Follow Up on Home Health Nurse

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.

About letstalkaboutfamily

I am a retired and was the primary caregiver for both my parents before they passed. I have children and grandchildren. This blog is an attempt to connect with other caregivers and share ideas and experiences. I hope you will let me know what worked for you if you had an experience similar to mine. The main issues I am going to talk about are elder care, death and dying, assisted living, family relationships and hoarders and hoarding. Other topics will come up as I address the issues and my relationship with other family members.
This entry was posted in Alzheimer's Disease, Assisted Living Facility, Caregiving, Elder Care, Eldercare, Fall Prevention and tagged , , , , , , . Bookmark the permalink.

6 Responses to Follow Up on Home Health Nurse

  1. Terry says:

    you are in a position, the same as me. We have done all we can. We can not fight some illnesses no matter how we try. God will take care of your dad as he is taking care of Al, my brother

    • You are right. Sometimes I want to fix everything myself. Then I get reminded that I don’t have the power to fix it. Only God has the power and I have to put my faith in him. I am sorry to see you work so hard to care for your brother. You are truly an inspiration!

  2. jmgoyder says:

    This is a difficult phase. Will your dad soon have to go into high care?

    • I take it day by day but I hope to keep him where he is for the rest of his life. He is 95 years old and the next step would be memory care if his behavior gets difficult. But so far he is cooperative and seems to be doing OK where he is.

      I hope to avoid nursing homes forever as the local ones tend to be noisy and chaotic. He wpuld only goe to a nursing home if he needed skilled nursing care or if his behavior became too difficult even for memory care. I really think I can keep him out of that unoess he gets a new medical problem like a stroke or something.

  3. Janet Yano says:

    I admire your clarity of thinking about his care and living situation.

    • Thank you, Janet. I feel like I am becoming a reluctant pro since I started overseeing mom’s health issues over 5 years ago. With mom gone, I have moved right into place watching over dad now. I feel more in control if I study all the issues before acting unless there is an emergency. And actually, my goal is to be a step ahead even in the nest emergency so I won’t feel as totally lost. In the end, I can prevent all bad things from happening, but I sleep better if I think I cave already prepared for contingencies. Thanks for commenting on my blog.

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