My husband's BP is very sensitive to salt. Tonight he ate a meatloaf and gravy meal plus other things that would not have salt in it. About 1/2 hour later, he started shivering and we had to cover him with a bedspread. I pushed the call button and asked for a doctor. Doctor did not come. I saw NP and she asked if Dr had come and when I said no, he came. Husband's BP was up to183/(forgot). He has only been there for a couple of days. I can get PT where I am in an outpatient facility. I believe the meatloaf and gravy had salt. I am thinking of pulling him out of there. I can take care of him as is and enroll him in outpatient PT. But I don't know how to do it. Please help.
I would first verify that your insurance will cover the needed PT and OT as outpatient, and for how long before I would remove him, and then just request that you want to bring your husband home, after you have said therapies already lined up.
But I would caution you before you remove your husband from rehab that you go into this with eyes WIDE open so you know exactly what you're getting yourself into with his care, so that in a few weeks you are not so overwhelmed with his care and the like that it's you that ends up being in the hospital.
Best wishes in doing what is not only best for your husband but for you as well.
The doctor could order low sodium diet and closer watch on your DH BP and meds to give if it went over a certain reading etc. It is a big problem even with hospitals trying to get a proper diet. If you think it was a one off, the wrong diet delivered, then perhaps that could be addressed.
I could not have managed my mom at home. She had a stress fracture. Looking back I realize I could have brought her food in. It does seem like it would be easier to just take them home but so much is done for them in the facility that is hard to manage at home w/o help.
If you are convinced they can’t manage his care in the rehab, then speak to the rehab social worker and ask for home health and OT/PT to be ordered. We used them often but the laundry, cleanings, meals, meds, etc will all be on you other than the weekly nurses visit, the aide visits for baths and the therapist visits.
Is your DH able to get in and out of your car? Get into your home? Will he need wheelchair, Walker etc? There is a lot to consider and please know that the home health doesn’t show up the first day. Give us a little more about DH circumstances and you might get more useful answers. I’m sorry this happened.
"he ate a meatloaf and gravy meal plus other things that would not have salt in it" Was DH suppose to have a selt free diet? Because meatloaf and gravy do have salt in it normally.
Is your DH in for just getting his strength back? If so, ask the SW if "in home" care can be set up. Medicare will pay for that. He will get PT and OT. Tell her it seems the Rehab cannot accomodate his no salt diet. You really don't want him stroking out. They may give you a hard time because Medicare pays 100% for 20 days. They want thosev20 days. You can go AMA but you will leave with no prescriptions or order for home therapy. You can call your State Ombudsman to see what his rights are. The facility should have the number posted.
Tell them you are withdrawing your husband from rehab care, even if against medical advice.
Request the Social Worker/Nurse manager or discharge planner be sent to your husband's room.
Discuss this question with Discharge Planning.
As you can imagine, facilities vary in how they are run and who is responsible to helping you to arrange discharge. You will then be responsible for your husband's care being transferred away from Discharge Facility MDs and back to your own MD who can order in home PT if this is possible.
In my own personal opinion you would be much better to begin by requesting:
1. increased frequency in blood pressure checks
2. checking to be certain that the diet is low sodium.
I worry about the dichotomy here:
On the ONE HAND you are "guessing" that there was sodium in the meatloaf and gravy, and you BELIEVE that the only recourse is to take your husband home.
However, on the OTHER HAND your competency doesn't include any knowledge about how one would go about such a transfer.
This makes me worried about your current choices. I would ask you to begin by discusses your believe with the Admin at the facility after checking diet orders. You may be reassured by speaking with dietary staff.
Good luck.
Rehabs do not always provide adequate training for caregivers because they often wait until the day before or even the hour before discharge. Even if you wait for the normal discharge, start asking (insisting if necessary) that they show you the steps necessary for his care at home.
When my husband had rehab for a broken hip, I had very little instruction to how to transfer him or even to get him in and out of our car. Depending on the issues your husband has, it can feel like taking your first born baby home knowing you never have done that kind of care before.
When he had his PEG tube placed, one nurse gave me hands on for part of the process while the nurse for the last feeding would only let me watch... meanwhile the social worker came in and said our hospital bed was scheduled to be delivered within the next two hours! I became panicky but fortunately the first nurse was still there and helped me calm down saying the delivery would not be done until the company confirmed we were home.