In September 2020 I had to move my 93 year old mother from her house in VA to my house in NC because she could no longer walk or get up from her chair or bed. I am the only daughter. I have two brothers one of whom is living with my Dad in VA. They could not care for her. I am married and this has been a big adjustment but the alternative- a nursing home - was out of the question due to COVID. I have also witnessed the neglect both my parents experienced in rehab nursing home facilities and feel it is not the best for them. I thought I had a good team set up which included getting her set up with my family doctor. Since she is bedridden he has had to use televisits to see her. That has worked fine. She has Medicare A and B. She arrived at my house from rehab with a small bedsore that I have managed to heal with prescriptions from the doctor. I have aides helping me 6 days a week and the doctor ordered home health care to come for out for wound care and a UTI. My mother is on very little medicine and really has no major health issues aside from her age and physical deterioration. We use a Hoyer lift to get her in a chair almost every day and she assists with changes of diapers in the bed by rolling herself on herside.
She does not have dementia and is oriented except when a UTI is brewing. Most days she can tell you what day it is, what is going on in the news and she . remembers birthdays and the aides names She has been here about 9 months and while hard at times, I am making it work. During televisits, the doctor has sometimes seemed irritated even though we have not had frequent appointments and try not to ask stupid questions. In June, shortly after getting her 2nd COVID vaccine, my mother developed pain under her arm on the same side as the shot. She also had extreme swelling and itching at the site. That went away but the side pain did not. I also noticed she stopped eating and drinking as much. Long story longer, on a Friday evening I finally sent her to the ER. That was the first and only time she has gone to the ER since she has been with me. She was diagnosed with a pulmonary embolism and a UTI. Both were treated and she was released in three days in good condition. She has continued to do well at home. I was told to follow up with her Primary to determine any changes of dosage of the blood thinner. His first words were to tell me I can’t keep sending her to the ER and that she is costing Medicare a lot. He suggested a nursing home “would be better for her”. I informed him that in the past 6 years she has been to the ER exactly 3 times (including thus trip) and one trip in 2015 was because she was knocked down by an automatic door. This was her first ER trip since being with me. Anyone with pain that doesn’t go away can legitimately visit the ER. He failed to address the dosage issue so I had to call back. Today he informed me that Medicare rules prevent him from keeping my mother as a patient because she needs to be seen in the office to certify her as bedridden! What?! He told me to sign her up with Doctors Making House Calls. I tried. The merged with Eventus Home Healthcare and they do not have any providers in my area at this time. My doctor’s response was there is nothing he can do. He has given me 30 days to find a new doctor and then he will discharge her either way. We do not owe him money and he is being paid by insurance- can he do this???? He is leaving my mother with no primary care doctor. What am I supposed to do if she needs a prescription or home health for a condition?