Bounced back to hospital

[Guest guest]

Last night the SNF's " Bounce Back Unit " that was to provide

rehabiliation post-neurosurgery for his broken neck and swallowing

problems bounced my husband back to the hospital during the 3rd night

of his stay.

Morning of day 2 NH nurse called me at 7 AM because they'd sent him to

the ER because he pulled out his catheter (due to hospital stay UTI).

The hospital Urology doctors reinserted the tube and returned him to

the nursing home.

At 11 PM of night 2 they called me to say they found him on his face

beside the bed, and his catheter had evidentally pulled out when he

crawled out of (low) bed. The ER had Urology docs reinsert catheter,

CT'd his neck to verify it was still stable, and sent him back to the ER.

Last night (3rd night) after I had just returned home from NH and put

on my PJs, they called me at 10PM to return, since he was " somewhat "

agitated & they didn't have sufficient coverage to manage him. I went

prepared to spend the night. Around 1 PM following meds and half-way

through tube feeding he began to act out because he wanted to leave.

He began hitting at me, knocking off my glasses, spitting and being

otherwise combative. The nurses came and asked me to leave the room.

Evidently he hit and kicked them, so they called their doctor who said

to send him back to the hospital. They couldn't get a regular

ambulance to carry him because he was combative, so they called the

county service, which also brought the police, who were kind to him.

Basically the NH didn't/doesn't want him back.

At the ER I told him that I felt I had been misled by both the

hospitals neurosurgery service and the SNF who had indicated they

(SNF) could handle him with his dementia related agitation and

combativeness, the catheter and PEG tube. The hospital restrained him,

the SNF would not. I had asked for consults with neurology and

neuro-psych while he was in hospital because I felt his dementia born

aggression was the main barrier to his recovery. The doctors

recommended increasing his Seroquel but no other medication changes,

with possibly eliminating Comtan if warranted. However, adding only 25

mg additional Seroquel (75mg total) in the evening did not make

significant changes by the time they released him.

He is now in the geriatric psych ward at the hospital as of 7 AM thins

morning. Right now I don't know what the next step will be. The

problem is (of course) that he's institutionalized and wants to

escape. He's frightened and has mentioned Hitler, and " assassination "

to explain his feelings. He wasn't making much sense while in the ER

last night. My dilemma is that he needs skilled nursing care and

therapy (PT and Speech) to recover from his broken neck before I could

bring him home. Even then, since he wouldn't always believe home was

" home " and would become violent, I don't know if I could manage his

care at home if we cannot decrease his present levels of anxiety and

agitation. As you all know, with LBD, this is a problem.

Kathy