and today, out of AF, she did the physical therapy she needs.
I suspect Shannondell's facility is more for its permanent residents, which I think number about 3000. But they've overbuilt it (which is a great idea) and allow laypeople to get in, in order to keep the facility running at max.
However it occurred, Mom is now at an elite facility with excellent elite staff. If we had known what rehab is, that it was inevitable, and that it differed greatly from place to place, we would have visited these places beforehand. As it was we were offered a list of places to choose from with no notion of which one was better and how.
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