Where to Begin – Part 1

This week has been a war of attrition. Back in April, my mom had a bad fall in her home. She ended up in the hospital for about a week and a half, and then was sent to a skilled  nursing facility for wound management and physical therapy. She has been there for about 4 weeks. The staff has said at this point she is not meeting their improvement standard; they want to discharge her to assisted living next, since she still cannot stand up without help and she lives alone.

I have asked her and my brother to fly her out here to live with me until she is strong enough to get up on her own. We don’t know if Medicare will cover her medical expenses if she comes here instead of going to assisted living, and she subsequently has something requiring medical services.

Yesterday I discovered a link that told me that it is against the Medicare Act to use “the improvement standard” as a standard for ejection from skilled nursing facilities.  http://www.medicareadvocacy.org/. It is a widely used standard, and has been used for decades. However, it is a misused standard.

My brother has filed an appeal to their decision. Hopefully we will win appeal. Medicare permits up to 100 days in a skilled nursing facility, and she has been there about 4 or 5 weeks. We believe that she might get strong enough with more weeks of physical therapy. Her first two weeks at the facility her wounds on her feet were still healing and her feet had huge bandages. thus she really has only had a couple of weeks of PT. Once she is standing, she can walk 75-100 feet, very slowly, using her walker, with someone at her side. Even if she is stronger, she should STiLL  probably be here……

As for the matter of me actually being able to give her proper care. I hope I/we can get her standing. There are 3 of us here (my husband and my 23 year old son). One of us will always have to be here, which is do-able—my tutoring has me in and out, and my son is still looking for work. My husband is away from the house on weekdays for 12-13 hours a day. His schedule isn’t flexible, but when he is here he can help. I pray that we can manage this, and keep her out of the hospital.

I cannot go to Ohio for weeks/months on end-my family needs me, my students need me, and we need my income to help  pay off the uncovered medical expenses from a number of years ago and other loans as a result of multiple job losses. If she is here, we keep our jobs and care for her.  My brother’s job is like my husbands—long and demanding. If he cuts his hours, he could lose his job–and of course then, there goes their home. If she is here, she won’t be shelling out $6,000 + per month for assisted living.

But of course, as medicare and medical facilities go, we will not know until the last minute what will happen. At that point, last minute plane reservations will need to be made, and I will need a hospital bed, a chair that goes over the toilet, and one of those belt things they use to help people stand up, and perhaps walkers and a wheel chair if she doesn’t want hers brought on the plane.

So that is where that stands. It would be good to have her here where she is loved, and we can try to help her. The getting from this point to that point is overwhelming. today we are going to have to move things out of the den and into other rooms and prepare for her potential arrival. She is overwhelmed beyond measure at the thought of the trek out here, and continuing to be away from her home.

So that is part 1 of the week. I am working on making lemonade for all of us.