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My mom is currently in the Hospital for an Acute Stroke. It has been a very stressful time for me and I am trying to hold it together but Medicare Criteria from the Dr. who is trying to assess her lately is telling me she needs to be in a Skilled Nursing Facility. Her wishes have always been to never put me in a Home. So does anyone know if Medicare pays for at home nursing services until she gets her Rehab started? She cannot walk which makes this hard for her to come and her left arm is very weak still as well.

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I’m sorry you’re going through this. My mom had a devastating stroke and went to rehab. Sadly, she didn’t recover what was lost and had to live the rest of her life in a nursing home. It was the last thing she wanted, as it is for most people. Medicare doesn’t provide in home nursing services. My mother was private pay with a LTC policy that exhausted within a year and Medicaid after that. Doing what’s best for your mother will also require you to do what’s realistic and sustainable for you. You’re no good as a caregiver if you burn out and are exhausted. Make the best decisions you know how with good medical advice and give yourself grace that it can’t be better. I wish you both peace
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I think the doctor means that she should go to a Skilled Nursing Facility for Rehab, not necessarily as a permanent resident. To my mind, those are different things. While in rehab, she will be working with Occupation and Physical Therapists each day to get stronger so that she can come home safely.

Medicare will pay, with a doctor's orders, for a visiting nurse perhaps once or twice a week to take vitals and blood/urine as long as your mom needs PT and OT (which of course she can get at home). It's just that there is better equipment for PT in a facility and there is also a certain sense of motivation to do as well as the other patients and working hard to get strong enough to get home (at least that was the dynamic that was going on with my family member).

No one WANTS to go to a nursing home (or rather, no one wants to NEED to go to a NH; but if that's the level of care your mom needs right now, then that's what she needs.

Many years ago (1965; Medicare had JUST come into being) my grandma broke her hip. She told all of her friends "I'm going to be an invalid and my daughters will care for me". Um, no.

My mom had three little kids and my aunt taught full time AND had three kids. No one was going to care for bedbound grandma. Mom and Aunt sent her to rehab "I can't believe you are sending me to live amongst strangers" said my grandma every day.

Grandma learned to walk again and went back to living independently. I hope that your mom can too.
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It usually works that the person, after 3 or 4 days in a hospital, is sent to Rehab for physical therapy. Medicare pays the first 20 days 100%. 20 to a 100 days Medicare pays 50%. This means the other 50% is out of pocket unless you have a good supplimental that will pay partial or all of the balance. If the person makes good progress, they maybe discharged anytime within that 100 days. If its felt that "in home" care is warranted, Medicare will pay for that. But its temporary. Its usually PT and OT. An aide will be given maybe 3 days for bathing. The therapist comes when they schedule. When its felt the person has progressed as much as possible they will be discharged.

There was a member who was able to get her Mom and Aunt help thru Medicare under ""intermittent care".

The hospital should be helping in setting Mom up with rehab and with an homecare in her home.
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JoAnn29 Dec 2021
Thats 21 to 100 days.
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This stint in rehab, in an actual rehab facility or in a nursing home, might be temporary. She needs the rehab to see what skills she can regain and see if it is enough for her to safely and sanely be cared for at home.

For now, tell her it's just for rehab to get her stronger and hopefully get her back home again. Then, see how it goes. Don't promise anything about taking her back home. It's going to take a bit of time and some hard work on her part to see what she is going to be capable of. Hopefully she makes a wonderful recovery!
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Kare, make sure that your mom doesn't have a Urinary Tract Infection. These are pretty common if she's had a catheter at any point during her hospital stay.

Get a psych consult once she has been cleared of a UTI. Vascular dementia often occurs after a stroke. The brain is damaged in areas that affect language, perception and reasoning. Get her help with that.

As to "promised never to..." sometimes our loved ones need what they never imagined. Give yourself permission to seek the best care for your mom without destroying your life, your family and your marriage.
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Nobody WANTS to leave their home and go into care. So, put that 'guilt' to rest. It just may not be possible for her to have what she wants.

Today my mom was showing me how wide her doorways are and how a wheelchair can make it down the hall. I pointed out to her she'd need to be able to get out of bed, get into the chair and roll herself into the kitchen, which is where she would have to sit, all day. So, about 20' of usable space. And she has no strength to roll herself anywhere. She would HAVE to move to a NH.

We NEVER promised mother she wouldn't go to a NH. YB did, but he will be 'outvoted' when/if the time comes. I personally really hope it does not come to that.
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I actually just posted to “you” when I saw your comment on someone else’s post in regard to your moms stroke. Try to see if you can read it.

What are your moms deficits at this time? My mom had a stroke in 2019 - she has left side hemiplegia - she also had a lot of cognitive deficits in the beginning. I took her home - as the SNF nursing parts just were not quality care - but I responded to you on what I would do today if I had to do it all over again.

Medicare does not cover in home aides - home health will offer a bath like 2x a week. You will get limited PT OT a and speech.

Does she have long term health insurance and or any money to pay for CNA or caregivers through an agency? I will share what I have learned. But off to wash mom up - please try to read my response on the other post and I will check back in a few. 🦋
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