Bill (91 with ALZ) was admitted to the hospital Saturday 7/11 and transferred to an acute rehab center on Tuesday 7/21. His diagnosis was UTI and fluid on his lung. On 7/11 he was dead weight and unable to sit up, so I called his VA doctor and she said to call 911. I did a window visit yesterday and took him some personal items. His care meeting was that morning and a discharge date of Friday 7/31 was set. I had not seen him yet, but thought he must really be making progress. He has not progressed! He can’t sit up or do any transfers without substantial help. I can’t see how it’s possible for him to make enough progress in a week to be safely able to get out of bed and walk on his own (with a cane). Is anyone familiar with the appeal process? Am I thinking too far a head; should I wait and see how he is on Wednesday?
My other concern is his recent weight loss. No changes in his diet or consumption and in two months he went from 192 to 190 to 184 and now 172. I asked his VA doctor about it and was educated by the nurse on proper nutrition. The man eats two hot meals, a lunch in between and an evening snack daily.
Thanks in advance,
Jennifer
What was his baseline level of function prior to this episode? If there is a marked change your husband may need to change over to the SNF/NH for a time to get more rehab if Medicare denies your appeal.
I sent the transfer request to the center he is in now, if they don’t reply I’m going to appeal with Medicare. He no longer needs medical attention, so my hope is that they will send him to a SNF for a couple weeks just to get him back to his baseline. My fear is that he is coming home before he is back to his “normal” physically, and he could fall and be seriously hurt. He is too much for me to lift or even push and pull at. I want him to be safe.
Considering how things are going with covid-19 in GA, Bill is going to be yours to take care of until you can get him into the veterans home, and that could be a while.
Can you do it?
Remember that key term UNSAFE DISCHARGE if they want to discharge him to home and you feel unable to take care of him.
My current savings can pay for a nursing home, but I will quickly run out of $. My business is only running at about 15% because of Covid.
There is no positive outcome in this situation.
thanks for replying
Is he willing and able to participate in physical therapy? If not, that will create a discharge, they have to be making progress to continue getting coverage for rehab.
If you can not care for him as he is, you must tell rehab that he is unsafe to discharge home. Period, end of discussion. UNSAFE DISCHARGE! That is the term that gets them looking for alternative living solutions. This may be what opens that bed at the veteran's home.
Best of luck getting this sorted.
Thank you 😊
I would certainly appeal the discharge if your previous experience has been that he usually makes progress. But be prepared that this time may be different. As his dementia advances, his ability to cooperate with therapists and comprehend what is being asked of him may have changed.
If this is "the new normal" perhaps it is time for him to be admitted as a long term care patient.