Since Mom’s stroke, she won’t move herself. We (hubby & I) care for her 24/7 & tried to get a mattress that’ll move her at night but the wound doctor said a Stage 2 wound only gets a GEL mattress. Yet she never moves by herself. She has Medicare & Blue Cross but Medicare decided she only gets a GEL mattress. The mattress delivered is NOT GEL, it’s just foam shaped like egg cartons inside a zippered cover. We have complained but they insist they delivered the correct mattress. Her wound is all across both butt cheeks but it’s not oozing, just dark red. We’re putting ointments on it prescribed by a dermatologist that saw the wound through a video visit since COVID-19 restricts face-to-face appointments nowadays. Since Medicare rules what mattress she gets & they practice reactive vs preventive medicine, how can I get a mattress that’ll turn her? I still work full-time & after hubby started turning her 3 times a night, he ended up having a stroke they said was related to lack of sleep. He’s okay, thankfully, but we both have to sleep to function. We’ve been caring for Mom in our home for almost 6 years, 3 of those years we also had my Dad but he’s passed on now. And I’m still very confused how foam mattress shaped like egg cartons is considered a GEL mattress. Anyone have any suggestions that might help me? I really appreciate all comments & advice.
I think if I remember correctly Stage 2 LU don’t qualify for an alternating pressure gel mattress overlay. You stated there was no breakdown just redness at this time. You manage this the same- repositioning every 2 hrs - as you would a Stage 4-5 PU.
You have nothing to lose by investigating the order and how the DME provider interpreted it. Sometimes it is simply a coding error. DME companies are not supposed to provide the proper coding for reimbursement- the ordering doctor initiated the order, so you need to start with them. Ask the billing office (or look at an AOB notice if you’ve received one already) then research what code they used, write it down then google search it to figure out if that code is consistent with your mom’s condition. It may be worth a try.
I hope your husband is getting well. It does sound like your family is overwhelmed now and Covid19 makes things worse. It may be time to place mom in a SNF as her level of care and her needs will only increase. It’s not fair to your family to bear the burden of what sounds like a person who has care that can’t be provided in her present setting.
Don’t feel guilty about it either. You have needs as well as your husband who has suffered a stroke due to the physical aspects of providing care . It may be time to take the burden off both of you.
I know this wasn’t your question but I would take this as another reason to make it a goal to get mom’s finances in order and apply for Medicaid if she qualifies.
Good luck to you.
Take a picture and tell "they" that this does not look like a gell cushion.