I met with the PT, OT, ST and one of the social workers Friday. The meeting arose as a result of a meeting with Janie Thursday when she told me Bill was going to be released from their services November 7th. It seems that since he is coming home he has plateaued, however, if the plan was for him to stay at the SNF new objectives would be written and he would qualify to stay for further therapy. I'm just not sure what sense that makes, however, maybe it's a good thing I've gotten the bump. We did, in the end, agree he will be discharged home on the 14th of November.
Yesterday Bill was slipping into a deep depression. He had real severe solemnity - more so than he has ever had. He said he had been struck with a profound sense of his mortality. One of the questions he asked was how long I had been told he is expected to live. When we agreed Friday on his discharge date I hadn't wanted to tell him until closer to the date. He has difficulty with time conceptualization now. I felt initially it would be easier on him to learn this Wednesday that he will be coming home in a week.
As the day went on yesterday and he seemed to be slipping away so quickly my decision to tell him he is scheduled to come home real soon was adjusted. We had gone out for the afternoon and each one of us had a pedicure, then we went to Lonestar Steak (decided we wouldn't go back there again) and had dinner then we went to an AA speaker meeting where he slept most of the time. On our way back to the SNF I made a comment about him coming home on the 14th. Immediately he perked up. He asked again - 'when am I coming home?' He then said, and I can't write it with just exactly his intonation, but I'll try. That's JUST gggrrreeeaaattt.
One big reason I think it will be better for Bill to be home is that for some reason when someone goes into a SNF those caring for him/her just don't manage the resident's personal hygiene very well. Bill has now developed a fungal infection in his groin area. Of course it's easier for Bill to let me assist him with personal issues. A mistake I have made during his stay at the SNF is that he would come to accept the help of others. He just isn't able to do that. And those caregivers are there to do as much or as little they possibly can and stay employed. I've come to accept that fact. Someone who can't remember to push a buzzer, or tell a loved one what has or has not gone on is a great candidate for a certain neglect. And I guess we all know that those in a SNF are largely in that category, aren't they?
There are changes in Bill's condition. He will probably not be able to use his cane. He is using a walker and for right now the PT feels he is too unstable to use a cane. From my observations I agree. He is accepting of his walker. He doesn't ask about his cane and it is right there in his room. We will use a walker as long as we can. He requires more assistance now in most things. He continues to have a great deal of difficulty talking because the thoughts can't make it out to words. The great thing about being a wife is that we know how our husbands were before their stroke. I know how important Bill's appearance was to him before his strokes. It has been and continues to be my goal to continue helping him maintain his appearance as long as I can. I also know this is much less important to him now - sadly, that is another symptom of the vascular dementia.
I do know my husband will receive the dignity he deserves in my care - and that's a good enough reason to bring him home.