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gdbrown Asked June 2018

Can an in-home care agency that works with doctors perform the face to face assessment in the home and report the results to the Dr?

The Doctor insists that my loved one, who is not ambulatory, come into her office for the assessment. I spoke with Medicare and I was told that a Medicare approved in-home-care agency that works with doctors can do the assessment. I forwarded the information to her and she still refuses. How do I get around this? He needs an updated assessment and care plan.

gdbrown Jun 2018
To GardenArtist, She is the only doctor he sees there is no care team addressing the issues. He just enrolled in the VA health benefit and a home health team will be contacting me next week to arrange an in-home assessment. The swallowing issue is relatively new and has not been seen by any other doctor.

And to shad250, I've always had the sense that she wasn't ever interested. It was never thorough and I would get push back every time I made a suggestion or observation.
Plus, since we missed a couple of appointments she stated that her office reserves the right to drop patients. She ignored the entire non-ambulatory issue. So yesterday the VA stepped up and made him a priority. Thanks to you all for your replies

shad250 Jun 2018
This doctor is subtly trying to get you to change doctors because she is probably not interested anymore.

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GardenArtist Jun 2018
This doctor doesn't seem to be very concerned about your plans, which I think show a lot of intuition and foresight on your part.

Is any of the medical team addressing the swallowing difficulty? This can get worse, and can compromise the daily pleasure of eating. Has he been diagnosed with dysphagia?

Do you have other doctors, specialty ones such as for the diabetes or dementia? These might be better choices to participate in a short and long term care plan.

gdbrown Jun 2018
He wasn't in a hospital or rehab. His condition has changed to where he isn't ambulatory. He is diabetic and has vascular dementia. Over time, he has gotten weaker, sedentary, muscular atrophy, difficulty swallowing, weight loss, depression and other issues. I know his condition is progressive but the goal is to have a future care plan. His doctor has never put a plan in place and seems to be resistant to establishing one. Plus I need additional training on how to care for him at this stage.

GardenArtist Jun 2018
What's the history on his situation? Was your DH in a hospital, in rehab? What happened that he now needs an assessment?

I suspect you have some planning in mind and need an assessment to plan for future care?

gdbrown Jun 2018
Thank you so much for that advice. I strongly felt that she and I were not on the same page. As I looked deeper into her primary specialties, geriatrics was listed as a secondary interest or specialty. Thank you

97yroldmom Jun 2018
You need a different doctor. The doctor you are working with has different standards than you are looking for. Ask him for a referral.
Look for geriatric primary doctors. Call your own doctor for a referral. You might try nursing homes for doctor referrals or visiting physicians. Even the home health or hospice agencies might be able to tell you which doctors they have worked with that will work this way. They may not be willing to make a referral but you could ask how to go about finding the doctors that they work with. A pharmacy once gave me a lead on a weekend doctor back before urgent cares were on every corner. Let us know what works for you.

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