moving into extended care

Today I pulled the trigger and put my brother on the extended care floor.  We had a "care" meeting today, I was surprised that only the social worker and physical and occupational therapists showed up. There were no medical people present.   They had no plan for his future.  I kind of put on my management hat and started telling them my goals for him was to get him open access on the floor to walk with a walker (they still have him in a wheelchair unnecessarily), out of diapers (at least during the day), and doing more activities.  I asked for consideration for anti-depressants and/or appetite enhancers (he is losing lots of weight), and told them he needed cataract surgery and asked them to coordinate with our case manager to make it happen.  I asked very nicely why they haven't shaved or bathed him but once. 

I told them I wasn't leaving until it was settled whether they had a public aid bed available for him, that I was going to take him out and save however many days for skilled nursing he still has from his insurance otherwise.  Wonder upon wonders, they have agreed to move him to a public aid bed tonight!  The only bad news was the report that he is still getting out of breath when he exercises.

The nurse supervisor wasn't there, so I talked to the floor nurse.  She had no idea he was supposed to be weighed daily because of his congestive heart failure, and no idea how much he weighed (she said she would have to go look it up in the computer.)  I mentioned that I had called and requested that they replace the battery in his hearing aid (which they hadn't done when I was there, this was 2 days after the request.)   I decided to put this all on hold because he is moving to a different floor with different staff, it would be a waste of time.

I am hoping that once he becomes a permanent resident, the second floor staff and he will get to know each other better and that the staff will understand his needs.  Barry said his main concern was that he will be ignored on the second floor.  Since he has hung out there a bit this last month, he may have a legitimate concern.  I am going to have to keep an eye on all this.  On the other hand, they have group dining, and daily activities that are all scheduled that didn't exist for the skilled nursing floor.  The activities director has been very helpful.  She is a young woman who majored in autism in school so she likes working with my brother.

My case manager is very supportive and thinks this is a wise move, given that he has been in and out of the hospital so much in the last two years and our last 2 experiences in nursing homes which were very bad.  By comparison, this place looks great!

I was pretty stressed out about making this decision, I am sad that his health has gotten this point, but I see no other alternative to keeping him alive and keeping my sanity, my health, and the emotional well being of my own family.