Hello, posting for a friend. Young guy, T3 para that's around a year post and he's been hospitalized almost since his accident due to a pressure sore in tailbone area and hasn't been able to do rehab yet because of this. He's admitted on the Internal Medicine floor and I'm really concerned with how they're treating him (I've been admitted on the same floor, that's how we met and most patients there are 70+ with dementia taking up a bed awaiting a spot in a care home if you get the idea). There's a long list of issues that make me question his care. But this morning I got a phone call, he was mumbling, saying he was twitching, spazzing, could barely hold his phone, I couldn't make anything over the phone so I went to see him this afternoon. He is a disaster, confused, drowsy, can barely push his chair, drops everything, he almost face planted 3 times just slightly leaning over (how did they even let him leave his room like that I'm not sure). Come to find out they upped his gabapentin dose yesterday, I really hope that's the issue? Apparently docs and nurses were all scratching their heads this morning not knowing why he was having these symptoms. I guess they finally realized he needs more specialized care? He's being assigned an entire new care team tonight - I really hope so because so far:

- He's had his pain and severe spasms ignored for months, his feet are bloodied from it. He can no longer transfer on his own. He then got accused of seeking pain meds, was cut off all pain medication and put on methadone. This is when he took a dive, could barely push his chair or sit up but they never bothered to find out why. Rehab came by to assess him finally a few weeks ago and they discovered that he had fluid in his spine and that may have been causing the spasms and other issues. Fluid was drained and he says it helped a bit but he wasn't told what the fluid was or why. I'm not sure he's assigned a permanent rehab doctor following him though. Shouldn't he have one? How do you go about getting one assigned when in hospital?
- His Dr. put him on Flexeril when Baclofen wasn't working - as I understand it, Flexeril is more indicated for muscle injuries/sprains and not to be used long term no? He says it doesn't help.
- He went from functional and alert to confused, drowsy, sleeps all day, isn't sure what dose of what meds he's on etc. It's a little scary to watch.
- They cycle him on and off different antibiotics, IV, intramuscular, etc. (for the pressure sore?) and some weeks he's too weak to get up out of bed, sweating, feverish and according to him no one knows why.
- They say he's allowed to sit up in his chair 2 hrs a day, I'm not so sure that's a great idea if he's got fluid in his spine and on this many antibiotics (maybe from the sore? again, he's too out of it to really know or care at this point, I've asked).
- He may be on other meds but I'm not sure, again, he has no idea at this point.

This guy has been doing this alone now, his family lives away, doesn't have many friends around. I'm not sure who can advocate for him cause he's a disaster at this point. I try to visit a few times a week. I think he's given up and he's just hoping he can leave the hospital soon and go back to his family doctor and start rehab. He was really looking forward to rehab but I doubt it's happening soon. He's aware his care is questionable but I'm not sure he knows how to advocate for himself or perhaps he's so drugged up at this point he can't? Patient advocacy isn't especially helpful either, I've dealt with them before. I've also tried hospital social workers and I'm not sure they're helpful, they mainly assess people to make sure they're able to get home from the hospital/able to function at home. I'm really hoping his new care team overhauls his care and changes things. Otherwise, can local SCI associations assist him? At this point he'd almost need a family member but that's not an option. What do people do in this situation?

Thanks!