House Call: Back from the Hospital

CAREGIVING:  Last Thursday my main task was to get Kathy back on hospice again. Because she went to the hospital for a procedure to “extend her life” – the feeding tube – she had to be discharged from Mercy Hospice. Now that she was back home she could be readmitted to hospice. I had called the hospice to let them know and Sam, the social worker answered. He didn’t know Kathy had gone to the hospital. He said he has been meaning to drop by just to visit. He said he would let the staff know.

Medicare requires that they start from the beginning each time a person comes into the hospice. It doesn’t matter that Kathy was already in the hospice yesterday. It seems a little wasteful, but that is how they do it.

Sam called back and said he would be coming by to do another Introduction/information session and a nurse would come by to readmit her. I lost track of what happened on which day, but I think he came on Thursday. I had to sign one form that showed Kathy was discharged from the hospice. Again, it was a Medicare requirement. He explained about different services the hospice offers from volunteers and aides. He also said that there was a one-time grant available from a hospice education association that he might be able to get us. The grant had to be for a non-medical use. He has helped patients get an air conditioner or a TV or even food. It isn’t a huge amount. He offered a gift card to a grocery store and I realized that would be a big help. I am always buying skin lotion and diaper cream and cleaning supplies for Kathy and the aides. 

He let me know that usually for a readmission the nurse-practitioner comes by to reassess Kathy face to face. But this time Dr. Rosen, the medical director (and Kathy’s new doctor) was going to do a house call. I had talked to him once on the phone during Kathy’s lung scare the last week of July and he was very nice. So, I wasn’t worried about it.

House Call: I mentioned to Louise, Kathy’s aide, that Kathy’s doctor was coming for an honest to goodness house call. She channeled my mom: “You gonna have a snack or something for him when he gets here?” She saw the look on my face. “ He’s coming all the way here on a hot day. You should at least give him something to drink or something.” I grabbed my wallet. She said, “Well don’t do it just because I said so.” 

But, I ran down to the store to get some juice, just in case. Dr. Rosen got here at about 4:30 pm and I led him through the basement. It is full of Kathy’s artwork. He was greeted at the top of the stairs by Marty. I asked him if I could offer him something to drink. He said he has “learned not to have any fluids when I am doing rounds.” Makes sense.

He listened to Kathy’s lungs and checked for swelling and other things. I told him that she has a low fever most mornings. He said it could be a cold. I told him that I suction a lot more since she got back from the hospital. Since Tylenol keeps the fever under control, that was the best thing to do. The antibiotics we were giving her never changed the fever. We talked a little about Huntington’s Disease and Kathy’s family history. He wanted me to stay in touch with the HD program at UConn. Dr. Rosen’s specialty is Oncology so it is hard for him to know every disease.

Bassets on TV: He reminisced for a while about a television show he watched in the 50s. It had a talking basset hound in it.“Oh yes, it was The People’s Choice with Jackie Cooper.” The basset’s name was Cleo and she would mouth wisecracks about the people. That got me interested since I didn’t know about that one. I watched a few episodes on YouTube. When Marty speaks through me he has a foul mouth. I think he has been listening to Trump.

Readmission to Hospice: The next day one of the hospice nurses came to readmit Kathy into Mercy Hospice. Miriam checked everything: skin, sores, blood pressure, heart, lungs, oxygen. I had to sign a bunch of papers saying I knew what hospice was. That it was to keep Kathy comfortable (and not for any type of cure). There was a list of people who could get medical information about Kathy (HIPAA). I remembered the first time Miriam came in the winter. She is a Pentecostal minister in her spare time. Outside of saying “God bless you” when she left, religion didn’t come up. Her visit completed the technical process of getting back on hospice. She said it happens a lot. Hospice always takes you back. I also gave her a copy of the anatomical donation paperwork. I wanted that put in Kathy’s record so that when she does pass away they contact UMass Medical School right away.

The New Chaplain: The only other loose end was tied up on the following Tuesday when Greg, the new chaplain for the hospice came to meet us: another Medicare requirement. The chaplain or spiritual advisor needs to contact you within five days of admission to hospice. You don’t have to meet or pray. You don’t even have to talk to him or her if you don’t want to. They just let you know that they are there for you. But I enjoyed talking and meeting with Rebekah when she was the spiritual advisor. She helped me talk through some stuff, She was one of the ones that helped me figure out whether to  have a funeral or not.

The chaplains are always generic chameleons of faith. Mercy is part of a Catholic hospital. Rebekah was a rabbi. And Greg is ordained by the United Church of Christ. And I am none of the above.

Greg is helping me brainstorm a Celebration of Life and an exhibit of Kathy’s art that I would like to do when the time comes. But there is no rush.

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