Doctors Appointments

Debbie21

I have been caring for my husband at home for several years and we have been managing to get by. Recently, I noticed it has become increasingly difficult for him to go up and down stairs and for the past several days, I haven’t been able to get him to walk more than a few steps from bed to chair.. My husband sees several doctors…primary care, a urologist, a cardiologist, a podiatrist , a neurologist and a dentist. Looking at our calendar, I am beginning to panic about getting him to all of his doctors appointments. He is in a second floor bedroom and we have several steps out the front door so a ramp won’t work. Although these doctors are just monitoring him, the urologist scans his bladder, the cardiologist runs an EKG and his primary car doctor does blood work so a Zoom call won’t work…and they won’t renew his prescriptions if they don’t see him. Any suggestions for handling this?

Bob in LW

My suggestion is to discuss your situation with each of his doctors and see what they can do.  I know that the technology exists to perform the routine exams remotely, but whether your health care providers offer that is another matter.  Also, is there a first-floor room in your home that could be converted to a bedroom for him?  If so, then you would only need to deal with the front steps.

ImMaggieMae

Debbie, welcome to the forum. I’m glad you found us, but sorry you are dealing with this awful disease. In addition to what Bob said, in many areas there are visiting nurses agencies that can send a RN to your home to do blood draws and possibly simple scans. If he is on Medicare, the tests are paid for by them, they just need a doctor’s order. I would check listings for visiting nurses agencies in your area and ask them what types of services they can provide.

I hope to see more of you here. I also care for my husband at home and this forum is a great source of information and support. It seems like no matter what’s going on, somebody here has gone through it.

Ed1937

Hi Debbie, and welcome. Sorry you have a need for a site like this. 

Debbie21 wrote:

He is in a second floor bedroom and we have several steps out the front door so a ramp won’t work. 

Did someone tell you that a ramp would not work? Ramps can be made for many different situations, and it might be worth calling a handyman to see if they can do anything.

You mention that the urologist scans his bladder. Has he had a problem with recurring UTIs? If not, maybe that's something you can skip. I would get in contact with the doctors to see if they can do their testing at less frequent times. Explain the situation, and they might work with you on that.

Sorry, I got called away after I began my reply, and didn't see the above posts. The visiting nurse is an excellent possible option.

Debbie21

Thanks for the suggestion. Unfortunately we live in a relatively small townhouse. Without knowing how long this is going to last, I am reluctant to put a hospital bed in our living room unless I have to. Other issue is that there is only a half bathroom downstairs and I can still get him in the shower…both of which are upstairs…..not a very good house for us!

MaryG123

You could also ask his primary care doc if they could manage all his meds, with maybe an annual visit to the specialist.

dayn2nite2

Down the road, you'll want to move him to the main floor just to make things easier for you, especially when it's time for a wheelchair.

I vote for using his primary to handle everything.  What are we scanning the bladder for?  If he had cancer, would you even treat it?  As far as his cardiologist, frankly if he has a heart attack or stroke that takes him, wouldn't that be preferable to him going to the bitter end with dementia?

See if the PCP will do yearly visits or even every-6-month visits in person along with blood work.  The rest of it can go by the wayside.  Eventually (generally when he stops walking) he'll qualify for hospice and all medical care will occur in the home anyway.

You'll want to make sure he is moved before he loses the ability to walk - you will not be able to carry him down the stairs.  Pick out a place now where a hospital bed might go, either in a den area or if it has to be in the middle of the living room, so be it.

M1

Hi Debbie. Although it’s hard sometimes to change providers, there are practices that will make house calls. You may want to investigate that as well.

Debbie21

Thanks for all of the suggestions regarding the management of doctors appointments. I agree, there are no easy answers. We live in a small townhouse and the bedrooms and the showers are upstairs. I could put a hospital bed in my living room but then my living room becomes a bedroom and bathroom for what may be a long time and we wouldn’t have access to a shower. More importantly, we are still sleeping in the same bed and my husband finds comfort in having me next to him. If he is in a hospital bed downstairs, I would be sleeping upstairs.

I agree with the suggestions about his doctors. I think I have to talk to find one physician….I am guessing his primary care provider or his neurologist to truly manage his care. We also have make decisions about what is necessary. I recently got his sleep doctor to agree we could toss the CPAP machine. If he is not having symptoms, maybe he doesn’t need his bladder scanned and if we are not going to treat arrhythmias, maybe we don’t need ekgs. I am hoping to find a podiatrist who makes house calls Wish me luck! I will also see if the visiting nurses can help

jmlarue

You might look into installing a stair lift (a chair that rides on a rail upstairs and down). I was told the average price is around $6,000 for a straight stairway to a second floor. I chose not to pursue it because we did have a bedroom and bath on the main floor. You have no such option. Perhaps the provider of these things can give you tips on grants or gifts to help people with extreme mobility issues. Just another option to consider.

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Jo C.

Hello Debbie, and a very warm welcome to you.   I am sorry to hear of your husband's recent onset of weakness.  I wonder if there is a problem with his meds or if he may have one of those "silent" UTIs, or perhaps even electrolytes that are off.

In any case, needing for him to be upstairs where you have room for him to sleep with you and able to shower seems to be what works best for you.

However, getting him downstairs and out the door is becoming more difficult to manage.  If you can have him stand and pivot transfer, the possiblity of a stair chair lift is one option. The seats when not running can be unlocked and turned to a safe position solidly on a landing and seats also have safety belts.  We actually had to put one in and I was surprised at how well it helped.  BUT:  If you are considering this, be sure to buy an adquate one with a good reputation. The two that seem to be the stars are either the Bruno or the Stannah; the one most advertised on TV is not the best quality buy and the warrantee not as good. We looked at both the good brands and got the Stannah.  It also came from a company that has its own tech employees and all the parts, etc. in their warehouse.  This lift also had a very nice unobtrusive rail for the chair.  It will run for multiple lifts if the power goes out. I would have been satisfied with the Bruno, it gets excellent ratings.

These lifts are pricey especially if new, but some suppliers will sell used ones at less cost.  Some places will let a person rent them - nice if someone has a leg injury or is post surgery.  If you have straight stairs cost is less; if you have turns in your stairwell, cost is higher because the rail needs to be custom made. We have straight stairs - about 14 of them and they rise mightily.  I think we paid about $5,000 for a new one but it became worth every penny.

As for the outside stairs being only two or three - there are indeed wheelchair ramps for that number of stairs.  If you use Google you can ask the question and they have examples of pre-made as well as instructions of ramp needs for having one made.  So you should be good to go with that too.

As for physicians, if there is not a significant acute necessity, perhaps your husband's primary care doctor can manage some of the oversight and simpler things such as EKGs and labs. If a problem arises that he/she cannot manage, then a referral to a specialist for advice can be made. In the meantime, if some meds are not truly necessary, you can have those reviewed .  Visiting Home Health can provide blood draws and there are practices with physicians make housecalls and accept Medicare and other insurances if you reach the point at which that serves best.

You are being a wonderful advocate on behalf of your husband and are doing a good job managing and providing his care.  I so hope there is also some time for you to get yourself some rest too.  I know; easier said than done. 

We are so gald you have found this place.  We are all here in support of one another, and now that includes you too!  Let us now how you are and how things are going; we will be thinking of you.

J.