Need fast advice, how do I get ER to admit grandfather?

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Ash1984 Asked March 2019

Need fast advice, how do I get ER to admit grandfather?

My grandfather has just been taken to the emergency room by ambulance. We just had this happen with my grandmother and I need to be sure the same thing doesn't happen with the discharge this time. He has been physically unstable for a few months, but keeps falling now. Tonight he woke up very confused and was trying to stand up to go to the bathroom (which says a lot because he also has a catheter in from a procedure). My mother was here (one of us has been staying on their couch 24/7 since my grandmother was discharged after a fall a week or so ago). They aren't safe here on their own and even with someone here, we can't keep them safe. He was confused tonight and said he was standing up, my mother rushed into the bedroom because she heard my grandmother trying to stop him and he actually was pushing against my mother to try and stand. He didn't even realize his feet weren't on the floor and his back was in pain (from another fall 2 days ago). So, ambulance called, they are at the emergency room and I am here with my grandmother. I have been told that if they try to discharge him into an unsafe environment, we can ask for a social worker in the ER to try and get him admitted. Is this something the ER HAS to do if they try and discharge him? We cannot keep him safe. I'm scared and we have to keep him in the hospital for the magical 3 days that would get him into a facility.

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score 1 · Answer 1

UTI's SUCK!! They can be very bad, and make the patients look like they are getting dementia, etc. It can effect the brain. Weird.

Older people, some doctors usually test for that.

Kindly ask the ER doc TO keep him in hospital for observance since he is older and fell, you want to make sure his pain level is manageable. Bones, muscles, brain. etc.

Since he is old, they should keep him in a bit longer to observe him and for PAIN MANAGEMENT

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score 3 · Answer 2

Some hospitals have a "transitional" ward, where they will keep patients for observation for a few days.

Ask about that and talk with a social worker. If social worker suggests a nursing home, that medicare will pay for the time, you should take it. They usually don't ask twice. That means you may end up paying for board and care. If it offered to you, take it.

Ask social worker or ER doctor or insurance about :Palliative Care. And Hospice Care. This will bring up conversation. A doctor or nurse may be able to go the residence and check up on him, rather than you trying to take him to a doctor appointment.

Do have the conversation about Palliative care and Hospice Care and what the difference is.

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score 3 · Answer 3

Before you assume he can stay in rehab/skilled nursing for 100 days you should figure out what his insurance covers and what he is personally responsible for, if any.

Medicare pays the first 21 days 100%, then the patient or their supplemental insurance pays approximately 165.00 daily. However, if Medicare doesn't allow him services after the initial 21 days, supplemental insurance won't pay either.

You probably know all of this, when my dad was hospitalized I had to learn on the fly so I tell anyone that I think might not know.

Well done getting educated and advocating for your grandparents.

I hope that he is feeling better and gets the care he needs.

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score 2 · Answer 4

Even if you were able to keep him in the hospital for 3 days he would only be sent to a facility for rehab. As soon as he isnt progressing or isnt able to participate in therapy, then Medicare would stop paying and they would discharge him from the facility. The only way to keep him in a facility is to pay privately for assisted living or a nursing home or if he has Medicaid then you can get him admitted to a long term care facility that accepts Medicaid. He possibly could have a urinary tract infection, especially since he has a catheter in. UTI’s can cause confusion in the elderly. Hospice may be worth looking into also for both of them.

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score 1 · Answer 5

Way to go, Ash! Not easy, but you'll get there.... stay on this forum; many here have been where you are going!

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score 4 · Answer 6

Glad to hear that you were able to get your grandfather admitted as an "actual patient" to the hospital and not just for "observation". That is the Number One problem that the elderly have to deal with in order to qualify for Medicare Rehabilitation in Long Term Care facilities--hospitals who "Admit for Observation" and refuse to "Admit as a patient". Now your grandfather will be eligible for Medicare Skilled Rehabilitation Physical Therapy and Occupational Therapy at a Long Term Care/Nursing Home facility for 100 days as long as he progresses in therapy. Then he will have to be private pay or Medicaid to stay at the nursing home.

JoAnn brought up a good point: Make sure your grandfather is checked for a urinary tract infection.

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score 4 · Answer 7

Make sure he is checked for a UTI. This is serious in Men and can become septic.

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score 4 · Answer 8

Ash, thank you for the update. Glad you were able to get him admitted. There is a lot of confusion about this issue.

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score 3 · Answer 9

Still refuse to take him home. He needs more care than you can provide.

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score 3 · Answer 10

Ash, if he's there under observation, that's not the same as him being an admitted patient. Talk to the doctors about changing his status to "admitted".

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They officially changed him from being under observation to being admitted as a patient today. We knew once they actually saw him trying to sit up, stand, or swallow anything they would have to admit and they did. This is the same ER that wrongly discharged my Grandmother, so I went in as educated as possible this time. We also got really lucky that the doctor on staff overnight actually cared about the patients.

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score 4 · Answer 11

Update: The ER doctor is admitting for observation. Extreme relief here.

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Observation is not the same as admitting him.
The hospital must give you details about observation and the financial impact.
Please "google" "Observation" to get more information.

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