We have been given misinformation from our local Healthcare provider . We were told that she needed a skilled diagnosis to get my mother admitted so on her back xray she had a fragment in her back so the er dr wrote for this and she was to be admitted mon. However the er Dr we had seen before stopped the order by stating that it was healing and her uti was being treated by antibiotics. Meanwhile my mother is another day without the care she needs. I have asked for her to be in skilled nursing because she will not volunteer for physical therapy . What am I doing wrong? Do I need to say longterm? Are the Dr's not getting enough kickback to send her into nursing home? The Dr's said she needed 24/7 care and were told that Noone would be at home to care for her, yet in Henderson county tn they sent her home and stopped her home health . This whole experience has made me very disappointed in the Dr's as people and the health care system. Thank you to everyone who has responded and responds giveing me some direction on where to go now. She has medicare part a n b and a Pekin supplement ins. Apps these are not good enough or I'm not using right words to get her in.
They probably think you mean Rehab. I would go to the Longterm facility and talk to them. If you need Medicaid, you need to find a facility that will except it. You need to explain that u no longer can care for Mom and what she needs in way of care. When you find they will except her, they should contact your doctor and get an order.
If not looking for a permanent placement, you call Moms PCP and see if he can order in home therapy. Hopefully, she has traditional Medicare because they should pay most of the bill. A suppliment usually goes along with it. If she has a Medicare Advantage, that may be ur problem. They are suppose to honor A&B but not always. Maybe her Dr will have to get involved.
Talk to the local police too and ask them to do wellness checks on her. They will. If the cops see that she's not coping they will get things rolling on getting her into a facility though APS. Faster than you will be able to.
Then there is the last resort. The 'ER Dump'. This is when you bring her to a hospital ER and ask for a 'Social Admit' because there is no one in the home to meet your mother's care needs and that you are not able to. Then ask to see a social worker. They will send one down to speak to you and you tell them this. DO NOT let yourself be talked into taking her home.
The hospital will make all kinds of promises of resources and homecare help if you take her home. None of it is true. DO NOT take her home.
She will be admitted to the hospital and they will keep her there until they find her a bed in a care facility. Hospitals have endless resources and legions of social workers. They will be able to find her a place a lot easier and sooner than you will be able to.
Based on what info you provided, she doesn't seem likely as a candidate for LTC.
If there are resources to pay privately, then one likely has a better pick of facilities and most will want to take. Where we leave near an urban area in the east coast area of the US, high quality nursing home facilities (such as they one my mom is in) cost about $15K a month ($180K) a year. Again, if you have those type of resources; there are lots of options.
If there are not those types of resources; then Medicaid (NOT Medicare) is a possibility. To qualify for Medicaid long term care coverage; your LO must meet two tests: 1) be below the asset threshold in your state (this mean all assets!) and 2) meet your state's "level of care" requirement. For the "level of care" the nursing home facility physicians and/or other have to submit "medical reports" showing she needs 24/7 care based on medical conditions AS WELL AS her inability to handle "safely and independently" a myriad of activities of daily living and instrumental activities of daily living. Then YOUR STATE, reviews and make a determination if she qualifies OR not.....In other words, just because any physician says she needs 24/7 long term nursing home care; it is YOUR STATE regulators that make the final go or no go decision.
Many Medicaid and Medicare qualified nursing home (you want both qualifications) like it if a person enters as private pay for a while, while your LO spends down. This option can be easier they just randomly calling nursing homes once she has spent down, looking/asking for a bed.
If she is not safe to be alone, call adult protective services and get them involved. If your loved one has some resources (spend their funds) and hire an elder care lawyer licensed in your state to help you navigate this. There are many rules and steps. There also is something called the "5-year look back" provision; whereby your State Medicaid folks will look back 5 years at all your LO's financial transaction to assure that assets of any type were not hidden or pass to others which is a violation of the "look back" rules and may disqualify you LO from getting Medicaid coverage for a period of time.
Good luck with this.
My mom doesn't have any additional illnesses either...no diabetes or anything like that. That is the main reason a long term care facility was not on the table. My mom is still mobile and can eat on her own for the most part. In memory care, they give her meds, help her dress, bathe, serve her meals. It is locked down. We were able to bring in moms own bed, dresser and TV.
Why are you wanting your mom to go to long term care instead of memory care? If the reason is finances, she could apply for Medicaid or a Medicaid Waiver and then you would need to find a memory care facility that accepts Medicaid.
Im not trying to minimize the problem. It takes a lot of work to apply for Medicaid and find a facility that has an open room. From what you have said, I think you're looking at the wrong level of care for her. Memory care seems like a good match.
Traditional Medicare only pays for Parts A and B which means they pay only for your doctors’ visits and hospital stay. Traditional Medicare WILL NOT pay for in-home care or SNF. Medicare Advantage WILL pay for in-home care services for your LO like helping to prepare meals, taking your LO to doctors’ appointments, laundry, shopping, etc., but it’s a limited amount of hours per week that they allow for in-home care. I have Medicare Advantage where I have zero copay and zero premium, plus I get supplies of OTC products of $70 every quarter and fruits and vegetables of $75 delivered every quarter. My Medicare Advantage pays for someone to come in and sit with a LO as companion. These are just a few of the many perks that I get from my Medicare Advantage which I love.
My dad lived in Assisted Living. He had dementia, CHF, Diabetes and colon cancer. I had in-home hospice set up for him which required 24 hour care. He had to pay out of pocket. Rent was $5,000 and caregivers were $20,000 a month. They wouldn't move him to memory care because he was too "active". A nursing home didn't work either for the same reason.
Also, I believe Medicare only covers so many days in a skilled nursing facility.
2. You may also benefit greatly from conferring with an
" elder law attorney" who should provide you with at least a one hour " gratis" consult to present your situation and, then go from there with their on going services as you and they deem appropriate.
3. the PCP or Case manager / Social Worker should / will be sure that your I'll loved one receives a current " level of care needs assessment". This will be a part of the decision process for facility placement.
4. Depending on where/ what stage the dementia has progressed to , the loved one may need/ qualify for placement in a " Memory Care" unit/ facility which can be different than other " skilled care facilities".
Save your sanity and overall health by getting help; one or more of above will be a good start.
Get emotional, spiritual support for yourself regularly from a faith leader or community chaplain of your choice. Practice other good self care/ exercise, hydration,proper nutrition etc., See your own physician as needed.
This is how my mom ended up in a permanent rest home!
She had another stroke and the neighbor called 911 then she went to the hospital and finally a rest home