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All this happened within 3 days and hospital says they can’t keep her because insurance won’t pay. They say it has to heal at home and she can’t be hospitalized for 6 weeks for this. She’s 91, frail and not very mobile to begin with. But they say if they can get her up and moving she’ll be released. Papers were just filed with Medicaid and we are waiting for word of an opening to a nursing home. What can be done in a case like this? Can you literally refuse to take her back into the home? Would appreciate any input from anyone that has either been through this or knows anything that can help. We’re at our wits end here. HELP!

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I have no idea about Medicaid or refusing to take her home but do want to let you know that there really is NOTHING that they can do except let this heal on its own. I had the same break (multiple pelvic fractures, tailbone fracture) and was in the hospital overnight, sent home (5 hour car ride) and then just had to wait it out. It was truly the worst pain ever (and I had all my children with natural childbirth and no drugs). Even once the bones were healed I felt that I had given birth to a 50 lb baby. At 91 I can't imagine how anyone can deal with this. I did have a friend who was a physical therapist who taught me and my husband how to get me up/down from a chair/bed/toilet and how to use the walker for the few, slow steps I could first manage. Make certain you get some help because I literally would have just laid in one place and not moved any part of my body except my head for 8 weeks if that was possible. You will not be able to deal with this on your own but there is no MEDICAL reason for them to put her in a rehab unit or nursing home so the insurance won't deal with it. Please give your MIL my sympathies, and you and your husband, too.
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Yes, you can refuse to take her back home. Let the social worker know that if she cannot to rehab you cannot take her home. Tell them you are not mentally or physically able to take care of her if she cannot get around. And pretty much trust me, she won't be able to. Both these injuries heal on their own over time. The tail bone can take as long as a year before you can sit comfortably. She will need medication for the pain in pelvis. You can say she cannot be cared for in your home and you will not accept her. They will then find placement. She will NOT be allowed to stay in the hospital. They are correct that NO insurance would allow that let alone medicare. But she can go to SNF or REHAB. Don't argue with them. They will tell you ANYTHING. They will say they will get you in home PT and help; it will never be enough and what they want now is to get her home, then that is a done deal. Time is needed to see where this goes. I know you know the risk of rehab. My bro's ex went to rehab and did get covid, back to hospital, now OK, but it is a risk. But your Mom will be very immobile at home. Bedsores will follow.
I wish you the best. Please keep us updated.
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Peg, I suspect she and many other patients will be encouraged to leave as Covid 19 patients continue to escalate.     It's really unfortunate that this situation is occurring, and that people won't take the necessary precautions to avoid Covid, filing up hospitals and forcing this kind of triaging.
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If you can swing it, get her a "Purple Royal Seat Cushion" (search those terms on Amazon).

My dad didn't have a break, but he had no meat on his backside and sitting was excruciating for him. This chair pad was a lifesaver for him.
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Isthisrealyreal Nov 2020
Those things are amazing. Every chair should have one. Especially every wheelchair!
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Tell the hospital it is not safe for her at home, and THEY have to find her another place.  They will, but their first go to is to dump on family.
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We are (were) in a similar situation with my mom. We couldn’t get a hospital to keep her because they wanted the bed and money for Covid cases. They said she wasn’t sick enough and they needed the bed. They sent her home with undiagnosed sepsis. They resulted in a fall and it was all downhill from there. Of course non of this can be proved without going broke with legal fees. She is now in hospice in a hospital that doesn’t take Covid cases. I will always wander what the other outcome would be if the had been allowed to stay at the first hospital.
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Ask your most objective contact to do a sweep of “home” and take pictures of the “dangers” that confront her there if she is forced to return.

Narrow stairs (no handrails or handrail missing on one side), hardwood floors, inaccessible toilets and tubs (too narrow for turning in a walker or wheelchair), no grab bars, slippery tile floors. Bathroom on second floor, narrow door openings to interior rooms......the point being to provide objective reasons why “send her home” is dangerous.

Having a portfolio of photos gives you an indisputable arsenal and saves to the discomfort of having to dispute something that should be obvious.

GOOD LUCK. Be “water on stone”, don’t get upset. Her safety and welfare are the most important while moving forward in FINDING the best care plan possible.
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There is basically no treatment for this except to wait for the fractures to heal. The hospital can’t justify keeping her in an acute care facility. Even a rehab center wouldn’t be able to do anything for her.

Have you considered placing her in a nursing home temporarily? If the bottom line is not bringing her home, that’s the option I would pursue.

My biggest concern would be skin breakdown from not changing positions frequently as it is very painful to move.. I know you don’t want to take her home but you may reconsider. Rent a hospital bed with an alternating pressure mattress. I hate to say this but to assure she’ll get turned and taken care of properly, home is the place.

I know this won’t be the popular decision here but in this case knowing the way LTC and NH facilities are functioning these days I would reconsider.

The hospital is not the safest place to be either. Not only does the chance of contracting Covid 19 exist but she can contract MRSA & other staphylococcus infections while she is there.

Many times I agree with refusing to take a family member home from the hospital when it’s too early to discharge. This is my exception. She’ll not get the level of care she needs anywhere else.
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