tell me Dad is being discharged home from the hospital tomorrow. Well I dont quite
understand this; hes 82 years old, he fell at home, hes totally confused, he
cant walk without help; they say hes too confused to go to rehab; they say he
can go to a nursing home, but that Medicare wont pay for it again because hes
too confused. He is confused, but is that his fault? Frankly, this is all quite sudden,
and Im just not ready to put him in a nursing home, and who can afford to pay
$300/day for a nursing home anyway. There must be some other option, some service that can
guide someone in my predicament."
Years of Experience
shown me that even highly educated, high-functioning families need at least a two-hour
consultation to help them get a grasp of what lies ahead following their loved ones
hospitalization and to put the necessary pieces in place. Hospital social workers and
nurses do not have two hours to give each patient that needs home care set up by the time
they return home. They do not get involved in helping you hire a home health care
attendant other than to give you a list of agencies to call.
To further confuse
you, they may make a referral to a certified home health agency and tell you that Medicare
will pay for an aide "for 4 hours/5 days a week." This only serves to complicate
the issue if your mother needs at least eight hours of help a day -- if not 24 hour care
at home. My preference is to interview aides prior to discharge and have them start in the
hospital to see how they work out before your family member is discharged from the
hospital. It reduces everyones anxiety a great deal.
Often the hospital
neglects to provide physical therapy to get the person back on their feet, which in turn
would reduce the need for home care. I can help advocate for discharge planning to be done
properly by seeing to it that the hospital does what it is supposed to do prior to sending
the person home, which often results in
preventing a rehospitalization. Sometimes in the course of the physical therapy the
conclusion is reached that a short stay in a rehabilitation facility would be beneficial,
and this is covered by Medicare. Please see "Paying for Care" for further discussion about
how care can be covered at home.