Home health care is coming in 4 days a week restricting active Mother.

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Also disturbing day sleeping member of household. My Mother and I live together.She's 92 years old and active in the sense that she visits her friends across town and isn't home a lot during the day.She fell about two weeks ago,as she tripped over a rug that had been shuffled around and not straightened out. Since then, her Doctor has assigned a Home Health nurse to come by and see her 4 days a week.. The Nurse began coming by last week.My Mother her has only been available for one visit from the Nurse because she's out and about vising her friends and with me as well as we eat lunch at Diners and fast food places .I spend a lot of time with her and neither one of us likes the idea of this home health nurse expecting my Mom to be home 'in waiting' every afternoon..in fact, the Nurse doesn't call until she's on her way which is at a random time every day.My mother is thinking seriously of dropping the Home Health visits completely but her Doctor became stern with her over the decision,insisting the visits are important..My Mother's only health problem is high blood pressure and she's been taking blood pressure meds for many years and checks her own blood pressure daily. It's not a major physical issue with her and we're not understanding why her doctor insists she stay home waiting for this nurse every day! it's interfering with her happiness actually..and at 92 years old that bother s me that anyone is fooling with her happiness..i don't see any reason why a once weekly visit isn't sufficient!! Actually my Mother wants to end all the visits and i can't say i blame her since she checks her own blood pressure on a daily basis..She doesn't check all of her vital signs however ,but she doesn't feel the need to do so every single day.The doctor admits that her blood pressure isn't abnormally acting up and there's nothing wrong with her elsewise.I'm wondering if anyone else here has any opinions on this..is my Mother just in dumping Home Health visits if she doesn't feel she needs them? There's also the problem that every time they come to the door,they wake my Sister up..She also lives with us and she works nights.The doctor wasn't interested in the fact that my Sister is being awakened after justa few hours of going to sleep every dayWhen she's awakened ,she can't go back to sleep easily and thusly is going to work lately ,risking coming home without a job,as her quality of work is suffering she says and she stays sleepy day and night.We all feel as though the doctor is disrespecting the fact that she is being awakened..view this as though you're beign awakened at 1 or 2am every night and then having to get up for work at 7am.You can see how this kind of situation can easily burn someone out after a short while.

11 Comments

Your mother is not interested in co-operating with her healthcare providers so the $/time should be better allocated. She needs to tell her doctor flat out that she will make no effort to be at home for a few hours each day to meet the care provider so that it can be done quietly, infact done at all. Sign a document to cancel that service. Let that precious commodity go to someone else.
As already already pointed out by another ,It is a precious commodity,but only if the person getting the service views it in that manner. When Mom is across town at noon for, example and the Nurse comes,It would be absurd to go back home , for an hour and then return across town again to visit friends..A Daily routine of doing such would actually become tedious and feel like 'work' .I for one don't believe that when one hits a certain age,that it should be the basis of allowing the state to interfere by their insisitance on visiting rights in the name of physical health unless it's for one's existing physical ailments.And even then,It should be a personal decision ,and certainly not based solely on one's particular age.
Your mother's doctor has perhaps misunderstood his patient. He sees a little old lady who, too stoical and modest to admit that she needs help, is telling him 'oh don't worry about me.' What he must be made to appreciate is that this is a little old lady who has a very full and active life, thank you, is well supported and gregarious, and who if in need of medical or nursing intervention will not hesitate to seek it.

In other words, the doctor must stop treating her like a little old lady and start treating her like an autonomous adult patient with her full complement of common sense.
Someone who is as active as your mom does not need home health care services. Simply tell the doctor and nursing agency their services are not needed. There are too many who go begging for in home nursing care yet can't get it, I assume this is government funded care?
Agree loose the home health service. You and Mom seem perfectly capable of managing her needs. When the time comes when she needs a daily bed bath and it sounds as though Mom has no intention of that happening request help if you need it. Your sister's needs are also of paramount importance. Be stern back to the Dr he isn't the boss the patient is. he is there to provide a service for which he gets paid. I was very short when offered Palliative care and asked to sign a DNR.
It can be maddening- everyone from the plumber to the home health people expect you to sit home all day waiting for them. I get that from one customer to another visit lengths can vary but even a few hour window can go a long way. What ever happened to good, old fashion appointments? So - if you don't think your mother needs to be seen by the nurse, cancel or reduce the visits. Call the doctor, thank him for his due diligence, and carry on.
1. Not to challenge anyone's opinion, but I totally disagree with Hcareworker's advice to sign something stating that your mother doesn't want the home health care. This could hurt your mother's future need for home health care if she does need it.

2. From having several home care services over a period of more than a decade, I think the problem is with the (a) doctor and his selection, as well as his adamant attitude (b) the nurse who is apparently not even providing a schedule beyond the calls, and (c) the agency itself.

3. NEVER in my experience has any doctor made arrangements for a specific service. In fact, they prefer to stay out of that process.

4. You and your mother do have the right for more advanced notice. Generally home health care people set a time with an hour to spare (i.e., between 2 and 3), and some call when they're on their way. But to just call and then show up w/o prior notice is inexcusable.

5. I'm also wondering why the nurse needs to come daily; typically visits are every other day, or 2 - 3 times weekly, especially when conditions are more serious than your mother's condition.

6. Is it possible the doctor hasn't been completely honest with you about your mother's health issues?

7. I can't help wondering if there's a private interest between the doctor and the agency. I discovered while doing research on the ACOs (Accountable Care Organizations) that doctors get paid for referring patients to ACOs, for profit entities that purport to monitor patients post hospital discharge.

It wouldn't hurt to do some background research to see if there's any connection between the doctor and the agency, or just come right out and ask him if he's made a referral to an ACO.

8. All home health care people I've worked with have a one page paper calendar for their client (your mother) on which they write their appointments. This is kept in your home; workers update it with their next appointments when they come.

9. Take control of the situation; call the nurse and reinforce this with a paper list the next time she comes - provide times when you and your mother are available and advise her that those are the only times. If she comes at another time, she won't find your mother or you at home.

10. DOCUMENT all these calls and visits, especially the ones when your mother isn't home. She might be billing for these and it will show up in the quarterly Medicare EOBs. There's no justification in Medicare paying just for nurse show-ups.

11. Even with much more serious medical issues, I've never experienced a nurse coming more often than every other day, and that's generally only during the week.

12. I would tell the doctor, in writing if you have to, that (a) this nurse's spontaneous arrival is not acceptable, (b) that you are open to the need for home care but want a nurse who sets appointments w/o just showing up. Consider calling various agencies and suggesting that the doctor hire another agency.

13. I also have never been in the situation where the doctor chooses the agency, but I have been firm if I have to that WE choose the agency. I've had to take this stance with hospital discharge planners and social workers from rehab center. It's YOUR right to have home care that meets YOUR needs.

14. As to waking up your sister, that's unfortunate; perhaps with a better schedule you can anticipate the nurse's arrival and greet her before she knocks or rings the doorbell.

15. I agree with all the others who feel that your mother shouldn't have to have home care if she doesn't need/want it. I would just caution that this doctor is going to be documenting, and so should you. If your mother does need home care in the future, you wouldn't want this doctor's opinion or actions to affect getting that care.

And kudos to her for being such an outgoing, gregarious and strong person!
Dan, has your mother assigned you her healthcare POA and given you authority to speak with her doctor? I would want to get to the bottom of why the doctor feels this is so necessary, there certainly seem to be some crossed wires here.
I don't think the visiting nurse came that many times a week to see my mother after her bowel resection. I think it was 2x a week and she made appointments.
my mother hated the nurse btw because she wanted to know what drugs she was taking and my mother read that as the government wants to take my painkillers lol

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