Care Picture · Family Working Copy

Where the patient stands, where she's trending, and what to manage next

Built from the full skilled-nursing portal export — labs, clinical notes, vitals, the echocardiogram, and the active medication list. It pulls the scattered numbers into one place so we can see the direction of travel and act on it together.

Snapshot assembled May 29, 2026 · Day ~35 of subacute rehab · identifiers removed

Then vs. now

Where the worry was when she was ~2 weeks in (early–mid May, fresh off the hospital transfer) versus where the latest data puts her.

System
~2 weeks in (early May)
Now (late May)
Heart rhythm
Abnormal ECG, QTc dangerously long (521), possible ischemia, fast resting heart rate
Repeat ECG normalized — QTc 385, heart rate down to 70s improved
Kidneys
Function dropped sharply (eGFR 40, creatinine 1.40) on the May 7 draw
Recovered on follow-up; was 81 / 0.78 baseline resolved
Skin / wounds
Two stage-3 pressure wounds (right buttock, left thigh) being tracked
Both documented healed/closed; skin intact healed
Mobility
Came in after a fall at home; needed full assistance
Walks ~10 ft with a walker, supervised; "high motivation, doing well in PT" progressing
Heart failure strain
Heart-strain marker (NT-proBNP) ~2,400 on May 1
Climbed to ~3,440 by May 13 — volume/strain rising watch
Blood count (hemoglobin)
8.4 at admission, briefly up to 9.6
Dipped to 8.27 (May 13), back to ~9.1 — bouncing in anemia range, never normal unresolved
Blood sugar
Wide swings 51–340; insulin being re-tuned; a hypoglycemia low of 51
Still swinging (178–340 most days); A1c eased 8.3→7.8 unstable
Mood
Mild depression screen; adjusting to placement
PHQ-9 now 12 (moderate); tearful about going home, fear of falling; new adjustment-disorder note worse
Breathing
Oxygen-dependent at 4L, stable; inhalers escalated
Still 4L oxygen, sats 92–99%; no acute distress stable, dependent

What's genuinely better

  • Heart tracing (ECG) normalized — the prolonged-QT red flag from April is gone.
  • The acute kidney dip recovered fully.
  • Both pressure wounds healed and closed.
  • Walking again with a walker; strong rehab motivation.
  • A1c (3-month sugar average) edged down from 8.3% to 7.8%.

What to keep eyes on

  • Heart-failure strain rising — the root cause is severe rheumatic mitral-valve narrowing + severe lung-artery pressure. Cardiology follow-up June 11 is the pivotal appointment.
  • Persistent anemia — hemoglobin keeps dipping; iron-deficiency is on her problem list but the workup/treatment loop isn't closed.
  • Mood worsening with no psychiatrist — she's been managed by PCP only; that vacancy is the active care-transition task.
  • Blood-sugar swings including dangerous lows (51).
  • Weight is fluid-sensitive — a dietitian flagged a +5% jump; in heart failure that can mean fluid, not fat.

How she's responding to the medications

Working / responding

  • Lidocaine patch for knees — she reported pain "much better" on the patch regimen (May 26).
  • Heart-rate medication (ivabradine) — resting heart rate down to the 70s; dose was increased and rhythm tracing improved.
  • Antidepressant (citalopram) — "good efficacy for many years" per her own history; she was well before the fall.
  • Sleep (trazodone) — sleeping well, insomnia well-controlled per psych note.

Not doing enough yet

  • Knee gel (Voltaren) + acetaminophen — repeatedly "not doing much"; tramadol added May 28 as a step up (a narcotic — watch constipation + the new naloxone rescue order alongside it).
  • Insulin regimen — re-tuned several times; still big swings and at least one hypoglycemia low. Not yet dialed in.
  • Diuretics (furosemide + spironolactone) — heart-strain marker still climbing, so fluid control may need revisiting.
  • Antidepressant dose question — 40 mg is above the recommended max for age >60 (20 mg); held there because she's still depressed and her QT is now normal, but it's flagged for review.
This page reorganizes what's already in her record so the family can see it clearly and ask better questions. It is not a medical opinion and nothing here changes a medication or a plan — those decisions belong to her clinicians. Where a number is the portal's "test name not provided," the label is an informed inference and is noted as such in the source files.

Looking forward — two paths to the same checkpoint

Same horizon (next ~13 weeks, to the care plan's mid-August review). The toggle compares staying exactly on today's regimen against making the corrections on the next tab. Both lines land us at the same date — the question is which numbers we arrive with.

Hemoglobin — projected
Will the anemia keep dipping, or climb toward normal with iron treatment?
Heart-failure strain — projected
Does the strain marker keep rising, or stabilize with fluid + valve management?
Weight — projected
Creeping fluid gain vs. steady, intentional loss toward the 175 benchmark — the food & weight plan is the lever.
A1c (blood sugar) — projected
Drifting up on facility-choice meals (the morning juice, etc.) vs. back toward <7% on a controlled-carb diet — as it did before.
Mood (PHQ-9) — projected
Stuck/worsening without a psychiatrist vs. easing with psych care + home support.
These forward lines are illustrative scenarios, not predictions. They were drawn by extending her observed trajectory and applying the typical, well-documented direction of response to each listed intervention (treating iron deficiency raises hemoglobin; optimizing fluid lowers the strain marker; psychiatric care lowers PHQ-9). Real numbers depend on her clinicians, her valve disease, and her response. Use them to frame conversations and to show why the corrections matter — not as a promise of any specific value.

Corrections to push for

Concrete, evidence-informed things to raise — in priority order — with the facility, the PCP, cardiology (June 11), and a future psychiatrist. Each is framed as a question/ask for her clinicians, with the reasoning so the family can advocate from the same page. None of this is a self-directed change.

1Close the anemia loop — iron studies and treatHemoglobin keeps dipping (low of 8.27) and "iron-deficiency anemia" is already on her problem list, but treatment hasn't visibly closed the gap.
Ask
Have iron studies (ferritin, transferrin saturation) been done, and is she on iron repletion? Given she's on daily aspirin and has GI risk, is occult-blood / GI loss ruled out?
Why it matters
Anemia worsens heart-failure symptoms, fatigue, and recovery capacity — it compounds nearly everything else on this list. This is the question Joe specifically couldn't get answered.
PCPFacility nursingLabs: ferritin, TSAT, retic, occult blood
2Treat the rising heart-failure strain as fluid until proven otherwiseThe strain marker climbed 2,400 → 3,440 in 12 days and weight is fluid-sensitive, on a background of severe mitral stenosis + severe pulmonary hypertension.
Ask
Should the diuretic dose be revisited? Are daily standing weights and a sodium/fluid target in place? And the bigger one for June 11 cardiology: is she a candidate for any mitral-valve intervention, or is this purely medical management now?
Why it matters
The narrowed, calcified mitral valve is the engine driving the lung-artery pressure and right-heart strain. Medication manages symptoms; the valve question is what changes the trajectory. This is the single most important appointment on the calendar.
Cardiology — June 11PCPDaily weights
3Fill the psychiatry vacancy before dischargePHQ-9 rose 8 → 12 (moderate), a new adjustment-disorder diagnosis, tearful about going home — and psych meds are still run by the PCP alone.
Ask
Lock in a psychiatrist (the active care-transition shortlist) so someone owns the antidepressant decisions — including the citalopram 40 mg dose, which exceeds the age->60 recommended 20 mg max (held high only because she's still depressed and her QT is now normal). Offer therapy with a female provider; she's been resistant, so framing matters.
Why it matters
"Building a care plan she trusts is part of the discharge plan, not a follow-up." Going home alone while depressed and afraid of falling is the relapse setup we're trying to avoid.
Psychiatry — vacantCMHA-CEI intakeTherapy (female provider)
4Get a written therapeutic diet order — don't leave food to resident choiceShe's self-selecting high-sugar / high-sodium items (the morning orange juice is the clearest example). With her diabetes, heart failure, and kidney disease, those picks directly drive the glucose swings, the fluid, and the weight.
Ask
Ask the facility dietitian and physician for a written consistent-carbohydrate + ~2 g sodium therapeutic diet order, with sugar-sweetened drinks (juice, soda, sweet tea) off the routine tray — keeping orange juice only where it belongs, as the hypoglycemia rescue already in her MAR ("if blood sugar < 68, give OJ"). A physician diet order overrides the open resident menu.
Why it matters
The low-carb approach is exactly what gave her the 105-lb loss and her best-ever A1c (7.6%). The facility's pick-your-own menu quietly works against the one strategy we know succeeds for her. Full plan on the Food & weight plan tab.
Facility dietitianPhysician diet orderNo sugary drinks
5Tighten the insulin regimen — fewer swings, no lowsGlucose still ranges 51–340 with at least one hypoglycemia low of 51; the sliding scale has been re-tuned repeatedly without landing.
Ask
Can the basal/sliding-scale balance be reassessed to cut both the highs and the dangerous lows? Is continuous glucose monitoring an option to catch the overnight swings?
Why it matters
Hypoglycemia at 51 is immediately dangerous, especially in someone elderly with heart disease; the highs damage kidneys and healing over time. A1c is moving the right way (7.8%) — the variability is the unfinished problem.
EndocrinologyPCPConsider CGM
6Repair the nutrition gaps — vitamin D and protein/albuminVitamin D is low (17.6) and albumin is low (2.9). Both quietly slow wound healing, mood, and strength.
Ask
Is she on vitamin D repletion? Is the protein/nutrition supplementation enough given the low albumin and the food-insecurity note she raised? (She also wants to lose weight — the goal is better nutrition, not just less food.)
Why it matters
Low albumin and vitamin D are upstream of several other problems (anemia, healing, mood, falls). Cheap to fix, broad payoff.
DietitianPCPVitamin D, protein
7Keep the QT and the bowel regimen ahead of the new narcoticTramadol was just added (May 28) with a naloxone rescue order. It worsens constipation and, with citalopram + trazodone, adds QT and serotonin considerations.
Ask
Confirm the bowel regimen (docusate, PEG, lactulose) is dosed to stay ahead of the opioid — her last KUB already showed a moderate stool burden. And confirm no further QT-prolonging meds are stacked without a repeat ECG.
Why it matters
Three of these interactions are avoidable with attention. The naloxone order signals the team is appropriately cautious — the family should be too.
Facility nursingPharmacy reviewRepeat ECG if meds change
8Make discharge home actually safeShe came in from a fall, is oxygen-dependent at 4L, and walks only ~10 ft with a walker. Home is a ground-floor apartment.
Ask
Confirm home oxygen + equipment (DME) are arranged, continued PT/home health is ordered, fall-prevention is set up, and the medication schedule (next tab) is reconciled against the real discharge instructions and the pharmacy. Don't let discharge be scheduled before first appointments with the new PCP and psychiatrist are on the calendar.
Why it matters
The fall is what started all of this. Going home without O2, support, and a med system in place risks a repeat admission.
Discharge plannerHome health / DMEPT continuation

Food & weight plan

Diet is not a side issue for her — it sits at the center of the diabetes, the heart failure, and the weight, all at once. The good news, from her own history: we already know what works. The problem right now: at the facility she chooses her own meals, and the choices are working against her. This tab lays out both.

🥤

The daily-choice problem — what's quietly hurting her

The facility lets residents pick their own food. That's her right — but with her conditions, several routine picks are genuinely risky, and no one is steering them.

  • The morning orange juice. A single glass is ~26 g of fast sugar — it spikes her blood sugar exactly when we see the big morning readings (282, 340). Orange juice has a place in her chart, but only one: the hypoglycemia rescue already written in her med list ("if blood sugar < 68, give OJ"). As a daily breakfast drink it's doing real harm.
  • Other sugary drinks & refined carbs (soda, sweet tea, sugary cereal, white bread, desserts) do the same — they drive the swings, which means more insulin, which means more dangerous lows, which means more rescue juice. It's a loop, and it's why the sugar chart looks like a sawtooth.
  • Salt. High-sodium tray items (canned soups, processed meats, gravies) make her body hold fluid — and fluid is the heart-failure weight and breathlessness we're watching.

What already worked for her — this isn't a guess

Her record holds one of the most effective interventions in her whole history, and it was about food.

  • A low-carbohydrate way of eating, done with family accountability, took her from 330 lb to 225 lb — a 105-lb loss.
  • Alongside it: A1c fell 8.8% → 7.6%, her sleep apnea nearly resolved, her asthma was downgraded from severe to moderate, and her insulin dropped from 100 units to 15.
  • That's not generic advice — it's her own proven response. The plan below is about re-establishing it, adapted for the heart and kidney changes that have happened since.
⚖️

The new rules since the heart & kidney changes

The low-carb framework still applies — but three constraints have been added since 2025, and the dietitian/cardiology/nephrology need to set the exact numbers.

  • Heart failure → low sodium (~2 g/day) and a fluid balance to settle. There's a real tension here: her kidneys argue for less fluid (~32 oz) while her heart can tolerate more (~64 oz). Cardiology gave a range, not a firm cap — ask them for her specific daily fluid target.
  • Kidneys → moderate, not extreme, protein. She has significant protein leak (heavy microalbumin) and fluctuating kidney function, so the very-high-protein / carnivore version that worked before needs a dietitian and nephrology sign-off this time — moderate protein, not maximal.
  • Separate fluid from fat. Much of her weight swing is fluid from the diuretics, not body fat. A sudden jump is fluid (a call-the-office sign); a slow, steady drop is real fat loss (the goal).

The continued-weight-loss plan

~203
now (lb)
175
benchmark
150
goal
·
1–2
lb / week, true loss

Both targets are already in her facility care plan. The point isn't speed — it's steady, real (non-fluid) loss that her heart and kidneys can tolerate.

1
Lock the diet order firstdietitian + physician
Get the consistent-carb + low-sodium order written (Correction #4) so the kitchen drives the tray, not the open menu. Everything else rests on this.
2
Cut the liquid sugar — the biggest, easiest winfacility + family
Juice, soda, and sweet tea off the routine tray. Water, sparkling water, unsweetened tea/coffee instead. Keep OJ only as the documented low-sugar rescue. This single change blunts the morning spikes.
3
Controlled carbs at every mealdietitian
Protein + non-starchy vegetables as the plate; limit bread, potato, rice, and dessert. This is the framework that already worked for her — just structured by the kitchen now.
4
Right-size protein for her kidneysdietitian + nephrology
Enough protein to protect muscle while she loses weight, but moderate — not the maximal version from before. Let the dietitian set the gram target given her kidney numbers.
5
Bring insulin down as the carbs come downendocrinology
Clinician-driven only. Fewer carbs → less insulin needed → fewer dangerous lows → less rescue juice → fewer spikes. It's the same virtuous cycle that cut her insulin from 100 units to 15 before.
6
Keep movingPT / OT
Continue physical therapy and add what she can tolerate, even seated activity. Movement protects muscle so the weight she loses is fat, not strength.
7
Weigh daily, read it rightfacility + family
Same time each day, logged. Slow steady drop = success. A sudden gain = fluid, not food — that's a call-the-office signal (see How we can help).
8
Family accountability — the part that worked beforefamily
She did this best with someone doing it alongside her. That partnership can continue remotely — daily check-ins on how the day's eating went. She responds to it.

Simple swaps for the tray

A cheat-sheet the family can hand the kitchen or post in her room.

Instead ofChoose
Orange juice, soda, sweet teaWater, sparkling water, unsweetened tea/coffee (OJ only for a low)
Sugary cereal, pancakes, toastEggs, plain Greek yogurt, cheese
White bread, potatoes, white riceNon-starchy vegetables, side salad
Cookies, cake, ice creamA small portion of berries, or a sugar-free option
Canned soup, processed/cured meat, gravyFresh-cooked, no-added-salt, seasoned with herbs/spices
This plan deliberately reconciles her proven low-carb history with the new heart and kidney constraints. The exact protein grams, the sodium and fluid targets, and any insulin change must be set by her dietitian, cardiology, and endocrinology — this is a framework to bring to them, not a prescription. The weight numbers are her care-plan's own goals.

How we can help

The medical team manages the medicine. This is the part that's ours — the things family does that genuinely change how the patient does. It's drawn from what she's actually told her care team: she misses home and her cat, she's frightened of falling again, she lights up about going home but gets tearful about it, and she mentioned food has sometimes been tight. Below: what to do, what to ask, and a running list you can fill in and bring to every appointment.

💗

Her spirits — the highest-leverage thing we control

Her depression screen went from mild to moderate while she's been here. This is where family presence does what no medication can.

  • Her cat. She misses home and the cat "a lot." Liz has the cat — send photos/short videos, and bring the cat up on a video call. It's small and it matters.
  • Keep the daily contact. She and Joe already talk daily — that rhythm is protective; protect it. A standing visit from Liz gives her something to count on.
  • Name the fear, then answer it. She's scared to fall again and anxious she's "not ready" to go home. Walk her through the concrete safety plan (O2, walker, who's checking in) so "going home" feels safe, not abandoning.
  • Celebrate the rehab wins. She's motivated and "doing well in PT." Notice it out loud — progress is the antidote to the helplessness.
  • Bring home to her. Familiar items, a blanket, photos. She's said the facility treats her well — anchor that with comfort from home.
🗣️

Be her voice in the room

She tends to agree with providers under time pressure, and her cognitive screen showed mild impairment — so what gets decided in a 10-minute visit may not be what she'd choose with time to think.

  • Be present at the appointments that matter — in person or on speakerphone — especially cardiology on June 11 and any psychiatry intake.
  • Bring an agenda. The "Corrections to push for" tab is your list — open it on your phone and work down it.
  • Ask for it in plain language, and write it down. "Can you explain that simply, and can we get the plan in writing?" Leave with a one-paragraph summary she can re-read.
  • Don't let discharge be scheduled before first appointments with the new PCP and a psychiatrist are actually on the calendar.
🏠

Set up home so it holds

She's going back to a ground-floor apartment, on oxygen, walking short distances with a walker. The fall is what started all of this — home has to be ready before she is.

  • Equipment first: home oxygen delivery, the walker, a bedside commode if needed, grab bars — confirm DME is ordered and arriving before she's discharged.
  • A scale by the door. Weigh her daily, same time — a 2–3 lb overnight jump is the earliest warning of heart-failure fluid. Log it (the call-list below tells you when that's a "phone the office" number).
  • The medication day: reconcile the "Daily care plan" tab against the pharmacy label, then use it to run her day so nothing's missed or doubled.
  • Food. She mentioned food has sometimes been tight — that quietly worsens her diabetes, her low albumin, and her energy. Line up Meals on Wheels / SNAP / a community resource as part of discharge, not after.
  • Continue PT/home health so the strength gains don't slip the moment she's home.
📞

Know when to call — her specific warning signs

For her conditions, these are the things that warrant a call to the office or, where noted, 911. Put them on the fridge.

Heart / fluid:Weight up 2–3 lb in a day or 5 lb in a week, more short of breath, new swelling in legs/belly, or needing more oxygen than usual → call the office.
Blood sugar:Below 70 (shaky, sweaty, confused — give fast sugar) or above 350, or any confusion → treat and call.
Call 911:Chest pain, fainting, a racing/pounding heart that won't settle, or severe breathlessness.
Mood:If she becomes withdrawn, hopeless, or says anything about not wanting to go on → call her provider the same day. Don't wait for the next appointment.
Infection:Fever, or burning/frequency with urination (she gets recurrent UTIs, which can cause confusion) → call.
Any fall:Even without obvious injury → report it; it changes the plan.
🤝

Divide the load — Joe (remote) & Liz (local)

Two people, a thousand miles apart, can cover this well if it's split on purpose.

Liz — on the ground

  • In-person visits and the cat
  • Being physically present at local appointments
  • Pharmacy pickups, home setup, groceries
  • Eyes on how she actually looks day to day

Joe — coordination

  • Portal, records, this dashboard, scheduling
  • Building the appointment agendas
  • Daily calls (already happening)
  • Tracking the corrections list to closure

Shared: the agenda, the corrections list, and the big decisions. The point isn't to do everything — it's that nothing falls in the gap between two people.

Our running list — concerns & questions to bring

Jot anything you want to raise or that's worrying you — a symptom you noticed, a question for June 11, something that doesn't sit right. It saves on this device and travels with you to the next appointment. Check items off once they're answered.

    This tab is about family support and advocacy — it doesn't diagnose or treat. The "when to call" numbers are general, sensible thresholds for her conditions; ask her care team to confirm her exact parameters (some people get personalized weight or sugar limits) and write those on the fridge instead.

    Daily care plan — the medication day

    A visual day, slot by slot, built from her current active medication list. Check off doses as they're given, drag a card (or use Move ▾) to shift it to a different time, and your layout + check-offs save on this device per day. Use the Reset day button each morning.