Healthcare for Elderly in Hospitals

After a few days of trying to figure out why my mom was acting off kilter, or I should say that she was way out in left field, I managed to convince her that it was time to go to the hospital to get checked out and find out what was wrong. It had become obvious by the third morning that she was very disoriented, dehydrated and weak. Her everyday routine was no longer and things were out of place. For example, I went to get her some ice water from the fridge and found two dish towels inside the fridge. I found tea bags ripped apart and tea leaves all over the countertop and floor and sugar was poured in the container where the unopened teabags were stored. There was a pan of food on the stove that I realized had been there for three days and it didn't appear that she had eaten anything at all for at least one day. Mom wasn't able to focus on anything, even just staring at the television but not absorbing anything she was attempting to watch. The only constant thing she was able to focus on was petting the two cats she loves so very much. Needless to say, I was totally worried about her. It wouldn't have taken much effort to just pick her up, put her in my pocket and hurry her on over to the hospital. She's only 5'1" and maybe 100 pounds. But, I respect my Mom and wanted to keep her dignity intact and her pride for making her own decisions. I made the suggestions and she finally made the choice to go get checked out. I was surprised that she could even sort all her thoughts out because she was so disoriented.

After about two hours of coaxing and convincing I managed to get her into my car and on our way to the emergency room of our local hospital. When I approached the front desk the lady sitting there asked me what they were going to be seeing Mom for, so I told them it was a guess but I thought she might be dehydrated, confused and could possibly have a UTI, (urinary tract infection). I explained that she was acting unbalanced and didn't seem to be able to do things for herself over the last three days. Luckily, we only had a ten minute wait to get into triage and then only a few minutes more before she was in a bed waiting to be seen by a doctor. Once all the insurance information was given, the nursing staff started getting an IV started, which was a feat in itself; and hooked her up with a saline drip. Then there were the blood draws and lots of questions to answer. All the nurses were very kind and understanding and I must say most of them showed true compassion which in past experiences didn't happen much. I was very impressed with their professionalism as past experiences weren't at all so good in that regard either.

I have been working in nursing homes for a long time and have seen the same signs and symptoms in my patients so even before I got Mom to the hospital I was 99% sure that her main problem was a UTI, but of course a diagnosis could only be confirmed by a doctor and of course treated. It took several hours for the results to come back, but my gut instinct had not failed me. She did have a UTI and was dehydrated, but even more severly than I had thought. Once the results were in she was immediately started on IV antibiotics and I believe it was a saline drip to rehydrate. I had Mom in the ER by 8:00am and she was finally started on IVs about 5:00pm. I remember feeling relieved that they were finally hanging the bags on the IV poles and hooking her up, but still silently scolded myself for going to work the night before and not bringing her to the ER instead of waiting until morning. She only has one kidney and has survived two bouts of cancer, so I really should have brought her in at the first signs of any problem. But, as one of the nurses at work stated, I was too close to see the signs clearly. At work I would have seen the symptoms in my patients right away, but because it's family, I didn't recognize the aggressive UTI right away. It took me two days to realize what was happening and then managed to get her to the hospital on the third morning. Having the nurses and doctors around to take care of her gave me a moment to step away, go into the hallway, silently scold myself and then fall apart at the seams. One of the nurses noticed and was nice enough to stop and reassure me that Mom would be just fine. But at that very moment I wasn't so sure. Every illness, every hit she takes seems to knock out a little more strength from her and she doesn't seem to really recover 100% and when someone is nearing their eighties it gets pretty scary.

Once she was somewhat stabalizied they had her admitted and settled her into a private room for the duration and continued changing out the empty bags for new bags of saline and antibiotics. My guess, which is probably low, is she went through at least four bags each everyday for six days. Some of her daily prescribed meds were either changed or stopped all together while hospitalized. Instead of Hydrochlorothiazide, she got three other blood pressure medications, since it is actually a water pill. They totally stopped her Fentanyl patch, but not sure why they did that and her oxycodone was still available to her. And instead of taking the oxycodone every six hours she was allowed to have them every three hours, but she had to ask for them. They weren't a scheduled medication. Because she wasn't herself for the first three days, they were never requested and I began to notice that she was sweating a lot and her body was getting restless. It occurred to me on the fourth day that she could be going through detox and was in a lot of pain due to back problems and severe arthritis, plus the fact that she had such a terrible infection. I started reminding her to request her Oxycodone whenever she felt she needed it, but up until the fifth day, she only took them twice and of course her pain had only subsided for a few hours at a time. By the fifth night, it was Mom that realized she hadn't been given her Fentanyl patches and said that was why she couldn't seem to stop moving around and get comfortable. So, one phone call to her doctor and a couple hours later she had her patches back. Mom slept so very well that night while I sat up watching her facial expressions and trying to make out the conversations, in both English and Japanese, that she had in her dreams. I finally got up at 4:00 am and went home to shower and catch some sleep, but was up and back at Mom's side by 6:00 am in time to order her breakfast and make sure she was getting her meds, clean bedding and a familiar person to talk with. I wanted to be sure that her needs were being met and that she didn't want for anything else except to get well.

On that fifth day, her doctor was ordering a transfusion of two units of blood for her and when they mentioned it to me I wondered if this was the right next step or not. I knew that Mom's next Procrit shot was due in just two days. Because of her weakened state, I knew this would be an appointment missed, so I asked if they could give her the Procrit shot first, run new labs and check her levels and then transfuse if she still needed it. I know I am only a CNA, but it made more sense to me to do things this way. After about three hours the doctor called back and to my surprise agreed with my request. She was given the shot that night and just before breakfast the next morning received only one unit of blood.

After six days in the hospital I was finally able to take Mom home to her own familiar surroundings and those two cats that she adored so very much. The doctor ordered one more bag of saline and antibiotics, then they came and removed the line from her arm to set her free. She was still quite weak, but happy to rest in her own bed and watch her own TV. She continued on oral antibiotics and her blood pressure meds were changed. She seemed to be getting stronger until her third night at home when she was experiencing more weakness and some dizziness. A trip to her doctor the next day we found out that the three new blood pressure meds were just too much for her light weight body, which caused the dizziness, weakness and sweating.  It was at this time when I thought she was released from the hospital too soon.  A nurse evaluated her by asking three questions.  What's your name?  What year is it?  And who is the president?  Hmmmm....pretty easy, right?  Maybe they need to work on that. 

Even though we were able to wait until the next day to make that trip to see her primary doctor, her blood pressure was up too high and then down too low throughout the night.  By the time we did get to her doctor, her blood pressure was normal.  Luckily, I had written down all the blood pressures taken during the 24 hours before, so doc had something to go by. 

Today, two weeks after being released from the hospital, she is almost 100% recovered from all the problems and is back to running her own home, doing her own cooking, laundry, bills, etc.  We still show up everyday to check on Mom, but she is doing much better.  I am so glad for her recovery. And I thank God and all the doctors, nurses, cna's and everyone else that had a part in her recovery. This visit to the hospital turned out to be a successful one and I have the highest regard for those that have the patience to put up with me and all my questions. And, like I said, they just need to keep the patients a little longer to monitor and be more aggressive when evaluating them to let them go home.  Don't let senior citizens go home half-baked just because they can tell you what the year is. 

Mom is a fighter. I love her so much.  Everybody does!  She's like everybodys Mom and Grandma.   Because of her recoveries from Cancer and other major issues our family now has the mindset that EVERY DAY IS A BLESSING.

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