My 88 yr old mother is coming back to our home. I'm her caregiver. How do I get Medicare to send someone to help with catheter and incontinence?

I truly thank this community for all the suggestions advice and other resources as well as my rights and vocabulary to use to the health care professionals. Since her blatter was failing she hated the catheter so we decided on • Suprapubic catheter (surgically inserted into the bladder through an incision above the pubis). Which is basically pain free no problems so far and will much easier/convenient for everyone once we return home
But is very aware, and insists on being independently privately involved in any/all decisions on home care which she dosent realize and whst is such a delicate line to cross as her caregiver closest friend and daughter is to confront her with the realization that I may not be able to give her the care shes receving now without coming across to her as insensitive, indifferent and disrespectful in reagards to her wishes to come home. We thought she could say she was ready to go and b/c shes of sound mind and body they couldn't legally keep her .But She must be discharged by a dr so that's a little help where i dont have to be the ultimate only decision maker.But I cant provide thev24 care shes getting ,although she says she doseht need ,while there and what a unsafe situation welll be in when we get home and its just me caring for her 24 /7.i simply cant do it with out help .but how much can I expect Medicare to do for her not my home..land the her s.s will completely go to the home starting in April so we split our home Bill's I cant afford on my own but I cant stay/afford it by myself but if I move us somewhere cheaper she gets better they release her I'll have to move again .. but medicaide /the home wants their money ..so I'm just beside myself were private people we have immediate family in the next small but it's my brother and I responsibility not theirs they have offered to help so I wont lose our home ..thanks again for any and all help advice

OP, can you update?

To answer your question. Home health will train you how to provide this procefure. They will come a few times to help you but they won’t do it for you. Just ask her doctor to arrange for home health or the rehab to help you find an Agency.
Medicare has greatly reduced services this year but I believe you could still get HH for a few weeks after her discharge.

At one point I thought my mom was going to need this after a fall and rehab but she saw a urologist and was given medication that helped her empty her bladder. I remember he did some imaging after she peed and could see that she still had pee in her bladder.
This has been a few years but it was a med given to men for prostrate problems if I remember correctly. Similar to Flomax for men. He prescribed her Cardura in the generic form. It is also used to lower blood pressure.
See if you can get her seen by a urologist. This might not be her problem or the appropriate med but see what’s available for her.

Medicare is not going to send a nurse to straight cath your mom every 6-8 hours. She will be incontinent and wear diapers. Is there something wrong with her that she was catheterized in hospital? Does she retain urine? There are meds for that. Medicare also does not pay for diapers although hospice provides them if she is at that stage. You might want to talk to social worker at facility to clarify what Medicare does cover and what you will be expected to do.

I have no idea about the catheter part. I do know that home health prescribed by a Dr. & being covered by Medicare actually provides little hands on help. A bath person will come out 1-2 a week to give baths. Therapy might also come that much if it’s prescribed. These things are nice, but if you need down-in-the trenches kind of help, that isn’t provided.

Medicare only pays for in home care if done by a homecare facility that can bill Medicare under Drs. order.

I can not find if Medicare allows for a Nurse to come in to do catheter changes. It does pay for catheters. I have a feeling they don't. I think because they feel a family member can do it. I worked for a non-profit Visiting Nurse Assoc and we did what Medicare would not pay for. Catheters were one of the services we provided.

Are you sure that you want mom to come back home with her need of catheterization and incontinence? One thing that will increase is UTIs (urinary tract infections). This may create severe confusion and instability in mom which may increase the likelihood of more falls.

I have not heard of Medicare helping with incontinence but I did read that the primary reason families put their loved ones into a nursing home is because of that.

My mom has bowel incontinence at times and a really inappropriate habit that I will not disclose right now. These things are not enough for me to place her but the frustration can increase at times so I have to TRY to always be mentally and emotionally prepared.

Good luck with your decision. I am so glad that others have provided you tips with this topic.

Ask her doctor to prescribe Home Health Care.  A nurse will do her cath changes, they will bathe her and there are other services available through Home Health.  They shouldn't release her until arrangements are made.  You'll have enough to do without these added worries.  💙

Please understand that Medicare will not send someone out daily to your home to deal with catheter and incontinence. They might send home health person out once or twice weekly for the short term. Such Daily services would fall under Medicaid, and you need to find out what your mother qualifies for. With such a high level of need you really need to have an accurate assessment of what she will require for support and whether you can continue to do it. Don’t believe the social worker who tells you it will all work out. Once gone your mother is not their problem. Incontinence and catheter was the tipping point for my mother in law moving to a skilled nursing facility on Medicaid. Her husband could not provide 24 hours a day care.

Before you bring her home you need to have a Care Plan in place.
Who will change the catheter?
Who will care for it?
Will you be trained to do this?
If so are you comfortable doing this task?
Will mom be able to pay for this increase in care?
Will you have to apply for Medicare for mom or does she have insurance that will cover?
So many questions.
Do not let them rush you both out the door without fully understanding what is necessary.

Just don’t allow them to discharge to you until or unless there is a complete care plan in place....including who will come to the house to do all this work...and who (NOT YOU) will pay for it.

dont allow them to discharge to you without a complete plan that is real. Just keep saying..it isn’t safe for her here.