On 1/11/2015 glb613 said:
"Edited to add, the reason no other home would take him was medicare. Once he was RE hospitalized (half dead till then) then the GOOD home would take him. Sorry I got so wound up I forgot to add this earlier. It was about insurance when my sibling would call places this is what he was told.
Rehab facilities can be very difficult and/or inadequate for patients with severe dementia. We found this when my mom, who had Alzheimer's, broke her hip and had to be in rehab for several weeks. They did work with her, but it was very challenging as she had difficulty understanding and following through on directions, and she was a great fall risk because she could not remember that she couldn't stand and walk on her own because of her hip injury. There were some initial problems with staff, but after our family had a meeting with the nursing supervisor, I believe they tried very hard to do their best for Mom. However, no facility can provide 24/7 one on one supervision for an extended period of time. We ended up having family or a private-pay caregiver with mom all the time. Ironically, Mom fell again and dislocated the repaired hip while under the supervision of the private pay person, who stepped away for a moment to use the restroom. There just is no perfect, foolproof way when people become sick, incompetent, and at great risks for falls and other mishaps.
Honestly, Shorty, I sincerely hope you will seek help to come to better terms with your father's illness and death. Your personal suffering is hard to read. I am sorry for the misery your father (and you) endured during his last days......but it does no good to blame and continually punish yourself for his experiences. They are over now, and your father is at rest. You are perhaps only hoping that his experience would have been much better or his life longer in another environment. He was old, sick, demented, and he died. I am sorry for your loss."
I worked in Health Care for 38 years and therapy is the "Bread and Butter" of most institutions. Therapy (Physical, Occupational and Speech) generates revenue and we are pushed to provide it everyone whether they need it or not. So for therapy to tell a family they must stop, there has to be a good reason.
Most of the time it's due to lack of progress. As a Therapist, you must be able to document measurable progress on a regular basis. When Patients have dementia, the ability to teach and a skill and make progress is very difficult and often fails. There comes a time when the therapy has to stop. It's never pleasant to cut off services. I should know, I had to do it more times than I want to remember. But it would be considered Medicare Fraud if you don't. When Patients are under Medicare part A for rehab, no therapy, no payment for room and board. The exception would be if there was another skilled level of care that is covered by Medicare part A like a wound.
As posted, I hope Shorty gets some professional help for her anger and grief.
I so agree with you. I am not an expert on some rules and regulations, but I can also say (as an RN) that a facility or caregiver has to JUSTIFY progress to continue under Medicare. Especially for physical therapy or other services that should see PROGRESS.
If a person is unwilling or unable (mentally or physically) to progress in therapy, by law, you must discharge them from that service. It WOULD be considered Medicare fraud. I worked as a visiting nurse, and we had to document progress in services also.
My own mother was going to be discharged from physical therapy (she had multiple sclerosis) due to seeming lack of cooperation. It wasn't that really, but she was medicated heavily for severe spasms of her legs. I used to go to the meetings to persuade them to KEEP her in therapy.
As an RN who worked with this a lot, and a daughter, it is SO HARD to go through it. MOST extended care facilities have very caring workers who work really hard under tough and especially for the nursing assistants, not very much money. Most care about their patients a LOT. We were always trying to find ways to make things better and help families too.
My mother went to one at the end of her life (we didn't know it at the time). We just couldn't meet her needs for 24 hour care, lifting, etc. A caregiver in the home is pie in the sky most of the time. My mother actually felt SECURE being there with access to 24 hour help. Try not to judge this decision if it is made.
Hyacinth
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