Mr. Pacculli Is Going To Sit
Mr. Pacculli is going to sit and Mary is going to kill me. Mr. Pacculli is going to sit and Mary is going to kill me.
Mr. Pacculli was transferred from a local hospital to one of the nursing homes where I work. The hospital discharged Mr. Pacculli to the nursing home for short-term physical therapy. Mrs. Pacculli would like to take Mr. Pacculli home when he gets strong enough.
Mary is the nursing home’s Assistant Director of Nursing. Mary is in charge of preventing people like Mr. Pacculli from falling and reporting on it if they do. Mary gets pissed when someone falls. No one wants to get Mary pissed.
A little more about Mr. Pacculli: He went to the hospital because his knees gave out in church and was no longer able to stand. He was diagnosed with having a syncopal episode (he got dizzy). Mrs. Pacculli said that he has had several falls at home and the First Aid Squad has come to her home several times to get him off the floor.
Mr. Pacculli is in the throes of Alzheimer’s Disease. If you ask his name, he can’t answer; if you give him a simple task, he can’t even start it.
We did not pick up Mr. Pacculli on physical therapy because he was unable to participate with our therapists. I was called in to talk to Mrs. Pacculli about this.
“But the hospital said Henry was brought here for rehab,” Mrs. Pacculli told me. “Why would they do that if he wasn’t going to get therapy?”
We in the long-term care industry unkindly call a case like Mr. Pacculli’s a “dump.” Mr. Pacculli was dumped in a nursing home because the hospital discharge process doesn’t know what to do with him. “Send him to a nursing home. He can be their problem.”
“I don’t know the specifics of Mr. Pacculli’s situation, but I’ve seen things like this before,” I said. “They see someone like Mr. Pacculli who has severe cognitive issues; he’s very confused. And they see someone like you — and I’ll be as delicate as possible — who is seen as a little frail and a little old. Home is not the safest discharge plan.”
Mrs. Pacculli is old and is frail. She is in her mid-80s. This is her second marriage, his too. Her first husband died of cancer. Now this.
I continued, “The hospital has few options and fewer resources in cases like this. One option, and a very good one, is to send him to a nursing home to see if there is anything the professionals at the nursing home can do.”
I was being kind. I call what the hospital did here “Discharge Planning By Nursing Home Admission.” They knew full-well that Mr. Pacculli was not a therapy candidate. They knew that it was unsafe for him to go home with his wife. That she couldn’t take care of her. They dumped him in our nursing home. Sure, he’s safe but her head is spinning.
And then Mr. Pacculli stood up out of his wheelchair and started walking. I grabbed his hand and started walking with him, talking to him along the way. The way to where? No one knows. We were just walking.
I was thinking about how Mr. Pacculli got in the hospital: He just sat and no one could get him up. How far would he walk before he tried that stunt again? 50 feet? 100 feet? 200 feet? If he sat again, it is considered a fall and …
Mr. Pacculli is going to sit and Mary is going to kill me.
My co-workers and my friends laughed as I ushered the confused man down the hallway. No one came to my side to help as the pressure alarm on the wheelchair (set to alert the staff if he got out of his chair) sounded. They passed me and did nothing and admitted to laughing about it later.
Mr. Pacculli is going to sit and Mary is going to kill me.
It took a lot of verbal and physical gymnastics to finally get him to sit back down in his chair. I went for a walk with Mrs. Pacculli as she pushed her husband through the halls.
She understood why we didn’t pick him up on therapy. She doesn’t know what she’s going to do next. She said that there are nights where she cries herself to sleep worrying about him, worrying about her.
“Mrs. Pacculli, I’m going to give you the same advice I gave my grandmother when she was taking care of my grandfather who, like your husband, had Alzheimer’s Disease: There is going to be a time when you realize that caring for him is no longer safe for him nor you. No one can tell you when that time comes; it may already be here. A very real option is to admit him into a nursing home like this one. When that time comes, call me. I’ll help.”
I think Mr. Pacculli is going to live the rest of his life in our nursing home. When I left for the day, Mr. Pacculli’s doctor had certified that it was unsafe to take him home without 24-hour homecare. Mrs. Pacculli may not have to make that decision after all. It may have been made for her.
Regardless, it must be awful to be Mrs. Pacculli right now. I bet she cries herself to sleep tonight.
If you liked that, maybe you will like this:
- 6 Places I Have Worked, Part III
- God’s Work
- Cue the Wacka-Wacka Guitar
- Laminated Humanity
- The Big Three, The Cops, and Me
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