The last entry in my blog was about Mom’s visit to Warrensburg, NY sitting on the beach on Kelm Pond. A truly great moment that fulfilled a wish from Mom to visit the lake. Unfortunately, a week and a half later, Mom complained of pain in her arm and my brother Chris as a precaution took her to Glens Falls Hospital. They admitted her primarily because her blood pressure was high (Systolic at 190). I was not consulted by the hospital and they proceeded to lower her blood pressure to the 120 range. In the process, Mom really was lethargic and confused. I found out about this during a call to the hospital the day she was admitted and explained that Mom’s normal blood pressure is in the high range and that’s it’s not uncommon that it occasionally goes high.
During the time Mom was admitted and the incident with the low blood pressure, Mom once again had a series of minor strokes. Unfortunately, as Mom came around, both her cognitive and physical capabilities were negatively impacted. I’m not sure where the stroke incident occurred, but once again we see a situation where a hospital or doctor doesn’t invest time to know the patient history. They react to the numbers. We see this countless times. It was clearly noted on Mom’s medical admission documentation as the health POA but was not consulted when the hospital treated the high blood pressure.
At this point, Mom needed almost total assistance to eat, dress, etc. She was no longer able to go back to assisted living. After two weeks in the hospital, it was time to discharge Mom for physical therapy. She was discharged to a skilled nursing facility I will not name. I flew back up to NY the day of discharge and arrived at the nursing home. In less than 24 hours, Mom was almost non-responsive with low blood pressure and bruising in her abdomen due to medication she was on. I was there in the morning with the facility and the attending physician in the facility decided to call the ambulance. Mom was promptly readmitted to Glens Falls Hospital.
I accompanied Mom and I’m so glad I was there. This time I got to talk to a really good emergency room doctor and explained to them that I felt during the first visit to the hospital, the physicians focused on the numbers instead of understanding the patient. It was a really simple discussion with the hospitalist that went like this “So, the first time she was here, the doctor followed procedure to lower her BP and made other changes in the medications and the results didn’t work in Mom’s favor, did they?” The doctor said “Apparently not.” I went on to say “So, wouldn’t it make sense to go to the medication prescribed prior to Mom’s apparent stroke that really worked?”
The doctor evaluated this, spoke to the doctors at the hospital who previously attended to Mom and agreed. It was really refreshing. Mom made steady progress and after a couple weeks, she was stable. It was once again time to discharge Mom to a skilled nursing rehab facility.
This started another odyssey for Mom. I was informed by the hospital that there was not a lot of rehabilitation/skilled nursing facilities with beds and the closest one was 50 miles away from Glens Falls in Ticonderoga, NY. Apparently, the hospital is empowered to discharge a patient to any skilled nursing facility within 50 miles of the hospital. I flew up again when it was time to discharge Mom and I personally made some unannounced tours of some of the options and I’m glad I did.
Luckily between my own due diligence researching and visiting rehab facilities and the help of a really good geriatric care manager, whom I mentioned earlier, Eileen Dunn, we identified a good rehab facility in Saratoga, NY. I called the case manager at the hospital and let her know the facility in Saratoga had an opening. The hospital contacted the facility and Mom was discharged to Saratoga Rehabilitation and Skilled Nursing facility.
Mom became a resident and patient at Saratoga Rehab. Within a week, the facility did a thorough evaluation of Mom’s cognitive and physical capabilities and Gina and I had a conference call with Mom’s rehab team.
It was really great to have this opportunity because in that meeting Gina and I got a good picture of where Mom was and the initial thoughts by her care team to what they felt Mom was capable of achieving with physical and occupational therapy.
It was during that call Gina and I said that if at all possible, the goal was to work with Mom to the point she could hopefully go back to an assisted living facility at The Landing in Queensbury. This would require Mom to make progress from essentially a total assistance situation, to where she can do basic transferring by herself and eating meals. Fast forward, that’s exactly what happened.
With the help of the wonderful staff at Saratoga Rehab and Skilled Nursing, Mom worked hard and made progress to the point the Landing at Queensbury was happy to accept her back. I was so proud of Mom for working with the staff. I’d like to personally thank the staff at Saratoga Rehab and skilled nursing for helping Mom and doing a great job communicating with me.
In early October, Mom returned to her room at The Landing. She was grateful to go back. It was a bit hard on Mom at first to get used to her surroundings. But after a week or so, she somewhat settled in. Every time my brothers visited her, she was happy they were there, but very sad when they left. I know she appreciated the staff at The Landing and she made one or two friends, but she said she was lonely there. I had always told Mom that we would like to have Mom back in North Carolina and that we were looking at a smaller residential assisted living home. Mom liked the idea of both coming home and living in a residential home in NC. Gina and I toured over a half dozen Raleigh and Cary assisted living homes. We really like this model of assisted living. Mainly because it’s a house to begin with and not a facility. There’s more personal care with a low staff to client ratio (most homes accommodate six residents). Each one of the homes was very different and unique. One thing that was common was the tremendous heart that owners of each have to provide exceptional care to their clients. We really admire this and we admire them to have the courage to answer a calling to help people in this way.
At the end of October we were fortunate to reserve Mom a room at a new house in Cary owned by LiveWell. LiveWell has a number of successful residential assisted living homes in RTP. The Cary house off of Wessex Parkway near SAS is wonderful. The house has a great open floor plan with a nice deck and backyard. Mom loves to be outside a lot, so I’m sure she will appreciate it. I made a trip to visit Mom in mid-October to talk to her about the house and show her some pictures and a movie (iPhone) touring the house. Mom emphatically said she would like to move there, so we set the plan. As I write this chapter of the blog, I’m in Chicago Midway airport on my way to Albany to accompany Mom to Raleigh on Monday Nov 7th. It just so it happens that Monday is our grandson Simon’s 3rd birthday. I just want to say that if Mom wanted to stay at the landing of Queensbury that would be fine. This is about Mom, not us.
With this chapter, I wanted to share some thoughts and advice to anyone reading this and going through a similar situation with their loved ones:
1. Continue to reach out for help to your circle of support. Our geriatric care manager based in Glens Falls (Eileen) had toured all the skilled nursing facilities and offered advice and an assessment about each and her thoughts on their ability to care for mom.
2. Work closely with the hospital discharge planner assigned to your case as well as the case manager. Good case managers are a god send. They work hard and have a lot on their plate, but if you spend time with them, encourage them and compliment them, they will go the extra mile for you and the family. I made it a point to get to know the hospital and facility case managers and it was very helpful to guide Mom to the right place at the right time
3. When an event happens that requires hospitalization, talk to the lead nurse assigned and the physician AS QUICKLY AS POSSIBLE. Understandably, they don’t know your loved one’s history so it’s very important to make that transition from a numbers game to a know thy patient game before making changes to medications and determine treatment.
4. When evaluating facilities to move to like residential or larger assisted living facilities do your homework. Doing your homework can be asking a geriatric care manager or geriatric advocate to research the possibilities and do all the groundwork. I personally feel good geriatric managers/advocates are worth their weight in gold. Gina and I feel blessed we know a number of them in our community and they are great.
5. When talking to Mom and Dad about big emotional changes like moving, try to present it in a fashion where they feel they are in control. That they are making the decision. You of course have a stake in the game but you can express it in a fashion you giving advice and input and not a mandate. Easier said than done and trust me I know but all the experts in geriatric coaching will recommend conversations offering your loved one the e control to make the decision and make it in their own time.
I also want to thank all of the staff at The Landing for the great care for Mom. I have nothing but good things to say about The Landing at Queensbury. When Mom went back to The Landing, she needed a lot of attention. While I was there, whenever Mom made a call for assistance or “pulled the chain” in her room, the staff promptly responded. It was not only the prompt response that impressed me but the bedside manner. They cared. Mom was one of theirs. God bless the staff at The Landing at Queensbury, part of the Brookdale family. Thank you from the Murray family.
My next entry will describe our experiences with residential living to give those considering living in such a place some insight to how it works.
This blog aims to help those currently navigating how to take care of an elderly loved one. For those looking for home care in Cary, Apex, and Raleigh, read the “Why Home Care?” section of our site to see if it’s the option for you and take our Needs Assessment.