Wednesday, November 10
Day 10 / Meeting with case manager, therapists,etc.
Yesterday, Rich & Kate met with a whole slew of people who are on Matt's 'team'. Basically, it's still a waiting game with Matt as no one can predict what progress he will make or how fast it will go. They did clear up one question we had as we kept getting conflicting answers on whether or not he was considered to be still in a coma. They explained that they use the Rancho Scale that goes from 1-8, not a 'coma scale'. From what I understood, it's based on his ability to respond/progress. Right now, he's 'hovering', I think they said, between a 1 and a 2. Their goal for rehab, they explained, is to move Matt up the scale - and, of course, they can't predict what he will be able to do. They're hoping in the next 3 weeks to make progress as whether or not he is able to stay at NIACH depends on his progress. (I was on speakerphone & everybody was talking at once - hah!). I believe the protocol is that the case manager, Sherri (sp?) monitors his progress and by the end of November will send in a form to ...who, didn't get that part...Medicaid possibly...or Social Security...with his current status/progress; kind of like re-applying for Matt to stay at NIACH. Apparently, the amount of time granted can vary. We're hoping that, one, he makes some progress in the next 3 weeks, and, two, if the case manager feels that Matt needs to stay at NIACH, that he is able to stay there & continue to receive rehab & a high level of care. So, to reiterate, we don't know how long he'll stay where he is; it depends on what kind of progress he makes, when and where he will go next depends on many factors.
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One of my jobs is to provide Guardianship Services in Indiana. We are Guardian for a gentleman who was in a serious car accident and is in a similar situation. Sounds like Matt must be in a more acute rehab type facility. Which means as long as he makes good progress, they can keep him. If his progress slows or flat lines, he will probably be transferred to a long term care facility (nursing home). He will continue to receive therapy in the long term care facility but it just means that it will take much longer for recovery. It is my understanding that the progress made in the first three months is the most critical, after that, it is much harder to continue to make progress.
I would suggest to Kate and family to start researching long term care facilities in the area. Find several that are known for dealing with his type of injuries and giving that type of therapy. Visit them unexpectedly to get the full feel of the facility. It could be difficult to find one that has other people his age as well.
Hopefully, a long term care facility won't be needed. However, in my experience, once a hospital decides they can no longer help and are ready to discharge, they will issue a blanket form to all the nearby facilities. Once a facility says they will accept him, they will only give you 24 hours or less to find something else or they will discharge him to the facility that will take him. You have to act fast in order to get a lot of input in the situation. (I've been through this three times now with my Mother In Law!). So, in short, it would be good to at least know which facilities you would like to try to get him into instead of going into the process blind should it become an issue.
So glad to see that he is making progress!
Elizabeth (Shaver) Ruh
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