Just wondering if any of you wise people here can help me brainstorm. My mother is immobile in a wheelchair after a serious septic infection last November. She can ambulate with her feet but cannot even stand alone.
She thinks PT will help her. They do not. I have a call in to them to inquire what it would cost out of pocket for them to work with her more. They are not rushing to return my call even though I have clearly stated I understand this would be a cost we would pay for.
My mother has often had a lack of realism. I do feel though that I should try to help her until it may prove fruitless which is likely.
I realistically can only take this to a certain level as she is on private pay which is a little over 9,000 a month and the fund we are drawing from could run out depending on how long she lives.
While I want to give her a sense of hope I also have to factor her lifelong lack of reality. I have posted before that this has become my worst nightmare. She has been overweight for years. Oddly now she is losing some weight but not any large amount. I do not say "I told you so" even though I think that. Some previous calls to PT have gone unanswered but awhile back when I inquired about this they actually said not to waste the money. I will continue to pursue the cost issue. I guess I am wondering what my position would be if they flat out refuse regardless of my willingness to pay.
It's probably safe to say she won't progress past the bike thing, and you'll only be out about $40.
What you may need to do is take her to her doctor. Hopefully PT sent him their report. When u make the appointment, ask if they have the PT report if not ask if they can request it. Make sure they know why ur making the appointment. Then her doctor can review the report. He can then tell your Mom how he feels. No matter if Medicare pays or u private pay, they need a doctor's order to take Mom on as a Client.
If the doctor feels further PT will not help Mom, HE needs to tell her. Sit right down in front of her, look her in the eye and tell her that further PT will not help her walk. Then when she starts again you can say, "Mom the doctor sat there and said PT will not help. And without an order from him, PT cannot be ordered." There is nothing YOU personally can do.
2nd - - you need to contact Medicare for advice. The OLD standard was "improvement", but that changed in December 2013 with the Jimmo Settlement. Here are the critical words:
"...to maintain, or to prevent or slow further deterioration..."
Many health care providers either aren't up-to-date or refuse to acknowledge or apply the change. The end result is that more PT should be financially covered than actually is.
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The Jimmo Settlement Agreement provides for the re-review of certain Medicare claims under clarified maintenance coverage standards for the SNF, HH, and OPT benefits, applicable when a patient has no restoration or improvement potential, but that patient requires skilled SNF, HH, or OPT services to maintain, or to prevent or slow further deterioration of, his or her clinical condition.
https://medicareadvocacy.org/medicare-info/improvement-standard/improvement-standard-update-cms-revises-medicare-policy/
I think that I would check into a chair exercise instructor and a massage therapist to come in and "work " with mom.
Both could help build her strength and help her feel better.
They would probably be cheaper than paying a PR to entertain her desires.
The chair instructor could set daily goals that mom could reach on her own and a massage is just yummy.
I hope you find something that helps her feel like she is making the effort and she is being listened to.
If she were on our books, and she wanted to work at mobility, we certainly wouldn't tell her no however unrealistic it might be that she'll be leaping about like a young gazelle ever again. There are so many things she *might* be able to improve on, such as standing with a stand-aid, with or without a sling - that's certainly what springs to mind.
There could be a dozen reasons the PTs aren't getting back to you, not limited to their (slightly snotty, I have to say) attitude that they won't waste their time/you shouldn't waste your money; don't forget the Covid Chaos going on out there, for a start.
He too had aspirations of walking again, and getting out of bed, but I knew realistically that was never going to happen, and it never did.
If it makes her feel better, maybe you can just try and do some simple leg exercises with her, either lying down, or while she's sitting in a chair. Wishing you and her the best.
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