I have written previously about my aunt. I had to create a new account because I am having login problems and didn't get the reset password email. Anyway, I flew out to see aunt, who is in SNF after a mysterious head injury. She is better but still not cognitively or physically ready to go back to living independently in her apartment. SNF says she has passed the basic test to qualify for discharge so Medicare won't cover after Sunday. I initiated a Medicare appeal today. APS is involved and agrees this is the thing to do. APS and SNF social worker have both talked with aunt and agree it would not be safe to send her home. So, it seems obvious what ought to happen, but what if it doesn't?
If the appeal fails, what recourse is there? If she is discharged and has no way to get home, what then?
This is hard to do, I know, I had to do it with my mom but, she got the services she needed because I was not an option.
Please scream UNSAFE DISCHARGE and then keep saying that. The thing is, Medicare doesn't pay for long term care and auntie is being discharged from rehabilitation, two different animals, Medicare will not pay for long term care. The social worker should be able to explain what comes next for auntie that is unsafe to go home but has reached her rehab baseline.
Best of luck, this is a difficult time for a difficult situation breathe!
First person experiences such as you are going through is very helpful to readers. There are so many nuances. When you come back and tell us what happened based on steps you took, it helps us learn and is a cautionary tale and helpful guidance for others with similar concerns.
And yes, plenty of red flags when an 86 yr old already showing signs of mental health issues living alone and with no responsible party nearby falls and is hospitalized. Facility care is most likely in her future though we do understand and appreciate your wanting to make sure her next steps are appropriate.
Please share what medical answers you received to bring you peace. We all want to know what helped.
Can you explain a little further please?
I am sorry that I misunderstood your posting. I hope that someone else will be able to help you further. I’m not sure what needs to be done.
I wish you well in resolving this issue.
https://www.agingcare.com/questions/need-help-to-planprioritize-a-rescue-in-a-one-week-trip-485796.htm?orderby=recent
Excellent job of getting the Social Worker and APS involved.
If the appeal is approved, it won’t be but for a few days. That might give them enough time to find her a Medicaid pending bed in a SNF that accepts LTC patients if that is what she really needs instead of going home.
As advised on your two previous posts, stand back. Let them do their job and find her a place to go. Remember she was not willing to give you any authority begore this all happened.
She has done a good job of staying independent as long as she could.
Not being willing to involve others is not all bad.
If she had given you POA then it’s the same as being competent as far as the authorities are concerned.
They can’t help her and you must if she has gotten you to accept that responsibility. She didn’t want that.
Since you aren’t the POA, the ball is in their court.
Let us know when you hear back when things settle down. They will. You just have to be patient. They have a lot more access and support than you do.
Let us know how you are doing.
I am not certain if you are POA for your Aunt, but if so, then the SNF social workers should be helping you with placement. For a while you cannot know if this will be temporary or ongoing. You say you flew out. I am almost hoping you are NOT POA and do not attempt to take it on as it is almost impossible long distance in these circumstances. I think you may need to discuss with APS how to resign any POA and put Aunt in care of the state for a court appointed Fiduciary. IF you do this it is important to know that you will NOT have any say in anything. For instance, if Aunt has a home it may be sold for her care if she requires long term placement and isn't improving. You wouldn't get to choose facility itself of type of care chosen. This would all be managed by the Court Appointed Fiduciary.
Being in a facility, even one that accepts Medicaid is not necessarily a bad thing. If she is unable to get herself around in her own home, it is dangerous. Does she understand that she is fully responsible to work as hard as she can to go home safely? Is she participating in therapy? Doing things on her own, such as bed exercises?
No one wants to go into a facility but, sometimes that is the best solution for their stage of life.
I would not ask the neighbors to be responsible for her, even if she can get up and about by herself, that is completely unfair to anyone.
Advocate for whatever care meets her needs. That is the most important factor right now but, be open with what the reality is, because has been, is not now and what was, may not be anymore. Her life as she knew it and you knew it may be history.
Best of luck getting her the care she needs.
She is in subsidized housing. If you scroll down to my answer the two links are 2 of Hollys previous threads regarding this event.
If you are not her PoA (and no one is) then you will indeed need to step away and make sure APS and the sw know she needs a court-appointed guardian, that you are not in any way part of her care solution. She needs to go directly into a facility. Has she been assessed as needing LTC? Every states' Medicaid pays for LTC but she has to qualify medically and financially. This will be the guardian's problem now.
If they allow her to go home, then you will need to keep in contact with APS and the sw.
Aunt has no assets, on Medicaid. Has not assigned POA.
She cannot use toilet without help due to loss of strength in hospital -- could previously. Does this qualify for extra rehab days?
I fear what nurse and SW say verbally may contradict what's in the med notes. If appeal is denied, and I am not on scene to pick her up and she can't arrange transportation, what would happen?
Will write more but am afraid of losing this so will post now.
Alternative is to get her to her apt, (SNF is 150 miles from aunt's apartment, very rural), get her Depends, ask her neighbors to help her out, and fly home. That's a terrible option too! I will not sign for her but SW says she has decision making capacity legally.
All advice is welcome ! Thank you.