Long story short, we finally got aunt's Medicaid application pushed thru and thought we were getting a bit of a reprieve only to get a phone call Monday that they were taking her to the ER. She seemed out of it and her sugar levels were off the charts, so they thought she might have another UTI. They were more concerned about the sugar levels. She never had issues in the past (or at least none that we knew of) but they indicated it was way too high and they were going to keep her in ICU for a few days while waiting on test results. Fast forward to today, the Dr. called again (still waiting on the results) and tells us that she tried to get off the gurney when she arrived at the ER. She’s been sleeping a lot and not eating so they have her hooked to IVs. The Dr said hopefully they can check her out better tomorrow and go from there. He also indicated that they can’t keep her there and she would possibly be sent back to the NH sooner rather than later if they can get her regulated. My cousin and I are both freaking out because we are pretty much all the family she has left. We really do not want to be put in a position where we have to make tough decisions. Anyway, thanks for listening as this more of a vent than anything
I think you need some perspective...
Day 1 infection starts
Day 3 swings in sugars. Suspect, UTI? Doctor or PA orders a sample.
Day 4 sample picked up for the lab, then there is a 3 day wait
Day 7 results and antibiotic ordered. From here the order comes from a local pharmacy to be delivered to the NH. Do not expect drugs to sit in a NH pharmacy ready to go.
It looks like the interception and trip to the ER happened early in the process. Did aunt use Lantus or sliding scale insulin because if the med was not in her med cart, there would have been delays to order it.
Now sliding scale insulin orders are within a set of parameters. Give too much can cause life threatening low sugars. Her ordered dose was probably given at the maximum and sugars were still high, then she needed more care. The right call was made.
Diabetics are vulnerable to infections. You are looking at sugar swings which is a symptom of the UTI. Keep in mind that lab results take 3 days to ensure she is getting the targeting antibiotic.
I suspect she may have been going into septic shock or there was concern of it, which kills. Monitoring with insulin was probably needed in ICU and this kind of care was well beyond the NH
I don't really understand your relation to aunt, but it looks, if you got the medicaid work done that you may be POA? Or is the cousin the POA and the aunt her mother? If you fill out your profile we can get a better picture.
As Aunt is in hospital it is the POA for health care involved now if aunt is confused. And yes, decisions need to be made, especially as involves whether aunt is a full code blue or not, if she wants full resuscitation were she to die, or not. Intubation and ventilator or not.
If the diabetes is this out of control her management may be beyond your average nursing home and she may need to go into SNF (skilled nursing facility) for some time to try to stablize the sugars.
I am so sorry. You have been through a lot with aunt and sounds like more is still getting piled on the plate. Sure do wish you good luck and hope you'll update us.
Keep us posted on how your aunt is doing.
Try to relax and be less anxious. You can visit her with less physical activity,rather than care for her. Keep the visits positive.