What's your experience with Medicare hospital stays and disjointed healthcare?

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My mom has Alzheimer's and has had recurring UTIs for the last year or so. The doctors think she has had the same bacterial infection for the last six months or so, and it is resistant to the antibiotics. We take her to a urologist, and two different doctors in that group have put in temporary catheters. That was their recent attempt to try and help the infection. Of course all that did is make the infection exponentially worse than what it was before. She has been septic with the infection getting into her blood once over the last 6 months period and now she is in the hospital with sepsis again. I have had quite a bit of experience with the hospitals and advocating on her behalf. The worst thing in the world was getting her admitted to the hospital in the first place, because they will use any excuse they can not to admit them. It is actually easier now that the infections have gotten worse because they can't really refuse to admit her. However, now we deal with them wanting to discharge her after a few days and stick her on an oral antibiotic. The oral antibiotics do not work at this point, so she has to be on an IV to really get any benefit. So we have been dealing with this vicious cycle of hospital admission, several days of IV antibiotics, oral antibiotics at home, and then back to the ER when she takes a downturn.. the situation has been complicated by the Medicare cuts that happened after Obama Care, and that really continue to happen as the federal government tries to manage its mounting debt for senior payouts. Of course no one in the Healthcare System wants to talk about it or label it is that, but that seems to be the main cause of the problems that we've had with the hospital system.

Some doctors really do care and really put forth every effort to help your loved one, but when you go in through the ER you don't get to keep just one doctor. You have different doctors coming through on rounds, and you also have different doctors there on the weekends. What happens so often is you have a good doctor working with your loved one and then a different doctor comes through on rounds and suddenly decides it's time to discharge the patient. These are the doctors who are most interested in the bottom line of the hospital, & want to rush Medicare patients out as quickly as possible. No amount of reasoning or common sense will apply in dealing with these doctors. Within the last month I have learned that as POA I have the right to refuse discharge on her behalf. The hospital of course acts as though you do not have that right, and tries to steamroll you into following their commands. I am not the most popular person these days, but no matter how much pressure and rudeness they send my way, I stand my ground.

The most frustrating part, and the reason for starting this discussion -- is the beaurocratic nonsense that underlies our entire healthcare system. Common sense would say that, a patient with recurring issues should be handled by a specialized team - or at least by a limited group of physicians who are familiar with the case history, rather than "reinventing the wheel" and endlessly passing the patient around through random doctors. Isn't this the whole reason behind having a primary care provider?? My mother has a primary care doctor, and even a urologist - but none of these doctors has any say whatsoever when she is admitted to the hospital. Hospital doctors operate in a vacuum, even though they have no way of knowing the patient's individual baseline (what is "normal" behaviour for that person).

We as the public have been forced to accept electronic healthcare records to enable "sharing of information", and yet we must continually fill out more paperwork and provide deeply personal information to every doctor we visit. We give our sensitive private information to health care professionals at every turn, which is entered into a cloud (making it vulnerable to breach) that was PROMISED to improve communication among healthcare professionals; and result in informed, focused and coordinated health care decisions. Instead, what we get is haphazard, random decisions that can be overridden or reversed by whatever doctor happens to be on call next.

Where are all the benefits that were promised us, of all physicians and nursing staff working as a team based on shared and accurate information in the patient's record? Who is accountable for ensuring that the government-mandated electronic health records are being used effectively to provide better services to the public? And if the electronic system is not improving communication between healthcare providers - especially between hospitals and primary care doctors / specialists - who will demand improvements or reform? Based on a Medicare patient's experience, there is NO BETTER coordination or communication taking place than before our records were centrally stored. I would love to know your thoughts and experiences.

3 Comments

I've had the opposite experience.

They want to admit Mom for the slightest reason, and keep her without having any medical reason at all. When I demand answers for why they are holding her against her will and mine (I am DPOA), I get stonewalled.

Last time this happened...I just demanded Mom's clothes...we dressed and left. Buh bye. Filed complaints with Medicare, the state department of health, and the hospital. Never go any satisfaction on any point.

I am very cautious about having Mom near a hospital for this very reason,
My experience with my father 17 years ago was that he would enter the hospital for one thing or another and after so many days would be "well enough for rehab" ("well enough" being determined by the calendar, not the condition), 30 days in rehab wing, "cured" sent to a nursing home. Two weeks later, the cycle would begin again.

The more things change the more they stay the same. Alphonse Karr (1808-90).
Etta, Been there. I'm not a nurse but have worked with them and a catheter is the worse thing to do if a patient has a history of UTIs. The only time they used one with Mom was to clear the bladder out. I don't understand why hospitals are in such a hurry to discharge because if that person is sent back for the same problem the hospital gets fined by Medicare.

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