IPU or Inpatient Unit

Dad woke up Saturday morning with pain in his left foot. He thought he had a muscle cramp, and we tried to work it out, no success. The pain got worse throughout the day, and he was unable to stand on his foot. The pain kept increasing, and the nurse came out to see him and ordered Percoset for pain. This did not help and by Sunday night he was in even more pain, and it seemed to be spreading through his foot. The nurse thought it might be gout, something I was not really familiar with, but it made sense as she described the pain and symptoms.

Sunday night was very miserable and dad didn't sleep much at all. He groaned, moaned, and was in and out of sleep, trying to get out of bed as well. Mom rang the doorbell for me to come help her at 3:00. I walked in their room and there was mom with her back against dad's bed, trying to hold him in the bed. He had again tried to sit up, and couldn't, and was falling out of bed. I got him back in bed and slept in the chair next to his bed, hoping to keep this from happening again. Several times through the night he woke up and asked for me to take his hand, not to help him out of bed, but just to take his hand. He tried to sit up but fell back into his bed again, and would then let go of my hand and tell me that was all he wanted.

Monday morning his hospice nurse called me and told me they had a bed for him at the Inpatient Unit and would be able to manage his pain from there, and see what they could do to eliminate the problem. They sent out a stretcher to pick dad up, and off he went. He was quite nervous being in the stretcher, afraid they would drop him, but they were two big guys, both very capable of taking care of him.

Dad has been in the IPU now on his third day. They still believe he may have some gout in his foot and have been treating him with morphine for the pain. This has helped immensely. His foot is still red, tender, and slightly swollen, but they will be giving him steroids to try to bring the inflamation down.

Dad has not been able to swallow his pills and they have ordered some of them as liquid and the others they give him with pudding to get them down. That seems to be helping. He is having difficulty swallowing water as well, but they are taking good care of him.

The doctor said they will be able to make him comfortable with the pain, but will most likely not be able to get him back to where he was before the pain started. The doctor suggested we look at options other than taking him home. I was not too sure about that, and thankfully Laureen is here so we bounced some ideas around. We went to tour one patient care center and knew that was not the place for dad. I talked to the hospice social worker and she knows dad, mom and me well enough now that she thinks dad will be fine at home. The decision was made to bring dad back home not to a care center. We will be able to have some help during the week to give me a break, and will be able to let him be comfortable in his own home, bed, tv, and with mom.

This has been a challenging decision as I know how hard it is going to be, and there will be challenges. Sadly, the biggest challenge for me is going to be the bed pan. I am not sure if he will be able to stand up when he comes home, or if I will need to help him use a bed pan, but I am sure either way I can do it. He does have a permanent catheter now and that will make a huge difference in the trips to the commode, but I am afraid it might be bed pan time for part of the toileting experience.

Dad was very relieved when Laureen told him he was going to be coming home. We did not suggest there were any other options, but he had to wonder being taken to a place like that if he were going to get to come home. He has quite a bit of confusion, but seemed to understand going home. I know that is the right decision, at least for now, who knows what the future will bring.