home oxygen delivery on a weekend?

January 24, 2021 8:34 AM

My relative is very very old and recently returned from the hospital after suffering several mini strokes. He also has parkinsons and hasn't walked since these strokes. According to his wife the hospital initially was going to send him home with oxygen but then changed their minds.

I noticed he was looking palid and brought over a pulse oximeter and his oxygen when sleeping is far too low. Dr has recommended ER as only option for low spO2 levels and weekend timing but his wife is adamant that he not go back as he becomes very agitated/aggressive (and is very disoriented, not just from stroke but bc of covid no one could be with him there) and hospital stay he just returned from went quite badly and reportedly several imaging studies were aborted bc he was too agitated to complete them. Is there any way to get home oxygen over the weekend? Including out of pocket / non medicare options ?

posted by elgee to Health & Fitness (7 answers total)

You need a prescription for oxygen therapy. Does your relative seem to be distressed or uncomfortable at that saturation? Are you sure this new? Possibly he's desaturated at night for years, and you're only now noticing it. Not that this is OK, just that it might not be the dire emergency you are visualizing. On the other hand, this may be a symptom of Covid. Has he been tested recently?

It's possible that changing his position in bed could help; the benefit of a prone position became famous with Covid. If you call his doctor and text or facetime to show the low oxygen saturation that might be convincing. Be specific about the numbers and the circumstance. There are plenty of people who use oxygen at night.

For home delivery the prescription is forwarded to an appropriate DME (durable medical equipment) provider and it is delivered with the tubing needed. I am certain there is a mechanism for weekend delivery if the prescription is properly submitted, but there is often a wait for the order to be processed and the tank delivered. Note that each insurance will have a list of specified DME providers, and your relative will need to go through one of them, not a random DME provider.

If by chance he is in hospice, which it doesn't sound like from your post, it would be provided directly by the hospice upon request of the hospice nurse.

The ER, or perhaps an urgent care, would likely be the easiest option on a weekend.
posted by citygirl at 8:58 AM on January 24, 2021 [3 favorites]

If hospice hasn't been mentioned, please ask someone about it. It sounds like he should be assessed for home care at the very least, and possibly in-patient hospice. If you have any questions about it, please feel free to MeMail me.

As for the immediate situation, the ER is probably the only way you're going to get oxygen to your relative, given that his doctor has said it's the best option.
posted by cooker girl at 10:21 AM on January 24, 2021

You can get home oxygen delivered on a weekend from a durable medical equipment provider, but as noted above, you do need to have a prescription. The best way to get a prescription on a weekend is through the ER.
posted by peanut_mcgillicuty at 7:18 PM on January 24, 2021

I hope you’ve taken him to the ER by now... if not, be aware that many of the sedatives they give seniors can have paradoxical effects (cause agitation, delirium, etc).

My dad has dementia; pre-Covid, during a hospitalization for something else, they gave him Haldol, and my normally easy-going and medically compliant dad just wigged completely out, went full-on delusional and agitated, myself and two nurses were unable to restrain him, what stopped him was what looked like a seizure just before they were going to call a code white.

Note that Haldol is contraindicated for seniors who have dementia (can cause cardiac arrest among other things), yet for whatever STUPID reason, it is a medication routinely used in seniors in Internal Medicine at our local hospital (a department with a lot of seniors). (At this hospital, the nurses said they *commonly* have to physically restrain people w dementia and they don’t know why...) I insisted they take him off Haldol and just give him Valium, and he calmed down. (I have POA so they had to listen.)

I am not sure about Parkinson’s specifically, but (you may need POA for this) find out what medication they gave him in hospital and insist they find something else that will work for him. Call his doctor again, of course, as well to see if a medication side effect or interaction is possible in your relative’s case.
posted by cotton dress sock at 8:18 PM on January 24, 2021 [2 favorites]

Someone found a working oxygen generator on Craig's list. No guarantees, no service calls attached, so this might be a risky loss of money.
posted by Cranberry at 12:38 AM on January 25, 2021

I hope he went to the ER; if his SPO2 is low giving oxygen will make it better, but doesn’t treat the underlying problem. You don’t mention a number, but “far too low” is concerning. I generally start looking for problems if it is less than 95. (And even at higher numbers if the patient is otherwise healthy.)
posted by TedW at 7:50 AM on January 25, 2021 [1 favorite]

Good point cotton dress sock about the Haldol often causing agitation in elders. It's often used because it is not a benzodiazepine which can have long-lasting sedating effects, especially for elders. It is a lousy med, though, and is not used much anymore in other circumstances. And as you saw it can cause delirium in some.

OP, please make sure you talk to his primary care physician about this experience. It is amazing how often primary docs are not informed that one of their patients has been in the ED. If it was this doc who directed your family to take him, please make sure he/she knows the details. Also, if your relative does not have a medical POA assigned, other than to his wife, who is the default POA holder, please inquire about being added.
posted by citygirl at 7:56 AM on January 25, 2021 [2 favorites]