Update of 7/3/15

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Update of 7/3/15

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ManPullingHairOutSaturday was regular care for clients. Armature radio field day today. Visit Mom at hospital.

Sunday was regular care for clients. Visit to Mom at hospital; she was discharged back to rehab center today. Armature radio field day continues today.

Monday was dialysis for Mom. She hurt so bad they had to take her off early and sent her to ER.

Tuesday was regular care for clients. Rehab center canceled Mom’s appointment with the surgeon for the follow-up on her fistula gram which dialysis is upset about and rescheduled for August 5.

Wednesday was dialysis for Mom. Dialysis got mom’s surgeon appointment rescheduled for July 8. I was found in violation of the grant I received when I was laid off from my job for having to take care of Mom and not qualifying for Family and Medical Leave Act benefits because of the size of the company. I am in violation due to changes that the rehab center made in Mom’s appointments as they have moved them to times that I cannot be there as I am at other clients and they do not keep me informed of what is going on and also the clinic auto scheduling appointments in conflict with her dialysis. I have been put on an extended year of probation without any funding and need to keep up my continuing education for one of my clients and don’t get my funding for it any more because of the probation. So the $100.00 I won in the blog program will come in handy for that.

I spent several hours today working with Mom’s dialysis case manager and the dialysis social worker about scheduling issues. I also had over an hour meeting with Service Excellence at the clinic because the pop ups that tell the schedulers not to schedule during her dialysis times and to contact me for scheduling are not coming up again! I was also on with the administrator, the head nurse and the transportation coordinator at the rehab center and they are being no help! I also stopped at medical records at the clinic and got print outs from her ER visits and hospitalization as they are not available on her on line charting system at this time as it can take up to 2 weeks for them to show up. I found out that her pain on Monday came from the rehab center not following her main management plan outlined in her discharge on Sunday as they had yet the to fill the RX before she left for dialysis.

Care for clients today. By the time I had everything reviewed today it was almost midnight. The state ombudsman will not help with any of this as they tell me it is my responsibility to coordinate the care even though the rehab center wants to coordinate to suit themselves and forget the family! The clinic/hospital care coordination department will not help during her time at the rehab center as their position is that it is the rehab center and the family’s responsibility to coordinate during that time.

Thursday, I slept in till 9:00 a.m. to be ready for my first client at 10:00 a.m. when I normally get up about 7:00 a.m. today to have time for myself. Care for clients today. Also spent over two hours at clinic tying to work through Service Excellence to get pop ups straightened out on Mom’s record and getting appointments corrected. President Obama was in town today to speak at UW-L that also caused much traffic congestion worse than it already is due to road construction.

Friday dialysis today with mom. Mom came to dialysis not feeling well. She had the runs and was going to the bathroom uncontrollably with every transfer. It is believed that her bowels are starting to work again and this is just part of getting cleared out. Care for clients and laundry today. Cannot work with the clinic today on their computer popup problems today as they are closed for the holiday.

To be in compliance with my grant I have the following requirements until August 31, 2016 now:
1. Keep all doctor appointments coordinated with me for my paid clients and regular scheduled cares.
a. Only allowed to drop a client for the following reasons:
i. They no longer need services
ii. I am unqualified for new services required
iii. They move to an assisted living center or greater level of service
iv. They move out of the area
v. Mom comes home and needs more services which her MCO is willing to pay me for and with all paid hours would be more than 40 hours.

2. Keep up continuing education for additional year without funding.
a. CPR for Health Care Providers (Cost $45.00 through the hospital for 2 year renewal or over $100.00 if taken through Red Cross for 1 year) Current expires July 2016
b. First Aid ($20.00 if taken through hospital with CPR class and good got 2 years or $52.00 if taken through Red Cross and good for 3 years) Current expires October 2016 (Hospital first aid was not available last I had to take)
c. Blood Borne Pathogens Class (Free with hospital first aid class good for 3 years, Red Cross does not offer locally, Online $10.00 and good for 1 year) Current expires October 2015
d. 6 hrs CEU in area that relates to mom or a client (cost about $120.00 if have to take locally can possibly get down some with some online classes but not substantially cheaper)

3. Yearly TB Test ($29.00 through local Health Department and you have to keep your test results report as no record is kept at health dept. or $62.50 through the hospital and is made part of your med record and you need to request and pay for a official printed copy of the results at $0.25 per page and $10.00 certification fee) (Takes two trips to Health Dept office as have shot one day and then go back for reading two days later.)

4. Tetanus booster ($29.00 through health dept if done separate from TB test or free if done at same time as TB test and is recorded in state immunization data base, hospital requires this to be done with a dr visit costing over $200.00 plus the vaccination price of $75.00 and is made part of your medical record plus put in state immunization data base.)

5. Coordinate ALL appointments and appointment changes for mom.

6. Be at ALL appointments for Mom or have an acceptable replacement present that is volunteer or paid for by me.
a. To be acceptable ALL the following MUST be meet:
i. I approve the person
ii. Mom approves the person
iii. They be physically present at the appointment
iv. No follow up appointments are made at the appointment as MUST be coordinated with me.
v. I receive a FULL report from the person plus a copy of ALL paperwork from the appointment the same day

7. Keep at least 22 hours of time available in my schedule for mom for when she comes home and her appointments including dialysis. (11 counted as paid hours and 11 counted as family responsibility.)

My normal schedule is :
Monday
4.5 hrs mom dialysis
2.75 hrs client time
Tuesday
3.75 hrs client time
Wednesday
4.5 hrs mom dialysis
2.75 hrs client time
Thursday
4.75 hrs client time
Friday
4.5 hrs mom dialysis
4.75 hrs client time
Saturday
3.25 hrs client time
2 hrs church
Sunday
2 hrs church
1.25 hrs client time
3 hrs visit mom at rehab center + 45 min to 1 hour dive each way

Regular hours total per week:
18 hrs mom
23.25 hrs clients
4 hrs church
Total 45.25 + time listed below.

I also have doctor appointments with Mom, up to 3.5 hours additional time for client doctor appointments and care coordination for Mom (Setting appointments, making sure rides are set up for her appointments, making sure required paperwork gets back and forth from appointments, dialysis and rehab center)

I sometimes lose hours from clients if they are in the hospital, have a doctor’s appointment that I do not attend with them during my regularly scheduled time, or are out of town with family. I have had this be as much as 20 hours in one month that I have lost this way but averages about hours hours per month.

Currently hours for mom are unpaid during her rehab time but have to maintain to not have to pay my grant (the one I am on probation for) back to the tune of over $8,000, including my PCW (Personal Care Worker Training), CPR for the professional care giver, First Aid, Blood Borne Pathogens, other CEU credits, TB Test, extended unemployment benefits, uniforms that they provided, and administrative services over the last just over three years.

Update:

Mom is back in ER again! At least this time they brought her to La Crosse! It is 7/3/15, 6:00 p.m..

Why they sent her:
1. Abdominal pain
2. Bolted abdomen
3. Nauseated
4. Sore neck
5. Would not eat
6. Diarrhea

Edit:
8:45 PM: They are admitting her; her white count is over 12,000!

 

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Denise

Oh, Larry, so many nightmares all at once! I'm so sorry for the additional stresses especially because you have so much to worry about your mom. \r\n\r\nI'm thinking of both of you. Please keep us posted as you can. And, know you've got our full support.

Maria

Larry,\r\n I am SO sorry to hear of the latest. You & your mom have been through SO much & deserve a break. The way the rehab center is treating you & your mom makes me SOOO mad! Your mom is lucky to have you as our other residents of the rehab center as when you speak up for your mom you are also speaking up for the other residents! \r\nHugs!\r\nMaria