The American Nursing “Facility”

My husband knows that i am going to write a blog entry using our personal experience as background for my assessment of the American Nursing “Facility” aka Nursing Home.
I will not use the names of the hospital,nurses,doctors or the nursing home itself. Furthermore,none of these personal events are related to the COVID-19 virus.
My husband was hospitalized in our home state. He survived cellulitis,sepsis,endocarditis and 2 strokes. I owe a debt of gratitude to all the doctors and nurses who treated him. More than them i have to thank God. He had anointing of the sick.I attribute his miraculous recovery more to the grace of the sacrament than anything.Once he came home he suffered congestive heart failure but we had him admitted to a totally different(excellent)hospital here.

Unfortunately we both made an error in judgment when he first showed signs of cellulitis from his knee down to the toes. He had his first SEVERE case and we didn’t realize how serious it could be-he had several episodes of MILD cellulitis in the past and we wrongly thought it would just clear up.

He saw his family doctor probably 2-3 days after it started.He put him on antibiotics and recommended he go to the hospital. Husband said he would give it a couple days while he took the antibiotic. His fever came down but it was too late for the complications that had already set in.The weekend went by.

Come Monday the pain was so excruciating he couldn’t take anymore. He went to the ER by ambulance. He couldn’t walk. I can’t even describe how terrible it looked. He spent less than 3 days in the first hospital when they transferred him out to a higher care hospital.

They ran 2 tests and transferred him out from there immediately to an even higher care hospital. They had called me to get consent for the 2nd test known as the t-scope. It takes a close look at the heart. I still had no idea how serious it was but they gave it a name at the next hospital he was transferred to.Endocarditis.

Soon they would tell me he had to have open heart surgery on his mitral valve. All this in less than a week.I had no idea what endocarditis was. I was still ignorant of the fact that cellulitis could even go into sepsis. I did a ‘crash course’ in endocarditis,sepsis,cellulitis and mitral valve replacement on all the credible websites i could find.I was stuck at home and did nothing but read morning,noon and night when i wasn’t on the phone with my husband and hospital.

I finally went to the hospital with his son to sign the consent forms. Long story short; he was out of it and could not give consent. You see, one day i talked to him over the phone and he told me had a test.I assumed it was a routine test. I called the nurses at the front desk-as i had been doing all along-to see what the test results were.

It was not routine .He had fallen out of bed and they sent him down for a CT scan. I wasn’t that shocked . I had to call the hospital after the visit to tell them my concern that his bed railing was down. They made up an excuse. After the fall and the cat scan they moved him to a room in eye sight of the nurses station.They knew they were at fault.There were no injuries from the fall but it did reveal he had suffered stroke at some point.

I knew from the visit and our phone conversations that something was wrong;the test results confirmed it.I am convinced the stroke had occurred back when he was admitted to the 1st hospital and they just didn’t catch it.The 2nd hospital didn’t catch it either but he was never admitted because of the immediate transfer so they wouldn’t have had much of a chance to see the signs anyway.

By the way,i tried to get him transferred to the Cleveland Clinic after meeting with the surgeon who was going to do the open heart. I wasn’t impressed with him anymore than i was the hospital. The plan to get him to Cleveland fell through. The insurance would not cover the whole transport due to the distance. i was crushed. Of course,in the end,i decided not to give consent anyway. We’ve since been to the Cleveland Clinic.

I also knew after the visit he wouldn’t survive the open heart surgery and while the dr scheduled him for the following Monday i  struggled with the decision. I stopped struggling,went with my gut feeling   & decided against it. I called the nurses station  & firmly withdrew consent. I made that call in  tears but know to this day it was the right decision.

He was then moved to a lower floor for rehab. I called often to see about his discharge and was told he had to go to a nursing facility. I said no. He was to come home and i would care for him here.I would get the help that was necessary. Oh hell no-he had to go to a nursing home.

They would not discharge him unless i chose a nursing home that had a bed available and offered rehab. The home could either be in their location or up here. I took the facility up here. I figured if he were closer to home it would be easier to get him home.Turns out it t wasn’t a heck of a lot easier but it was close enough i could get him transported home. BINGO.

The nursing home was quite the experience.It was another  fight to the finish to get him out. It’s ok if you’re a patient that would like to get back in bed & you don’t mind an hour wait for a nurse to come in and help.

It’s a great place if you want to struggle to go from one end to the other in a wheelchair. You know what it’s a great place for-to dry up your insurance until the payment runs out and you’re no longer covered.You know what they’re good for-MONEY and they will clean house until there isn’t a dime left.

Who monitors these cash cows? They’re called a nursing home? You mean a glorified babysitter for the elderly or infirm. Thank God there are in home services these days and a nursing home is not the only option. He’s here,been here. I think in part because i did enough jumping up and down to the ‘caseworker’ as they’re called.

He still requires surgery to repair the mitral valve. We’re working on that.
The surgeon mentioned he would need rehab after the surgery. The answer is NO. This means a nursing facility again. It is NOT going to happen. We are still discussing whether the surgery will be open heart or minimally invasive.

The COVID-19 virus would have put a hold on the surgery but it’s about the amount of time we were given anyway.We are going to see if it could wait a couple extra months,that is until August. We know he can’t go past a year but we’re hoping August will be safe enough barring any symptoms getting worse.

So far,so good. His oxygen levels have been good and he’s not doing badly except that he still shuffles his feet; a leftover problem from the strokes.You would have to know his previous condition to marvel at how far along he has come;shuffling his feet is no big deal. The nursing homes so called ‘rehab’ did him little good.

Were the hospital honest they should have just said his insurance had run out and a longer stay would not have been paid for. Don’t tell me their insistence he stay until they had a nursing home lined up didn’t have something to do with his insurance coverage.

It’s what known as a network. I can tell you he won’t ever go back to the original hospital that placed him in this network to begin with.Was that ever a mistake.
I want to be clear though. I am NOT faulting ALL nurses or doctors. I wasn’t available 24-7 to be certain of the care he was getting. I could assume certain things but you can’t go by an assumption.

We’re grateful that he survived at all. On the other hand i believe that my criticism of nursing homes in general is warranted. I especially resent that I was basically forced into having him placed in one.

It was NEVER my choice.I made that clear to them until they made it clear to me they would not discharge him until I agreed [unless i let him be released without a doctor’s consent].For one,I had no way to transport him home.

They definitely had me over a barrel.
I will say this about the nursing home and give them(NOT the caseworker)the benefit of the doubt and say it’s possible they are understaffed.

As for the distant ‘higher’ care hospital [before the nursing home] i have one other valid complaint. When his son and i went down to see him we took his favorite bathrobe with us.

It was brand new. He requested it. I also placed an order from for a teddy bear,box of Godiva Chocolate and roses. The only difference is that i made a special request NOT to include the glass vase;concern about it getting broken in the hospital. I figured the hospital would have an appropriate container.
Screenshot_117

FROM YOU FLOWERS

The company notifies you of the delivery. Husband had confirmed it but it was nice of the company to confirm it too. Some don’t.

I always told him one day i would get him Godiva chocolates as a gift. He loves chocolate and Godiva is primo as chocolates go.I’d gotten them for my mom once.They’re primo for a reason. They also have a primo price; but worth it.
The order was delivered.

He got maybe one piece of the chocolate. When he came home he was missing the teddy bear. The roses were gone if he ever had them;but you could attribute that to their dying. They wouldn’t have lasted long enough or been transported with him anyway.
There was no excuse for the new bathrobe or the teddy bear. Those things should have been with him.i checked with the security at the hospital. They were not turned in.

Husband was incapacitated.
He definitely did not get up and lose everything.

They kept him in bed for nearly his whole hospital stay.The only people he knew were me and the family HERE that visited him the day BEFORE he got the delivery.
NOBODY would have been in the room with him BUT hospital staff. The robe and stuffed animal were not with him at the nursing home and they made certain all his belongings came with him when he was discharged.

I called the responsible hospital back,told them what the order cost me,did not include the bathrobe in the figure and they told me they were not responsible. They weren’t going to reimburse a dime.
Yes,they were responsible and their response was par for the course as far as I’m concerned.
If you have any comments to make re your own experience with a nursing home for good or ill PLEASE add your comments. I definitely would like to hear these!
The Covid-19 Virus showed us the shortcomings of these ‘homes’ or facilities as they call them.I wish someone in the media would do a more extensive investigation.

(WASHINGTON) JW REPORT: Emails Suggest Obama FBI Knew McCain Leaked Trump Dossier and a new understanding comes from 138 pages of emails between former FBI official Peter Strzok and former FBI attorney Lisa Page #AceNewsDesk report | Ace News Services

#AceNewsReport – Apr.26: We are getting more insight into the thinking of the corrupt FBI officials involved in the plot against Donald Trump – in particular what they knew and when they knew about the smear/leak operation using the shady “dossier.”

Source: (WASHINGTON) JW REPORT: Emails Suggest Obama FBI Knew McCain Leaked Trump Dossier and a new understanding comes from 138 pages of emails between former FBI official Peter Strzok and former FBI attorney Lisa Page #AceNewsDesk report | Ace News Services

David Limbaugh: Coronavirus uncertainty – all these things we still don’t know warrant humility

COVID-19 is so new and information is changing so rapidly that it is difficult to separate fact from fiction and truth from partial truth.

Like everyone else, I’m just trying to make sense of the evolving information.

Many of us have been monitoring the daily reports measuring the number of deaths relative to the number of cases. We’ve been treated to crash courses in lay epidemiology via daily press briefings and voluminous articles.

We understand that the administration and state governments have been trying to “flatten the curve” of the coronavirus by slowing its spread. The main purpose, as has now been clarified, is to reduce the velocity of the contagion so that our hospitals and necessary equipment are not overwhelmed, which would result in more deaths.

Though many didn’t grasp this initially, flattening the curve doesn’t greatly reduce the overall number of deaths, except for those saved by reducing the burden on hospitals and others saved by lifesaving therapeutic treatments and vaccines developed with the extra time flattening provides.

Many have suggested that the estimated death rates have been grossly overstated because the numerator (number of deaths) has been exaggerated and the denominator (number of people infected) has been understated.

They say the numerator was inflated because many deaths actually caused by the flu were attributed to COVID-19, and because every death of a person with the virus in their system was treated as a death caused by the virus even though some other accompanying illness may have been the proximate cause.

The denominator was likely understated because so many people had the disease before we were aware it was circulating here; many were asymptomatic and never got tested; and many who were symptomatic assumed they had the flu. Several recent studies have confirmed, through randomized antibody testing, that in certain locations, exponentially more people were infected than we’d assumed.

Stanford University researchers found that Santa Clara County in California had between 50 and 80 times more infections than officials were reporting.

A separate antibody study showed that the number of coronavirus infections in Los Angeles County could be 28 to 55 times higher than the official count.

A just-released study estimates that some 2.7 million New Yorkers may have been infected – more than 10 times the state’s confirmed cases to date.

Obviously, we’ll know more when antibody testing is conducted throughout the country. But these tests strongly indicate that the virus is less lethal by orders of magnitude than previously known.

Many argue that this emerging data proves we overreacted by shutting down our economy and wreaking such financial devastation. If we knew in December what we think we know now, this may have been true.

Until comprehensive testing is performed and the data analyzed, however, we won’t be sure of the virus’ lethality. I suspect it will be more than that of the flu.

If it is as contagious as we fear, we might think twice before making final judgments as to what should or shouldn’t have been done.

I think the critics’ skepticism is based on their distrust of other experts who have ginned up fear over apocalyptic climate change based on computer models.

Knowing how much disinformation those experts have spread, people are justifiably suspicious of what now appear to be wildly erroneous coronavirus models that scared the world into a global economic shutdown.

People are still debating whether these initial models factored in mitigation measures, but we can certainly fault modelers for their absolutism and arrogance, and we can use this experience to challenge the credibility of climate change modelers on their projections.

So where does it leave us?

While there is still much we don’t know, I am less cynical than some about the mitigation measures we’ve employed to slow the spread. If I weren’t, I’d be freely moving about in public without fear of catching the virus. I do believe we have slowed the spread and saved lives.

But I am also very saddened by the immeasurable economic devastation and suffering. While some may be too readily dismissing the threat of the virus, others are unspeakably insensitive to the financial disruption and pain people are experiencing, and callous about mitigating it.

We have to be prudent moving forward. Even with these new findings on lethality, we have nowhere near approached herd immunity, so the virus is still highly contagious.

We don’t want to immediately reopen every aspect of our society if it would cause the virus to rebound, which would make the economic pain we’ve already suffered pointless – and much worse.

So, I think the administration is wise in recommending a phased-in approach and deferring, when practicable, to state authorities.

I trust that the more we learn and the more testing we have, the better we’ll be able to combat the virus if it resurfaces in the fall and in subsequent years.

Scientists will be armed with more widespread antibody tests as well as tests to determine whether people have the disease so that contact tracing can be used to find who they might have infected.

Officials will also have developed efficient systems and strategies for preventing flare-ups from igniting full-blown outbreaks.

We can then employ a more targeted approach against the virus that will not cause economic devastation, as research confirms that the virus is far more deadly to certain groups: the elderly and those with certain underlying health conditions.

Until we develop herd immunity, less vulnerable groups can freely move about, and more vulnerable ones can self-isolate.

As we reflect on this crisis, we must also reflect on our precious constitutional liberties and consider how quickly they can be compromised in actual or perceived national emergencies.

While individuals and businesses deserve to receive relief funds from the government because it forced them to suspend their economic activities, we must now soberly consider our national debt and the existential threat it represents to the republic.

Perhaps we will become more responsible about our out-of-control federal spending, which can only be rectified by entitlement reform – a subject we can no longer afford to avoid.

Pray for America and those hurting from this pandemic.

 

Source: David Limbaugh: Coronavirus uncertainty – all these things we still don’t know warrant humility

Stop The Panic-Facts Matter

The tragedy of the COVID-19 pandemic appears to be entering the containment phase. Tens of thousands of Americans have died, and Americans are now desperate for sensible policymakers who have the courage to ignore the panic and rely on facts. Leaders must examine accumulated data to see what has actually happened, rather than keep emphasizing hypothetical projections; combine that empirical evidence with fundamental principles of biology established for decades; and then thoughtfully restore the country to function.

Five key facts are being ignored by those calling for continuing the near-total lockdown.

Fact 1: The overwhelming majority of people do not have any significant risk of dying from COVID-19.

The recent Stanford University antibody study now estimates that the fatality rate if infected is likely 0.1 to 0.2 percent, a risk far lower than previous World Health Organization estimates that were 20 to 30 times higher and that motivated isolation policies.

In New York City, an epicenter of the pandemic with more than one-third of all U.S. deaths, the rate of death for people 18 to 45 years old is 0.01 percent, or 11 per 100,000 in the population. On the other hand, people aged 75 and over have a death rate 80 times that. For people under 18 years old, the rate of death is zero per 100,000.

Of all fatal cases in New York state, two-thirds were in patients over 70 years of age; more than 95 percent were over 50 years of age; and about 90 percent of all fatal cases had an underlying illness. Of 6,570 confirmed COVID-19 deaths fully investigated for underlying conditions to date, 6,520, or 99.2 percent, had an underlying illness. If you do not already have an underlying chronic condition, your chances of dying are small, regardless of age. And young adults and children in normal health have almost no risk of any serious illness from COVID-19.

Fact 2: Protecting older, at-risk people eliminates hospital overcrowding.

We can learn about hospital utilization from data from New York City, the hotbed of COVID-19 with more than 34,600 hospitalizations to date. For those under 18 years of age, hospitalization from the virus is 0.01 percent per 100,000 people; for those 18 to 44 years old, hospitalization is 0.1 percent per 100,000. Even for people ages 65 to 74, only 1.7 percent were hospitalized. Of 4,103 confirmed COVID-19 patients with symptoms bad enough to seek medical care, Dr. Leora Horwitz of NYU Medical Center concluded “age is far and away the strongest risk factor for hospitalization.” Even early WHO reports noted that 80 percent of all cases were mild, and more recent studies show a far more widespread rate of infection and lower rate of serious illness. Half of all people testing positive for infection have no symptoms at all. The vast majority of younger, otherwise healthy people do not need significant medical care if they catch this infection.

Fact 3: Vital population immunity is prevented by total isolation policies, prolonging the problem.

We know from decades of medical science that infection itself allows people to generate an immune response — antibodies — so that the infection is controlled throughout the population by “herd immunity.” Indeed, that is the main purpose of widespread immunization in other viral diseases — to assist with population immunity. In this virus, we know that medical care is not even necessary for the vast majority of people who are infected. It is so mild that half of infected people are asymptomatic, shown in early data from the Diamond Princess ship, and then in Iceland and Italy. That has been falsely portrayed as a problem requiring mass isolation. In fact, infected people without severe illness are the immediately available vehicle for establishing widespread immunity. By transmitting the virus to others in the low-risk group who then generate antibodies, they block the network of pathways toward the most vulnerable people, ultimately ending the threat. Extending whole-population isolation would directly prevent that widespread immunity from developing.

Fact 4: People are dying because other medical care is not getting done due to hypothetical projections.

Critical health care for millions of Americans is being ignored and people are dying to accommodate “potential” COVID-19 patients and for fear of spreading the disease. Most states and many hospitals abruptly stopped “nonessential” procedures and surgery. That prevented diagnoses of life-threatening diseases, like cancer screening, biopsies of tumors now undiscovered and potentially deadly brain aneurysms. Treatments, including emergency care, for the most serious illnesses were also missed. Cancer patients deferred chemotherapy. An estimated 80 percent of brain surgery cases were skipped. Acute stroke and heart attack patients missed their only chances for treatment, some dying and many now facing permanent disability.

Fact 5: We have a clearly defined population at risk who can be protected with targeted measures.

The overwhelming evidence all over the world consistently shows that a clearly defined group — older people and others with underlying conditions — is more likely to have a serious illness requiring hospitalization and more likely to die from COVID-19. Knowing that, it is a commonsense, achievable goal to target isolation policy to that group, including strictly monitoring those who interact with them. Nursing home residents, the highest risk, should be the most straightforward to systematically protect from infected people, given that they already live in confined places with highly restricted entry.

The appropriate policy, based on fundamental biology and the evidence already in hand, is to institute a more focused strategy like some outlined in the first place: Strictly protect the known vulnerable, self-isolate the mildly sick and open most workplaces and small businesses with some prudent large-group precautions. This would allow the essential socializing to generate immunity among those with minimal risk of serious consequence, while saving lives, preventing overcrowding of hospitals and limiting the enormous harms compounded by continued total isolation. Let’s stop underemphasizing empirical evidence while instead doubling down on hypothetical models. Facts matter.
https://thehill.com/opinion/healthcare/494034-the-data-are-in-stop-the-panic-and-end-the-total-isolation