Hubby tried to get Fil out of bed this morning without any pain medication, and it was just too much for Fil. So they gave him a pill and then waited for it to start working before they got him up and dressed. By the time we got to the health and rehabilitation center (which I'll just call the center from now on), he was groggy and so loopy he could barely answer simple questions. The nurse who did the evaluation thought he had dementia or Alzheimer's even though we kept saying that he wasn't like this before the pain medication. She was very gentle with Fil and got him to stand up by himself, and showed him how to help others get him onto the bed. She also mentioned that some patients NEVER heal from a vertebrae fracture, especially if it is a compression fracture, and the doctor at the VA didn't mention what kind of fracture, just that it was on the L1.
Then, while we were eating, she came over to say she had called one of the staff doctors to tell him about Fil's pain medication. The VA doctor put him on methadone because he is allergic to codeine. This staff doctor was shocked and suggested tramadol, or even a cortisone injection. The tramadol should relieve the pain without making him as sleepy and confused, and the cortisone shot would even be better because it wouldn't affect his mind at all. The doctor put in an order to start tramadol tonight and only use methadone if the tramadol doesn't work well. He is also going to meet with us tomorrow - yes, on Labor Day - to discuss all this and to see if Mil wants to switch Fil's primary care from the VA to him.
We are so impressed with this facility and the level of care he is already getting from the staff. If they can control his pain while keeping his mind clear, I think he might make some progress. After seeing him decline the last two weeks, Mil is afraid he is there to stay though. It broke her heart to sign the DNA form, but his quality of life has not been great lately.
So, things are looking up right now. Mil also heard of a condo nearby that is for rent. Brownie, our daughter, is a CNA. We have been trying to talk her into moving back to Texas, and when we told her about this facility, she said she would look into employment there. It would be good for Fil to have her there every day too. And she could share the condo with Mil so neither of them would have to live alone. I know that's a long shot, but it sure would be nice.
Both girls were home last weekend, and I asked them how much they remembered of Fil when they were young and spent a week every summer with the grandparents. Sadly, neither of them had solid memories of their grandfather when he was strong and active. So Hubby and I are going to start reminiscing, and I'll probably record those stories here so the girls can read them and hope that doesn't bore the rest of you too much.
We just got a call from Mil. The center called her and said Fil is combative, and to come right over. So more later.
Back again. There are a lot of fires today since it is really windy and has been dry for such a long time. Two fires were near the center, and they had an emergency staff meeting to explain evacuation procedures if the fires got closer. The aid checked Fil's room as she went to the meeting and he was still asleep. After the meeting, she looked in again and he was gone. The meeting had only lasted ten to fifteen minutes, but in that time, Fil had woken, gotten out of bed, and walked down the hall and into another room.
When they saw his empty room and didn't see him in the hall, they organized a search party and found him in the room down the hall. The head nurse ran to bring his wheelchair because they were afraid he would fall, and he began running down the hall. They ran after him and when they caught up with him, he began hitting, kicking, and grabbing their hands when they tried to get him to sit in the wheelchair. He twisted the wrist of one aid, bent back the thumb on another, and hit two others. The head nurse picked up a towel and held it tight between her hands to give him something else to grab onto. He got the towel away from her and began flailing them with it. They decided he was a very strong man who only looked thin and frail.
They finally convinced him to go back to his room to rest, and that's when they called Mil. So within three hours, he had gone from the man in a groggy stupor, to the man who flipped his lid (at least that's the way I overheard one aid describing him to another).
The head nurse is still an angel, and told us she called the doctor who said it is common in methadone patients to experience aggressive outbursts as the methadone wears off, and that the methadone stays in the system for 48 hours. She quoted the doctor as saying "Who in the h*** ordered methadone for him?!!!" From the research I did in our brief time home today, I can see why he said that. Parkinson's patients often have hallucinations and methadone causes hallucinations, so why on earth would anyone prescribe something that would surely make them worse?
She said they all understood he isn't doing this on purpose, but still, they aren't equipped to handle it and they needed Hubby to spend the night if Fil is going to stay there. Also, if he has another episode like that, they will have to send him to the ER and then back to the VA hospital. That's certainly understandable. We don't want him to harm anyone else, or himself either. But we are also worried that we won't find anywhere else with this level of care.
So I made a quick trip home (the center is about 30 miles from us) to pack some things for Hubby, and make us a few sandwiches for dinner, and went back to pick up Mil and take her home. Now to get some sleep so we can be back at the center at 8 a.m. tomorrow.