My mother in law is close to death and we want to take her home for in home hospice but the rehab is dragging their feet. Advice?

Exactly who have you spoken to about your situation? I don’t mean a person’s name. I mean, what position of authority are they in?

Absolutely, use hospice for her final days. They are incredibly compassionate and are excellent caregivers.

I take it that you have hospice on standby.

I am terribly sorry that you are struggling with all of this.

I wish you peace during this difficult time.

I will keep your family and your mom in my thoughts and prayers.

Have her physician order "Transfer to in home Hospice " and have the hospice agency interviewed now; they will arrange transfer for you. This is an MD ORDER. Has very little to do with their wishes. Will be done at once as soon as the MD order is in.

I would hope contacting the hospice program that is largest and most well known in your are asap would get her home all the sooner. Also contact your local long term care ombudsman's office and/or the local area agency on aging. This is an outrage. Also, it might even be more efficient to contact a certified elder law attorney. I'd be taking her out like you said AMA, but you might have regrets later, and if you call Hospice first, they can no doubt document the transfer of care as well as have needed equipment (if it is) already placed in the home. YOU GO GUY!

Perhaps you can get hospice involved in getting her discharged ASAP. You can also have her transferred to a hospice facility where she will be able to spend her final days/weeks, and she will receive great care. Bringing her home under hospice care will be a lot for you all to handle, but it certainly can happen if your family is ready to step up to handle her 24/7 care. Hospice does but only so much when in the home. The nurse will come only once a week to start, and they'll send an aide to bathe your MIL, about twice a week. Other than that 99% of her care will fall on you and the family. Whereas in their facility she will receive the 24/7 care she needs. It's your choice. And just so you know, hospice care is covered 100% under your MIL's Medicare. They will pay for any and all needed equipment, supplies and medications. They will also cover her transportation by ambulance to either home or their facility.
If push comes to shove, I would just go in the rehab facility and get her out, whichever way you go, hospice in home or in their facility. I wish you the best in getting her where she needs to be.

Rehab is an option, not a given. Dad could have turned it down. I agree, talk to Moms PCP and get an order for in home Hospice. Rehabs are not prisons. Don't ask, inform the NH you will be placing Mom on Hospice. This is a safe discharge. Tell them you need her discharged immediately. If under AMA, Medicare will still pay for the days she was in rehab and don't allow them to say they won't. Medicare will also pay for her care under Hospice. Call your State Ombudsman.

I would think hiring the hospice place would get you where you want to go. Hopefully you have a POA or you can get the father involved to do this. These facilities really know how to play the medicare game and either dump people out of their system too early (my case) or hang onto them to get their 20 days of payment. I'm fighting the system as well this week. In my case I believe there is hope but with cancer, sadly, the best case is at home with family. Good for you!

You CAN just put her in a wheelchair to your car & bring her home. Have hospice ready with the bed, etc. This isn't jail. I have done this myself in CA. Good luck to you,, hugs.

She is not a prisoner.
Contact the Hospice of your choice.
Have her evaluated. Should not take long and is just part of the process.
Ask Hospice to arrange transport to your home. They will coordinate with their supplier to have all the equipment delivered so it will be set up when she arrives home.
Hospice will also arrange discharge from rehab and into their medical care.

Exactly the same situation happened with my mother. She wanted to die by starving ( awful choice but it was her decision) but the facility where she was wanted to force-feed her. So my brother carried her to the car to take her home which was only a few miles away. There she died two days later under the care of my brother and in-home hospice. She was happy to be in her beloved house on the coast.

Call her doctor now and tell them you want her home for hospice care immediately. Then call hospice for an evaluation. They will work with the facility, set up medical equipment in the home and arrange transportation to home. The rehab is not in charge of her care.

You can change the hospice agency ANYTIME. Get another one on board for home hospice and bring her home. I was a LTC Ombud in CA for 7 years. Her POA should speak to the head admin at the rehab and tell him or her you want Mom transferred to home ASAP. Keeping her a day longer is doing it against your consent and you want your "lack of consent to remain in the rehab put in her medical record." Then "threaten" to call your atty about a filing a lawsuit and the state agency overseeing the facility. Use those words, "lack of consent."
The head of the facility will not want any of this. Be strong, the POA rules.

I disagree with a few other posters. Do NOT remove her AMA (against medical advice) or the insurance company might not pay for her current care at all. (It happens all of the time.)

Get the MD to write an order for home hospice. Once approved, just put her in a wheelchair and take her home.

Report them to Medicare, it worked for me

Yes, you can discharge her yourself!
I did that for my sister when she was in the Hospital dying with Cancer.

I brought her to my home to live or die as per God allowed.

Call your Insurance Company too.

You should also call her Dr and tell him you'll be checking her out and to sign her up for Hospice Care at home.
Bring all her meds with her.

Prayers



You can even

Take her home. The rehab's financial loss does not supercede the family and patient wishes EVER. Contact Medicare or her insurance carrier. Also, call the state ombudsman.

"Welcome to the Ombudsman.IN.gov website, where citizens can connect with multiple Ombudsman for state agencies. The mission of an Ombudsman is to investigate and attempt to resolve complaints when dealing with specific state agencies. Use this site as a method of contacting the Ombudsman and accessing the provided resources."

We all have the right to have our final days spent surrounded by loved ones.

I would recommend having her doctor order the hospice, to expedite and avoid any other issues. When the nurse at MC called hospice, they came in off hours, looked at mom's records, which were over 1.5 years old (missed her checkup due to the early days of the virus) and denied. Nurse made them come back during regular hours, and they still denied. Oh look, she's eating, and hasn't lost any weight in the last 6 months, WTF? She had just had a stroke, which impacted her dominant side. Of course she hasn't lost weight! She JUST had the stroke! For someone younger, sure, get some testing, rehab, etc, but at 97 with dementia, almost no hearing, losing eyesight, WTF???

So, the nurse set up a TeleHealth with the doc, who ordered hospice. Zippy zing, there they were, no problemo. You may not need this, but if her doctor ORDERs it, you'll have less push back.

Call and talk with the doctor who signed orders to place her in the rehab.

Talk with her doctor. He/She can write discharge to home with hospice and prescriptions. Ask doctor and social worker at rehab about local hospice companies that take her insurance. Call hospice company (or companies) and arrange for hospice before she arrives home.

Just so you know, leaving AMA (against medical advice) has no effect on your insurance. Check out this site's caregiving topic "Know your rights: Understanding Hospital Discharge Against Medical Advice"

And, if it were me, I'd just have an ambulance, or car if she can manage, and take her out myself. They really cannot hold her as that could lead to charges of false imprisonment.

It will only take a few hours to set up hospice once you have chosen an agency. They may even help with transportation.
My dad once left an overly-possessive rehab facility AMA. The only problem we had was he still had an IV port in his arm. I had to take him to the hospital emergency room to get it removed.

PaulBould: Imho, have your MIL's physician order the hospice. I am very sorry that your MIL is in her final days on earth. Many prayers sent to you at this most difficult of times for your family.

Contact the counties social worker. You can find them at the health and human resources department. Contact her physician to get discharge orders and get medications transferred. You have the right to get your wishes granted. The nursing home is being unethical. The social worker at the nursing home should listen too. File a complaint with the home and your state. The nursing home by law has to fill out a complaint and remedy the situation. Go and get her if nothing happens in a day or two.

Don't let the facility tell you differently. Take her home and follow the advice of everyone. Hospice will help you. Reach out to them today. They have their doctors who can help, too.

The nursing home doesn’t have feet - but you do.

Just get her out immediately. If you need to involve the authorities and/or initiate legal action, do so. You don’t have time to lose. Even the threat of these actions may spur the administrators to facilitate her quick release.

I would also make sure you have the support and extra help at home to care for her. A CNA would be invaluable to help her stay clean and comfortable.

This is a very hard, round-the-clock job.

Hospice help me get my dad into a nursing home, im betting they can help get someone out too.

Yes, most hospices accept direct referrals from Family, however I would contact them to let them know your loved one is inpatient and the final wishes are to have her home with Hospice care. Hopefully the person has all advanced directives completed, and you might also inquire about DNR DNI, since most desire all forms completed before acceptance, also need to understand that this arrangement is home with Caregivers, and you receive support from Hospice staff, usually social worker, chaplain, nurse, and home health staff. No life saving actions, and someone usually is the primary care person and decision maker, possibly with Durable Power of Attorney. This can be arranged while inpatient if family member is terminally ill and Hospice can be contacted while patient is there to help get patient transferred home, at times some hospices have inpatient beds to accept patients if this is necessary as well. So, give them a call. Do not go AMA, get information first and then this will be certified care. You also have the right to Family Meeting to ask for Hospice assessment, if this is terminal, do not understand why this is not being offered. Family Meeting with physician and team should clarify this, and remember you can file a complaint or see Patient Advocate .

Home hospice is NOT 24/7 care.

You and your loved one have an advocate that can help you with this process of being heard. Call your local Area Agency on Aging and ask for the Ombudsman Department. They are all about patient rights. Talk to them about your situation and see what advice they may give you.

If you have health care POA, you can and should take her home today...as in the next 2 hours.

Call a home hospice and they will take care of moving her out of there and home immediately.