My partner is in an inpatient rehab from hospital discharge. He is making progress however slow. He can't come home in a wheelchair because I can't physically help him. Inpatient facility wants to discharge him. He's been there 1 1/2 weeks. What can we do?
To get an answer to your question, you will have to speak to the doctor in charge at the rehab facility to find out the reason why they are releasing him from their care.
* Talk to administrator at facility. Ask what their legal responsible is.
* Ask his MD / make recommendations or prescriptions of needed care.
* Contact Medi-care and/or other government agencies that contribute to his care (if they do).
* It certainly might be up to the facility. You need to ask them for written documentation reflecting their decision. You need to talk to the facility management first and then get all their responses documented in writing.
* Start checking into other facilities / rehabs if you believe (and MD recommends) more rehab care is needed.
Gena / Touch Matters
If he gains some mobility in a wheelchair, enough to transfer where you just are there to help balance, you might be able to make changes to your home or he could live in a wheelchair friendly home, but right now he will need to be under supervision so he doesn't fall.
You mention that your DH is currently in a wheelchair. He is taking 50 steps with a walker and on oxygen. I'm assuming that he didn't leave home with ANY of these things correct? Oxygen, walker, wheelchair? They will be able to help him get to a certain point, but there will likely be limitations even with hard work on his part. And they may already be able to see that in his daily PT and OT.
That being said - as you said - it is an unsafe discharge for him to go home right now - so Skilled Nursing is the only option.
Beds are a revolving commodity. What is available right this minute - won't be there in 24 hours or even 12. They are asking for additional options because there is no availability where you prefer him to go. You could look into it on your own - entirely private pay and private transfer and might potentially have more luck. But it's doubtful.
You could appeal it - but that takes time and in the interim they could try to force your hand - and the response to that is that he is an UNSAFE DISCHARGE. Learn those words. You cannot and will not take him home and he is an unsafe discharge.
Here is the thing we were told multiple times at multiple facilities. If FIL was "discharged" from the rehab - then he became skilled nursing care and he had to pay the private pay rate until he left as long as he occupied their room. Now I don't know if that is an option for you. But they weren't going to kick him out on the street because they knew they were playing with fire because he wasn't in a position to go home. There is some wiggle room typically - you just have to pay out the wazzoo for it.
We never actually had to use that - but the last facility did keep him until we were able to get him transferred to his SNF.
Repeat after me - UNSAFE DISCHARGE.
Because YOUR evaluation and the patient's evaluation may not match the expert evaluation of the rehab.
There are many reasons for discharge and this is something, if you are next of kin or POA you should be included in by law-- legally mandated discharge conferences. There, the personnel, whether nursing or PT or OT will tell you of progress, or lack of it.
Some patients cannot fully participate. In those instances rehab is a waste and cannot be legally covered by medicare funds.
Some patients have made all the progress they can make in rehab in the opinion of the experts.
Briefly, the answer is yes, discharge can happen before you or the patient are ready if the facility believes that the goal is met, or if they believe it CANNOT BE MET.
Now we come to the important part for you:
If this patient is not well enough now to return to your care then THAT is what you need now to make clear to discharge planning, social workers at rehab. In facility placement may be necessary.
DO NOT ACCEPT home someone you cannot physically/mentally care for. THAT would constitute an unsafe discharge.
The rehab will tell you all sort of lies. "We can get equipment" , "we can get you help", "we can make this work". They won't, they can't, and it won't work. So don't buy that and tell them this old RN told you so.
Best of luck to you.
About a week of rehab he fell in the bathroom because he couldn't get anybody to answer his call light he tried to go on his own. He hit his head and has a huge knot and black eyes. He was transported to the hospital for exam.
A week later our insurance decided he was able to be discharge. Although he was in worse shape than when he went in.
I couldn't possibly bring him home and was given 48hrs to get him out!
I ended up admitting him to long term nursing care at the same facility. Self pay!
This is emotionally, financially, and dealing with all the bills and running back and forth to the NH is taking a toll on me.
although I'm relieved from taking care of him at home 24/7 I can't help feel guilty too. He keeps asking to come home.
I am a little unclear about why you would need to lift his wheelchair. Is it that your home is on 2 floors? If so, you could rent a wheelchair for each floor, and he could concentrate e in rehab on going up and down stairs. I had to rent 2 wheelchairs for myself for a brief period because I lived on 2 floors, and if you rent from a Medicare-approved supplier, it is not very expensive. You might also be able to have an OT/PT come into your home to show you how to assist him in other ways. In this situation, Medicare would also send home PT/OT providers, although they would probably come only twice a week.
I'm suggesting these alternatives because e it sounds as if your husband is very motivated, and the amount of therapy you receive in a nursing home is considerably less than in rehab. And however you cut it, if a home environment can be managed safely, it is happier for all concerned--especially since you know your husband will continue to work to improve. I'm speaking here from personal knowledge with the experiences of our family, and of my own experience when I had to be i a nursing home for 6 days. Your husband of course cannot come home if it is not safe, but I'm suggesting that it might be worth it to try to make it safe enough that he could come home and avoid the nursing home.
I would appeal.
Have you had a care meeting with the social worker and other staff at the rehab? If not, request one and ask for the physical and occupational therapist to be present.
The other option would be to consider getting his doctor to order home health where he can continue PT and OT at home.
If you want to avoid skilled nursing for now, would it be possible to hire additional help at home?
Wishing you and your partner all the best.
The person who decides he is making progress is not you, but his PT or doctor. If he is not making enough progress or is not cooperating, then they will stop his PT and send him home.
Is your partner telling the discharge staff that you are his caregiver? You need to have a discussion with them to let them know you are not his caregiver and not able to provide the care he needs at his current level of abilities.