Friday, April 06, 2012


Thursday night Carl’s mother fell and broke two bones in her wrist.  She spent six and a half hours in the ER.  Friday morning we call the orthopedic surgeon the hospital recommended.  The person answering the phone said we could have an appointment.  In three days.  THREE DAYS!  

Now my mother-in-law is in pain with only a soft cast and we don’t know what to do, we don't know how to bath her, we know nothing about physical therapy, and if she falls on the soft cast, she may break the bone again.    
Something positive: the doctors at this hospital are able to access the hospital x-rays on their computers.  Half an hour later the receptionist called back and said, “Ouch,” and gave us an appointment for that afternoon.  The orthopedist reset her arm and created a hard cast in half an hour instead of the six and a half hours in the ER. 

I asked the nurse for referral to a service to help her get back in her home.  The orthopedic nurse claimed she’d never been asked for that before, but found three brochures.  The surgeon didn’t like any of these agencies and scribbled a note for one he liked, but neither he nor the agency told me how to access their services. Now it's Friday evening.

We took my mother-in-law back into our cramped guest room.  Her hand was turning blue.  The doctor had said it would swell and become blue, but how blue?  Should we worry?  And if so where do we take her?  It’s Friday night.  Do we go back for another 61/2 hours in the ER?  The possibility brought her to tears. We applied ice to the cast and the swelling went down a bit.

Saturday:  We spent the day trying to navigate the system. This is what we learned.
Check insurance coverage.  She has Medicare and AARP.  AARP said she had the “best policy” and would cover what Medicare didn’t but didn’t tell us how to get any medicare services.   
Find a doctor.  It’s Saturday.   Her private doctor was out of his office.  At three o'clock the wonderful doctor covering for him called back and said the magic words, “I’ll write a prescription for a service and if they don’t call within three hours, call me back.”  At six o'clock Saturday evening we had a service.

Sunday morning a nurse came to the house, ordered a physical therapist, and said she could go back to her own apartment.  Monday morning, we were there along with the housekeeper she loves, who offered to spend the night with her for the next week. 

Everything was perfect until the physical therapist arrived, took one look at her blue, swollen hand and said he couldn’t do anything.  She needed immediate medical care and we found ourselves in of health care hell once again.


Sunday, April 01, 2012

America.  The Best Healthcare?
Thursday night my elderly mother-in-law fell and broke her wrist.  She called 911 and the paramedics took her to one of the major hospitals in Los Angeles.  We were at the theater.
Fortunately a friend in her building happened by and saw her on the floor and called our house.  Fortunately, we had a houseguest staying in our guest room.  Fortunately the friend was home. Fortunately we saw the message at intermission and sped to the hospital. 

Otherwise, they might well have sent her home in a taxi, drugged, confused, and very unsteady on her feet, with no support at all.

When we arrived around 8:30, she had been there for two hours, confused and in pain.  They had x-rayed the arm, wrapped it in a soft cast, hung her fingers unwrapped in wire hangers to let the arm set and pumped her full of pain medication.  Six hours later, around 12:30 they took some more x-rays and said we could take her home with a prescription for pain pills she was to take every 6 hours and a referral to an orthopedist. 

I asked for a social worker or case manager so we could get home health services.  “Don’t have anything like that,” the nurse told me.  “No discharge planner?”

 “No.”(The hospital actually has a home health department with an emergency number.  We found that out two days later from their website.)

I asked the ER doctor, “What do we do with her?”
Her answer did not include “I’ll write you a prescription for a visiting nurse to evaluate her.”  Her answer was, “She’ll have to go home with one of you.”
(Note: they did not even give us one extra pain pill that she could take at 6am.  Instead, my husband had to drive from 1:30am to 2:15 in search of an all night pharmacy.  Fortunately I was at the house and could take care of her, while he was gone.)