Katie sang, Katie laughed, Katie smiled.
- “There are always bumps in the transition road–we expect them,” the Provider said. “Give this about a week and Gloria, Sam and Katie will start to get into a routine.”
- First bump: In short, the home health agency did not show up on Tuesday, and will be unable to come until Sunday. This occurred because the nursing home did not send the orders until the day of Katie’s release; orders were incomplete; the staff was uncooperative in rectifying the problem.
- Second bump: The environmental modifications could not be provided until after Katie’s discharge. Katie’s living area is carpeted, which makes it very difficult to move the Hoyer lift and wheel chair. In addition, since Katie is dead weight in the bed, it takes two people to move and transfer Katie. The laminate floor will not be installed until after the New Year.
- Third bump: Sam is having difficulty visualizing that Gloria will be able to handle the heavy aspects of Katie’s care without assist. He points out that this has always been his biggest concern. The success of the plan rests on the caregiver’s ability to work independently. In the meantime, Sam will have to pitch in to help Gloria, or make arrangements to have the neighbors help.
Sam is embroiled in the middle of a very difficult situation. It’s hard for him to see the positives.
- First positive: The Provider is monitoring Gloria’s ability to handle Katie. They will make adjustments where needed and are confident that it will all work out.
- Second positive: The Provider reports—“ I cannot believe how alert and oriented Katie is—it blows me away. She is reminding Sam to do things! Sam went up to get some tape and came down and said, ‘I can’t remember what I went upstairs for.’ Katie replied, ‘Honey you went for tape.’ After Sam leaves the room, Katie says to me, ‘I think Sam needs to do some of my brain teaser exercises to stimulate his brain.’ Gloria, Katie and I cracked up. She laughs, she smiles—she is funny and right on point.”
- Third positive: Katie’s new mantra–
Well, Katie may have had the date wrong—but the concept was right. KATIE IS GOING HOME on Monday, December 15th.
The Provider met with the nursing home staff this week to compile a specific and detailed plan for Katie’s care. I was invited to attend the meeting, and I asked Judene to accompany me because she always provides good perspective and moral support.
When Judene and I arrived, it was immediately evident that KATIE IS EMERGING!
When the Provider began checking down the list–
- The medical bed, air mattress and Hoyer lift will be delivered Friday.
- The Home Health Agency will start on Tuesday. They will provide a nurse and therapists.
- Your caregiver, “Gloria” is very anxious to get started. She is moving in on Friday.
Katie began slapping her leg. “This is how I clap,” she said. And we all clapped with her.
We talked about meals: Gloria cooks very healthy food. What do you like for breakfast?
We talked about treatment and therapy: Gloria can tend to your wounds. She can help you with your stretching exercises.
We talked about visitors: Gloria will be glad to have your church group over to sing hymns.
Everyone is doing what they can to facilitate the transition home and to make the plan work.
- Katie is required to see her family doctor within 5 days—he has offered to make a house call.
- Sam purchased a wheelchair van at auction. It will provide her with more opportunities–many, many more.
- Family and friends have made commitments of support.
Sam and Katie’s home will be hectic for a while. But I believe the plan will succeed because…
Each time Judene and I visit, we try to be optimistic, but too often we leave feeling discouraged, generally for one of three reasons: Will Katie be unresponsive? Will she be crying out in pain? Will she show any discernible emotion? All are difficult to understand—mysteries buried deep in Katie’s brain.
Indeed, our visit last week was really good. Katie was alert. She no longer has to wear her braces during the day. She did not cry out at all, and for the two brief moments that she did experience some pain, she said, “Ow, ow, ow,” QUIETLY.
Three steps forward for sure!
From the onset, I had a specific idea of the care plan that would be necessary for Katie to be cared for at home. But, I was skeptical that such a plan would be approved.
The plan was based on two major factors:
- The opportunity to use an existing handicapped-accessible living area:
First of all, Katie has an ideal living situation in her home. A number of years ago, Sam’s mother chose to utilize her finances to add a handicapped-accessible living area onto Sam and Katie’s house. They built a large living area with a handicapped bathroom that extended off of the existing first-floor family room so they could provide the assistance needed.
- The ability to get approval for consistent 24/7 care:
Secondly, Katie requires total care, which Sam would not be able to handle alone. He works part time and needs the freedom to come and go without having to constantly make arrangements. Although Sam and Katie have two sons, only one is local, and both have the responsibility of young children. Katie needs one consistent fulltime caregiver, in addition to Sam, living in the home.
At the October 23rd meeting, Katie was relatively alert and able to participate in a limited way. Sam informed the provider that all narcotic medication had been discontinued. The provider assured Sam that they would be able to care for Katie in the home environment. More importantly, another meeting was scheduled for the following week with all involved parties: Katie and Sam, the Area Agency on Aging care manager, the nursing home social worker, the provider, and the prospective caregiver.
At this meeting, Judene and I were also in attendance to provide support for Katie and Sam. When we first arrived, Katie greeted us with a vivacious, “Hi!” We were delighted.
When the Aging care manager outlined the specifics of the Waiver Program’s, “Services My Way” plan, I was floored. It provided more than I had dreamed of in my wildest imagination, such as:
- A 24/7 Service Provider
- Equipment: electric Hoyer lift, customized wheelchair, shower wheelchair / commode chair combo;
- Environmental modifications: ramps, laminate flooring, wheel-in shower modification; and
- Transportation: two roundtrip EMS transportation services monthly for medical appointments.
And if this was not enough to make the day, the provider brought the caregiver they had in mind to look after Katie. “Gloria” has experience working in a family unit. She knows how to use a Hoyer lift. She’s described as being a homebody, having spirit, and being reserved yet warm. We were all most-impressed when Gloria reassured Katie with a gentle touch and calmed her with an uplifting hymn.
One more meeting was scheduled to complete the Public Partnership paperwork for final approval of the plan. The paperwork has now been submitted. The target date for Katie to come home is December 15th. And again, we wait…