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I visited my mom in the hospital after Covid infection. She clearly is not well mentally. She kicked a nurse spews profanity. Sometimes she does not recognize me. I believe she now has the onset of dementia. I have asked the Dr. caring for her now to have her evaluated and he has refused. She only has coverage for 21 days of hospital care and we are at day 15. I need advice on how to get a second opinion. He also will not sign for skilled nursing even though she is not eating, able to stand and like I said severely confused.

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Your profile mentions your mother has mental health problems. Call her psychiatrist and have him request the evaluation. Or call the Medical Director and request this consultation. It could also be that her insurance is refusing to pay for this and has deemed unnecessary. You could also have her checked after she is released. If necessary she could be readmitted if required.
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Infections can cause delerium. Best outcome is this recedes as your Mother beats the infection.

Your profile mentions Mother's current history of mental illness. She may be so confused she is not taking her regular medication, or maybe it is not so effective when ill, or when mixed with other meds for Covid. Very hard.

I suspect it will be a watch & wait situation.
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I don’t think an evaluation of her mental condition would do much good at this point because she may be temporarily ill with hospital psychosis and Covid. be sure her doctors know of her mental issues. I hope she is better soon.
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Your mother is only 76, which is barely old. You state in your profile that she is an "aging paranoid schizophrenic": is that an established diagnosis, a condition she has been living with for some years?

What was she admitted to hospital for, and what treatment has she been receiving? If this sounds like a silly question, to which the answer would be "for Covid, durr!", please bear in mind that most people don't need to be in hospital and don't require ventilation, so for her to be kept in for 15 days so far there must be some clinical need for it, and there's not much point in a psych evaluation until she's medically stable.

The issue you might like to get ahead of, then, is how the discharge plan is beginning to shape up. Have they got as far as suggesting where she will go next, and roughly when, and with what continuing care?
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When this kind of problem come up on the forum people are usually advised to make it abundantly clear to the social worker/discharge planner that you will not be available to look after her and that unless she improves dramatically to release her would be an unsafe discharge. Is there any option that she be sent to a rehab facility?
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Who told you mom only had coverage for 21 days in the hospital? If she has Medicare, she has 90 days of coverage. If she was placed in a rehab facility, that's when she only has 21 days of coverage from medicare.
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Speaking from my own personal experiences, it is honestly not fair to her, or ultimately, to you, to attempt to evaluate cognitive/psychological issues in someone currently recovering from active Covid infection.

You will be able to request an evaluation when she has become Covid symptom free.
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Was your mother on medication at home for her schizophrenia? When anyone gets admitted into the hospital, they ask what home medications a patient is taking so that they can continue those meds. Schizophrenia meds would be such meds.

A psych evaluation is not going to do her much good right now. Any psych meds are going to take weeks to start working. That also likely is contributing to her not being a candidate for a skilled nursing facility.

I see on your profile that your mother lives in your home. Call the social worker at the hospital and tell them she needs placement in an in-patient geriatric psych facility and that you cannot accept her back at home. Your mother's psych situation is going to take weeks to sort out and that's done best in a hospital setting.
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