Kathie Gagne died 4,582 days ago.

Re: Mom and Therapy
July 31st, 2012 @ 4:41 pm

My sister sent me this email:

Hi, David.

Sylvia 1 returned my phone call this afternoon. She said that it would be best to go ahead and send them a payment from Mom’s Social Security equivalent to her monthly amount minus the $[redacted] that will go into Mom’s Personal Trust (Mom’s “fun”money account, so to speak). She said that otherwise, once Mom’s Medicaid is approved, we wold have to cover that amount retroactively. Plus, it keeps Mom’s accounts less than the $[redacted] that Medicaid requires.

I just mailed a final check to Grace Manor to clear out Mom’s account with them. I will get a check to Woodland Terrace as soon as possible.

From what I understood of what Sylvia said, the parts of Medicaid that Mom was denied are the ones that don’t really apply to her anyway, such as the ones directed for people still living at home. She says that the type of Medicaid that is applied towards a nursing home is still in process, that Medicaid has all the paperwork, and that there is nothing left for us to do.

As for therapy, Sylvia said you would have to check with the nursing staff to see exactly what they are doing. Sylvia said that the physical therapists usually do a Restorative Plan for patients, and that the nurses should be doing range of motion exercises and things to keep her participating in activities, at the very least.

Hopefully, we should know by Wednesday 2 about Mom’s Social Security Disability. […]

1 Sylvia Gray, business office manager at Woodland Terrace
2 I assume she meant today, Wednesday, August 1, 2012. I’ll have to clarify that with her.

Reluctant to Give Out Information
July 31st, 2012 @ 3:16 pm

I called Woodland Terrace at six o’clock their time, as Dawn suggested a few hours ago, to get an update on my mom. A woman answered the phone and said, “Woodland Terrace. This is Marty. How may I help you?” I said that I was calling for Dawn in the West wing and she said she’d get her for me and put me on hold.

A few seconds later the line was answered by a man, who said, “West wing. This is Jason.” I said that I was calling to talk to Dawn and he said that she was either at lunch or in a room with a patient, but then said, “Hold on. Let me look her up.”

About a minute later Dawn answered the phone by saying, “Hello.”

I said, “Hi, Dawn. It’s David,” and she straight away said, “I haven’t seen anything new in her chart, except that the doctor ordered some bloodwork done for altered mental state.”

I asked, “Oh. Does it say anything about what kind of bloodwork or anything like that?” and she quickly rattled off a bunch of meaningless codes, like, “CBC, C7, ABG …” that didn’t make any sense to me at all. I interrupted her and said, “Okay, so just some standard stuff?” and she said, “Yes, it looks like.”

After a pause I said that my mom’s friend had been there to visit her over the weekend and told me that she seemed to be doing much better.

Dawn didn’t reply to that, so I prompted her by saying, “Have you noticed any change in her condition?”

Dawn said simply, “No. Not at all.”

I waited a few beats, but it was clear that Dawn was not going to elaborate, so I said, “Okay. Can you tell me anything?”

Dawn said, “No. No changes.”

I said, “Okay. I was wondering if I could get an updated list of her medications. Is that something you could give me?”

Dawn said, “I can’t do that now.” She said that she was very busy and mentioned something about other patients needing attention in some way. She said that she would ask “administration” to fax me a list of medications. Then she said that she was reluctant to give out any information over the phone. I told her that I understood, but that she’d talked to me before, and that I was, in fact, the only person to whom she should feel comfortable talking to about my mom. She just reiterated that she’s leave a message for “administration” to contact me.

I asked her if she thought that was something they’d be able to get to today and she said she didn’t know.

I asked Dawn if my mom was awake, and if not when did she think would be a good time for me to try to call to talk to her. She told me that mom was asleep now, that she knew that mom was up for “most of the afternoon” and that “they put her to bed just a little while ago.”

I said, “Okay. Thanks, Dawn,” and she said, “Sure thing,” and we both hung up.

I was so flummoxed by how little information she was giving me that I completely forgot to ask her about physical therapy, like I had told my sister I would earlier.

Mom and Therapy
July 31st, 2012 @ 12:59 pm

My sister just sent me this email:

[…] Do you know if they are doing any kind of therapy with Mom? As I was reading the blog entry about the Olympics and thinking about Mom in a wheelchair, I got concerned about whether or not they were doing ANY physical therapy with her. Even just range of motion stuff to keep her muscles from atrophying. From what I understand, PT and OT are not covered by Medicaid (I might be wrong), so it would need to be paid from her Social Security now before everything gets set up to where Woodland simply gets all of her Social Security to cover basic costs along with the Medicaid.

Has Sylvia 1 talked to you about making any payments? She has not called me back after I left her a message, and when I just called now, she was on another line. […]

I replied at 2:09 PM PDT with:

Nobody at Woodland Terrace has ever talked to me about any payments. I am pretty certain that they are doing physical therapy with mom, though; I seem to remember someone saying something about that. I’m much more concerned that — even after eight full months — she is not receiving any sort of psychological counseling or therapy, which is what she needs more than anything else, and we still have not managed to get her Medicaid application approved.

I’ll confirm when I call Nurse Dawn at 3:00 PM PDT today to get an update on what Dr. Peele said today.

1 Sylvia Gray, the Business Office Manager

Returned Admissions Forms
July 31st, 2012 @ 12:01 pm

This afternoon I signed and / or initialed and then faxed to Woodland Terrace the majority of the new documents which Rosa Rivera sent me yesterday. I included a cover letter, and then also emailed it to her:

Dear Ms. Rivera,

At approximately 3:00PM EDT I signed and / or initialed and returned the following sixteen (16) pages via fax to 386-740-8308:

  1. WOODLAND TERRACE CLOTHING POLICY (1 page)
  2. WOODLAND TERRACE AUDIO, VIDEO, AND PHOTOGRAPHIC RELEASE AUTHORIZATION FORM (1 page)
  3. SELF ADMINISTRATION OF MEDICATIONS (1 page)
  4. INFORMED CONSENT FOR PNEUMOCOCCAL VACCINE (declined) (1 page)
  5. CONSULTANT PERMISSION (1 page)
  6. WOODLAND TERRACE NOTICE OF PRIVACY PRACTICES (5 pages)
    • Please note on page three (3) item seven (7): I have specifically indicated that only myself, David Vincent Gagne, and my sister, [name redacted], are authorized to be disclosed information relating to my mother’s health and / or care
    • Please note on page three (3) item ten (10): My mother is not an organ or tissue donor and in the unlikely event of her death while at your facility, we (she and I) specifically refuse that her remains be used for organ or tissue donation.
  7. WOODLAND TERRACE PRIVACY ACT NOTIFICATION (1 page)
  8. WOODLAND TERRACE SMOKING RULES & REGULATIONS (1 page)
    • Please note that Kathleen Gagne is not a smoker.
  9. WOODLAND TERRACE Bed Hold Policy (1 page)
  10. Personal Items Responsibility Acknowledgement (1 page)
  11. RESIDENTS BILL OF RIGHTS GRIEVANCE PROCEDURES (1 page)
  12. Licensing and Regulatory (1 page)

Please note that I am currently not returning the following ten (10) pages until I have had further time to review them with an attorney:

  1. OBRA DIRECTED ACKNOWLEDGEMENT CERTIFICATE (1 page)
  2. WOODLAND TERRACE Authorization to Disclose Health Information (1 page)
  3. WOODLAND TERRACE ACKNOWLEDGEMENT OF RESTRAINT POLICY (1 page)
  4. WOODLAND TERRACE EXTENDED CARE CENTER PATIENT ADMISSION AGREEMENT (7 pages)

I will return these to you, signed and / or initialed as requested, as soon as possible. In the event that I or my attorney has any questions, I will contact you as soon as possible to clarify.

Please email me at [redacted] and / or call me at [redacted] to confirm receipt of this fax, which is comprised of eighteen (18) pages, including a two-page, signed cover letter.

Sincerely yours,

David Gagne

Calling for a Status Update
July 31st, 2012 @ 11:08 am

I called Woodland Terrace because I was told that Dr. Peele makes his rounds on Tuesdays and Thursdays and I wanted to (a) get an update on mom’s status and (b) confirm which medications she’s currently being prescribed.

Rachel answered the phone and was quite polite when I requested to speak to the nurse assigned to mom. She said, “I’ll page overhead,” and a few seconds later Nurse Crystal answered. I told her who I was and asked her if she was the nurse assigned to mom, and she said she was. I said I was calling because I wanted to know if Dr. Peele had seen my mother today and to find out what he said.

Nurse Crystal said that Dr. Peele had seen my mom today, but that he had only just recently left the building and she had not yet had time to review mom’s chart to see if he had made any notations or changes. I asked her if I could call back and she said I could, so I asked when would be good to do that. She said, “about an hour,” so I said, “Okay, I’ll call back in about an hour.”

Update: I called one hour and seven minutes later — at exactly 12:15 PM PDT and asked to speak to Nurse Crystal in the West wing. The receptionist transferred me to the West wing and a nurse answered the phone. I asked to speak to Crystal and she told me that Crystal had just left for the day, as she leaves as soon as her shift is over at 3:15 PM. I said that I had just talked to Nurse Crystal an hour earlier and she had asked me to call in an hour, and the woman said something like, “Oh, wait. She’s still here. Hold on.”

Then a few moments later she returned and said, “I’m sorry, but she’s gone.”

I said, “Okay, well can I talk to Nurse Dawn or Nurse Cheryl?”

The woman replied, “This is Dawn.”

I said that I was David and my mother was Kathie; I’ve talked to Dawn several times already. I explained that I had called to get a status update on my mother, and that Crystal had told me she hadn’t had time to look at Dr. Peele’s notes yet and had asked me to call back in an hour.

Dawn told me that she had just started her shift and hadn’t had time yet to look at any charts, and asked if I could call back. I said, “Yes, sure. Should I call in an hour? Two hours? You tell me, please.”

Dawn suggested I call after 6:00 PM EDT and I said, “Okay. I’ll call you back after six o’clock your time. Thank you, Dawn.”

Medicaid Application Status
July 31st, 2012 @ 8:16 am

I just sent this message to wtsocialterr@wterrace.com, which I believe is the email address of Shelly Sparace, the social worker at Woodland Terrace who has been working (primarily with my sister) on my mother’s application for Medicaid:

Dear Shelly,

I am writing to get information on the status of my mother’s application for Medicaid. Has any progress been made?

What are the next steps? Is there anything I need to do or can do at this point?

Thank you,

David Vincent Gagne

Fire Alarm
July 30th, 2012 @ 5:20 pm

I called Woodland Terrace on my way home from work tonight. I thought it was probably too late to talk to mom, but I might be able to at least talk to one of the nurses to get an update.

After about ten rings a woman answered the phone, “Woodland Terrace. May I help you?”

I said, “Yes, I’m calling for the West wing.”

She said, “This is the West wing,” so I said, “Oh. Great! Can I talk to Dawn? Nurse Dawn?”

She said, “Let me find her. Hold on,” and put me on hold.

After about twenty seconds she returned to the line. I could barely hear her because of some loud screeching in the background. She said, “I’m sorry, sir, but our fire alarm is going off so she’s going to have to call you back.”

I said, “Oooookay,” and assumed she was going to ask for my name and / or number — or at least ask who I was — but she just said, “Thanks,” and hung up.

Admission Pocket
July 30th, 2012 @ 7:15 am

At 7:15AM PDT I received another email from the copy machine at Woodland Terrace. It contained no subject line or message, but had a twenty-six page, 3MB file attached named doc04431020120730101424.pdf.

About five minutes later I received this email from Rosa Rivera with the subject line “Admission Pocket”:

Good morning David. I’ve resent the pages that need to be signed for our records. I’m sure you already have this from the original time everything was sent. Please review them and return as soon as possible with the required signature. You also have the pharmacy notification. This also needs to be signed. If you have any concerns as you explained during our previous conversation. You can speak with Susan Macklelfresh (our director of nurse) This is the only pharmacy that we use.
Thank you.

Rosa.

At about 3:20PM PDT I replied to Rosa with the following message:

Good afternoon, Rosa.

Please note that none of the twenty-six (26) pages included in the PDF you sent me this morning were included in the original forty-six (46) page PDF I received on July 16th, 2012 at 4:11 PM EDT. This is the first time I’ve been sent any of these forms.

Yes, I do have the “Financial Responsibility Agreement” from RxPerts Pharmacy in Tampa. I did not include that in the signed forms I faxed you on July 20th, 2012 at 12:11 PM EDT because I have no idea how that form should be completed, since I am not the one who will be financially responsible for paying for any prescriptions. I would think that is something which needs to be completed (or handled) by Sylvia Gray in the business office, or by Shelly Sparace, who is working on helping my mom acquire Medicaid.

I’ll review these twenty-six pages and sign and return via both fax and USPS as soon as I can.

Thanks,

David Vincent Gagne

Watching the Olympics
July 28th, 2012 @ 10:51 am

Mom’s friend from church called me on Saturday morning. She was visiting mom at Woodland Terrace and wanted to see if she could get mom to talk to me for a minute. She handed mom the phone and I could clearly hear her say, “David?”

We “talked” for about five minutes. It was mostly me asking, “Hello? Can you hear me? Are you there?” Aside from my name, the only other things she said which I could hear or understand were, “How are you?” which she asked as soon as she seemed to comprehend that it was me, and then a minute or so later, something about a “committee”, which made no sense to me. I told her that we were all trying to help her get better, and she mustered the strength to say, “Keep trying.”

That was about it. After that I had about a ten-minute conversation with her friend from church. She said that it “seemed like a really different day for your mom.” She said the nursing assistant Joy who was with mom in the morning was “shocked” because it was the first time she’d seen mom so animated.

When mom’s friend from church walked into the facility, she saw mom sitting in a wheelchair in the common room watching the Olympics with three or four other residents, and that she actually, “said a few words,” when she talked to her. For example, she said, she asked mom, “How are you doing?” and mom replied, “Not so hot,” which has been sort of a running joke between the two of them for the past few years. But her friend from church was very excited about the fact that she said something instead of simply making the high-pitched, whimpering cry that’s been her standard for weeks now.

She said mom was fidgeting with her wheelchair handle, but seemed almost serene compared to the state of overwhelming anxiety and agitation that has seemed to consume her for the last few months. She also said that she wanted to reassure me that the nurses there are quite good, and that without mom speaking they still do a very good job of knowing what she wants and how to “calm her down.” She said that when she got there she pulled up a chair and started watching the swimming events with mom and it was nice.

She said that she felt badly because she could tell that I couldn’t hear mom talking to me on the phone, because she was speaking so softly, but sitting right next to mom she could hear her saying words to me.

Apparently at one point that morning, Joy was startled when mom’s roommate coughed (or something) and mom asked her, “Is she going to be okay?” That was the first time Joy had heard mom talk in the two-plus weeks she’s been there.

We talked a little bit about the confusion of Thursday; she wasn’t really aware of what had happened, though she did say my uncle called her and said that they were taking mom to the hospital because she seemed extra agitated.

Pulling on things — anything — seems to be what she does constantly. Mom’s friend from church said that usually when she goes to visit her, she is in a wheelchair at the nurses station, pulling on anything she can find, like wires, cables, threads, etc. (Mom apparently pulled down the big curtain between her and her roommate in her room.)

She said she wanted to call me because just the idea that she could sit and calmly watch TV for a bit was “something positive”. I thanked her profusely.

She also said that I could call and talk to the nurses to see if they were doing anything differently lately which could have gotten mom to calm down a bit. She said that Joy was “johnny on the spot” and “if she soils herself, she takes care of her.” She also told me that she was going to visit tomorrow (Sunday) and would let me know if there was anything different to report.

Update: Mom’s friend from church didn’t call me on Sunday, so I am not sure if she visited and there was nothing interesting to report, or if she simply didn’t visit or what. I’m sure I’ll talk to her soon, though.
An Irate Family Member
July 27th, 2012 @ 8:02 am

I called Woodland Terrace this morning with the intent of talking to Sherri Spillman, the administrator, about what happened yesterday when my mom was “lost”. Rachel, who has been incredibly nice the last few times I’ve talked to her, told me that Sherri was at an “administrator meeting” in Daytona all day today.

I asked Rachel who was “the boss” when Sherri was out of the office, and she said that would be Susan Macklefresh, the Director of Nursing. I asked her if I could then speak to her. Rachel put me on hold. For about a minute I could hear what sounded like poltergeists gnashing at electrical cables and then the line was answered.

“Hello. This is Sylvia. May I help you?”

“Sylvia Gray?” I asked.

“Yes?” she replied.

I said, “Hi, Sylvia. It’s me, David Gagne. I was actually holding for Susan, the Director of Nursing.”

“Well, that’s strange. They paged me for the phone,” she told me.

I told Sylvia that I was actually calling for Sherri, but had been told that she was out of the office for the day. Then I asked her if she had heard about what happened with my mother yesterday. Sylvia said she had heard that something happened, but since she works in the business office she tries not to get involved with nursing matters. I said, “Sure, sure. I understand,” and then told her I actually felt a little awkward, because I was really calling to talk to Sherri about Susan. I said, “Either someone horribly, horribly lied to Susan — and she passed that incorrect information to me — or Susan herself lied to me for some reason.” Sylvia seemed fairly uninterested and asked me to hold on so she could get Susan for me.

After about thirty seconds on hold, Sylvia returned and said that unfortunately Susan could not speak to me right now because, “she has an irate family member in her office right now.” She asked if she could get my number and have Susan call me when she could.

I told Sylvia that everyone there should have my phone number ten ways to Sunday, but she insisted that it was easier if they “have it right in front of them,” so I just gave her my number again.

Update: It is now 2:30AM PDT on July 28 — about 18 hours later — and I have not heard anything from anyone at Woodland Terrace.
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