I understand that people go all kinds of crazy when dealing with a family member - but you wouldn't believe what I've seen over the past 25 years. Starting with my own family, many of whom still aren't speaking with one another after mom died ten years ago.
People go nuts when it comes to caring for a family member - they stress, they don't sleep - and they listen to anyone except the professionals who actually have the ability to help. They'll listen to their mother's complaints that no one answers her call light - not the staff who can show the call-light history that mom never pressed the button. They'll refuse to believe that mom is confused because she's "clear" when they're present (in full denial, by the way); and they'll accuse staff of acting unprofessionally because they don't realize the limitations presented by our current healthcare system.
Fast forward to last night, where a friend described the situation with her parent. Her mother was discharged on a Friday afternoon with no notice to a nursing home that has a one-star rating from Medicare (the lowest rating possible). The hospital case manager had told them that no other nursing home will take her mom - but that's a crock of shit. That was the only place they could "turf" her to on a Friday afternoon when they were done squeezing the rehabilitation dollars out of her.
This is typical hospital protocol, send the patients out on Friday and have the family or patient sign a "patient choice" form that intimates the patient chose wherever they were sent. The hospital often refers to favored nursing homes and don't even try to send patients where the family requests. Then, they "sell" the family on the place the patient's sent to.
My friend bragged about the care that the nursing home provides - that they were rated "four-stars" for staffing. I didn't have the heart to tell her that the hours the director of nursing, MDS coordinators, staff development, and any other licensed personnel count toward the staffing hours even though they're not providing any direct care. That rating means absolutely nothing - but in this case, the nursing home only has that to brag about.
The patient is now one month into her lower-level of rehabilitation, and the family needs to do some planning as to who will care for mom if she's not able to remain independent when she returns home. My friend yelled at me, told me that she trusts the secondary insurance company because they've had that insurance for years and they were told that the insurance will pay forever (unlimited benefits) - and that she's sure her mother won't qualify for Medicaid if she needs custodial care.
FYI, the secondary insurance only pays what Medicare approves but doesn't pay - that 20%... and when Medicare stops paying, so does the secondary. My friend is under the impression that her mom can go back to the hospital and get her full Medicare rehabilitation benefit back at any time... but that's not the case. Medicare won't pay for this woman forever - in fact, she only has a couple of months left and if she's not able to care for herself, they'll send her home. This will all be discussed in a discharge planning meeting held at the last minute, just like the hospital Friday afternoon discharge.
Medicaid eligibility is possible - and if a patient qualifies, they should take advantage of the program. Few people can afford to pay $6,000+ a month for nursing home care, and few people bought long-term care insurance. Medicaid also has programs that assist patients in the home.
Her mom is eligible for VA Aid & Attendance, which will give them an additional $1,100 per month to pay for assistance. My friend told me a woman she knows told her that the VA won't help at all.
The nursing home held its "care plan meeting," a dog & pony show designed to appease families every 90 days... and all they can do is tell my friend that her mom is "improving."
Everyday, in my job, I'm yelled at, told I'm full of shit, and otherwise ignored when I attempt to discuss the reality of what insurance pays & doesn't pay. I'm told that the attorney that did the Revocable Living Trust 20 years ago knew what he was doing... but the truth is that he didn't and by not planning better, mom will not be eligible for help. I'm told that I don't know what people are going through, that they have received professional advice (funny, that's what I do too) and that they know people who have been through this.
They'll ask if I get a kick-back from a referral (I don't), if the company I work for is affiliated with whomever I'm referring... I make nothing, receive nothing other than the satisfaction of seeing but one of my case load benefit from utilizing the system to obtain help with an elderly relative.
So, I'm gonna stand by and watch a family become decimated by the trauma of caring for an elderly woman, attempt to pay out of their pocket the $6k to $8k it costs to care for a patient, and ultimately crash & burn. Then they'll turn to me and ask, "Why didn't you say something?" It sure doesn't make me feel better knowing that will happen, either.
Bringing on the "crazy" doesn't do anything except guarantee that whoever reads the chart notes will do their best to stay away. Yelling, screaming, demanding, threatening staff and demeaning people doesn't do anything except guarantee that the best healthcare providers don't stick around to help out.
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I understand that people go all kinds of crazy when dealing with a family member - but you wouldn't believe what I've seen over the past 25 years. Starting with my own family, many of whom still aren't speaking with one another after mom died ten years ago.
People go nuts when it comes to caring for a family member - they stress, they don't sleep - and they listen to anyone except the professionals who actually have the ability to help. They'll listen to their mother's complaints that no one answers her call light - not the staff who can show the call-light history that mom never pressed the button. They'll refuse to believe that mom is confused because she's "clear" when they're present (in full denial, by the way); and they'll accuse staff of acting unprofessionally because they don't realize the limitations presented by our current healthcare system.
Fast forward to last night, where a friend described the situation with her parent. Her mother was discharged on a Friday afternoon with no notice to a nursing home that has a one-star rating from Medicare (the lowest rating possible). The hospital case manager had told them that no other nursing home will take her mom - but that's a crock of shit. That was the only place they could "turf" her to on a Friday afternoon when they were done squeezing the rehabilitation dollars out of her.
This is typical hospital protocol, send the patients out on Friday and have the family or patient sign a "patient choice" form that intimates the patient chose wherever they were sent. The hospital often refers to favored nursing homes and don't even try to send patients where the family requests. Then, they "sell" the family on the place the patient's sent to.
My friend bragged about the care that the nursing home provides - that they were rated "four-stars" for staffing. I didn't have the heart to tell her that the hours the director of nursing, MDS coordinators, staff development, and any other licensed personnel count toward the staffing hours even though they're not providing any direct care. That rating means absolutely nothing - but in this case, the nursing home only has that to brag about.
The patient is now one month into her lower-level of rehabilitation, and the family needs to do some planning as to who will care for mom if she's not able to remain independent when she returns home. My friend yelled at me, told me that she trusts the secondary insurance company because they've had that insurance for years and they were told that the insurance will pay forever (unlimited benefits) - and that she's sure her mother won't qualify for Medicaid if she needs custodial care.
FYI, the secondary insurance only pays what Medicare approves but doesn't pay - that 20%... and when Medicare stops paying, so does the secondary. My friend is under the impression that her mom can go back to the hospital and get her full Medicare rehabilitation benefit back at any time... but that's not the case. Medicare won't pay for this woman forever - in fact, she only has a couple of months left and if she's not able to care for herself, they'll send her home. This will all be discussed in a discharge planning meeting held at the last minute, just like the hospital Friday afternoon discharge.
Medicaid eligibility is possible - and if a patient qualifies, they should take advantage of the program. Few people can afford to pay $6,000+ a month for nursing home care, and few people bought long-term care insurance. Medicaid also has programs that assist patients in the home.
Her mom is eligible for VA Aid & Attendance, which will give them an additional $1,100 per month to pay for assistance. My friend told me a woman she knows told her that the VA won't help at all.
The nursing home held its "care plan meeting," a dog & pony show designed to appease families every 90 days... and all they can do is tell my friend that her mom is "improving."
Everyday, in my job, I'm yelled at, told I'm full of shit, and otherwise ignored when I attempt to discuss the reality of what insurance pays & doesn't pay. I'm told that the attorney that did the Revocable Living Trust 20 years ago knew what he was doing... but the truth is that he didn't and by not planning better, mom will not be eligible for help. I'm told that I don't know what people are going through, that they have received professional advice (funny, that's what I do too) and that they know people who have been through this.
They'll ask if I get a kick-back from a referral (I don't), if the company I work for is affiliated with whomever I'm referring... I make nothing, receive nothing other than the satisfaction of seeing but one of my case load benefit from utilizing the system to obtain help with an elderly relative.
So, I'm gonna stand by and watch a family become decimated by the trauma of caring for an elderly woman, attempt to pay out of their pocket the $6k to $8k it costs to care for a patient, and ultimately crash & burn. Then they'll turn to me and ask, "Why didn't you say something?" It sure doesn't make me feel better knowing that will happen, either.
Bringing on the "crazy" doesn't do anything except guarantee that whoever reads the chart notes will do their best to stay away. Yelling, screaming, demanding, threatening staff and demeaning people doesn't do anything except guarantee that the best healthcare providers don't stick around to help out.