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Chanacres1 Asked January 2016

My Mother needs physical rehab but bureaucracy is letting us down. Any advice?

Between Medicare and insurance she is being sent home without proper...My 87 year old mother has had up to 4 narcotics at a time and her family doctor will send her home to a 80 year old caretaker that is hard of hearing. She has severe back pain and arthritis and needs to build her strength and get off narcotics to help with her confusion. She re- injures herself with falls. I think her doctor is not addressing the real concern. He listens to her altered mind from narcotics that he is more than willing to put her on. Insurance and Medicare enables this vicious cycle at my mother's expense. She has always been sharp as a tack. With the proper rehab, I am positive we can get her back. Is there an agency that could help us. We cannot financially afford to do it on our own.

Chanacres1 Jan 2016
Yes, I think the 3 day requirement is correct. It has to be 3 consecutive midnights, so I just estimated the 3.5 days to include the 8 -12 period after that 3rd midnight before a normal discharge. Thank you for your suggestion.

GardenArtist Jan 2016
Chana, in my limited experience with severe fractures and severe pain, it's not unheard of to prescribe narcotics. Both my father and I have been given prescriptions for them, but he's only taken them for leg fractures and I never took them except after a surgery.

I'm wondering if your mother has seen an orthopedic doctor for her back and arthritis issues. If she does, and it's recommended that she take Celebrex or Vioxx, think twice. These meds have had serious consequences and are the subject of lawsuits.

Until you find a better doctor, you might ask this one what non-narcotic alternatives can your mother use.

You're right on the hospitalization, although I thought it was 3 days of hospitalization before being able to go to rehab with Medicare paying.

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Chanacres1 Jan 2016
Thank you! There are 4 of us children all working on this. The recommendation to get rid of her doctor is right on target with our plans. She is home right now, but is scheduled for another outpatient back procedure once again to repair fragmented fracture from another fall. She has home healthcare come in but she cannot get well. She needs a more concentrated rehab. We are told she has to be hospitalized 3.5 days before they can send her to a rehab facility under maedicare and insurance requirement, but yet they keep paying for these temporary fixes and mind altering drugs. It is pitiful! ....thanks again for your suggestions!

GardenArtist Jan 2016
Where is your mother now? If she's in a hospital, talk to the discharge planner and emphasize your feeling that rehab is needed. You can also ask that another doctor be consulted as to the specific issues that brought her to the hospital, stating that you're not pleased with the family doctor's opinion that she doesn't need rehab.

Medicare would pay for rehab in a facility, up to a certain point, assuming she's making progress. I don't recall now how many days it is before Medicare wouldn't pay, but you could contact Medicare directly and ask that, or ask the hospital's discharge planner.

And get rid of that doctor; find another one.

If she's in a rehab facility, talk with the social worker about home care; the rehab facility would have its own doctor who oversees her care and could script for home care. It's not as thorough as rehab in a facility, but it will help.

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