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Who has the durable power of attorney for healthcare? Can your mother verbalize what she wants? Those are the two most important points right now. If no one in your family has one on file in the hospital, you need to have your mother do one while she is competant to sign it. A DPH lets you speak for the patient if they can not for themselves.
As far as the discharge to a local SNF. If there are none acceptable, you can tell them NO. You do not need to put her into a snf just because the on staff doc and sw want to. They push it for various reasons....but if you believe you are competant and dedicated enough to do it, and you sound as if you are capable, then tell them that a stepdown to a SNF is unacceptable - they may be discharging her to a snf because they feel she needs to be hospitalized, however cannot continue to bill if she is stable. If she needs to stay in the hospital *not a SNF* tell them that. At this point, remember that you must document everything in writing - and keep copies. Don't just have a conversation. Hand them a written copy of what you will say to them and instruct them that it is to be placed in her file. Remember, although everyone is supposedly on the patients side, the truth is that family does need to advocate for frail elders.
Please call her doctor and inform them that is what you are willing to do. If they give you a problem, contact the ombudsman and talk to them. The main thing you care about is whether she is stable enough to leave the hospital, and what can be done for her.
sorry for the lateness of response. Wishing you the best of luck
My mom's actual doctor does not visit her in hospital but rather employs a group of hospitalists for that purpose. SW was most importantly pushing nursing home for the therapy she needs. I wonder if they have ever been to these places.
I know my mom would be happier at home. I am not dillusional and think she is going to get better. therefore I just can't see torturing her in the insitutional setting. My mom's level of functionality has not changed drastically since this last stroke. She had previous strokes too. She knows us. Can talk. Can feed herself, but needs assistance for everything else. Thank you for your encouragement. I think today I will try to contact my mom's real doctor and also her neurologist, maybe he can recommended home therapy. It would be nice to know that Medicare would pick up some cost but if private pay is necessary, we've been managing so far and have the capabilities to continue.
I admire you looking at the options for your mom - hope I can give you my thoughts on what options you have. My experience is that if you keep talking and engaging her in activitie she may very well do better than at a SNF. If you have the determination and ability to do so, she will probably do better at home if she is stable. Being in a familiar setting with people who you know may be the best thing for her. You do want to do your homework though. It does take time and effort to be an advocate and provide the best for your parent.
If you have not discussed your plans to keep her at home with her doctor, you should do so and get their support as soon as possible. Many doctors are used to admitting to SNF's because family can't or won't take on the tasks. You also would like to have her evaluated by a neurologist - and get info from them on what they see. Once your doctors are onboard, you will need to talk to the hospital physical therapist and if you are lucky - go find the hospital SW or discharge planner who will support your plan to take her home. PT and OT can be ordered as in home service by the doctor in most cases (check insurance - you will need authorizations and to stay on top of who is sent).
You will need to have a care plan to follow, although most of the real therapy will take place in the time and attention you give. Much of what you will be doing is constantly being there most of the time, attention and encouraging talking
What do you think? Please help with comments. We need to have some answers for doctors.
In a perfect world all of us would reach out to as many decison makers as we could and carry our message about the future of caregiving and its current state of affairs.
In a perfect world caraegivers would be recognized, have healthcare and accrue social security benefits for the future.
Ahem,
Now that I think of it although a perfect world is subjective and elusive, this site is as close to perfect world as I can think of for what matters most right now. Thanks to Carol and all the people who care to post & participate. Right on Lindam for starting this thread.
In a perfect world my dad would have had lots of love as a child and been more secure and less self-centered. He would have known how to love my mom and and us kids.
In a perfect world we would have been raised by a whole generation that was not scared of the Great Depression and would have had plenty to eat and new clothes to wear. '
In a perfect world we would not be resentful of our choices of taking care of our elders, we would be gracious, patient, and compassionate. Some of us are only reacting the way we have been taught.
In a perfect world our parents would have had the tools and insight to teach us about selflessness, not martyrdom. We would have been able to communicate and let old wounds go.
We would understand how scared and powerless our elders are and that they have no control sometimes. We would be able to have empathy for them as one day we will be them.
But this is not a perfect world and we can only do what we can do. There are gazillion "boomers" going to need care one day and the thought scaires me half to death. Will I be placed in a substandard nursing home, and if my son gets burdened with me will he have a place to put his resentments and unresolved feelings?
And because this is not a perfect world, nor are we, I am very grateful to have a place to put my feelings. God Bless