Rest was an illusion beyond our grasp. Our choice to move forward required action. A barrage of consequential and heady decisions confronted us–the who, what, where, and when’s of care beyond the ICU. The thought of leaving the place that had become our safe haven–was scary and intimidating, but necessary. In our youth, Mike and I had joked that babies needed to come with a parental guide–yet, if ever there was a need for such explicit instructions, it was now. We addressed the unpredictable unknown like an intense game of strategies. Each option and each move were over-analyzed and considered in relation to its long-range ramifications and implications on Matt’s quality of life. We coveted the assurance that we'd be on the best path forward if we did x, y, and z.

Being forced into a rushed decision or having to compromise on what we felt was best for Matt, was to be avoided. Soon after we had made the decision to move forward, we began to confer with the Unit Care Manager. Several variables would impact the discharge process. We needed a clear understanding of everything–his health insurance coverage, available qualified nursing and rehabilitation centers, the rehab services provided, and determining how long Matt might be at any one facility. 

The staff recommended transferring Matt to a subacute floor located within the hospital for several weeks, before moving him to a rehab facility. I liked that idea. It would have given Matt more time to stabilize and ‘come around’ before moving to someplace new. For undisclosed reasons that plan changed. We proceeded to consider local transitional units equipped to care for patients on a ventilator. The stay would only be as long as necessary to ween Matt off the ventilator before moving him closer to home. Applications were submitted while we simultaneously took the opportunity to tour several facilities. We favored the units that offered 3 hours of rehab therapy per day.

The medical director from an Acute Rehab Unit located within St. Luke’s medical complex also reviewed Matt’s case and stopped by to examine him. It was not a good experience. He did not mince words. The doctor firmly told us Matt’s brain injury was too severe, too extensive, and well beyond the scope of their services.