My mother was brought to the hospital by ambulance with excruciating pain due to spinal compression fractures and PMR. She stayed three days under observation status, then released to go home after we expressed concerns for pain management and mobility issues. We were told that arrangements were being made for a visiting nurse and PT. Now five days later she is experiencing hallucinations (stopped the tramadol), is barely ambulatory and we just found out she was denied services because of a high risk home situation (Dad is 90). The hospital was aware of this at the time she was discharged. I have been in touch with her primary and was told the only thing we can do is bring her to the ER because it was unsafe for her to be at home. Because of Medicare guidelines we are in limbo. I initially requested mom be sent to palliative care, but with the observation status umbrella she did not qualify. I do not know where to turn going forward. Has anyone experienced something similar?
I should also add my sister and I share part time responsibility for her care to help out my dad ..... but we both have our own family commitments and jobs. Also mom has dementia.
Consider selling the home to help with their care. If you think Medicaid will be needed sooner than later talk to them about Dads money vs Moms money. If Dad wants to stay in their home then assets will be split so that Dad can still cover the bills but Moms portion will need to be spent down to receive Medicaid for LTC. Or hire a lawyer versed in elder care and Medicaid. Money spent can come out of Moms and Dads money. There are ways to get on Medicaid even if your a little over. Some states have a Miller trust which handles the overage and reverts back to Medicaid upon death.
Ur local Office of Aging may be able to help.
I can understand you may not agree with this decision but look at it another way....the home care nurse assessed through her/his professional judgement that once the HC staff leaves, who will continue to care for that patient? So the RN leaves, who will assist your mother to the bathroom, bathe her or feed her? Your father can’t. The nurse thinks 24/7 care, not just the limited time (hours) they (PT/OT) are there.
You and your sibling may take turns taking care of them, but to a home care nurse that’s not good enough. The HC is being an advocate for your parent in recognizing your mother needs more care & a part time situation won’t fit her needs for safety.
Most likely the home care nurse made this call as they assessed that no one could provide ongoing care to your mother, a vulnerable adult, because your father was assessed not to be able to care for your mother day to day.
Send her back to the ER and refuse to take her home- insist on NH placement. If your parents have the resources you may need to self pay until they apply for and get Medicaid. Or hire caregivers at her home for 24/7 care.
Its unfortunate no one spoke up at discharge time to say no, she needs more than Homecare, she needs 24/7 supervision and insisted she be changed to “admission” status for the 3 night stay requirement for consideration for nursing home placement. That was the time to inform hospital staff of her needs. But it’s not too late - once she is sent to the ER the process can be started over again but financially Medicare may not cover it but I am not sure how payment would work.
Depending on your state, if your parents are on Medicaid, more support services might be available free of charge. Check with your local council on aging.