speech therapy

On the Move Again

/ Shirleyjdietz / Leave a comment
Dennis is missing lots of beautiful sunsets, but the sun is setting on one more of his stroke recovery experiences.

It’s been 23 days in “swing bed” status at St. Mary’s in Superior. The husband has become accustomed to the people, the environment, the routine. So, naturally, it is time to change things up again.

Thursday, November 3: Care conference with the case manager, therapists, in Dennis’s room and with me on the phone was concerning. The physical and occupational therapists have noticed that he has trouble remembering steps and sequences for moving. He doesn’t seem to be able to build to a greater skill level because of that. He heard this report and later when I questioned him he agreed with their assessment.

The goal with these physical therapies has been to make transfers possible without mechanical help and multiple people. Dennis has muscular strength but he doesn’t know how to direct it when it comes to complicated (yes, complicated!) movements like standing up, or sliding over. He has reached a plateau. They feel he should transfer to another long term facility. His only remark was that it should be as close to home as possible. However there are no beds available in Hayward.

Friday, November 4: By the time I reached the hospital parking lot my plan for the day got scrapped. I got a call that there was a bed available in a town 30 miles from home. I had not visited this facility but decided to say yes to it, pending approval after I had seen it. Dennis and I discussed the move. He’s already dreading leaving this batch of new friends…

It is so confusing to navigate the rules of Medicare. If it were not for the social workers and case managers that we have encountered I would not know what to expect. They are very good at keeping track of how many days are left at different levels of care, and how to keep Dennis getting some more time with the therapies he needs most.

One of the most improved areas lately has been his work on swallowing. He has steadily increased the time on the E-Stim device and the number of swallows he takes. I am glad that the speech therapist made sure he got one more evaluation with the fiber optic camera and it did show improvement. He was given the choice of having some soft foods like pudding if he was okay with the slight risk involved. But there is still more work to be done before he can consider having the feeding tube removed.

Tuesday, November 8: I visited the new facility in Spooner yesterday after my time in Superior with Dennis. It was neither greatly good or greatly bad. It’s hard to be specific about what makes some places clearly “nursing homes” and other places “hospitals”. Sometimes it’s the fact that many nursing homes are in older buildings, abandoned for their original purpose or dated in some other way.

Maple Ridge Care Center is a former hospital with several wings off a central nurses’ station. There are parts of the building that are completely unused. One section has been made into a daycare for the employees children. The outside of the building and the grounds are neglected, sidewalks and curbs cracked and crumbling, the foyer sports a rumpled rug at the entry and leaves and debris have blown in from outside. Doors in the hall are open showing offices with varying degrees of mess and disorganization.

The better aspects of the facility were the people working there. Many of them were young and appeared competent. The patients were mostly sitting around in wheelchairs watching birds in the small aviary or playing bingo in the dining room. Therapists were wheeling people back and forth after their sessions. It looked busy and fairly happy.

The room where Dennis is most likely to end up was large and empty. Some painting or repair had taken place and it hadn’t been refurbished yet. I could see it being a nice room, although it was in the long term wing instead of short term rehab. I’m not sure if there is a message in that, probably not. I hope they are getting it ready today since he is scheduled to leave Superior at 9 a.m. tomorrow.

I will try to be there to meet him when he arrives – they have open visitor hours 24/7. They also have some Covid patients that they keep in quarantine. They evidently aren’t having too hard a time with the virus. One other concern about Maple Ridge is that I’ve noticed it’s hard to get anyone to return a phone call. I will have to train Dennis to pick up his own phone when he gets there.

For anyone wishing to send a card or letter to welcome Dennis to his new place, the address: Maple Ridge Care Center, 510 First Street, Spooner WI 54801

510 First

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Progress Report: Week 3 in Rehab

/ Shirleyjdietz / 4 Comments

– The trach came out on Saturday!! He had no trouble and the hole is healing up with only a bandaid on it.

– Wednesday and Thursday were good days in PT and OT. He’s tossing bean bags in a basket and sitting up by himself for most of the sessions.

His aim could use some work, but they were all close.

– Swallow test on Monday showed he is still not completely safe from aspirating, but he is coughing less during sessions with E-stim. Had his first taste of ice cream on Friday.

Chocolate.  The electrodes on his neck are stimulating his swallow muscles.

– Alert more and engaging others in conversation. Surprised a couple people with phone calls where he did some of the talking.

He stood in the stand-up machine for almost 10 minutes before his blood pressure tanked.

On Tuesday of week three I got a call from the social services gal assigned to Dennis. She reported that the weekly meeting of all therapists, nurses and doctors had resulted in the decision to move him out, maybe by the end of the week. His progress was too slow to warrant the acute rehab aggressive schedule. He was often too tired or unable to focus for the whole sessions in PT. There were often issues with blood pressure and bowel problems this week as well. I understand what they are dealing with, nevertheless the change from 60 days to “out by the end of the week” was a little alarming.

The next day I went around to our local facilities in Hayward and got his name on their lists. There are three of them and they are all full with long wait lists. But since we could be waiting for years yet, it was still worth it to sign up for something in town.

After social services investigated facilities that would offer the needed therapies within reasonable travel distance, I was given the short list to consider. On Thursday I decided to visit the one rehab/nursing home that had an open bed. It was in Shell Lake, 40 miles from home. True, that would cut my travel time in half on most days but still… it makes me sad to be thinking of this level of care.

The building was acceptable and clean. The staff people who gave me a tour and spent time with me were pleasant and seemed candid about the quality of care given there. I felt it was a possibility, but was a little concerned about their ability to meet the needs of someone who can’t even turn himself in bed.

Back at home I happened on a friend whose mom had been in three different facilities as an Alzheimer’s patient. Shell Lake was the worst of the three. It was back in 2014 and things could have gotten better, but it did cool my already lukewarm enthusiasm a bit more.

I am praying that his progress toward the end of the week will cause the rehab team to reconsider and give him more days at Miller Dwan. It could happen, right?

Week One in Rehab

/ Shirleyjdietz / Leave a comment
Occupational Therapy, clothes on, in a chair, ready for work. Thumbs up.

Progress Points: Week One in Rehab

New routines are getting in place at Miller Dwan Rehab Hospital.. OT early in the morning to get dressed, brush teeth, ADLs. Speech therapy. Off to the gym for an hour with PT and then back to rest. OT and Speech again in the afternoon. Evening rest.

Off oxygen and still doing well.

Blood pressure remaining stable.

No more finger pricks for blood sugar testing.

On a new mattress that avoids painful pressure points.

Allowed to sleep at night, undisturbed if he doesn’t need anything.

Beard got trimmed (yay!). Wearing real clothes during day.

Having real conversations with wife. Voice getting stronger.

Getting “known” by staff.

Got to ride stationary bike in PT, with help.

Room got personalized – the “love” poster from family and all the cards are on the wall where they can be seen.

Sayings

When told rehabbing was his new job: “Take this job and shove it.”