I'd file a complaint about the former group home that kicked him out AND this hospital with the Wisc DHS. They even have a form for that.
I would call his GI doctor AND this doctor demanding the release, AND the hospital patient advocate, AND the Director of Medicine/Chief Medical Officer and say:
"Hi. I understand you're insisting my husband be discharged to the group home today. I want to confirm I have that right - as follows:
- That he is SAFELY discharged there and does not require Skilled Nursing Support.
- And that you've prescribed all the correct medications and the protocol and his eating requirements
- And you say he does NOT require a feeding tube for survival and is capable of following the dietary requirements.
- And your name ...so I know who to sue when he has an immediate crisis or dies."
Then follow up with an EMAIL to them AND the hospital confirming the conversation word for word. Since you know their lying tricks by now.
What a disgrace. In what UNIVERSE would it be "difficult" for a HOSPITAL to "obtain transportation"??? Is that some secret code for "Medicaid won't pay for transit on a Sunday"? Is this some type of false deadline imposed by Medicaid rules? Like...after four days something about discharge has to take place and they're responsible to make it happen? I bet "the doctor" wasn't even a "real" doctor but a resident. Because it's the weekend. I never deal with residents.
/rant
I assume they've been feeding him successfully there? I guess they'll tell you WHAT foods/liquids.
HOW DID THE MAN LIVE AT THE GROUP HOME ALL THIS TIME NEEDING PUREE FOODS AND THEY DON'T EVEN OWN A BLENDER??? Hell, I only casually follow your thread but even I KNEW he's supposed to have been getting puree foods all this time. Or, at least you said "finely chopped". (which is taboo now, probably forever).You cannot "finely chop" foods enough by hand for his type of problems. Consistency is a challenge in these foods for these people. It's touch and go to avoid aspiration. If his esophagus is compromised, finely chopped isn't a thing. The materials will get stuck on the ulcers. If his esophagus is weakened, it won't pull the foods down into the GI effectively and they'll pool in there with mucus/saliva and acids. Sometimes if it's too thick, it'll be "stuck" when it hits the upper chest area.
(I don't exactly know from your older postings WHAT he has wrong with it until now...).
At least NOW you know why he was "vomiting" at the prior home who kicked him out. THEIR complete incompetence and malicious indifference. Including not even giving him the correct prescribed meds.
/rant
FEEDING:
I assume you have the esophageal dietary instructions from before? And he's on Liquid stage? The stage after clear liquids but before actual pureed real foods?
I assueme you're supposed to meet with the hospital dietitian about all this? He has malnutrition so his protein intake will be important along with calories. And carbs. And low FATS because of the ulcers (othewise, I love fats but not for GI compromised subjects)
You can use the multiple stage BABY FOOD at the puree food stage, too, also even as a snack.
Remember, nothing carbonated!
Not sure if he gets mucous-y with milk but you probably use low fat skim milk for his Carnation?
You also can ADD calories, carbs and other nutrients by using
clear Coconut Water instead of plain water. With Carbohydrates, potassium and naturally occurring electrolytes. Not to be confused with pure Coconut Milk or Coconut Creme, which probably have good calories and carbs but too much fat for his condition. I assume he needs a certain amount of water per day (and they probably want Thick-It in it) to avoid dehydration. Remember that being dehydrated affects his muscles and ability to ambulate. And of course his mental capabilities. So when the time comes to puree FOOD, they can add some coconut water to the food or even the Liquid Diet stuff like the Carnation. Instead of just plain water and say, sweet potato. 8 oz of Coconut Water is about 50 calories and 12 carbs. It would be great if he eventually could reach at least for now....100gr unrefined carbs per day (sweet potato and veggies or dairy) and 100 gr protein per day. They're advocating low carb/keto for cognitively impaired people now but he's not healthy enough for that, IMO.
For survival this would be just over 32 oz for a 150 lb human.
This amount does not allow for any activity that would increase water loss, the amount is thus considered unrealistic. This is at a ratio of 5:1 or 20% body weight in ounces of water. Note this is far less than the recommended intake of 10% of our body weight in ounces 5 times a day recommended as a daily minimum. It is the equivalent of only 40% of our ideal water intake.
Coconut Water has 60 cals per 11 oz and more natural sugar and electrolytes than plain water.
I assume they're going with the standard ones AND he should probably be using the LIQUID BOTTLES "ready to eat" not the powder to avoid caregiver ERRORS:
The
Muscle Milk I think, has the most protein in one bottle but will he tolerate that?
The Carnation High Protein Ready to Drink is less than half the protein but more carbs, which, IMO, he needs.
So you could alternate, too, I guess.
Remember he's not going to be able to wolf down large amounts - multiple small slow meals. ELEVATED head perpendicular to shoulders. And remaining raised for at least an hour or two after eating.
Carnation: 15 grams protein
https://smile.amazon.com/dp/B01IP48A...540050101&th=1
Muscle Milk: 40 grams protein
https://smile.amazon.com/Muscle-Milk...n%2Bshake&th=1
A goal in a "healthy" person would be say, minimum 1 gr of protein per lb of lean body mass and his lean body mass...who knows but let's just say 100 lbs because his weight is 140 lbs and he has malnutrition.
So a target working up to 100 gr protein or more may be right.
Direct Message me with your email address or if you have one already on Paypal, and I'd be happy to donate to his care. If you don't have a Paypal, you'll get an email with instructions. Also, I'd be happy to send you the Foods (if you give me your address for Amazon delivery)
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Monday, November 27, 2017
