Appealing a doctor's decision to discharge. Any advice?

GA, I want to mention something about your feeling that you have about saying you can't /won't sign for dad to be released from the hospital. I remember so clearly the first time I did this (and it was because of knowledge that I gained here that I was able to do it). Mom had been hospitalized three times in two months (out of control bp that settled down once she was in hospital ). The doctor came in to say they "had" to discharge her and I replied that I wasn't signing until they figured out what was wrong, and had a plan to fix it. The doctor walked out, a bit taken aback (I'm not a very assertive person ) and mom burst into tears. "I'm going to be thought of as a difficult patient" she wailed.

It was one of the few times I lost my patience. I asked if she thought I really had all this time on my hands, running to hospitals, losing work days, not caring for my husband with serious cardiac issues. I told her we had to get the problem FIXED so that she could get back to leading a semi normal life.


She never complained about my handling of her medical issues after that. Sometimes you have to stand up for YOU as well as for the patient.

Talk to the DON, director of nursing immediately. The doctor is having a bad day and it's about to get worse because he/she did not read the patient's chart. Then, there might be a patient's rights advocate or Ombudsman, the nursing office or administration can give you contact info.
OR, you can call the doctor, inform him/her of the missing details.
Call the hospital administrator next.
GA, you are there or caregiving from a distance?

GardenArtist, no experience with a hospital wanting to do an early discharge, but am dealing with the rehab/long term care that is talking about discharging my Mom. It's like are we talking about the same person??? No way on earth is that woman ready to come home, she needs long term care, some place, some where. Not in a 3 story home when she is now in a wheelchair, and probably doesn't even know her name anymore :(

I know what you mean about getting caregivers out to the house. The agency I use need 24 hour notice and they charge 1.5x for the first day because everything is so last minute. So I had to stay over with my Dad at my parents house one night and got maybe one hour of sleep because I don't have the strength to help Dad upstairs.

I tell ya, I really hate what my parents are putting me through. It wasn't a life well planned on their part. They should have been in independent living or assisted living years ago.

Hey garden. Google right to fast appeal. Should take you to Medicare.gov which explains your rights if you think discharge too early!

GardenArtist, what has worked for me in the past is notifying via fax the hospital social worker assigned to his case, the nurse unit manager and the physician that this man lives alone and that they are discharging him to live alone. They bear the responsibility for whatever happens to him. You are going to be out of town. Ask for an occupational therapist to do a home safety evaluation and report prior to discharge. Do not offer to pick him up, do not be available by phone. Insist on all communications in writing. Appear as though you are getting ready to sue their sorry a$$es and they will perk up and behave. (hopefully).

About the cake ... that is a new one for me, too! I don't think the design of a B-29 is "copyrighted" LOL. Mickey Mouse is copyrighted/trademarked/whatever. So is Disney's version of Cinderella, and Mulan, etc. Bugs Bunny? Yes, he is off limits on a commercial cake, unless the bakery has designs approved by Loony Tunes.

But a B-29? Who is going to sue? Boeing? I admire that bakery's integrity, but I think they don't have a good grasp of intellectual property laws. I guess their motto must be "better safe than sorry."

Getting a bakery to do an airfield and placing a model plane or a plane-style pencil sharpener or a toy, etc. is a good alternative. I've known many home-based cake decorators who will do a lovely beach scene with seashells and big rock and then the mother takes it home and places a Little Mermaid doll on the big rock. I once did a lovely park scene, and placed a hinged porcelain box of Madeline on it.

You may or may not be able to find someone to print a B-29 on rice or frosting paper for a cake, depending on the picture. No one wants to get into trouble with copyright infringement! But there must be thousands of photos of that plane that are in public domain and you can use Bing to find them. Just limit your search to "public domain" on the license drop-down list.

(I once took an invitation I had designed into a nice copy place for many copies. The clerk told me he could not put that photo on the invitation, because of copyright concern. I asked for the manager. I said, "This is a picture of MY son. I took it with MY camera, in a public place. I OWN the copyright. And I want copies!" I got them.)

You can't blame businesses for being careful, but there are ways to get what you want on a cake, without necessarily becoming a cake decorator. :)

Sorry GA. Wasn't sure if you had gotten copy of IM for Medicare.gov yet. Have a friend whose stepdad has MRSE infection and already had to appeal once. She said they push out but if you don't have care in place they cannot discharge to unsafe. The advantage plans are bad about this especially if failure to improve. "no my father lives alone and has no care at home." Lather rinse repeat. Is your father telling the doc you can cover?

Babalou, I've taken notes on your last post. It's really helpful. I understand now how the respiratory crisis happened. It sounds similar in action, not necessarily in specific organs, to when my sister had a bacterial shower after a chemo session. When the line was flushed after the infusion, she shortly thereafter began shaking uncontrollably.

It was explained by one of the chemo nurses that even a small amount of bacteria that can get in the system during the flush rushes through the body and causes the reaction.

Those bacteria are bad bugs!

I can imagine the discomfort of the bi-pap; my father was on a vent mask and he hated it. I remember when I wore a respirator while doing some sanding and then painting, and I felt so confined, so trapped, and almost disoriented.

Thanks so much for sharing your experience. If Dad gets a chest tap and something happens very quickly in his breathing, I'll understand and not panic.

I don't think I can pull together the bomber cake, so I've decided to work on that for a special occasion after Dad comes home from the hospital. I do have a B-52 pencil sharpener which I could use on a vanilla airfield with chocolate ribbons for the line markers.

A cousin's nephew was a submariner cook; I may contact him to see if he has any military patterns. Guess I'll have to learn how to decorate cakes and be forced to eat all those tempting samples and experiments.

On the issue of the discharge, it's now been resolved, but in retrospect, I am so glad I replaced the PCP with a hospitalist. It was shocking though how unprofessional the PCP became in his comments about other medical specialities.

Oh, GA, I'm sorry things aren't going well.

Re pleural effusions, my mom has had her chest tapped several times. Last time they did it, she had some terrible breathing difficulties and the ER personnel wanted to intubate. We said no (she's got a dnr/dni), so they used a bi-pap and that worked.