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cbazbaz Asked November 2021

MLTC won’t approve additional hours for home health aide after a fall and hospitalization. How can I have her discharged with only 8 hours?

Appealed for more home care hours, denied twice.
My mom needs 24/7 care, close to live-in care as she can not ambulated and she fell badly while she was ali e, only an hour after home health aide left.


Most of them are completely unreliable and there is no consistency whatsoever in different sides that are assigned my moms case, then they are arbitrarily taken off. After we’ve invested so much time training them and desperately trying to not only have a care plan to follow, but also some semblance of a routine for my Mom. I’m livid at the lack of care and caregiving to this degree of 14-18 hours is not safe, effective, and has began to affect my health, job, life, everything.


My mom does have TBI from an head injury a while ago, a freak most horrible accident and she already has cognitive issues due to that closed head injury.


Shes also suffers from chronic pain and of course, severe migraines, and muscle atrophy as she can not do PT as consistently now because of her poor health. Also the agency sends PT maybe once a week until of course it expires. It’s basically their belief that if patient does not improve over a certain, very very low amount, pt is no longer necessary. It’s horrible, unconscionable.


Anyway she’s 72 and I really feel for her. We took her home from horrible nursing facility after COVID ( although it took about 5 months) and we thought we could manage her care from home and it’s been a complete disaster and everyone is suffering especially her of course, but the situation seems to simply get worse and worse. That’s why she ended up in hospital last week as she fell because she had no assistance with her ADLS. I couldn’t lift her from ground had to call 911 and she was admitted to hospital. And, we’re none the wiser and now, we’ll be an even more acute care-giving, medical care situation than before she was admitted. She will need more supervision and we have no more hours approved despite our appeal etc.


Its also going to take her a while to recover from hospital as she suffers from PTSD and the stay was to not surprise very difficult. Doctors go around shaming seniors for their medications and ignoring their chronic symptoms, disabilities. It’s truly unethical. I feel most of the time I’m protecting my Mom from their insensitivity, lies or deception, judgement etc. I shouldn’t be sticking up for and seeing my Mom’s pain is simply acknowledged, and respected than her diagnosis and further treatment for her!


Anyway I know I’m venting but I know anyone who can relates whole heartedly understands. Their lack of even the slightest compassion amd efforts to communicate proactively is so disappointing. I cried almost every night and had to leave the room at one point because I was so angry and upset with Doctor’s failure to follow through on just about everything I had taken the time to carefully explain to him. Losing your cool is never smart, they’ll just take it against you. I’ve learned that the hard way.


Thanks for giving me a platform and safe space I can share my thoughts as I’ve been consumed by all these emotions and still have a lot of work to do.
many thanks

BurntCaregiver Nov 2021
Your family's situation is very sad and tragic, but believe me when I say your mom is one of the lucky ones if insurance is paying for eight hours a day of aide care. Most people don't get anywhere near that many hours a day. Also, you have to keep in mind that your mom's caregivers are agency hires. This means they're getting minimum wage or maybe a few cents above. So your expectations on the quality of care given and the caregiver themselves should be pretty low. It's not your fault, but this is how the system is and you're not getting better unless you're paying for better.
Unless you and your family are willing to reach into your own pockets along with mom if everyone's able to and pay for additional privately hired help or make up the hours after the eight you get already yourselves, you're probably going to have to put her in another care facility.
You sound like a very kind person who loves your mom. If you really want to try keeping her out of a facility, move her in with you. Or hire a couple private CNA's who are willing to take a live-in position. I don't think your mom is rich and can afford to pay high wages above-board and everything, so pay them in cash. It's not as expensive as you think. Go and start looking at profiles. Good luck to you and your mom.

babsjvd Nov 2021
I agree, nursing home care, start the process now. Go to your county’s, aged and disability resource center. They can help you find the information you need to proceed. Probably would give you a list of Medicaid homes.

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ZippyZee Nov 2021
Sounds like she'll have to go into another facility.

mstrbill Nov 2021
From your description your mom needs to be in a facility (NH) that can provide 24 hr supervision and care. I'm sorry. There simply is no other available help through Medicare unless you can afford to hire private care givers.

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