My dad’s team in the icu is pushing for him to be discharged to LTAC like kindred. They say he needs time to wean from vent and that acute rehabs in Philly area won’t take him (Magee already confirmed this for us). I kind of agree given that he’s too tired now to do 3 hours of therapy a day. Is it really all that bad to be sent to kindred for a pit stop before applying for an acute rehab? Is it actually appropriate in some cases?
-
-
if he's a veteran get him to a VA facility -
Thanks, my dad lives in the southeast. Any particular VA that is good?Comment
-
Comment
-
Not VA but I know in the past (2017) Lake Taylor Hospital in Norfolk, Virginia achieved some distinction for assisting patients in weaning off vents. Not a recommendation, just an LTAC to consider in the Southeast.Originally posted by Scidaughter2 View Post
Wishing you and your family all the best.
https://www.laketaylor.org/2017/10/0...e-designation/
Comment
-
The one in Augusta would be most convenient for family but now he is stuck in ICU in Philly with an ileus.Comment
-
Still contact them in Augusta and get him on their list for admission as soon as he is able to travel by plane. They will also connect with the staff in Philly so this can happen as soon as he is able to travel. If he is non-service connected for his VA benefits now, you may have to pay for the air transport; once he is admitted to the VA system he should be reclassified as Category 4 catastrophically disabled) with many more benefits. If he is service connected, he may be eligible for the VA to pay for the flight, or he may be eligible for programs such as "Angel Flight". (KLD)
-
-
Thanks KLD! Luckily he is insured through Medicare and private insurance too. I will contact VA in Augusta. He really wants to do rehab up in philly but because of his age and injury and the fact that’s he’s still on a vent, I’m not sure if they will accept him.Comment
-
Medicare will likely limit his inpatient acute rehab stay to 6 weeks or less (if he is still vent dependent) and will also not pay for much of the DME he will need at home (bathroom equipment especially), nor the sophisticated wheelchair he will need. The VA will do all of these things, and are not under any restriction of length of stay: they can take him as an acute injury and then transition him to their rehab program (only at a VA SCI Center) when he is ready, and keep him as long as needed before discharge. Please don't delay in getting him referred to Augusta!
(KLD)The SCI-Nurses are advanced practice nurses specializing in SCI/D care. They are available to answer questions, provide education, and make suggestions which you should always discuss with your physician/primary health care provider before implementing. Medical diagnosis is not provided, nor do the SCI-Nurses provide nursing or medical care through their responses on the CareCure forums.Comment
-
Actually that sounds great! Will call Tampa and Augusta on Monday morning. I remember my grandfather received treatment years ago at the Tampa VA and my family was very impressed. It was like a small city. I will have to convince my father that it makes sense to air transport him. I’m not sure when he is due to be discharged, no one in the ICU has brought it up. The social worker here is not very helpful at all.
They are waiting for his ileus to resolve, giving him small bits of nutrition through Ng tube to see how he tolerates it. He’s off the vent during the day, tried out the Passey-Muir valve yesterday, and is just vented at night so he can rest.Comment
-
Very discouraged after call into Tampa SCI. They are saying they rarely transfer patients from LTACs because they need a different level or care. I'm hoping Dad gets strong enough soon so that he can start making the significant improvements that make him look attractive to acute rehabs.Comment
-
Did you also call Augusta VA SCI Center? Also consider Richmond (VA) if they don't pan out. Their admission criteria can vary from one VA to the next. (KLD)Last edited by SCI-Nurse; 27 Dec 2022, 2:18 PM.The SCI-Nurses are advanced practice nurses specializing in SCI/D care. They are available to answer questions, provide education, and make suggestions which you should always discuss with your physician/primary health care provider before implementing. Medical diagnosis is not provided, nor do the SCI-Nurses provide nursing or medical care through their responses on the CareCure forums.Comment
-
I left a voicemail with the coordinator over in Augusta. I will have Dad's case manager send over records and application to Tampa and Augusta anyway, even if he's denied I know we can reapply later. It just hit me that he might not be accepted into any rehab at all and that thought is very depressing.Comment
-
Well my poor Dad cannot catch a break. He had one good day (finally!) He tested positive for Covid yesterday, they started him on remdesivir and today dexamethasone after he was requiring more oxygen. I’m scared that this is just all too much for his body to handle at once. The devastation of a recent sci and now a covid infection is really an uphill battle of epic proportions. I’m so sad and this is made worse by the fact that we can’t visit.Comment
-
It's the 6 week anniversary of his injury today, my Dad tested positive for covid 5 days ago. I got to talk to him today after a nurse kindly called us using the room phone and he sounded very weak but oriented and alert. What a relief. He is using a nose cannula for oxygen. I'm glad they were able to infuse him right away with the appropriate drugs and he's also vaxxed and boosted. My 80 year old stepmother also caught it and she's been fine on Paxlovid. The hardest part is not being able to visit but I've been checking in a few times a day with the drs and nurses. I asked dr if possible to start PT with him again to get him out of bed and moving/stretching his limbs and she said she think it would be okay.Comment
-
My dad is having ongoing bowel issues. He had an ileus right after injury. Has watery stools and sometimes stomach appears distended. Today has a lot of diarrhea and stomach softened. They are doing X-rays to monitor for impaction and today did a ct scan. He’s not eating a ton, says the food doesn’t taste right. Drinks a lot of ensure. Dr thinks might have to put in a feeding tube. Asked Dr to monitor intake more and check in with GI consult. Still covid positive so unable to see him. Before, when family was around, they would encourage him to eat. They also put in rectal tube because his skin was getting irritated where he would have accidents. Said he didn’t like the tube because it was uncomfortable. I guess he can feel it! He has been doing PT a few times a week. They stood him up 2 days ago using a sheet for support and PT said knees were contracting. Said he was able to bear a little weight on legs. They noticed some wrist movement and movement on right side that was more than trace movement, it was against gravity. This is all new. Classified as Asia C. Today when they sat him up he totally crashed, blacked out and they had to reposition with legs up. After a few minutes he was back to normal. Don’t know what caused this as he has been able to sit up fine before. Dr thinks may be body’s response to losing fluids through diarrhea. He also has fluid in his lungs, they can’t say for sure what the cause is. Respiratory said he doesn’t like cough assist and dr thinks he can cough well in his own. Has been between 4-10l of oxygen lately. So, it’s a little all over the place right now. Some hopeful things but also some frustrating setbacks.Comment
Comment