A Day in the LIfe - Rehab by the Numbers - Part twelve

Finishes.....!!

I pondered the differences between the two facilities.  The regimented ward operated for several patients as a hospice.  It was surprising how many people had dire illnesses.  Physio treatment allayed their mobility restrictions while they struggled to hold on to life’s spark. At least one person died while we were there.  For some the rehabilitation on offer merely opened a window of opportunity to go home before their condition worsened.   

This was no place for people with terminal illness – they needed hospice care or the comfort of their own home.  It suggested that existing facilities did not have the capacity to manage the numbers of people requiring intensive hospice care.  As the numbers of ageing people with chronic conditions are set to rise exponentially over future decades, it is glaringly obvious that public resources are inadequate.  Survivors of severe stroke and various devastating tumours, some of whom had lost the capacity to fend for themselves, were a discernible component of the ward population.  Several did not appear to have family support, either because of geographical displacement or other circumstance.  

These public facilities were fully occupied with continuous waiting lists.  It did not take much imagination to figure hospice facilities were similarly stretched.  ‘Future proofing’ did not appear on the horizon.  A rather dystopian outcome looms if the paradigm does not shift substantially to counter the coming tidal wave.  Hopefully, our citizenry will not only demand increased public health resources but cultural change to make the labyrinth better respond to individual need.

As with so many turns along the journey, we were pleasantly surprised when informed the consensus among the specialists was that Carolie need not go to RILU but could go home as soon as practicable.  Her physical recovery had accelerated and the required home modifications completed.  She had lost a lot of weight, had trouble eating and dealing with bouts of nausea.  The left side palsy left her weakened, lacking coordination and struggling for balance.  Her speech was affected and she had experienced a degree of cognitive damage that affected her overall capacity in areas like decision making, information and complex task management, and general motivation.  The degree of damage and her capacity to find new pathways was unknown.  It was daunting but our overall sense was elation at surviving a horrible ordeal.  

We knew the next phase would bring difficult challenges.  Little did we know at this stage how these would eventuate, involving more major surgery and the extraordinary arenas of orthotics, 3D imaging, cranial implant construction and cranioplasty.  Carolie’s outpatient experience for the next year or so was a complex rehabilitation regime, including physio, speech, occupational and vocational therapies.  We had both changed and our relationship had evolved, but then we all change and evolve all the time.