I’d insist on a meeting asap and go over her head if needed.
Is her rehab facility part of a nursing home? There should be an ombudsman who you can call to voice your concerns. Medicare has limited rehab days- I think it is like 20 or so and then a large (~$275/day) copay kicks in- this is usually when the facility says it is time for discharge. Have they offered you any options besides discharge? What type of services are being offered for when she goes home?
Imagine me, with 35+ years of experience, arguing with a Medicare representative, less than 25 years old. I’m stating, this man cannot walk to the bathroom from his hospital bed. She, wee, he’s ready for discharge. Me, if he falls, count on me for joining a legal suit.
She held firm. I told the family to pay and hire private aide.nwhen I called the MD, she said she would override and inside on an SNF.
I have run into issues with Medicare reps from hospitals and Rehabs. More legal suits need to be filed. When it is your own parent, just call it a rainy day and hire an aide.
This place does have another floor that is a nursing home and we asked about sending her there at least temporarily. Thing is, she would not get rehab there.
My mom just called me and told me that someone came to see her today from the “office” and talked to her about moving to the nursing home floor because she isn’t “complying with her treatment” or something to that effect. Had her in tears. WTH?!!! Why couldn’t they let US talk to her about it?!
EPTR, your mom cannot refuse PT on a regular basis, no matter how tired she is. I try to get the patient pain meds a half hour prior. People don’t realize that they cannot say, come back later, or tomorrow. PT or OT must document improvement over a week.
I’m not saying your mom isn’t complying, but she may not be aware of the rules.
@EPTR Tell the SW that you want her referred to a subacute rehab that is not at the hospital . You have the right to choose from more than one option. Does your mother have a medical power of attorney? If she does, the SW is supposed to talk to that person . If she doesn’t have a legal POA, unfortunately she is the person responsible for the decision making. Please talk to your mom about making someone a POA and contact an attorney ASAP to get that done. If she does have one, contact the supervisor of the person who went to talk to her and lodge a complaint . Also, tell your mom to request to have one of you present when discussing her plan of care. If need be, contact her orthopedist to see if he can help.
If the patient isn’t making progress and has plateaued, Medicare stops paying for rehab. We went through this with my mom. We did one appeal of the decision - tied it to having to go back into the hospital after a medical event which meant she was pretty much starting over. It was granted. She was then 4 days from discharge when she fell and Got a hip fracture at the facility. She was discharged with 100 days into an adult family home.
Try an appeal. It can’t hurt. We had the “good” SW who had our back. We were going from an independent woman to dependent in 4 months. She can’t take care of herself and is still a major fall risk. Since she can’t take care of herself when the door is closed, assisted living facilities are out.
They did the sme thing with us - telling mom she would be discharged. We were there every single day…they could have waited, but didn’t. Livid doesn’t begin to cover it. Private pay in the nursing wing was over $500/day in a shared room. It was so horrific down there and there was no way we could place her there.
The SW recommended someone who helps find suitable facilities. She is paid by the facilties where she places clients. We found mom the wonderful (in our eyes) AFH. Cheaper than full-time care, which would run $8-12K per month on top of rent. Mom doesn’t like it a good part of the time, but we don’t have an alternative. The aides are wonderful, the home is beautiful, clean, and well-maintained. It’s mostly mom not having control.
Good luck. And poo on the place for upsetting your mother.
Do you mean ALF! Assisted living facility?
Bookworm, my mom hasn’t refused PT or anything else. The word compliant was invented to describe my mother. I think they meant that she is not improving but chose their wording badly (or my mom is misquoting). The only thing that she has sort of had an issue with is that they keep trying to get her to use the call button when she has to go to the bathroom. She won’t use it and goes in the adult diapers. Why? Because when she has to go, she has to go and she knows that if she calls for help, it will take them over 15 minutes to get to her. Might as well just go ahead and pee if it’s gonna end up in the diaper anyway.
Zeebamom, What is AFH?
It took the aide two hours the other day to bring my mom some tylenol.
@EPTR Tell them your mom isn’t being noncompliant with toileting, she can’t remember to use the bell and that she needs to be on a toileting schedule . You might also remind them that she came into the hospital without a decubitus and you expect her to leave without one.
Well, tell her to use call button, then pee in Depends. Unusual, as no compliant generally refers to,patients saying, “come back later” for PT or shower. They keep a log book. Come back later can equal non compliant in some places.
Most folks don’t mind if someone uses a Depend; they do mind if they pee in bed and sheets and clothes have to,be changed.
It’s not a question of whether they mind if she uses the depends or not. They are releasing her to go home on the premise that she will be alone for a good amount of the day. she either needs to be able to use the toilet independently (can’t right now) or have someone there who can change the depends so that she isn’t sitting in a wet one all day.
What did SW say when this was raised at the meeting? That is where answers need to be offered.
“Come back later can equal non compliant in some places.”
+1. My dad was in the hospital with a (n unstabilized!) broken pelvis, because the pelvis was the least of their worries on the first pass and was scheduled to be fastened with a screw on the second pass. PT comes just as he’s able to request another dose of pain meds, says they’re here to get dad moved from bed to chair. Dad says, “I just called for my pill and am in a lot of pain; can you wait half an hour.” PT goes away, documents noncompliance, does not return.
The nurses also rolled him on the unstabilized pelvis every six hours, to prevent bedsores. As soon as the screw was in, so it didn’t hurt him to be rolled, they stopped doing it, and he got a bedsore.
@EPTR I’m assuming your mom was continent before she broke her hip. If they don’t put her on the toilet and just change her in bed, she will not be able to increase her independence and safety with toileting. Is she wearing pull ups or adult diapers ?
She was fairly continent before surgery but had the occasional leakage. She was also only on oxygen at night while sleeping. But now…all day.
Not sure if she’s using depends or pull-ups.
Thing is, if she isn’t using the call button, they don’t come to check on her and see if she wants to try the bathroom.
This place has been a disappointment. We chose it because it had a good reputation but it has been awful. I could make a long list of complaints but suffice to say there have been some situations that have ranged from mildly annoying (my moms undies stuck behind the safety bar in the bathroom) to outright neglect (sat in a chair for 6 hours and had to be asked to be moved).
They need to get her out of diapers and into something she can pull up and down like underwear . Have they tried to wean her off of her oxygen? They need to check her O2 saturation levels off of the oxygen and they need to drop below 90% to qualify her for continuous O2.
What’s a decubitus?
Bed sore.
Adult family home is the term used in WA for a home with up to 6 residents. Mom has her own room. She’s taken care of 24/7. They eat home-cooked meals in the dining area, there’s a lounge for tv, as well as a tv in her room. She was eligible for PT when she first moved in.
The inability to use the toilet independently is awful. Mom got the hip fracture when she decided she couldn’t wait any longer for the aide who had taken her to the bathroom and tried to get back to her wheelchair herself.