Questions of a stroke??

[john m]

My wife's father (in his late 60's)had a series of strokes 3 weeks ago.
he lost his ability to swallow,and most of his speaking ability.
he has a feeding tube (stomach).He can however say sentences we can understand. His mind seems totally there,but he just seems so frustated he can't express himself.he can write real well,shave himself(electric shaver),and move all limbs on comand.
The hospital where he's at is very un-cooperative in doing any type of therapy (speech, swallowing)saying they can't do no more,and has to go to a nursing home. The questions I have are:

Is there a possibility he can regain his swallowing?? He can stick his tongue way out,and sideways,and should therapy at least be tried?

we are having a hard time finding a nursing home to take him because they are so full,(the good ones,that work with therapy),and the hospital(small town)says it is completely up to the family to find a place, not their's.is this true? or do hospitals share in this responsibility??

Medicare will not pay any longer at the hospital,because they signed him off,but we can't find ANY nursing home at the moment (5 days now),so he's stuck in this small hospital and there telling us we have to pay for the remaining hospital stay till a room opens at a home. is this true?

Thank you.

[CCF-Neuro-M.D.-JT]

Sorry to hear about your father's recent stroke. Although I do not know the specifics of your insurance coverage and your hospital's policy, I can tell you what we do here at the clinic. When someone has a swallowing problem, we have speech therapy come and assess them as to what is appropriate for them to eat. Then speech therapy works with them on both their speech and swallowing. Swallowing in itself can be a problem but with time does get better in many cases. Some studies report success with a trial of sinemet a parkinson's drug in patients with swallowing porblems due to certain types of strokes. Your father in law sounds like he would definitely be a great candidate for speech therapy.

As for placement issues, we have case managers who help family members with making sure a patient goes to the right place such as acute rehab, subacute rehab, home with physical/speech therapy or a nursing home. If your hospital does not have this, perhaps a social worker can help you. There has to be someone at the hospital who can help you, some patient-hospital liaison, because even if they say it's your responsibility they should  give you some guidance. Finally, talk to the doctor who's taking care of him or your own family doc who should know the system. Your father-in-law does need speech therapy at the very least. Is it possible for him to stay with a family member and get outpatient speech therapy? Or get it at home? Sometimes, hospitals will do this on an outpatient basis if the doc gives them a prescription for it. Again talk to your docs, and try to find a social worker. Good luck

[debra21784]

Let me give you the name of an organization that can help.Catastrophic Health Planners,Inc.They are a non profit that can assist with case management services anywhere in the country.Number is 410-861-8969.Call during normal business hours EST.There is no charge for thier services.They have the resources you need.They helped me find the care I needed after my stroke.They do have a web site.I think it is CHP1.com
Good luck ,give them a call

[john m]

Thanks Debra!