Recently I wrote about dad’s dizzy spells and how the doctor referred a home health nurse to come and check on him.
The home health nurse visited dad several times a week for three weeks. When I went to see dad on Tuesday, the home health nurse was there. She was just finishing with dad and was completing her paperwork. She explained that she had to give us some forms to sign because she was discharging dad on Thursday.
Apparently there is a Medicare rule that one can appeal such a discharge because after the discharge Medicare would no longer pay for the home health nurse to visit dad. I signed the papers because dad was confused about what they were.
The nurse checked dad’s blood pressure each time she visited. Each time there was a drop in blood pressure when he stood from when he was sitting. However, only once was the drop greater than 20 points. At that point, the nurse has to phone the doctor and tell her because this is a significant drop. This is called orthostatic hypotension It can be serious as it causes dizziness and might cause him to faint.
She called dad’s doctor to report this 20 point drop, but the doctor didn’t take any action based on this report. Perhaps if it happened every time he stood up she might change his blood pressure medication to prevent his blood pressure from becoming so low. He did have much higher blood pressure in the past, but in the past 2 years it has settled down to below 120/90 on a regular basis.
However, this only happened once in the 3 weeks whereas the rest of the time it fell 10 points or less. She told the staff ti make sure dad drinks more fluids and told him to get up more slowly. She also tried to get him to place his walker closer to his Lazy Boy rather than across the room. She wants him to use his walker all the time and not just when going out of his room.
Dad has always preferred to leave his walker when he goes to the bathroom or to his bedroom. He only uses the walker to go to the lounge or dining room or when we go out to lunch. I tried to explain to dad why he has to use the walker more, but he forgets.
I didn’t object to the nurse discharging dad because I felt she did as much as she could do. Now it is up to us to follow up as much as we can. I bought ice cream and individual containers of orange juice for dad. Put the juice in his refrigerator and gave the ice cream to the kitchen staff. I asked the staff to offer dad ice cream after his meals as it would increase his fluid intake.
I saw the nurse again when I visited dad on Thursday. She pointed out how dad left his walker across the room and it should be nearer to where he was. She also emphasized to him the importance of drinking more fluids. Dad doesn’t like to drink water but said he would drink orange juice if I brought it. I will check tomorrow and see if he drank any of the juice.
This is a bit frustrating because of dad’s Alzheimer’s. I know I have done as much as I can do, but I am not sure we will be successful in changing dad’s behavior. He forgets that he should use the walker more. He forgets that he should drink more fluids and that he should stand up more slowly. He said he continues to be dizzy but doesn’t remember there is anything he can do to help.
I feel like now this is in God’s hands. I have done as much as I can do for dad, and he wouldn’t want anyone trying to watch his every move to prevent him from standing too fast or drinking too little. I have to just hope that what we have done is enough and that will not fall. I am glad I called the doctor and arranged for Home Health Care. At least I understand what is happening now better than I did before. But I am not sure anything will change.