A few days ago, my 90+ year old mom with dementia passed out due to a UTI and dehydration and was admitted into a hospital. Her doctor said the UTI was resolved and mom is now hydrated so she is ready for discharge tomorrow. Medicare will pay for 20 days at a rehab center. However, during this and other stays at the hospital she has been resistant and argumentative to the point that the hospital found her initially "unfit for rehab." After I spoke with them the evaluation was changed, but not before several rehab centers declined to accept her. Thanks to the hospital's care manager/planner, we were able to find a nearby rehab center that is both decent and has a caring staff. Unfortunately, today Mom became really combative with the staff. What are the chances that this rehab center will now refuse to accept her? If so, what are Mom's options for discharge since she doesn't qualify for MEDICAID and I can no longer provide her with care at home?

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Have you told her it was only temporary? It sounds like it will probably end up being permanent but if you can get her to accept the little white lie that she just needs to get her strength up before she can go home that might calm her enough to have time to adjust.
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So how did yesterday go, EverHopeful?
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Daughter, at 90, if you spend 3 days in bed with a UTI and dehydration, you basically lose your ability to walk. Thus, rehab.

Ever, has there been any resolution?
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My question, why doesn't she qualify. If its just that her monthly income, SS and/or pension, is over the cap, then Miller Trust (in some states its called something else) can be set up for the overage.

My Mom had 2 months, 18k, left that I used to pay the first 2 months of her LTC and Medicaid kicked in the 3rd month.
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I have been on this forum only about a week but I have discovered that @BarbBrooklyn, whoever she is, always has informative and good responses. So, I won't repeat anything she already posted.

UTIs are tricky. It takes at least 48 hours in the lab to fully diagnose, and then, if they say yes, it's UTI, then usually they will not retest until 5-10 days after last dosage of antibiotics. And, I'm being generous there, because I have always been told 7-10 days.


Are you feeling confident that they know that the UTI has been resolved?

Also, I don't understand why someone is being sent to "rehab" for a "resolved" UTI and a cured dehydration problem. Is there more going on here?
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Ask to have mom retested for UTI, certainly.

It sounds as though your mom would benefit from a psychiatric workup. Find out if they can schedule that in the hospital or if they can transfer her to an inpatient psychiatric unit.

If mom doesnt qualify for Medicaid, can she private pay in a long term care facility until she does?

But as CM says, make it very clear that you will not sign for her discharge and you will not pick her up. She needs to be someplace where there is 24/7 staff and supervision.
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So you're sitting there at half past two in the morning wondering what the heck happens tomorrow.

Not good.

In the morning, call the hospital's care planner again and consult. Also, see how mother is. Also, speak again to her doctor. If the cause(s) of your mother's combativeness, whatever that may be, hasn't been determined maybe it's about time her medical team shifted themselves to give an opinion on that.

If your mother's care needs far outweigh what can be provided by one person in a standard family home, her discharge home would be unsafe. Make that Point #1. She's not coming back to your home.

So, she needs to be admitted elsewhere. She may not be suitable for rehab. She doesn't qualify for Medicaid (will she, any time soon, or is it an income issue?). It sounds as though she may need Dementia/Memory Care, do you think? - what has the planner to offer on that front?

But GO TO BED! That things always look better in the morning has just been proven through highly respected academic research. And suspected through the ages.

There will be a way, sleep well.
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shad250 Apr 2019
You do know that hospitals NH, etc will wait till late at night to call about any issues with a loved one.
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