A Fall, and a Lesson

A lady lives on my walking route along the pathway that winds through the neighborhood. She’s maybe ten years older and lives in a big, lovely house on a corner lot. I don’t know her name, but since I pass right by her home and she is often in the yard tending flowers, we are familiar with each other. After a recent trip to the coast where I shirked exercise and paid with stiff joints, I was hitting my stride as she popped up, greeting me from her porch couch as I ambled by. Slight of build and clad in brownish hues that camouflaged her presence amid the growth of potted flowering plants around her deck, I was a bit startled. She immediately gestured to her right leg. I noticed the knee length boot as she launched into her story.

“I fell in the bathtub,” she shared. My mind instantly flooded with questions that sorted themselves out as she provided details. Yes, she had a mat in the bathtub, although it was a mini version that didn’t cover the entire tub surface. The uncovered spot is where she stepped and slipped. No, she didn’t have handrails. The shower had a glass door. No, she didn’t have a phone handy nor a medical alert device in the bathroom. (And yes, you were naked, I thought.) Unable to put weight on the broken leg, she crawled out of the tub, out of the bathroom, and located her cell phone to call 911.

She spent 4 long weeks in a local hospital after a surgery where a rod and screws were placed in her right leg. At discharge, she spent days trying find a rehab facility, days where she wondered why she—with no experience making such decisions—was being asked by hospital staff where she “wanted to go” to rehab. The few facilities she mentioned, all of them well known brands, had no available beds…nothing! After finally being released from the hospital she landed in an older facility in a neighboring town. She described rooms large enough to accommodate four chairs, built-in beds and shelving, but staffing so minimal that she had problems getting a daily shower. With grave concern, she even told me of a patient across the hall who fell and had to lie there for an hour before staff arrived to offer assistance. The daily support services she receives now in her home are in fact far superior to what was provided in the rehab facility.

Though she has excellent insurance and had no problems with treatment and recovery when suffering a heart attack several years ago nor a broken ankle more recently, this experience was very different. She has been denied coverage by some providers and she was turned away by others because of a lack of personnel. The home health care provider she currently uses has just one full-time employee, a RN. Most of their services are provided by traveling nurses or contract employees. (These are the kinds of intimate details strangers share these days—neither of us knows the other’s name—when a casual acquaintance is the only available listening ear.) As the population ages and people live alone without family or community supports, this scenario will likely become a routine occurrence.