UPDATE: What can we do? (medical insurance related)

[bumbershoot]

There should be some kind of karmatic law that says children of abusive parents shouldn't have to deal with this crap when their parents are elderly. Sorry for the TMI, but it's true and I've about had it. Another poster said I sounded "put out" at having to deal with the house -- well, you're damn right I am. Who wouldn't be? My sister and I grew up in near squalor conditions (hoarding mess, not poverty), couldn't have friends over very often, were called every name in the book, had fists, belt buckles, and boards taken to us and now we're doing the best we can and have to fight tooth and nail to get some kind of care for my dad (mother passed away 2 years ago after very similar crap). The two of us can't go through another summer of this. We just can't. But we also can't just not do anything because we do love him despite our childhood and we're just not that way. I don't care what anybody thinks of us, but we can't give him the care ourselves. We're not physically OR mentally able. I think we're doing an awful lot for him by fighting with the insurance company and trying to clean out that horrible house.

Sorry for the vent. I'm just frustrated. I wish that someone could just take over and DO this for us.

You are much much nicer than I would be in your shoes. I wouldn't have been taking care of either of them. And you're right. There should be a law, karma-based or otherwise, that prevents this sort of thing from happening...you shouldn't have to do it. Though on the other hand, you're getting major brownie-karma points. And maybe he's going to learn from it too, for the future (if you believe in the whole karma thing).

Just a brief update -- they released him today and now he's incontinent!!! He's in so much worse shape than when he went in there. He also can't get from a chair to a walker to the bed. None of us can physically help him if he falls.

We have spoken with his nurses and doctor this evening and they told us to take him back to the ER and insist they readmit him. The nurses said that the incontinence issue will force them to take him for fear of urinary tract infection.

Thank you all for the advice.

I'm so sorry for him (and you!) that he has this problem...but I'm glad for everyone that it will get him back under care.


I"m not surprised they tried to boot him. I was booted from the hospital 42 hours postop when the stinkin' law says that insurance companies must pay for 48 hours. They fudged the info in my papers, they kicked me out before they got my last lab work back, and it turned out I was just a smidge above a hemoglobin level that would have gotten me transfused (and never told me). It was AWFUL. So despite your dad's history, I really feel for him, and I completely feel for YOU.

 

[cm8]

Now the insurance company is denying him the personal care home. What a mess. I'm going to lose my mind and my sister is right behind me.

There should be some kind of karmatic law that says children of abusive parents shouldn't have to deal with this crap when their parents are elderly. Sorry for the TMI, but it's true and I've about had it. Another poster said I sounded "put out" at having to deal with the house -- well, you're damn right I am. Who wouldn't be? My sister and I grew up in near squalor conditions (hoarding mess, not poverty), couldn't have friends over very often, were called every name in the book, had fists, belt buckles, and boards taken to us and now we're doing the best we can and have to fight tooth and nail to get some kind of care for my dad (mother passed away 2 years ago after very similar crap). The two of us can't go through another summer of this. We just can't. But we also can't just not do anything because we do love him despite our childhood and we're just not that way. I don't care what anybody thinks of us, but we can't give him the care ourselves. We're not physically OR mentally able. I think we're doing an awful lot for him by fighting with the insurance company and trying to clean out that horrible house.

Sorry for the vent. I'm just frustrated. I wish that someone could just take over and DO this for us.

 

[Handbag Lady]

I have nothing to add except that I am sorry you are going through this and I'd feel the same way in your shoes.

 

[minkydog]

Just a brief update -- they released him today and now he's incontinent!!! He's in so much worse shape than when he went in there. He also can't get from a chair to a walker to the bed. None of us can physically help him if he falls.

We have spoken with his nurses and doctor this evening and they told us to take him back to the ER and insist they readmit him. The nurses said that the incontinence issue will force them to take him for fear of urinary tract infection.

Thank you all for the advice.

Even before I finished reading I'm thinking,"Holy cow! Get him to the ER immediately!" This hospital has dropped the ball on all counts. If you can't physically move him, call an ambulance and have him transported to the ER. If he is incontinent, immobile, and has active MRSA infection, he will be at high risk for a urinary tract infection. Not something to take lightly--UTI is a leading cause of sepsis in the elderly. That's what killed the Pope, several years back. It can come on quickly, too, within a day or so. Don't wait! Go right back to the hospital and REFUSE TO TAKE HIM HOME. They cannot make you take him. Demand to talk to the nursing supervisor immediately. If she cannot give you satisfaction, start going up the chain of command. This is a very unsafe situation for your father and you have to keep repeating that to everyone you speak with.

and btw--my empathy to you for trying to get your father the right care. I remember when you went through this with your mother, how awful the situation was with that. I think you are to be commended for doing all you can to help your parents, especially in light of the fact of their abusiveness. I went through something similar with my own dad. I "get" that paradox of loving the parent who harms you. We always want our parents to approve, to love us, to be the parent we always needed. I'm so sorry this has been so hard.

 

[MushyMushy]

Another update -- we took all of your advice to heart and armed ourselves with the information, prepared for a fight with the hospital when we took him in. When we got there, they breezed him right through to triage, then right into an ER room. The triage nurse admonished us for having him at home, and we let her have it with an earful! From then on, we told our story to anyone who would listen. The ER doc came in immediately and assured us they would readmit him, that all they needed to do was contact his PCP.

Several hours later, they'd put him in the skilled nursing unit and he's all settled in. We requested to meet with an administrator tomorrow and a case manager to discuss options.

Please keep your fingers crossed for my dad and us. I really just want what's best for him and hope it won't be nearly as difficult as things were with my mother. What a nightmare that was.

 

[bumbershoot]

Whew.

 

[minkydog]

Another update -- we took all of your advice to heart and armed ourselves with the information, prepared for a fight with the hospital when we took him in. When we got there, they breezed him right through to triage, then right into an ER room. The triage nurse admonished us for having him at home, and we let her have it with an earful! From then on, we told our story to anyone who would listen. The ER doc came in immediately and assured us they would readmit him, that all they needed to do was contact his PCP.

Several hours later, they'd put him in the skilled nursing unit and he's all settled in. We requested to meet with an administrator tomorrow and a case manager to discuss options.
Please keep your fingers crossed for my dad and us. I really just want what's best for him and hope it won't be nearly as difficult as things were with my mother. What a nightmare that was.

No kidding! I"d be interested to know why it was acceptable to send this man home in the morning,apparently "all better" in their eyes, but suddenly 8 hours later, voila! he needs a (previously unavailable) skilled bed SUMBODY messed up, bad. I think heads should roll. This was a seriously botched discharge. Thankfully, you were able to get things turned around before something terrible happened.

And when you meet with the admins BRING A NOTEBOOK AND A PEN. Write everything down. Take names. If you really want to go all the way, wear your power suits. You're going to have to play some serious ball with these people, because they're going to be covering their bases any way they can.

 

[laurie31]

Yes, what Minky said.

And here's my 2 cents' worth...

When you go to the meeting be CALM. Ice-cold calm. If you're mad and rant, they will blow you off and not take you seriously, but if you are calm, they will know you mean business and aren't going to go away. Dress well. Speak confidently and calmly. Tell them what you've told us, in a condensed form, if possible. Think bullet points. Be sure to include that you felt it was UNSAFE for him to be discharged and no one would listen to you. Also, that you were trying to prepare for a discharge date, and it was moved up without warning and you were not given time to make the environment SAFE and you were not able to properly care for your father at home, medically, physically (and whatever other way you want to throw in). You can be intense, but stay calm. Look them in the eye. Tell them they failed to provide safe care.

Be sure if there is a deductible associated with each hospital admission, that it is waived for this second admission, since he never should have been discharged in the first place. If they get deer eyes at that, say you'd like to discuss it with Risk Management (if someone from Risk Management isn't already at the table).

Your ultimate goal is your father's care, but make sure he doesn't get financially screwed if you can help it.

When the time comes for him to truly go home, they need to arrange for home health care BEFORE he leaves, and the discharge planner needs to meet with you to go over his plan of care and make sure he will have everything he needs to meet his nursing care needs at home. That's everything from how will he bathe, shave, get to the toilet, to medications and dressing changes.

Good luck!! The DIS is rooting for you!

 

[yoopermom]

I agree with what everyone else has said, dress nice, stay as unemotional as possible, and act as though you're taking notes every minute that they're talking (even if you're scribbling), ask for each person's name and title and write those down, too. There's something about that act of continual writing and name noting that really gets "officials" attention. Be very careful about what you "agree" with them about. Go home and type up as much of the conversation as you can remember, and, as questions come up, make a list of them and email them to the proper person. Document, document, document...

You are an amazingly strong person to have gotten through this. Thoughts and prayers and to you and your family.

Terri

 

[chloelovesdisney]

Although I'm sorry you had such a rough day, I'm happy to hear that your dad is now settled where he should be and it sounds like everything will be taken care of much better from now on.

 

[Pea-n-Me]

I agree with sorting it all out in a calm and rational manner, but I'd have to disagree with the extreme note taking, writing down names, etc. First off, most hospitals today have electronic communications, so everything's already documented, you just have to get the record and you'll have all the information and names right there. Nothing will keep people out of your father's room more than you writing down people's name, rank and serial number; and that's exactly what you don't want. You want people to be sympathetic and want to help you. A better strategy, IMO, is to be friendly and open, but firm. Familiarize yourself with the Patient Bill of Rights. Get a social worker and care coordinator involved. As others have said, discharge cannot occur until it's safe and all parties are prepared. I know the process can be frustrating (I've had it happen myself with my own family). Find some allies in the hospital and work with them. Don't alienate everyone because if there are subsequent hospitalizations, you'll all come with a reputation for being difficult (sorry, but it happens, and people learn your room is one to be avoided, it's human nature). Recognize that your personal history with your father is driving some of your anger; don't take it out on the staff. Granted, they may have made mistakes, but they're not all bad. Allow them to help you and they will.

 

[lucyanna girl]

You have recieved good advice here. I just wanted to wish you the best, goodness knows you deserve it.



Penny

 

[MushyMushy]

Another update -- a good one this time (knock on wood).

We'd gone through our options with the case manager and Dad's doctor. The doc said he needs more time either in assisted living or with a home health care worker, but said that would probably be a lot more than we want to pay, so we got my dad to agree to a nice assisted living place that my mother went to before she died. We really like it and hopefully my dad will too. You can pay month to month and my dad actually wanted a roommate -- he got my old driver's ed teacher.

My sister and I have POA, so we shouldn't have any problems taking care of his finances and such. We're planning on keeping him there at least one month, maybe two with a goal to bring him home if he can be independent. He can afford the assisted living, but not to keep up with the house for very long after a few months.

Some family members are strongly opposed to what we're doing, but you know what. They are more than welcome to take over if they don't like it. We're doing the best we can for him. We put him in a place that we would feel comfortable living in ourselves!

 

[tonilea]

Some family members are strongly opposed to what we're doing, but you know what. They are more than welcome to take over if they don't like it. We're doing the best we can for him. We put him in a place that we would feel comfortable living in ourselves!

Nothing like an armchair quarterback!

 

[minkydog]

I think you've done a wonderful thing for your father. I know that a lot of people think of ASL or nursing homes to be the absolutely most horrible, most desolate, most disrespectful thing you can ever do to a parent or grandparent. I disagree. When you go about it the way you have, made sure you found a nice facility then it can turn out to be a very good thing.

My MIL resisted it mightily, but she simply could not take care of herself and her home, and neither of her kids could take her(especially not us, not with Christian.) The best option for her was assisted living. It took some time for her to adjust, but once she did it's been pretty good. When she lived in her home, she was very isolated. She had no friends and only a few family members that called now & then. Nobody to go to lunch with, nobody to help her shop for groceries or just go to a park. At the ASL they have a pretty active calendar. She made some lady friends to eat lunch with and play cards with. Sometimes local farmers would drop off a load of watermelons or green beans, then all the little old people would sit on the porch and snap beans. Sometimes they'd fire up the gas grill and have a cookout--she certainly never had that at home! She went to a nursing home last year after a broken hip. Now her schedule is busier than ever! The hairdressers come once a week to do hair and nails. There's Bingo and cards. There's the therapy pets and the Girl Scouts coming in to sing for them. Sometimes they put Big Band music over the intercom and those little old people just rock!

I hope your dad adjusts well and it's a perfect fit. Who knows, maybe he'll come to prefer that living arrangement? Stranger things have happened.