Health Care Failure and Redemption Part One

This is a personal account of a real situation that I found myself in with a loved one this past week.

My loved one was taken to a local small hospital due to having “episodes.” (later revealed to be small seizures), a CAT scan quickly revealed a profoundly serious condition, and she was transported 2 hours to a regional medical center affiliated with a very prestigious research University. MRI revealed the probable worst but there was more info to be gathered.

Transport occurred in the wee hours of Thursday and MRI Thursday morning leading to several CAT scans to find the origin of these events. I arrived in town late on Thursday after the scans were performed and met with my loved ones Friday morning prepared to have the hardest conversation we ever have with people we love.

To my relief this married couple of over 41 years had come a peace and resolve that can only be described as a miracle. My loved one said, “I am 85 and have had a beautiful life, I want to enjoy the rest as much as I can.”

Medicines were prescribed, that included steroids for inflammation 4 x daily (Decadron), and an anti-seizure medication. These medications were new to them and complicated already existing issues. Her glucose soared, as it often does with steroids, and short acting and then a combo of long and short acting insulin was started, and this was also a first for my person. HTN increased, also because of steroid, new BP medications were added.

I asked every provider over the span of the hospitalization to make sure Home Health was ordered for my loved one to ensure medication compliance, understanding and medication management. I was assured this would occur by every provider. I felt like a broken record and made sure I made my loved ones ask every provider in case I missed one.

This seems like and open and shut Medicare Home Health patient. I had already explored the best Home Health provider in the area via HH compare and colleagues I knew in the area. I started letting the providers know which Home Health we wanted to have so this should be a seamless situation.

My loved one stayed in the hospital for 6 days and received excellent, thoughtful, and even cheerful care from everyone they encountered.

After a very technical diagnostic procedure that required anesthesia, my loved one was released from the hospital last Thursday 5/15/25.

I had to leave to go home after the diagnostic procedure and was not present at DC, however my loved one’s spouse and a friend were present.

My loved one was never offered a Home Health referral by the discharging provider (yes one of the ones we had requested HH from during her stay) nor the case manager. My loved ones were so happy to get discharged that they also forgot to ask directly, AGAIN, for a Home Health order/referral.

I regret not being there at DC as this could have all been avoided.

But before I get into the full saga that ensued and the heroes that emerged, I need to ask you as Home Health providers doe the following look like a slam dunk HH referral??

  • Patient 85
  • Recent unexplained weight loss of over 30lbs
  • New diagnosis’ – likely metastatic brain cancer, lesion left upper lung (biopsied under anesthesia) suspected primary CA, steroid induced hyperglycemia DM II – all test results pending other than scans.
  • Long standing diagnosis’ DM II, cognitive change/decline (related to brain??), tremors, HTN.
  • 4 new medications, including likely insulin injections.
  • Requires assistance with all ADL’s and to leave home.

 

Trust me, I can see the opportunities I missed in making sure the referral to Home Health happened, but remember, I have been in this industry since 1998.  I am knowledgeable, and yet this still happened. This is not the entire story, the rest will make you think, make you angry and hopefully make you see what happens before the patient gets to you. It may also give insight into how you can advocate for all the patients under your care to ensure they get the care they both need and deserve.

Stay tuned for the rest of the story, but in the meantime:

What would you have done in this situation first?

 How would you advocate for your patient or loved one?

Where do you see missed opportunities?