| My step-father Norm. He's never been my favorite person but my mother loves him and he loves her. They've been married for some 20 years or so and Norm has always been an active participant in life.
He's worked on and off when ever he can find work. In fact he was working the day he broke his hip back in June of 2008.
To friends and co-workers he's always been personable and popular. When I met him he was leading a group that was studying the books and teachings of a psychologist, Ron Smotherman and we were studying a book called "Winning Through Enlightenment."
He and I did not always get along. When we met I was an adult and out of the house and I am protective of my mother.
But, over the years he proved supportive, helpful, and human. We'd often argue over just about anything but it was I believe in the spirit of exercising the mind.
Now, however, in the period of a few short months he has been reduced to a helpless shriveled invalid.
Only a month ago, he was still combative and enjoyed listening to his favorite radio show.
Back at Thanksgiving he was swinging in and out of his wheelchair to his bed on his trapeze while visiting with family at rest home where he was staying.
Now he can no longer talk and groans and moans pathetically motioning with his arm and shaking his head.
He's lost almost 100 pounds since June.
WHY DID THEY LET THIS HAPPEN?!
I have talked to Registered Dietitians who work in these homes and I've been told, that they are supposed to review weight loss in a timely fashion. He was put in a body cast in July and yet no one bothered to re-cast him as he lost enough mass to put a hand between the cast and his leg.
They should have been giving him a protein drink but there was none.
The cast was initially for his hip to hold it in place when the half-hip replacement would not hold and kept dislocating. When did it dislocate? While Norm lay in bed, when his did what a physical therapist told him to do.
His doctor scolded Norm, and threatened him with a full body cast if he didn't stop dislocating his hip. He even went so far as to fully blame Norm for the dislocations.
So, the 3rd or 4th time it happened, Norm lay in his room at the home in horrible pain and on pain meds rather than tell the Dr or complain to vehemently and on his next trip to Kaiser they discovered it. The Dr. kept good on his threat.
TRIPS TO KAISER
Almost every time Norm was sent to Kaiser for a check up his room was moved and he had new staff taking care of him at the home. And when ever we met him we were greeted with, the question, "What was he like before, was he very active?" And every time we answered it, "Yes!" but now he's in this cast and can't move at all.
And then because of the cast they had to keep his foot in a cast because he had developed Foot Drop. So they had to continue to cast him. For months!
After one trip, Kaiser suddenly called Norm back, because the blood work had come back and Norm had a Staff Infection.
It was because of a pressure wound that had developed because of the ill fitting cast. Combine that with the lax at the rest home and it's no wonder.
When he got back to the rest home he was put in a room that was supposed to be restricted to Gown and Gloves. Contagious Disease Protocols. Yet, when we got there they were disregarding the sign, we were told we could go right in. The man in the bed next to Norm was dying of pneumonia, we found out later.
REST HOME TO REST HOME
We got Norm out of that home in hopes we'd put him in a better one but alas, it was from the frying pan into the fire. Both are Kaiser contracted homes. We toyed with the idea of taking him out of the Kaiser system but it would take 30 days. We were hopelessly locked in, at least it feels that way.
The new home just assumed that Norm was an unresponsive invalid. For days the only meals I saw him get were sandwiches. We started bringing him stuff from the outside to try and help. He couldn't even chew the meat. His dentures no longer fit. And apparently the Nurse never even checked or cleaned them.
When we talked to the new Doctor we were again asked the questions, "So was he ever an active person?" "How many years has he been like this?"
Each person taking on the case sees where his is at the moment as assumes that's the status quo!
When he was taken into the ER as his Kidney's shut down we were asked the questions again and when Kaiser transferred him back to Kaiser West LA (WHERE ALL HIS RECORDS RESIDE!)
Again with the questions.
Oh yes, he has a regular Dr. at Kaiser. I don't think we've seen him once in all of this. Norm did have a regular Dr. who had retired about 14 months ago. As soon as the new younger Dr. took over Norm was put on different medications and began to go down hill. I guess that's just Big Pharma getting it's licks in.
WHAT SHOULD WE DO TO CHANGE THIS?
I Believe that there should be at least ONE Doctor or social worker or Nurse or Health care Professional who's responsibility it is to track the care of a patient from becoming a patient at a facility like Kaiser to leaving it.
This person should KNOW the person, know is likes and dislikes, his tendencies, his family. The way the family Dr. used to know a patient.
That controlling physician should be able to communicate with an effective team of specialists who have direct contact on a daily basis with the patient, especially in a case like Norms, where there were complication after complication.
The family should be involved and we have been to the best of out ability.
But, the patient should never be put into a facility that is so far away from the family that they can't get to him on a daily basis if they so choose too.
Doctors and Nurses taking over the case as it progresses should be required to review the records of the patient online. MY GOD WE HAVE THE TECHNOLOGY TO HAVE VIDEOS OF THE PATIENT ON A DAILY BASIS! Use the technology to help the specialists get a better understanding of all that has gone before. Pictures as sometimes better than words.
Clink on the links to see the change:
Norm after the full body cast was put on
The full body cast
Celebrating his Birthday in Aug
In Nov. after a family meeting... Note the bandage coming off his heal. And we're in the room that was supposed to be gown and gloves.
He's getting ready to swing out onto his chair.
At Kaiser WLA he's getting his cast off. Early December 2008
The night we had him taken to the ER after witnessing Elder Abuse.
Norm still keeping spirits up at Kaiser Sunset.
After his first physical therapy at the new home. Dec. 26, 2008
January 13th. 2009
Norm in ICU |
