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And the three days (actually nights, where the patient is there at midnight) have to be logged as "Inpatient."
I've seen some cases recently where hospitals keep people, on the books as "Observation," for several days. Then, in a weakened condition and not being able to go home alone safely, they didn't have a qualified Medicare stay.
There are a few reasons a hospital may do this to their favor. Hospitals are also regulated in who and what can qualify as inpatient.
Dealing with all of it is mental gymnastics for family and/or friends of the patient.
A few months ago I was in the hospital for three nights under "observation" for chest pain. Since I was not "admitted" my insurance (I'm not on Medicare) paid everything but I had to pay the $100 fee for being seen in the emergency room (waived if you are admitted). Before that happened to me I had no idea that you could be in a hospital, in a bed, seen by doctors & cared for like a regular patient for days and not actually admitted to the hospital. Odd.
My husband is in the hospital rehab program. It is off to a good start with his therapies. He seems to be eating a little more, but I was there for both breakfast & lunch & all afternoon to remind him/coax him into eating.
He must have been starting to get hungry again, or the food was more appetizing or something because the nurse's aide said that he ate much of his dinner. Yippee!!
Last week my husband fell down a flight of stairs and hit his head on the tile floor and the wooden front door. He developed swelling and bleeding on the brain. Thankfully, it was not too serious (for that type of injury). He spent four days in intensive care and now has been on a general floor for another four days. He will be transferred to the hospital rehab floor as soon as he is completely stable (he is having difficulty with his sodium levels, his white blood cell count is high, plus a few other problems --- like he is getting weaker because he is not eating).
But, why am I venting? Arrggg-ing? Needless to say, I have already needed to take off of work from both my full time and my part time job plus cancel/ not schedule any "gigs" to earn extra money. Of course, my place is with my husband in the hospital and I really need to be there almost all day due problems caused by his previous brain damage and his confusion (explain it to the therapists, nurses, etc) remind him to ask for water, juice, etc and drink the liquids .
I am hoping that once he starts rehab in the hospital he will be able to be on his own a little more. One day this week I came early in the morning and then needed to leave for a few hours and returned in the late afternoon, I noticed a completely full meal tray and assumed that they had just brought the evening meal. Nope, it was the lunch tray and my husband had not even had one bite of the noon meal. They just removed the completely full tray and replaced it with the evening meal. How can someone possible recover from a serious injury if they aren't even eating? Sheesh! You would think that someone from the hospital would notice the full lunch tray at 1 PM or 2 PM or 3 PM or 4 PM and suggest to my husband that he should eat something.
The doctor said that for him to be placed in the hospital rehab program I needed to verify that after he was released, from rehab, he would be under continuous supervision at home 24 hours a day, seven days a week for a minimum of three weeks. The doctor was emphatic about that. He even asked me if I would be able to make sure that he was supervised if I needed to go to the doctor or if I had someone to buy groceries , go to the drug store or to run other errands like that.
Yikes! My vent is "how can they expect people to handle that?" I can barely pay the bills, with having a full time job, a part time job plus "extra gigs" (babysitting, etc) to earn extra money.
I mentioned my concerns to the hospital social worker and she rather flippantly said I should "just use my sick days" so that I can be home full time for a few weeks (this is after being with hubby almost full time in the hospital for a few weeks). Well, substitute teachers do not have sick days. If you do not work you do not get paid. I also work as a tutor, it is the same thing, if you do not work, you do not get paid (and, in addition, if I take off too many times even my long term clients will look for a different tutor). And, you certainly don't get paid if you don't babysit. Arrggg!!!
Vent! Vent! Vent!
I mentioned this problem to a dear friend, and their spouse overheard and chimed in "When we needed someone to stay with my dad we just paid an agency to send people 24/7". If I am a 63 year old adult who has to get date night babysitting jobs to have enough money to pay my bills, will I really have enough money just sitting around to pay an agency to come to my house 24/7?
This is so frustrating. Now, I may be able to do some juggling of schedules with our adult daughter, but the very, very best situation would be that I would be earning maybe 20% or 25% of my usual (already too low) income for five or six weeks (and maybe longer). Arrggg!!!! Vent! Arrggg!!!
How can I be in two places (work and home) at one time?
That makes no sense to me. My mom is in rehab right now, after a surgery. And she will NOT be released until she can get around, safely, on her own, as there is NO one at home to care for her.
That makes no sense to me. My mom is in rehab right now, after a surgery. And she will NOT be released until she can get around, safely, on her own, as there is NO one at home to care for her.
The rehab doctor and the hospital social worker (who plans discharges) both told me again today that someone had to be home with my husband 24/7 for at least two weeks, preferably three weeks, after he was released from rehab at the hospital. They said that if I couldn't do it I should ask family members & friends to stay with him or hire an agency to stay with him.
It seems pretty strange to me, too. Either, he would be ready to go home on his own or not ready to go home at all. But, perhaps, it was because my husband suffered a head injury.
Rehab rules are crazy! A few years ago, after my husband was in intensive care in the hospital under a medically induced coma for ten days (long story), they released him after only one day out of the intensive care unit. He could barely stand so they gave him a brief lesson on using a walker and sent him home without any restrictions at all! I complained but his doctor said that there "was no reason for him to be in the hospital anymore".
He was scheduled for daily out-patient physical therapy but no restrictions on driving even though he couldn't walk by himself or get in or out of a chair by himself. The hospital said that he "did not qualify for in-patient therapy". I needed to take off of work to drive him to therapy because I felt that it was unsafe for him to drive a car with so little control over his legs. Yes, rehab rules are crazy! It is so hard to be a caregiver.
Last edited by germaine2626; 09-15-2015 at 09:48 PM..
My husband is in the hospital rehab program. It is off to a good start with his therapies. He seems to be eating a little more, but I was there for both breakfast & lunch & all afternoon to remind him/coax him into eating.
He must have been starting to get hungry again, or the food was more appetizing or something because the nurse's aide said that he ate much of his dinner. Yippee!!
I had a dentist appointment, plus some other appointments today so I did not get to the hospital until 3:30 PM. Guess what I saw as soon as I walked in the room? My husband's full lunch tray, he did not even take one bite. How can he possibly get better unless they encourage him to eat and drink? He did eat some things while I was there, but not very much.
After all of the craziness where they said that he had gained nine pounds they did a more accurate weight and it looks like he has actually lost 5 to 7 pounds in the one and a half weeks since he went in (they don't know for sure because his first weight may have been wrong).
He had 3 1/2 hours of therapy yesterday and 4 hours today (it may have been slightly less, but that was the time listed on the schedule).
I remember going in to a hospital where I found my dad sleeping in front of a tray of cold food. Hours after meal time. No silverware. I called in the nurse and asked her to get the kitchen manager. I asked the kitchen manager to look under the piece of meat. She looked around and asked "where is the silverware?"
Yeah. Good question. That hospital had won awards, too.
But even more important, he was on a mechanical soft diet with thickened liquids. Never happened unless one of us kids or a particular nurse from Haiti was around. He did aspirate. A couple times. We moved him.
The dorks.
A word about awards. Many are from the company that owns the hospital, often more than one or with other health related businesses. Or from an industry club the hospital pays dues to in exchange for marketing. That's where the glossy posters and colorful banners come from. In my experience awards are worthless. If you are ever in a bad mood about your loved ones care (or lack of care) and want to make someone squirm ask a) what the criteria was for their award, and b) ask who the awarding agency is and do they have a website. Don't ask the nurse. Ask a department manager. They should know.
Aunt was sent home from the hospital so sick she couldn't make it to the bathroom. When the the home health nurse came the next day, she refused to accept responsibility for her care and insisted she readmitted to the hospital. Which she was, and where she passed on to her reward a few days later.
Hospitals are under pressure by insurance providers to get people out of the hospital within a certain amount of time for each diagnosis. Patients are sent home who can barely stagger to their feet.
I had a dentist appointment, plus some other appointments today so I did not get to the hospital until 3:30 PM. Guess what I saw as soon as I walked in the room? My husband's full lunch tray, he did not even take one bite. How can he possibly get better unless they encourage him to eat and drink? He did eat some things while I was there, but not very much.
After all of the craziness where they said that he had gained nine pounds they did a more accurate weight and it looks like he has actually lost 5 to 7 pounds in the one and a half weeks since he went in (they don't know for sure because his first weight may have been wrong).
He had 3 1/2 hours of therapy yesterday and 4 hours today (it may have been slightly less, but that was the time listed on the schedule).
Have you asked if he could be given something to stimulate his appetite. If you honestly believe that this lack of appetite is not normal for him, and is due to the pain/current situation he is in??
Also - morphine and other opioid pain killers will kill appetite (basically you're in a morphine fog, so you're really not hungry).
We ended up requesting an ng tube for my father after his criticial hospitalization years ago. He lost so much weight so quickly and was not eating after the surgery - but was in serious pain and heavily medicated. I tried to help him eat, but he literally had to be fed, and would fall asleep after one bite. (And If I wasn't there, he didn't get fed, the hospital just removed the uneaten tray). The doctors very consdescendingly told me he was just ready to die. I told them - "2.5 weeks ago, before this crisis, this is a man who was eating a bowl of SF icecream at 9pm as a "snack"; after 3 solid meals!! And you're telling me this total lack of appetite is "normal??" I fought for the tube, figuring if we could just get him some nutrition he would have some strength to recover (how can you recover if you're essentially starving?).
He was on the ng tube for perhaps 2 days. Then he basically "woke up" from his stupor and started pulling the tube out himself! After that, he always ate just about everything they put in front of him and he began the slow climb to at least a level of recovery. (Never regained mobility, due to lack of rehab and significant bedsores he gained in the hospital when he was in his opioid stupor and they never moved him to prevent sores).
I would definitely fight with the hospital to get your husband nutrition assistance. Without good nutrition, the body can't even begin to try to heal.
My husband will be released from hospital rehab on Thursday. Since our condo has stairs and the bedrooms & bathroom upstairs I decided that it would be best for us to move into an apartment immediately and prepare to sell our condo while we are living nearby. My brother helped by making a lot of phone calls to find a suitable place.
I looked at the apartment yesterday and filed out the paperwork today and will move the essentials like a bed, boxes of dishes & cooking supplies, a table and a few chairs on Tuesday or Wednesday so my husband can move directly into the new place. Due to quick move my brother asked his son (my nephew) to help us move, plus we would use his truck. Although, it is a little short notice my nephew agreed to help. In a few weeks, I may hire a moving truck to move the rest of the furniture that can't be moved by car.
Tonight, I got this really snarky email from my Sister in Law complaining that "her children have busy lives" and should not be expected to help and why didn't MY children help. Well, our daughter is already helping several hours a day (carrying for the house, doing all of the grocery shopping, laundry & cooking, plus walking the dog) & our son, who was here already to help, needed to return 2,000 miles to his new job. Plus, he is already planning on coming back. In addition, neither of them own a truck.
Of course, I am still venting. My nerves are just frazzled and getting a snarky email really put me over the top. Unfortunately, I read the email right before I was going to bed and it got me so upset that it is now over two hours later that I am still too wound up to sleep.
Last edited by germaine2626; 09-18-2015 at 10:47 PM..
Well, I think your SIL clearly rhymes with witch. But I suspect she is known for this. Her son obviously has more compassion than she does. Thank him well with cash and beer (or pizza). Let him clearly know just how much his help did for his uncle. Make him feel needed. Helps overcome the selfishness of his mom.
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Update
If I am a 63 year old adult who has to get date night babysitting jobs to have enough money to pay my bills, will I really have enough money just sitting around to pay an agency to come to my house 24/7?
