3-10-22 Goodbye NHC, hello...we're not sure

 (Tricia)

Ed and I went over to NHC at about 7:00 this morning to clean out Linda's room and release the hold on the bed. It no longer made sense to continue paying for the room when we're so uncertain about what's next for Linda. Leaving was bittersweet because we had gotten to know so many of the nurses and CNAs and a few of the residents over these last seven months. Luckily, one of our favorite nurses was on shift. We have gotten to know her very well, so I was glad we got to say goodbye to her and a few other people. She gave me a big hug, along with the pictures below, which I believe a resident had colored. She told me that the one on the left is an angel to watch over Linda and the one on the right is for me. It was incredibly sweet.

 

 

 

Yesterday I spoke with the hospitalist at Mo-Bap, who said that because Linda's needs right now are so complex, requiring doctors from so many different specialties, he is likely to recommend that she be sent to a long-term acute care hospital (LTACH) after discharge. There are only two LTACH providers in the St. Louis area: Select Specialty and Kindred. There is a Select Specialty location at Missouri Baptist, which means she would not have to change locations. That said, neither Select nor Kindred receives the best reviews, so we're back to just hoping that the good reviews prove more accurate than the bad reviews.

Of course, last July, when Linda was coming out of her coma but still on a feeding tube, St. Luke's Hospital also recommended Linda go to an LTACH after discharge, not a skilled nursing facility. But Linda's insurance, Anthem, turned down that referral repeatedly. That sent us into a scramble trying to find a SNF that would take her. I think St. Luke's case worker contacted close to 20 SNFs at that time, and only NHC would accept Linda because of her comatose status. We're not in that same situation today, but even so, whether or not insurance will pay for an LTACH is in question.

Yesterday, I also spoke to the admissions director at Anna House, a highly rated and recommended nonprofit SNF that is in Bridgeton, very close to Ed and me. I toured Anna House back in November and liked it, but decided against a move at the time because it was more expensive. But at this stage, we want Linda to get the best care possible and be as comfortable as possible. If we felt we could provide that care safely at our house, we would bring her home, but her condition is still too fragile. They have put a "soft hold" on a bed at Anna House for the next two weeks, so that will be there for Linda if needed.

I went to visit Linda yesterday afternoon and Ed came in the evening. Linda was having a rough time. She was sad and really did not want to engage with anyone. The palliative care nurse stopped by to see how Linda was doing, but Linda didn't want to talk. She also fought off the nurses when they came in on their rounds, because she didn't want them to be handling her anymore. Unfortunately, they have to check her blood sugar and vitals. We were able to convince her to let them, but it was not easy. I can only imagine what Linda is going through. I know she is grieving the loss of control over her life.  She wants to be able to get up so badly, but they had her on bedrest yesterday because her heart rate is still spiking unpredictably.  However, the ortho surgeon tells us that she has to start getting up and standing on that hip so that it will heal. It's a horrible Catch-22.

As it has been from the very beginning of all this, Linda is dealing with medical issues that have worked against each other at every turn, hindering her recovery in nearly every way possible. Every day, though, I hope it will be a good day for her. I hope it will be a day when she will see some progress. Linda really needs a "win" in her column, so that she can keep her spirits and motivation up.