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The doctor and caseworker agree. She is fighting sepsis!

The sepsis - I’m pretty sure- is the primary reason why rehab is not under consideration. The assessment also looks a her health chart not just based on whatever they asked of her during the 23 minute period Till she clears sepsis, a skilled nursing facility with a rehab sector usually won’t take this type of patient discharge from a hospital. Also Your sister Susan has a lot of health challenges as she’s on dialysis so she’s ESRD and has congestive heart failure and not very ambulatory; sepsis atop all this is really hard on her organs. She has to clear sepsis to then figure out a future care plan.

FWIW my MIL was in a NH became very ill, went to the hospital and diagnosed with pneumonia and sepsis and organ issues. She then went from the hospital to a LTACH - long term acute care hospital. It was in a building adjacent to the hospital connected by an air bridge. The LTACH are more set up for dealing with this type of care. The MD who is the hospitalist overseeing her care in the ICU would be the one to speak with to see if this might be an option for her as it’s a by referral only to get placement into a LTACH.

I’m guessing she’s younger?, like not over age 65? if so this poses it own set of issues for what long term type of placement once she leaves the ICU (or the LTACH) she may be able to get. If she is not enrolled in special category Medicare due to being ESRD, pls pls get that done for her. If the suggestion for her to go into a board & care comes up again, if there is a smaller one that can meet her many many needs, that probably is her best placement.
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Reply to igloo572
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It seems to me that she needs to improve medically (sepsis) before she can really participate in rehab in any meaningful way. She's right that she won't ultimately be better without rehab but she's gotta kick this sepsis first, IMHO.
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Reply to againx100
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Where is your Sister at present? In a hospital?
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Reply to Beatty
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Rehab is not a place for someone who is suffering from Sepsis. They are not Skilled Nursing. She needs to stay in the hospital till its cleared up. Its life threatening and I personally would not want to care for someone suffering from it. I would not want the responsibility. Tell them she can't come home its an unsafe discharge. You refuse to take responsibility for her care. Don't let them tell u there is help. Once you walk out the door with her, their help stops.
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Reply to JoAnn29
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tb2024 Jul 12, 2024
Thank you!
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If you believe it is unsafe for her to return home -you tell them exactly that. UNSAFE DISCHARGE.

But be prepared. If they do not feel that she is a candidate for rehab, you will probably have to make some fast decisions regarding Skilled Nursing Facility placement. The social worker at the hospital can help with that.

But if she can't safely go home, it is imperative that you stick statement and continue to tell them it is unsafe. They will tell you that you HAVE to take her home or that they will provide you with all kinds of assistance AT HOME.

Neither of those things are completely true. You don't have to take her home, especially if it is unsafe. And the "help" they will offer at home won't likely be enough, if anything. What they want is the responsibility back on your shoulders.

She may not be able to go to to rehab, that's entirely possible. But that doesn't mean you have to take her home either.
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Reply to BlueEyedGirl94
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You don't give us much information, but I can tell you that after my late husband developed sepsis and septic shock after almost dying from aspiration pneumonia, that he was left completely bedridden and all of the PT in the world would not have made any difference in his status.
I wish you and your sister well in getting this all figured out.
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Reply to funkygrandma59
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Are they saying your sister is not a candidate for rehab ?

If so , are they saying she should go to a skilled nursing facility for permanent placement ? This is what you chose as a category for your thread .

What are her chronic health issues .

Are they suggesting palliative care in a skilled nursing facility ? Have they mentioned hospice ?

If she goes to SNF and improves after sepsis , she could be reevaluated for PT and receive PT in SNF .
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Reply to waytomisery
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tb2024 Jul 12, 2024
Thank You! This is Susan's second bout with sepsis. Her first time it took a toll on her kidneys and she now is on dialysis. Prior to that she had/has congestive heart failure and hasn't walked for a couple months. The ball has been dropped multiple times with Susan's coordinated care after leaving the hospital last time such as having a physical therapist set up to come to the house, home health care services for basic blood work/blood pressure, and wound care.
They wanted to discharge her to her group care home and then set up services again. Susan said, " I won't get better if I don't go to Rehab."
We just wanted to advocate for a 2nd PT evaluation because we felt it was premature. Plus it was early in the morning. We think they probably woke her up to evaluate it. That was all we wanted. They refused and said they were discharging her. I hope this helps with context. We told the caseworker, we weren't disputing the results, per day.
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More details please. ‘The doctor and caseworker agree’ – with what? Are they saying that rehab is not appropriate because of the sepsis – or what?
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Reply to MargaretMcKen
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tb2024 Jul 12, 2024
Dr and PT agreed that Rehab would not help, weak muscles, not because of sepsis. I think they have a premature evaluation. She just came from ICU
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