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I have no idea what I'm doing so I'm trying to figure this out one step at a time. My mother recently fell and fractured her ankle and since then she has needed me to do everything for her including putting her on and off the toilet. After seeing the specialist she was given the ok to start walking but didn't give her any physical therapy. She doesn't have the strength to get up much less walk she has bad arthritis and had a bone density test done and we see her PCP soon and figured I would ask about PT and possibly a home caregiver as I work and can't be there to take care of her needs is this something that would be approved by her doctor and Medicaid?

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You contact an agency and hire a caregiver for mom.
There is no need for a referral.
I am surprised that PT was not ordered. I would think that that would help more than a caregiver.
Mom also would benefit from having the proper equipment that she needs to make her life easier and safer.
Properly sized walker
Possibly a riser for the toilet
Support frame to go over the toilet so she can get up more easily.
Talking to a PT would help getting mom back to pre fracture status.
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Reply to Grandma1954
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Like Grandma I am surprise PT was not ordered. It sounds to me like your mom should be in rehab for some period until she is back on her feet. I do not think you will get a caregiver daily in home.
This is something now to discuss with the MD and the basics you will need to let him know is just what you told us. A) Your mom is basically bed ridden now B) Neither she nor you have been given a clue how to help her regain mobility; she has had no physical therapy C) You work and cannot leave her alone in these present circumstances.

This really is a bit of an emergent situation. I assume she could not receive rehab care because she was not hospitalized, but just had her foot set as an outpatient. If there is no family to take on the hours you are at work then having someone with her is going to likely be more costly than you can afford. Time to get doctor and social workers on this so you can get supportive care while she heals.

Sorry you are going through this, but a further fall is going to result in some real problems I am afraid. Sadly, you may be looking at family leave act needs so discuss with your employer.
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Reply to AlvaDeer
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Her PCP can order PT in the home. The Caregiver is usually an out of pocket cost.

If she has a Medicare advantage they may supply an aide. Medicare Traditional will pay for PT/OT and an aide to come in 2 or 3x a week to bathe Mom. You could try to see if the aide can stay longer than the usual time of an hour. But this is only a temporary fix. Medicare does probide "intermittent" care but like it says, not a daily thing.

Medicaid has criteria that has to be met. Therebisca cap for assets and monthly income.

Your Mom is 72 (I am 74) and should be able to heal from this. Bone density is just to determine osteoporosis. Most woman have it. It will worsen with age. Its a menopause thing. We no longer make Estrogen. Taking Vit D3 may help but I would not take the shots. The one was shown to cause brittle bones. Meaning breaks if you fall.

Do not enable Mom and do not disable her. Even having arthritis its better to move. You working maybe a good thing because she will be forced to do for herself. Get her PCP to write up an order for in home physical therapy.
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Reply to JoAnn29
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Things to make life easier for your mom: 1. a bidet (get the one that has a heated seat and warm water so she will use it). It is best to get the bidet and 2. side handles for the toilet at the same time so you know they will work with each other. Amazon has many but you need to look at your toilet (is it a one piece, is the back of the bowl rounded or 90 degree angle). Amazon seller usually are good about showing you what you need. My mom eventually could not use the bidet but it was useful for me or the caregivers because it was very effective and the warm water helped her sit still to get clean. 3. Ask around for caregivers (my mom went to funerals of older people and snatched up the now unemployed caregiver who helped with my dad for 5 years). Also consider posting an ad in Craigslist/gig and be very specific!!!! Even to the personality of your mom. 4. I almost got care.com for my MIL and found through the BBB and other reviews it was a very very bad idea. They have terrible customer service and the contract is 2 years and that means money is coming from your account for that time even if you don’t use them or cannot find anyone and you gave up. I went to Craigslist/gig (10 bucks for 30 days) and posted a very specific ad asking the interested applicants to please specify how their experience fit what I wanted in the ad. Of the 29 applications only 4 did exactly that. One was head and shoulders above the rest and she got the job. She is still there and it has been a year. I wanted the caregiver to light meal prep, pick up scripts, drive to doctor appt and accompany my MIL. She is a caregiver/light housekeeper/sandwich maker/driver. My MIL is a hard woman of 93.6 and I am so glad I was specific in the ad. “THIN SKINNED/feelings easily hurt personalities will not be successful in this job; mom has no filter on her praise and snarky comments”. We also prayed for God to give us the best person for this hard job.
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Reply to Tandemfun4us
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KPWCSC Jun 9, 2024
You were fortunate to find a caregiver through Craig’s List because there have been so many horror stories on the news even about simple sales transactions going very bad. I feel that is very risky to consider it would be successful for everyone no matter how specific the ad reads. No matter how good the person is as a caregiver, I would be concerned using a caregiver found on Craigs List especially for a loved one living alone. It is so sad that we need to be so careful In todays world. Please everyone be careful.
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I've read some of the other answers.
I too am shocked that she was sent home without PT, or rehab.
Since you ask about medicaid, I am going to assume she has medicaid already, or you plan to apply.
Bring this up with her PCP. And insist!
I would ask if she could get the doctor's referral to a Rehab facility. These are meant to be short-term, with intensive therapy to get patients back on their feet and independent enough to go home. A skilled Nursing Rehab will also provide cares such as toileting, meals, bathing, medications,... kind of like a hospital, but it's a transitional step from hospital to home.
Make a phone call to her Medicaid case manager and talk about her needs and what is covered. After she is transitioned to home, she may still need some home care, which medicaid will cover (depending on the needs of the patient).
Ask about Home Based Community Services.
Generally, Medicaid will pay for services in the home because it is much less costly than in a skilled nursing home.

If she has Medicare, (over 65 or disabled) you can call Medicare and see if they might cover a short term rehab stay as she heals from the fractured ankle.
Medicare only covers doctor and hospital necessities. Medicaid covers what Medicare doesn't - only for income eligible.
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Reply to CaringWifeAZ
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Next-door.com , Nesterly.com , Care.com. Ask the PCP for a social worker to help you navigate the system especially since she just got discharged you are eligible for PT , a CNA and a VNA Nurse covered by Medicare and a walker or Rolater .
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Reply to KNance72
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Luis111: Assuming that your mother has MEDICARE insurance as she is 72 years of age, there is no requirement for a referral. Physical therapy should have been ordered from the get go. Speak with her PCP about rehabilitation.
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Reply to Llamalover47
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I would not wait for the PCP appointment, use the portal or call tomorrow explaining the situation and requesting a home health evaluation immediately. If the doctor is efficient, you might have someone out the next day, likely a nurse or PT. You don’t say if your mom was hospitalized or just went to the emergency room, which might explain why home health wasn’t put in place. I can’t imagine she would be discharged from a hospital without appropriate resources in place, even with today’s healthcare shortcomings.
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Reply to MidwestOT
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