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So, I have written in a few times and have tried to be proactive with my parents' and their aging plans however they choose the disaster plan. My Dad got a bakers cyst and is 82. They gave him a cortisone shot, but said it may take 6 weeks to work. In the meantime he fell at home hit the knee and went back to the emergency room. Now he is at rehab, but may be sent home in two weeks. Neither of them have any sort of plan for how to deal with that. I live out of town, have my own health issues and I’m not an option. There is no one else other than a helpful neighbor who is in his 70’s. I contacted a home health care agency. They said they are unlicensed but can do many of the things that I think my parents will need done. Is being unlicensed okay? What are other options when my Dad gets out of rehab? It is unclear to me if he will need 24/7 care but if so what is the best way to accomplish this. Anyone deal with a bakers cyst?


Thanks!

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So a quick update. Dad will be discharged tomorrow. Only one at home is Mother also 82. I tried to get them to hire a caregiving agency to get them through the first week and see how it goes from there but they had every excuse in the book. I found the agency talked to them etc… They are licensed and recommended by rehab center. I’m just so done with this. I really don’t know how you all do it. I give up.
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BarbBrooklyn Jul 2022
I'm so sorry that your parents are acting unreasonably.

Sometimes we need to allow people to suffer the natural consequences of their actions. When they see for themselves that their plan won't work, their buy-in to the solution is much stronger.

Good luck.
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Ask that home healthcare agency admin why they aren't licensed...are they in process? Suspended? Other?
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Kmjfree, see ReallyReal's latest post and my comments. The more I think about it, I wouldn't even consider the unlicensed company.

I haven't checked recently but Medicare used to publish a very lengthy online list of companies providing care. I don't recall if they were ranked; I believe they were, but the criteria wasn't the same as that which I would consider.

At one point, the hospital which we used began to host reps from rehab companies; they solicited for their company but also provided good insights into the level of sophistication of those companies.

I usually spent about an hour with each rep, asking questions from a list I had already prepared. The eloquence, answers, level of response, and interest were easy to gauge, and I made my decisions that way. I also made sure to be at Dad's house whenever a new company started in-home rehab.

That turned out to be a very good way of judging people. One company that was highly recommended (by itself) turned out to not even meet standards. Only one of the staff was any good; I let them go after 2 weeks of poor performance, as well as meddling in our affairs.
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No, do not hire an unlicensed care agency. They are not reporting back to the State and you want the State overseeing them.

Why do you think Dad is 24/7 care because of this cyst? I read where its curable. You can have him evaluated for 24/7 care and go from there. Rehab all depends on how a person progresses. Medicare pays the first 20 days 100%. Hopefully he will be discharged by then. 21 to 100 days 50% with the patient paying the remaining 50% or their secondary insurance if they cover rehab. Upon discharge, if its felt he should have some in home care it will be suggested and the discharge planner can set that up.
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Kmjfree Jul 2022
Thanks Joanne. His mobility was not great before so the cyst has not helped. 2 falls at home just trying to get to the bathroom. Maybe it will just be temporary 24/7 care until cyst is cured. I talked to his nurse today and will talk to case manager next week.
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Kmj, whenever my dad was released from rehab, someone sent out the home healthcare nurse, OT, PT. I don't know who coordinates it, probably the rehab.

It's crazy, we get services and don't have a clue who sets it up or where they come from.

I bet though, if he needs help with ADLs, that will be up to him to find a service.

My thoughts on an unlicensed company, unlicensed usually means uninsured and unbonded.

I would hire an unlicensed private hire but, never an unlicensed agency. Just my opinion.

I hope your parents use this as an opportunity to put some plans in place that aren't you.
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Kmjfree Jul 2022
Yes I hope to use this as a way to get some plans in place. Navigating the rehab Medicare system is confusing and I don’t think I was getting great info from either of my parents. I talked directly to the facility today. I didn’t think they would talk to me without POA or some authorization but so far no problem.
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Medicare will cover home health for a short period of time if the doctor writes an order. Whether or not LTCi will cover is dependent upon the policy.

What do your parents know about their coverage options? "Gee, mom/dad, this is why I've been asking you to make a plan BEFORE there was a need."
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bundleofjoy Jul 2022
"Gee, mom/dad, this is why I've been asking you to make a plan BEFORE there was a need."

i so agree with you, barb. unfortunately, some elderly parents very -- intentionally -- make no plan: they know, that out of the kindness of their heart the adult child will in some way come and help. they prefer to let the chips fall on the adult child, and let the adult child sort it out.
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Km, if your desire is to get your parents on the page that says "folks, you need a plan--and I am not the plan, because I'm far away and I'm sick too", then I would call the discharge planner and her her/him that you are at a large distance and unable to help.

Your parents need a geriatric care coordinator to research options and manage their care.

Cleary, their plan is that their LTC insurance will step in and manage for them. Let the discharge folks work this out.

I am aware of the fact that this sounds mean and uncaring. But you have an opportunity here (if your folks don't have dementia) to allow them to see that lack of planning is imprudent.
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Kmjfree Jul 2022
Thanks Barb. Geriatric care coordinator sounds great. I hope to use this event to force some planning. None of what you said sounded mean or uncaring! The elder care system is a confusing mess and I appreciate all advice I can get.
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Kmjfree, I would first begin researching home care treatment, as in my experience discharge from rehab is followed up at home, through a visiting care agency. Some are top notch, some are good, and a few aren't worth it, so doing some research now is worthwhile.

I would NOT hire an unlicensed agency. I can no longer remember the benefits, but I don't recall reviewing any agency's qualifications that didn't state it was licensed.

I would assume that an unlicensed agency wouldn't have to meet certain criteria or standards.
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Kmjfree Jul 2022
Thanks. Does the rehab center coordinate the follow up care or make recommendations? M
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Treatment

1) Medication.
Doctor may inject a corticosteroid medication, such as cortisone, into the knee to reduce inflammation. ..

2) Fluid drainage.
Doctor may drain the fluid from the knee joint using a needle.

3) Physical therapy.
Icing, a compression wrap and crutches may help reduce pain and swelling.

source: Mayocliniconline.com
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