U.S. CitiesCity-Data Forum Index
Go Back   City-Data Forum > General Forums > Retirement
 [Register]
Please register to participate in our discussions with 2 million other members - it's free and quick! Some forums can only be seen by registered members. After you create your account, you'll be able to customize options and access all our 15,000 new posts/day with fewer ads.
View detailed profile (Advanced) or search
site with Google Custom Search

Search Forums  (Advanced)
Reply Start New Thread
 
Old 07-01-2014, 09:02 AM
 
Location: State of Being
35,885 posts, read 67,263,408 times
Reputation: 22402

Advertisements

More info on "observation stays" . . .

Hospital Observation Stays Sock People on Medicare | Next Avenue
Reply With Quote Quick reply to this message

 
Old 07-01-2014, 09:18 AM
 
Location: State of Being
35,885 posts, read 67,263,408 times
Reputation: 22402
BTW - not getting the use of the word "macabre" in the title. ???
Reply With Quote Quick reply to this message
 
Old 07-01-2014, 09:26 AM
 
Location: middle tennessee
1,927 posts, read 997,223 times
Reputation: 7025
Quote:
Originally Posted by anifani821 View Post
BTW - not getting the use of the word "macabre" in the title. ???
there are people who think that the chance of dying at home and alone is horrendous
Reply With Quote Quick reply to this message
 
Old 07-01-2014, 09:57 AM
 
Location: Up North in God's Country
670 posts, read 820,646 times
Reputation: 993
Default A Macbre Question

Quote:
Originally Posted by Robyn55 View Post
There's a big difference between someone deciding his or her own fate - and spending his/her own dollars to reach that goal - and imposing on family members to accomplish what they might prefer to do. No way I'm going to spend my 60's or 70's being a caregiver/nurse/maid/etc. for others. YMMV. Robyn
Wow. I've spent most of my 60's being a caregiver for my mother and father. My father is gone now, but my 89 year old mother can't live alone. She is of sound mind (a tad forgetful) and gets around with a cane, but there are too many things that she cannot do. After all, they spent their 20's and 30's taking care of me.
Reply With Quote Quick reply to this message
 
Old 07-01-2014, 10:40 AM
 
Location: Prescott AZ
6,138 posts, read 9,116,800 times
Reputation: 11602
Most people cannot afford in home care 24/7 unless they have unlimited funds. The problem is nighttime. Leaving the elderly frail alone at night is always the problem. This is why agencies push for facility care.

Private nursing agencies charge about $21 an hour with a 3 hour minimum, and just trying to find a caregiver on the internet (I tried CL, got their resumes, their references, etc.) they still wanted $15/hour. Being in another state compounds the problem. The only solution, for me, was to find an inexpensive ALF, here, not in Illinois where everything was $$$$$.

It's always a patchwork solution of services, relatives, church members, neighbors, etc. and putting together this plan is not easy. It can give you a long lasting headache especially if one of the "patches" should fail.

Last edited by AZgarden; 07-01-2014 at 10:41 AM.. Reason: added info
Reply With Quote Quick reply to this message
 
Old 07-01-2014, 10:44 AM
 
Location: Prescott AZ
6,138 posts, read 9,116,800 times
Reputation: 11602
Quote:
Originally Posted by NilaJones View Post
My understanding is that it is almost always less expensive to have caregivers at home than to be in a facility. So where does this pressure come from, to put people in facilities?

Is there funding for the facilities but not for the in-home care? And, if so, are we doing something about that?
See my post. Its not always less expensive for home care. This is a business and they want to make money just like everyone else.
Reply With Quote Quick reply to this message
 
Old 07-01-2014, 03:23 PM
 
293 posts, read 439,334 times
Reputation: 1319
Quote:
Originally Posted by Robyn55 View Post
There's a big difference between someone deciding his or her own fate - and spending his/her own dollars to reach that goal - and imposing on family members to accomplish what they might prefer to do. No way I'm going to spend my 60's or 70's being a caregiver/nurse/maid/etc. for others. YMMV. Robyn
I love this attitude and wish I could adopt it. Unfortunately, my mother has no money, is not disabled enough to qualify for a nursing home (paid by Medicaid), and needs help almost daily with things around the house. I hate that I'm stuck this way, but only one sibling is local and willing/able to help, so I don't have too much choice. If my mother had the funds to pay for assisted living (or paid in-home help) I'd be out of here in a heartbeat.
Reply With Quote Quick reply to this message
 
Old 07-01-2014, 07:48 PM
 
Location: Baltimore, MD
3,746 posts, read 4,229,892 times
Reputation: 6867
Quote:
Originally Posted by GotHereQuickAsICould View Post
Hospitals are supposed to follow a discharge plan that does not involve just dumping people but that doesn't always happen.

My aunt was discharged to her home in such poor medical condition that the home health nurse who came by the next day refused to assume responsibility for her care and called an ambulance. She died in the hospital two days later.

I've seen people who are barely able to ambulate discharged to homeless shelters.
A couple of years ago my sister, who coordinated the services required for aftercare, called me from a facility to obtain a current list of homeless shelters. She had to get a dude out of the facility and no one in his family, including his wife, was willing to take him.

The nurses at the facility were disgusted that the family would not take him in until I reminded my sister, who in turn reminded the staff, that the guy may have been a real SOB outside the facility. Sometimes what goes around, really does come around.
Reply With Quote Quick reply to this message
 
Old 07-02-2014, 07:10 AM
 
Location: Verde Valley AZ
8,631 posts, read 9,712,181 times
Reputation: 11024
Quote:
Originally Posted by anifani821 View Post
I should add . . . if an elder is admitted to the hospital for 48 hour observation, and subsequently sent back home, they will be billed as an outpatient. Medicare will not reimburse as a hospital stay. The 30 day readmission regs are part of ACA. Hospitals have to absorb the tab if Medicare patients are readmitted within 30 days.

Also, observation stays can affect whether or not a patient will be able to go into a nursing home setting with reimbursement from Medicare. Medicare requires 3 days in hospital stay.

Now you tell me: if you were a hospital administrator, what would YOU be advising staff? The shortfall for hospitals is in the billions with re-admissions. You would have that patient evaluated and you would be assessing the possibility of future admissions within 30 days (something very likely with many diagnoses, and in particular, heart failure).

Perhaps it is best for that patient to be in a higher level of care unit within the hospital or transfer the patient to a nursing home facility.

Perhaps it is best to get other agencies involved and do a home assessment and include home health visits and so forth.

Things have changed with Obamacare. Elders and their families may not be aware of the changes. When it comes to Medicare reimbursement, folks need to be educated about what to expect with hospital admissions and observation stays. It is no longer a matter of "self determination" in many situations when the patient's bills are being paid by Medicare.
My nephew and nieces are going through something like this now with my sister. In Mar. she was admitted to the hospital in very bad shape. She nearly died and I flew up there to see her. She was in the hospital for about 10 days and then transferred to a nursing home. She was there for three weeks and sent home. She should have never been sent home. Three weeks ago she was in the hospital again and then again this week. She has so many infections and it's partly from bad hygiene and the fact that she simply cannot do much of anything for herself anymore. She weighs 300 pounds now, can't even get out of her chair and ends up being in it 24/7. That means she needs her depends changed several times a day, etc.. Her kids do the best they can with her but she's terribly stubborn and refuses to "take orders" from anyone. She has been assigned MANY caregivers over the past few years and she ends up getting rid of them or they can't deal with her and leave. She really NEEDS to be in a nursing home but they keep sending her home because she wants to be there and refuses to cooperate with nurses, etc.. I tried and tried to get them to do a home assessment back in Mar. but they either wouldn't/couldn't/didn't want to and that's too bad. She is 70 and the way she's going I wonder if she'll see 71.
Reply With Quote Quick reply to this message
 
Old 07-02-2014, 07:52 AM
 
Location: State of Being
35,885 posts, read 67,263,408 times
Reputation: 22402
Quote:
Originally Posted by AZDesertBrat View Post
My nephew and nieces are going through something like this now with my sister. In Mar. she was admitted to the hospital in very bad shape. She nearly died and I flew up there to see her. She was in the hospital for about 10 days and then transferred to a nursing home. She was there for three weeks and sent home. She should have never been sent home. Three weeks ago she was in the hospital again and then again this week. She has so many infections and it's partly from bad hygiene and the fact that she simply cannot do much of anything for herself anymore. She weighs 300 pounds now, can't even get out of her chair and ends up being in it 24/7. That means she needs her depends changed several times a day, etc.. Her kids do the best they can with her but she's terribly stubborn and refuses to "take orders" from anyone. She has been assigned MANY caregivers over the past few years and she ends up getting rid of them or they can't deal with her and leave. She really NEEDS to be in a nursing home but they keep sending her home because she wants to be there and refuses to cooperate with nurses, etc.. I tried and tried to get them to do a home assessment back in Mar. but they either wouldn't/couldn't/didn't want to and that's too bad. She is 70 and the way she's going I wonder if she'll see 71.
This sounds like a deteriorating situation. I am so sorry that you and your nieces and nephews are not getting cooperation (from your sister as well as from "the system").

Is there a niece or nephew who can communicate directly with your sister's care team should she be admitted to the hospital again? Has she had a psychological or neurological assessment?

She should qualify under the right circumstances for in-home care but it sounds like she has been uncooperative in the past with having them in her home to help her.

Someone needs to speak with the administration at nursing homes to see where there are placements available. See if there is paperwork that can be filled out and on file for the future.

Find out if anyone has her POA so they can deal directly with Medicare and find out what is and isn't possible when she is next hospitalized.

Is there any history of early onset Alzheimers in your family?

I can't believe that your sister really wants to be in pain and have to keep going back to the hospital (and it sounds like she is in denial - and that the rest of you simply cannot convince her to do what is needed to take care of herself). She may feel she wants to stay in her home but to be that young and in such bad shape . . . it really sounds like there are other issues with her health (mental health? undiagnosed disease?) that are keeping her from thinking clearly.
Reply With Quote Quick reply to this message
Please register to post and access all features of our very popular forum. It is free and quick. Over $68,000 in prizes has already been given out to active posters on our forum. Additional giveaways are planned.

Detailed information about all U.S. cities, counties, and zip codes on our site: City-data.com.


Reply
Please update this thread with any new information or opinions. This open thread is still read by thousands of people, so we encourage all additional points of view.

Quick Reply
Message:

Over $104,000 in prizes was already given out to active posters on our forum and additional giveaways are planned!

Go Back   City-Data Forum > General Forums > Retirement
Follow City-Data.com founder on our Forum or

All times are GMT -6.

2005-2019, Advameg, Inc. · Please obey Forum Rules · Terms of Use and Privacy Policy · Bug Bounty

City-Data.com - Archive 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24, 25, 26, 27, 28, 29, 30, 31, 32, 33, 34, 35 - Top