Mom's in the hospital and insists she wants to go home against my and her doctor's better judgement. Any advice?

You let her go to rehab and take this one day at a time. If she can make the PT goals, she can go home, but that could take a month. If she can't make the PT goals, then you and the MD talk about long-term care. Just remember ONE DAY at a time. Medicare will cover 100 days of rehab. I'm not really optimistic that a patient with severe dementia will understand the PT, but the MD has to give her a chance, he has to justify any placement decision. Do NOT take her home, let the rehab people work with her.

You have a real bonus when mom goes tohospital/ rehab; a social work and discharge dept that knows the ins and outs of Medicare/medicaid, etc. If your mother has severe dementia (and it should be pointed out that she probably had some demential when she sold her house and gifted the money, that was only a few months ago), then you don't even entertain what she says about wanting to come home without therapy. You need to engage in therapeutic fibbing....just a couple more days mom......we're getting the room set up for you, I need till next week. With regard to insurance/Medicare and rehab, sometimes you have to know the right questions to ask. "will Medicare pay for HHA?" The answer is no. Will Medicare pay for HHA if ordered by the doctor after hospitalition is a different questions. Will CHAMPVA pay for rehab? the answer was no. will Champva pay the copay for rehab that is ordered by the doctor after a hospital stay? My mother also has secondary insurance; the first three times we asked about the copay, they told us no. the Medicare liason at her rehab/nursing home asked the questions and the answer was yes. Dont' undertake this by yourself!

I spent all afternoon yesterday talking to Medicare and CHAMPVA. My mom is in a nursing home with a rehab dept. Because she's in a Nursing facility Medicare will only pay 20 days and then there is a $152 per day coinsurance. My mother has CHAMPVA and they will pay the $152 per day coinsurance. The facility won't accept CHAMPVA so the customer service rep had a 3 way conversation with the Nursing home and told them that not only will they pay the $152 copay but when Medicare stops paying they will pay in full up to 100 days. If the Nursing home doesn't accept it and I have to pay for it CHAMPVA will reimburse the money to me.

It's an excellent rehab center but I don't know why they have to make things difficult.

Don't take anyone's word for it, call Medicare or CHAMPVA yourself. They were extremely helpful.

Thanks for your advice. I just got a call from the rehab and thay said that Medicare pays for 20 days and any time after that I would have to pay $150 per day co-pay. I can't afford that so I hope she can walk within 20 days or I will just have to take her home. I will have a problem with long term care because my mom sold her house and gifted a good deal of her money. I was unaware of the fact that the money could not be gifted.

Does your Mom have secondary insurance or a Medigap policy? My Mom's secondary health insurance covered 80 % of the amount in excess of what Medicare paid after day 20. Check it out or have the rehab check it out for you.

BTW dementia patients often talk about 'going home'. For my Mom (and many others) the home they are referring to is the one they grew up in.

Not going to rehab, is not an option. You need your life. Then, spend that time finding out how to get her into a nursing home. Not all nursing homes are bad. The one that my mother is in (very small town) saved her life. Go to a nursing home and talk to someone about admittance. They deal with families every day, that are in your situation.

I have seen a daughter have to stand up for herself and say "She is not going home with me." The hospital, etc. then has to come up with a solution.

Get some legal advise from an attorney that specializes in elder law. An attorney could help shed some light on the gifted money issues. Also, call your local Area Agency on Aging , Senior Center or Senior Services bureau for services that may be available to help you care for her in your home. Are there other veterans benefits she can benefit from?

Send her to PT. Then enlist dr and her care team to reinforce that she cannot go home until she is able to walk, etc. --don't promise anything, and just say "mom you can leave as soon as you can walk twice around the ward" or whatever.

Talk to social worker about the funding and how Medicare can pay for longer if she isn't ready after 20 days.

It might be time to start researching care facilities that can take her if you can't any longer with your home situation. Depending on her needs and income, there might be group home, or memory care, VA, etc. I don't know about the gifting, but you can reach out to ricipients to see if they can return some of the funds.

IMO anyone who is gifted the money should place in a savings account for 5 yrs earmarked for caregiving expenses if needed prior to 5 yr look back period for the very reason you state. This technically should still be regarded as part of the estate to use for medical care if the person needs it during the look back period.

ChampVA states they are secondary coverage, Medicare is primary. Do the 20 days with Medicare, and ChampVA will provide home health care if it is ordered by the doctor. One step at a time.

May I suggest an Elder Law Attorney or SHINE (SHIP) counselor? They are good advocates to keep you on target & stress level down.