Oh, boo hoo, jack is on a carb diet for his diabetes.
Also, all of that is high in starch and carbs, but hospital don’t have a healthy selection of food options since that cost too much money View attachment 4613542
Man, I wanna see the rest of that completed ticket.
Probable explanation: hospital diabetes care,
at most hospitals, is geared for safe institutional care of adult Type II diabetics. This is likely not "carb restricted" as such, but what's also known as a "consistent carbohydrate diet."
If it's restricted at all, or listed on the menu as "carb restricted," it means that they won't let you order infinite pancakes. Usually the selection menu will have carbohydrate numbers (sometimes exchanges or "carb choices") listed after each item, and a total at the bottom. You can circle as many "toast (15)" and "apple juice (15)" as you want, but if you go hog wild, Dietary will only send you items up to your carb level.
Inpatient diabetic diets are utterly wack for Type I diabetics or Type II diabetics who are conscientious and self-motivated and really do eat low carbohydrate diets at home. They're designed for standardized care of Type II diabetics on orals + sliding scale, or with routine basal/prandial insulin (and probably also sliding scale). If
every diabetic patient's meal is 45 grams of carbohydrate (and inpatient activity level is pretty standard) you've taken one variable out of their glucose management, and it's just a question of adjusting detemir/glargine and which step of the sliding scale for a particular patient.
There is also the psychosocial factor. If you offer Grandpa a moderate serving of hash browns, he'll grumble, but if you tell him "it's cauliflower rice time lol" he'll fucking riot.
If you are an insulin-dependent diabetic inpatient, ask the admitting prescriber for an order to keep your pump/self-direct your insulin doses. You'll probably get the order (the former almost certainly) if you're not being admitted for suicidality, altered mental status or DKA. Once things are calm, ask to have a hospital dietician come in (likely during business hours) and they can help you figure out what the hospital has that you can eat, and help get you the right diet order.
I don't know much about stroke rehab/end of life care, but what do a few weeks in a nursing home accomplish? Is it just about supervision/making sure he actually takes his meds, stays on a diet etc? They probably realize he's a very low-compliance patient.
Suspect he's going to a "skilled nursing facility" for rehab, and the reason is daily physical therapy/occupational therapy/possibly speech therapy if he's having aphasia.
Often the same facility has a long-term care wing/floor too. People say "nursing home" and mean both a rehab/SNF and a LTC interchangeably, but the care is different and the eligibility/reimbursement are
very different.
If an inpatient is not cooperating with PT, or refusing PT at all, Case Management calls them "not skillable;" i.e. insurance won't pay for post-inpatient rehab because it would really just be respite care for their family. They're not going to a SNF for the "skilled" part and would be wasting the insurance's money. Long-term care is a different, and less-covered, service.
I think the "few weeks" is bullshit. He is trying to conceal near complete permanent disability.
Jack's clearly been working with PT, and it's probably because inpatient PT are great at drill sergeant-ing couch potatoes and Jack is all about the path of least resistance. (Or they threatened to call Tammy on him, which works cartoonishly well with men his age and older.) Once he gets to the SNF, though, there will be care conferences where they talk about next steps, and planning to get Jack safely home.
If he starts slacking or runs out of SNF days before he can wipe himself, that's when they'll start talking about plans like long-term care, assisted living, or a home health aide coming in. This is where it gets expensive and poorly-covered, and Jack-and-Tammy will have to spend down their assets in paying for his care before he'll qualify for Medicaid LTC benefits. Or they can just take him home and pay for home health--or not, and say that Tammy will do everything. What actually occurs may be something else, but the SNF can't discharge him without a safe plan.
(He can go AMA from a SNF, though, if he's decisional and has a ride. I suspect he won't; anecdotally I have seen SNF AMAs happen in the context of family members with strong personality disorders, and/or the resident has a substance use problem.)
Imagine if Jack gets a black RN/CNA lol
"If." I hope he gets some
foreigners with
accents.
