Friday, October 21, 2011

Part 9 - Going to Rehab

Continued from Part 8 

When we got to the rehab hospital, we checked in and got Dad settled in the bed in his new room.  He was happy because his incision had finally healed enough for him to wear his reading glasses (the staples were close enough to his ear that there had been concern previously about the ear piece possibly dislodging them), and so he relaxed in the bed reading the newspaper while Mom and I unpacked.  

Dad, reading the paper in bed just after we got to Rehab
The Rehab Director came by and did an initial assessment, with the focus being on Dad’s cognition and safety awareness.  I reiterated that we were seeking a short-term stay of about a week so that Dad could get intensive therapies to get him started in his recovery.  He said that the therapists would all do their initial evaluations and then the team would report back to us regarding their recommendations.  With a rehab background, I felt like I understood the process and told him that we would like to have input into the plan and to get recommendations about equipment needs so that we could get the house set up as soon as possible.

Two more physicians came by that night after I'd left to drive the three hours back home; both spoke to my aunt, who was sitting with Dad while Mom went home to change clothes before she spent the night with Dad.  Dad immediately liked the neuropsychologist (I think it was because the guy looked like a runner.); they talked for awhile about the benefits of inpatient therapy and agreed to talk again in a couple of days.  The next doctor was a radiation oncologist who informed my dad that he would be getting the initial phase of radiation at the rehab hospital, after which he could be treated at a facility closer to my parents’ house.  My aunt told the doctor that she thought we had been in contact with another radiation oncologist and that he should come back at another time to speak with my mom.  Dad was somewhat confused about the whole conversation; he wasn't clear about the fact that he had been diagnosed with brain cancer, much less that he was supposed to get radiation in the near future.  

Around 5:30 a.m. the next morning, the nursing tech came into the room and announced that he was there to assist Dad in getting bathed and dressed for the day.  As usual, Dad hadn’t slept very well the night before, and so Mom asked if the shower could be delayed.  “Nope,” nursing tech said, “We have about 40 patients to get ready for the day, and we have to do it before shift change at 7 a.m.”  Hmmmm.  In that case, Mom told him, she would help Dad get ready a little later.  The tech presented her with Dad’s therapy schedule for the day before he went on to the next room.  

The therapy schedule board at the Rehab Hospital

Waiting for therapy to start

It looked like it was going to be a busy day, just the kind that Dad typically would have appreciated and the kind we were expecting as part of the short-term rehab stay.  The schedule said that Dad would get OT, PT, and Speech Therapy (to work on memory) back-to-back starting at 8 a.m. and then more therapy that afternoon.  Good plan, except the OT showed up 45 minutes late, which threw off the entire schedule.  In what became a pattern during Dad’s stay there, the therapists juggled things around to try to fit Dad in, and oftentimes Dad and the family member who was with him were not informed of the changes or the scheduled ended up not being able to be adjusted and some of his therapy got left out.  Dad did a lot of waiting, and, as par for a brain injury like his, he was having trouble dealing with schedule changes or uncertainty.  He asked many times what was next, but the answer didn't seem clear to anyone around.

Mom asked the OT about equipment recommendations during that first session, and the OT said we shouldn’t worry about that yet since she expected Dad to progress so quickly.  About mid-morning, my aunt came again to stay with Dad, and Mom went home for a wardrobe change.  During that time, the facility's radiation oncologist again paid Dad a visit; he told my aunt that he had been told he would be handling Dad’s radiation treatments at that facility.  My aunt told him that was incorrect, that we would be taking Dad to a specialist recommended by Dad's oncologist.  A few minutes after the first guy left, the rehab director came in and told my aunt that patients typically stayed in rehab there for a couple of weeks or more and that they would have a plan to present to the family in the next couple of days.  My aunt passed the info on to my mom and to me; I was uneasy about both of the communications because they were different from what I had heard when I was there just the day before.  In what became another unfortunate pattern in Dad's treatment, there were details to be ironed out with what was going on in this facility, and it was impossible for someone who was off-site to do any ironing.  

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