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We have an elder in our family in the late stages of Alzheimer's/dementia + frontal lobe brain tumor, currently living in Skilled Nursing Facility (SNF). The past 5 months have been multiple hospitalizations, including 1 for pneumonia that he didn't "bounce back" from very well. After the pneumonia hospitalization, he has been in a loaner wheelchair from the SNF. He's weakened to the point that he cannot sit up straight and slumps over while sitting, therapy is no longer any help, this is just where his body is at. Due to the slumping, he has managed to toss himself over a couple times, landing on his head. SNF not allowing a seat belt because it is considered a restraint. The SNF has asked the family to purchase a custom-built "tilt in space" wheelchair costing $4,000-4,500 new, all private-pay! A used one, retro fitted, would cost @ $3,500 we've been told. There is NO insurance/Medicare coverage for this item. Anyone else had this dilemma? What are your thoughts -- is it really worth it at this stage in the game?

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I bought a Sleep-Lift Chair for DH since he has so much trouble getting off the bed and/or couch. Cost $1500 delivered into the house. The fabric is waterproofed but I use a Pellon Cooling Mattress cover as it gets hot sitting in the chair and the mattress cover is also waterproof-lined - another $35 and machine washable so I got 2 of them. One is on the couch and one on the chair. He spends time in both of them daily.
Ray has lymphedema which means the blood pools in his legs and they swell.

So the chair I bought also has a Zero Gravity position and 60 minutes daily in the ZG position keeps the blood flowing back to the heart. At 96, we do whatever we can to keep him mobile.

I know, we all become a font of information. One day at a time.
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Couple of suggestions.... google "geri-chairs" and see if dad can possibly qualify for hospice.

All sorts of Geri on market from the fat recliner ones to sleek bariatric with fold out table (think airline seat meets school desk) styles & all on wheels. Most Under 1k new. There's also Geri bathing chairs that are fiberglass clamshell with drainage slots & grab bars.

My mom at her NH fell pulling her wheelchair, shattered a hip & became bedfast and went onto hospice. Hospice ordered both regular Geri & bathing Geri for her along with specialized bed & pneumatic mattress. All are "rented" equipment by mediCARE under Medicare hospice benefit. If he can get hospice, they can arrange for items like these but will come from already vetted list of vendors who take Medicare. So you don't get to select style. My mom was on hospice 18  l....o.....n....g months and her equipment got swapped out during this period. So I imagine there exists a "used" equipment market that you could shop from as well if dads not hospice eligible.
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I know what kind of cherry you're talking about, my elderly friend had one for a while before he died. He was a retired Army medic and the vets got him one but he said they owned it. It was supposedly on loan from the vets and that if anything happened to him, they wanted it back. I think the computerized version was bought for about 5 grand from what I was told. I don't know if they really cost more and they got a discount or they were really that price for everyone. All I know is I would never buy one out of pocket unless I was buying used.

Anyway, if the nursing home wants him to have one, why don't they get it? Why are they asking you to take responsibility for something that's not your responsibility?

Another question, why hasn't the insurance buying it if he really needs it?  It sounds to me like something fishy is going on and I personally would call your relative's insurance provider and check into this. The question I would ask after giving the patient info is, "do you cover an item called the tilt in space wheelchair or?" If they say yes, then the nursing home lied and they're just trying to get more money out of you through fraudulent practices. You may not be the only one they're doing this to either so definitely do your homework. Another thing to check out is if the insurance may not have preapproved this item, because if they didn't, they won't cover it, (especially if insurance like Medicare or Medicaid has limited funds or going broke). If funding is limited which I think is probably true due to the various signs pointing in that direction, that explains why they don't cover much. However, if they do have the money and won't spend it, it may very well be that they may still be under limited funding and your items they need approval. This is why your item should probably be preapproved by whatever insurance you have and it would probably be a good idea to call the insurance customer matters and speak to a live operator. If on Ohio Medicaid, you can ask for member matters when you go through the automatic robo prompts. They will most likely ask for your member ID if you're on any program under Medicaid such as care source, united healthcare, etc. When you get to the point of expressing your concern, just ask them if they cover that item and tell them your nursing home approached you and said this person needs it but you don't have the money for it and neither does the patient. If they do cover it, they'll probably say it needs preapproved and they'll tell you how to get it approved if it's prescribed because there are certain paperwork that needs done by the doctor and it needs submitted to the insurance. It may also turn out that you could probably get insurance to lease you the item until the patient passes. I would check into these particular options but it's not your responsibility to be paying out-of-pocket for a very expensive item that cost as much as a new car, especially if you happen to be hurting financially. 
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Not sure if they would meet your needs, but check out adjustable back wheel chairs at spinlife.com. Some for less than $1000. I have purchased a regular wheel chair, a rolling walker, a transport chair and a ramp from them. Like their service via internet, email and phone.
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My mom is at home so I know it is different, but she also cannot stay sitting unsupervised in a wheelchair. We purchased a nice recliner for her (cost around $350) and an alternating pressure mattress pad. She also has a hospital bed with an alternating pressure mattress pad. She spends about 12 hours in each... Transported by wheelchair from one to the other.
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I purchased an Invacare tilt in place wheelchair with customized back and seat for my mom (fitted by an OT) and I feel it was well worth the investment. A good wheelchair is something that assures comfort and safety wherever they go, whether it's the doctor's office, walking in the garden or just sitting in the lounge or dining room, and other than bed it is where they spend all of their time. I'm in Canada and the health system is different here, but I can't understand why there would not be some king of coverage for at least part of the cost when it is prescribed as a medical necessity, are you sure you have explored all your options? Also, you might try searching for cheaper used models online, the basic chair frames are adjustable and the custom cushions can be purchased separately.
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Have the doctor order physical therapy or occupational therapy for a wheelchair assessment. Either PT or OT can help you decide what chair is best for your loved one. If the chair is a medical necessity the chair could be covered by insurance. You will need the doctor's order and evaluation from the PT or OT first before the chair will be covered by insurance. The vendor who supplies the chair will submit all the paperwork. Good luck.
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It sounds like he might be eligible for Hospice.
With Hospice I got a Broda Chair. It had a mesh seat and back so it allowed for air circulation, it did have full cushion on it so it was not just webbing. But that chair could be tilted back, had "wings" at the upper portion of the back so that it would keep the head and trunk supported. It could be tilted back in numerous positions. I am sure that Hospice could provide something like that.
If you do not want to contact Hospice a chair like you are talking about could probably be "rented" and paid for by Medicare if it were Doctor's order.
There is also another chair that I had from Hospice, it did not quite "fit" my husband and that was when we go the Broda Chair. The other chair is called a Geri Chair. Both good chairs and adjustable.
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Hi. Only you can your family can decide if the expense is"worth it at this stage in the game". I know less than nothing about these chairs however I looked on a medical supply website (amicamedicalsupply) and found some tilt chairs for under $2000. That's still a huge expense but half of what you have seen. I wish you peace in your decision. God Bless.
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My mom is 82 and has Medicare. They are paying for a Barton Chair for her. The monthly rental is around $600. Her doctor had to write a prescription for it and send that to Medicare, and they ok'd it within a few weeks. Her doctor was the one who told us about the Barton Chair, and it is great! It can go from a flat position for transfer to her bed, to completely upright, or reclining in a lot of positions.
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