23 January 2025
She says that to anyone who tries to get her to do anything. Get out of bed, walk down the hall, eat her lunch. If you cared about her, she is arguing, you'd let her stay in bed, not get on the walker, leave her lunch untouched.
She said something else today, though, when I asked her why she doesn't want to do any of these things that could help her.
"I'm old and I'm failing."
She thinks it's all downhill. I keep hoping she'll come back home and be able to make a cup of coffee.
℘
MEANWHILE I did finally catch up with the staff, several of whom had been trying to talk to me (I've lost my voice so the phone is out). I do let them know I'm there in the facility every day around noon. But it never quite happens.
Today Loren the Social Worker, who was home sick, did get me on the phone at last. She told me Joyce's Medicare runs out Feb. 9 (a Sunday of course) and wanted to know if I still wanted her to come home.
Well, not in this condition, requiring 24-hour care. I'm smart enough to realize I can't do that. Who can?
So if we want to avoid the $14,000 monthly charge at Golden Heights, we have to apply for Medi-Cal. Right. I told her that several social workers before her have informed me that her monthly Social Security benefit is too high for that. But Loren said, she could still qualify but have a share-of-cost.
I know all about that. They take all of your Social Security check except for $30 for personal expenses (you know, like deodorant and toothpaste). And I am left to pick up her portion of living expenses.
Except my Social Security doesn't fill that gap.
I told Loren that Golden Heights has done nothing for Joyce since she arrived on Nov. 1. She's lost weight, she's immobile when I'm not there getting her out of bed and no one has addressed her dementia with any kind of activity other than changing channels on the TV.
I asked her about other places that treated dementia patients and did wound care. She couldn't think of any. Well, that's what I'm looking for. Joyce could afford a couple of months of that if it helped her enough to return home.
℘
WHEN I GET HOME I hear from Yanne (Anne) the treatment nurse who has been doing Joyce's dressing changes along with Binita. She wants to start Joyce on a Wound Vac.
Our experience with a Wound Vac at home was unpleasant and Joyce hates them. They are loud cast iron devices you have to carry with you everywhere. And the dressings leak so the pump runs constantly trying to achieve a vacuum.
In the hospital, though, they used a larger, quieter machine. And they knew what they were doing when they sealed the wound.
Of course Anne didn't know what kind of machine they would get even though she said they have several of them in use in the unit now.
She said Dr. Dimaano thought it would be a good idea.
It's a good idea for them because it means instead of daily dressing changes (or even two daily dressing changes as they are supposed to be doing now), the Wound Vac dressing would only be changed three times a week.
And with home health services (limited to three times a week), Joyce on the Wound Vac could move to another facility that treated dementia but was not licensed to do wound care. Theoretically.
Well, I said, Dr. Tong is in charge of this wound so you'll have to discuss it with her. Dr. Dimaano has not been involved in Joyce's wound care at all. And, I pointed out, we've just gotten the results from the cultures back showing some level of bacteria and Jennifer the RN is consulting Dr. Tong about antibiotic treatment. So you will have to discuss any change in the order with them.
An hour later, she had. Everyone was on board. Dr. Tong didn't think antibiotics were called for. Try the Wound Vac while she's still at Golden Heights.
Of course they wanted me to convince Joyce. But this isn't like getting out of bed. I suggested Anne tell her Dr. Tong recommended this as a trial before her stay expires to give her more options.
I have the feeling, though, that wound care is the least of our problems. Both Joyce and me, I mean.