Need help from a social worker but mother discharged from ER over 30 days. Options? - AgingCare.com

Need help from a social worker but mother discharged from ER over 30 days. Options?

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My mother has dementia and needs to go to a home ASAP as my father can't care for her properly. We are being told there is a one year wait list for all the homes within a reasonable distance. I understand if my mother goes to the hospital a social worker there can help get her placed and get past the wait list issue. We didn't know about this and my father declined to speak with the social worker and took my mother home. It has been just over 30 days since she was released. Is there a way to get help from a social worker without my mother having to go back to the ER?

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Let me try to organize some information for you:
1. If you mom is on Medicare, and if she spends 3 consecutive midnights ADMITTED to a hospital, she is then eligible for 20 days of rehab if scripted by an MD. Meaning, that the hospital discharge planning office will assist in getting her a bed in a rehab/nursing home. Those first 20 days are paid for IN FULL by Medicare. After that, if medically necessary, Medicare will pay 80% of the cost of the stay up to 100 days.

It's not so much that a social worker can assist you; it's that the HOSPITAL discharge department can get her admitted to a rehab/NH because it's been decided that she cannot be discharged home safely. Therefore, she jumps the waiting lists.

2. Has someone--her doctor, a social worker, the local Area Agency on Aging done a "Needs Assessment"? Do you know that she needs NH care and not, say, Assisted Living or Memory Care? It's important for someone professional to assist in assessing her ability to do Activities of Daily Living (feeding, grooming, dressing, toileting) accurately.

3. You need medical documentation that she needs Nursing Home care. Talk to her doctor about this aspect.

4. I wholeheartedly endorse Tacy's brilliant idea. Get the doctor to script a social work assessment AND call back hospital discharge. And get the doctor to script a bath aide and some home care, so that there is not so much pressure on dad.

Good luck and let us know how this is working out.
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Call your parents primary care doctor and have him order an in home social worker. Its paid for through medicare skilled care. Make sure you use a different agency for each because of potential conflicts of interests and the two social workers working together may be able to accomplish more.
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call the hospital back. Can't hurt. Has mom's doctor written a script for NH care? In other words, is she medically eligible.?

Get her on EVERY waiting list you can. Visit them all and make sure that they are acceptable.
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My sister and I can speak with my father. He is actively trying to get her into a home and isn't resisting this in any way. Every home has told him there is a year long wait. If we can get help from a social worker I think he will be agreeable but I'm afraid we missed our chance since my mother left the hospital already. Can we call the hospital back? Can a social worker outside of the hospital help?
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Social worker cannot override Dad. You have to convince Dad.
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