Several times over the past year I have walked into my dad’s room at the nursing home and found him in dire straits. Some days it was that he was positioned poorly and leaning far over the side of his wheelchair, other times I would find him with food still left in his mouth from the previous meal.
On each of these occasions I would think to myself; what if I hadn’t come.? would anyone have found him and helped him to become more comfortable? One evening last week, I walked in to find that he had vomited or spit out what looked to be a glass of orange drink (a protein supplement they give him daily). Dad’s shirt and pants were soaking wet. I helped him out of his wet shirt and into a dry gown.
Yesterday afternoon I walked into his room and found him having difficulty breathing. His throat and mouth were full of secretions. He was skin was clammy and he was in obvious distress. My efforts to find a nurse were unsuccessful so I rushed back to his room and put his call light on. Though a nursing assistant answered the light quickly it took a full 10 minutes before a licensed nurse arrived in the room. A quick assessment showed that the oxygen level in dad’s blood was 81. Optimal levels are 97-100. He was started on oxygen and after about 20 minutes was able to clear his throat and mouth. He was finally breathing easier and the gurgling sound was no longer present when he breathed in and out.
Again, I asked myself, what would have happened if I hadn’t come. Would he have suffocated to death? I can’t bear the idea of it. This morning I began to contemplate the idea of placing a nanny camera in his room. I would love to be able to log onto my computer and see into dad’s room any time of day or night to insure that he is comfortable. I do not know the legalities around this idea. I would imagine that I would need permission from the nursing home to do such a thing. Staff likely have a presumed right to privacy which a nanny cam would clearly violate. I think that it is definitely worth investigating because my dad has a presumed right not to suffocate to death despite being surrounded by health care professional right outside his door.
A chest x-ray revealed signs of aspiration. By evening he was running a temp and they had started him on an antibiotic. As of today he is still needing oxygen to maintain a healthy blood oxygenation. Here we go again. Today I brought up the topic of a hospice consult. I believe given his change in status that he would meet the criteria for hospice. Hospice would provide additional services to him right at the nursing home. Hospice nursing assistants would visit weekly and offer an extra bath and badly needed TLC. The hospice nurse would work with the nursing homes nurse to insure that all of dad’s needs were being met. Of greatest assurance to me would be the knowledge that extra sets of eyes would be on dad during times when myself and my siblings can’t be there.
So tomorrow I will make the call and ask for a doctor’s order to begin the process. We are planning to celebrate dad’s 89th birthday at my house on Saturday. I am praying that he will be feeling well enough to come to the BBQ and drink a beer (nectar thick of course but still full flavored.)