MIL in hospital on IV nutrition. Any advice?

I have learned to DESPISE the new model of using hospitalists while a person is inpatient and not having their regular doctors come to the hospital. The hospitalists, in my experience, have no knowledge of their patients, no history other than what appears before them on an iPad chart, and that iPad is what they use to diagnose and treat, barely looking at the patients. Okay, that may be an over generalization but it’s what I’ve seen. Only way around it is using a major university teaching hospital where your regular doctor is part of the teaching/medical staff. Tangent over—yes, rehab is often within a NH setting and can provide IV nutrition or hydration. Yes, every hospital has a patient advocacy office for times when your voice and questions aren’t being heard, use it. And it never is a bad idea to ask about hospice, if it’s not the right time, the hospice agency will let you know. The business office at my mother’s NH was well versed in dealing with LTC policies and getting the ball rolling with them, no charge. Wishing you peace and luck getting clarity and answers

Every hospital has a patient advocacy office. It is not something they want you to know about. Go to the front desk and tall them you want to speak to them. Once you are connected demand her pulmonologist is called in. They advocate for the patient and the family not the hospital.

you need to call the insurance company and they will help you navigate that issue. My parents both went into the hospital and their policy did pay while they were hospitalized. I do not have experience with payment while in rehabilitation

If she has long term care insurance you can read the policy then contact the company to let them know what is going on. (If she doesn’t have one, it’s too late to try to get one now.)

Some policies cover assisted living, for example if she was deficient with 2 ADLs. If her policy was covering her AL, it may continue to pay some or all of it to hold her spot, IF her policy covers that, while she is the hospital or rehab, but they won’t pay the AL and the nursing home for the same day if it comes to that.

The company can explain how to transition from AL to LTC in the skilled nursing facility. Or if they didn’t cover the AL, how to start a new claim.

Check the contract with the AL to verify the amount of notice required and if any fees are reduced or waived when the resident is not present.

You need a Pulmonologist consult for your MIL IN the hospital STAT. And a hospitalist who you can understand and who can understand you. Speak to the Patient Advocate Office immediately b/c this is unacceptable what's going on here! The Patient Advocate will listen to your concerns, respond to a complaint, explain hospital policies and procedures, assist you in finding community services, provide information on payment coverage or discuss a concern between you and your medical team.

For all you know, your MIL could be dying right now as pneumonia can cause sepsis *blood infection* in a New York minute, yet nobody is telling you WHAT is going on or WHY the woman is immobile in the bed! While her pneumonia might've started out 'mild', something's gone awry and you need to know WHAT so action can be taken to address the matter.

Yes, you have to pay her rent in Assisted Living while she's in the hospital and rehab recovering.

I have no idea what 'long term care insurance' your MIL has, but I'm sure you can call them for guidance.

Medicare normally pays for 20 days of rehab in a Skilled Nursing Facility, or, up to 100 days if medically necessary. (You'd have to ask if the rehab would give her IV nutrition; I wouldn't guess so; the idea of rehab is to get PT & OT daily to get the patient up and on her feet again, not to lie in bed on an IV. I could be wrong though. The hospital shouldn't release her until & unless she no longer requires IV nutrition) I would think your MIL needs rehab if she can get out of the hospital successfully. If she doesn't improve significantly enough TO go to rehab, the hospital may recommend she get onto hospice care in a Skilled Nursing Facility or back at her ALF if she's in good enough condition to return there. That's up to the AL if she can return there, depending on her condition at the time. If she's not going to be able to return to her AL, then you can give them notice and end her lease; they normally require at least 30 days notice if not more.

If your DH is his mom's POA, tell him to buck up and stop the nonsense, that HE has decisions to make here coming up! Nobody 'likes' such things, but this is a serious situation you're facing and you can't do this alone. You need him and together you'll face this crisis!

My mother had pneumonia in 2019 at 92 years old; at first the doctor thought she'd need hospice but she rallied, went to rehab for 20 days, but wound up wheelchair bound permanently. It can be very hard for an elder to recover from pneumonia, especially with COPD wreaking havoc on the lungs at the same time and having caused them damage. Pneumonia used to be called 'the old man's best friend' for the lives it claimed; it still does; it's what took my MILs life at the age of 91.

Wishing you the best of luck making yourself heard at this hospital!

Its not that her Doctors are not allowed its that they do not have privileges in that hospital. If they do, they are allowed to see their patent. If her lung Dr does not have privileges ask that a lung doctor be called in for consultation. I would also ask for someone you are able to talk to that there seems to be a language barrier. You can also try to transfer her to another hospital saying you don't think she is getting appropriate care. Call ur State Ombudsman.

That sounds a lot like our recent hospital experience with my MIL. She lived at home and couldn't go back and they discharged her before we could even get the nursing home referral, had her sitting by the nurse's station. She had a fall and compression fracture, but also wouldn't eat but kept tearing her IV out.

That was seven weeks ago, she is now in a nursing home on a Medicare rehab paid stay, but still not eating and has lost 23 pounds. She is 93 and just keeps going. We can't put her on hospice while she's on a rehab stay, which is ridiculous but the nursing home is saying it's saving us money. We've given them two weeks to turn her around and then we will get hospice involved ourselves. They have put her on an appetite stimulant but from what I've read it's probably not going to work with advanced dementia.

So I would say, start getting a nursing home lined out NOW. Unless she bounces back, you may be looking at hospice but obviously the hospital is not going to be a big help. Maybe she can get on a Medicare paid rehab stay like my MIL and she will improve.

I totally get it about the husband with his head in the sand, I have one of those too. We are headed to see an elder care lawyer about her medicaid application and meeting his sister, who is not our friend in any of these decisions. I digress, but god help me. I wish husband could handle this himself, but he can't.