Yesterday and this morning my dad was having more “spells” where he is disoriented, has visual hallucinations, and says things that have no relevance to the real world.  About 4:00 this afternoon, my mom called.  She said my dad had been on his way to the bathroom when his legs just “gave out” and he sank to the floor. She was able to control his fall so that he did not hit his head or anything.  (Heretofore, when my dad has fallen it has been because he has lost his balance, and once we could get him back up on his feet, he was able to walk using a rolling walker.)  She said there was no point in calling J, the lady across the street who has helped her lift him before, since he was too weak to walk.  She asked me to come over and once I got there she was going to call an ambulance.

I arrived within 30 minutes.  He was lying on the bedroom carpet covered with his “blankie.”  She called 911 (999) and asked for an ambulance to transport him to the hospital.  When you call an ambulance here, typically a fire truck comes as well.  Today we learned why. Typically, there are only two ambulance attendants per ambulance.  The two ambulance attendants, both men, could have lifted my dad the short distance necessary to pick him up off the floor and put him onto the collapsible gurney, but the width of the interior doorways in most homes, including theirs, is too narrow for the gurney to fit through.  My dad was in the back bedroom, which required negotiating two doorways and a narrow hallway.  The 2 ambulance attendants rolled my dad onto a sheet and, using the sheet like a stretcher, the two ambulance attendants and the 4 firefighters carried him to the gurney in the den.

When the ambulance attendants took my dad’s vital signs, he was running a fever and his blood oxygen level was somewhat low.  They loaded him into the ambulance, off goes the firetruck, and then off goes the ambulance.  My mom and I followed them in separate cars in case she stayed at the hospital all night, since I would need to go home and tend to the kitties.

C Medical Center, consists of a 977-bed primary hospital and is at the center of a complex including the primary hospital with 8 floors, a children’s hospital with four floors, a heart hospital with four floors, a ground floor imaging center and both a children’s and an adults’ emergency rooms, all interconnected.  Across the street are two huge 5-storey parking garages each of which is connected to the hospital complex by a “skyway” which enables pedestrians to cross from the parking garage to the hospital via an enclosed bridge over the street.  I’d be willing to bet it was  at least a half-mile hike from where I parked to the emergency room, and once I got to the ER, I had to go down two long hallways to get to his “bay.” Eventually, they took specimens of this and that, and a chest x-ray, none of which showed a source for his fever.

You have to understand that my dad eats like a bird.  In the first place he can’t chew because his dentures don’t fit and cannot be made to fit due to bone resorption in his lower jaw. In the second place, he cannot adequately protect his airway when he swallows, and invariably most of the time when he swallows he ends up choking, gagging or coughing paroxysmally because food or drink has almost spilled into his windpipe.  He’s not getting enough liquids or calories in particular, and enough nutrients in general from two fruit turnovers, a couple pieces of raisin toast, a “Little Debbie Nutty Bar” or two, and two or three bites of whatever else mom can get him to eat.  He likes the International Coffees Orange Coffee mix, which to which my mom adds a packet of vanilla breakfast drink mix.  He may drink three or four  6 oz cups of that a day.  Needless to say, he is practically skin and bones.  It doesn’t surprise me that he’s become weak.  Frankly, he looks like he’s been in a Nazi concentration camp for a couple of years.

My dad’s doctor, Dr. H, came by and said all my dad’s tests were negative.  Then he and mom discussed that if they were to have sent him home, how was my mom supposed to get him from a wheel chair to her car, back to a wheelchair and from the wheelchair into bed if he’s too weak to stand?  Dr. H was able to get my dad admitted for overnight observation, and mom is going to be meeting with a social worker to discuss care options, as my dad is fast getting to the point where he can’t walk at all or even stand on his own.

The two main options are to put him in a nursing home, which runs $3000-$4000+ (£1790.19 to £2386.92 or €2170.30 to €2893.73) a month for a questionable level of care.  Another alternative would be to rent a hospital bed from a medical equipment rental company and hire a sitter or home health aide to sit with him during the night.  Since he is not diabetic and does not require specialized medical care, renting a hospital bed and having a home health aide come in during the night might be the more cost effective option.  My mom would be with him during the day to care fore and feed him, etc.   Having him at home as long as possible would mean my mom wouldn’t have to get out in the weather and drive anywhere to see him like she would if he were in a nursing home and she could ensure a constant level of care, which can be problematic in a nursing home.  Another thing:  Medicare won’t start paying for a nursing home until after 90 days (which would mean my mom would have to pay $9000-$12,000 out of pocket before Medicare would start paying).

Like I say, we’re going to be facing some hard decisions here soon.