I took my brother out for breakfast yesterday, because I have mentioned, my car is in the shop and my husband needs the other car on Sundays so he can play basketball. As soon as I got to the nursing home, one of the more together patients, Carole, wheeled up to me and let me know that my brother's girlfriend, Veronica, had passed away. She knew because for some reason, Veronica's daughter was still visiting the nursing home even though her mother wasn't there. Carole didn't want to be the one to break the bad news, so she asked me to.
I told him at breakfast. There was a slight look of shock in his eyes. He said "my God" and that was about all. I couldn't tell if he was upset because he missed her, or because he was dealing with his own mortality. Maybe it was a bit of both. But I know my brother and know that he just doesn't connect emotionally in the same way other people do. The subject was changed and we talked about other things, I don't remember what. I tried to circle back to see if there was anything he wanted to get off his chest but there wasn't. I said something like she must have been pretty sick and he said, "yes, very sick and very crazy".
During breakfast he gagged on his food. He hasn't done this since he had his gallbladder taken out. He was gagging quite a bit for several years, and it took that long to discover that he had an infected gallbladder and that the stones had gotten stuck in a liver duct. But the gallbladder is gone, it shouldn't be happening anymore. I asked him was it his throat (he was hoarse again) or his stomach or his esophagus and he couldn't tell me. I asked him how often it happened and he said frequently, and when I asked how frequently, he said once a week. I know from experience this kind of information is just not reliable. I started looking at him a lot closer. I noticed he looked a bit swollen in the face and almost like he was getting jaundice, kind of a tanned look on his face. I also saw that he had a long gash on his arm. I asked him what that was from and he said he woke up with it. This has been another ongoing problem, he picks at his skin. Last year, I took him to a dermatologist and the doctor couldn't figure out what it was, she thought maybe it was neurological, that he felt something that wasn't there. The nursing home says it's not that unusual among their patients. It's one of the things that used to drive me crazy when he lived in assisted living because there was no one there to notice and patch him up, the cuts tend to get infected because he doesn't keep them clean.
When we got back to the nursing home, I talked to the nurse about it. She looked up his weight and it looks like he has gained about 3-4 lbs, not enough to start talking about removing water from him but getting there. She said the jaundice may be because he is getting swollen again. She said she would write into this chart that the nurses should keep a look on him for water retention and gagging. I mentioned that if he had to go to the ER, I wanted him to go to the hospital nearest to where I lived, not the hospital closest to the nursing home. She said she would write that in too.
Later on that night, about 9:30, I got a call from the nursing home. Of course I figured that something was going on with his heart, but they were calling to let me know about the gash, that it was bad enough that it sets off a reporting requirement where they have to let the relatives know. This has been an issue before, they have called in the middle of the night for these minor issues. I told the new nurse about the gagging problem and I didn't like her response. She said that the CNTs keep a good eye on it in the dining room. I told her that wasn't the issue, the issue was did a doctor need to look at him.
The whole situation does not give me a lot of confidence that the nursing home is going to catch an adverse condition in a timely way. I am a little aggravated that I am the one who has to keep an eye on all this. Plus, his insurance is going to run out this month, and then he will be soley on public aid until July when medicare kicks in.
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