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My mother got cellulitis last year. Her Primary Dr just told her to elevate her legs and it would go a way.


Sh did this and it did not. So her Dr put her under wound care coming into our house and it clear up but then it came back.


So my mother went to the ER which gave her some meds that made it worst.


2 Days before X-Mas we had a visit from Adult Protective Serves they got a call my mother was refusing medical help.


We showed them all the Dr visit papers the ER Paper and even she was taking her Meds.


My mother asked the APS worker to call an ambulance to take her to a Diffirent ER because she could not stand up. (Some presure from the APS Worker but it was my mothers call)


For the rest of Dec and the First 3 days of Jan my mother was in a Hospital.


They moved her to a Nursing home we all thought we were in agreement. that after 3 months of Rehab to get her back up and walking they would release her home.


Her Primary Dr said she would release her on March 31st.


But Rehabe made her come home for less then an hr to see if she could walk the house March 22nd she had to walk the house by her self with no help from any one other then her walker.


They told her and us the house was ok.


But went back and lied in their report about the house and demanding we remolde our entire house.


Now her Primarty Dr is making threats.


1. She will not release her in less she is living with a family member that does not live in the house.
2. If my mother checks her self out Her Dr will no longer fill her meds or see her.



These treats are not coming directly from the Dr but from her Nurses.



For the past 2 days we demanded a meeting with the Dr. and the Nurses have denied it.



My mother wants to know


1. can she legally change Drs right now?


2. is it legal for a Dr who is currently your primarty care to refuse to fill life threating meds. my mother is a Diabatic and must have her meds?


3. Can they legally make us remold our entire house at our cost?


4. If my mother changes Drs and the new Dr says to release her. Can the Nursing home refuse?



We know that if she checks her self out Medicaid will not pay for her time there. But


5. will they pay for her meds if they are filled by a new dr? Let alone will the pay the new Dr at all?


My mother is on medicaid and on SSDI


The nursing home plans on taking my mothers SSDI Check next week away from her. she got a letter that her check is being cut down to $30 a month from what it was I know it was in the 700s


Finally


6. My mother wants to know if she can legally demand to see the Rehabs report to the Dr? She been told what is in it but she wants to read it her self.



When my mother went in we were told it would be Short term care but now they are trying to make it long term care aginst her wishes and the family's wishes.


My mother is buying a house on contract with out her SSDI check she can not make her house payments and will lose her home. The owner is already making demands that if the payment is not by her soon she will start the process of kicking my mother out of her home.


The nursing home mail system keeps losing her payments.



My mother is refusing to go to physical theyrpy because they are the ones who came in and changed all the plans we had the house clean we had everything we could do with very little help getting the house ready.


And They had to move 1 item because I had a table out to far I did not relized they got her a new walker that to big


They went back and said the enite house must be remold and when I asked who will be paying for all of this they informed me the family would have to pay it.


We agree if she needs more rehab we would reather it be at a nursing home of our chossing not her Dr's as her Dr did not even put her in here the Hospital did and then her Dr took over but in the 3 months she been there she has seen her Dr face to face 1 time. the rest of the time its the nursing home's nurses or her Dr's Nurses and my mother wants to speak with her Dr not a nurse.

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You say she has cellulitis and diabetes?
Anyone here know of complications the mother could develope from this if it doesn't heal ??!!
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My sympathies with the enormous frustrations of this pig's breakfast of a situation.

There is a communication problem. The problem probably arises from too many people giving subtly different versions of the same scenario to too many other people.

For example: the OTs telling your mother and you that the house was fine, then going back to the office and writing a report that essentially says "the house will be fine - once they've rebuilt it."

Take deep breaths. Focus on the end goal.

Your mother wishes to return to her home. This should be achievable, once a number of contributory factors have been successfully accomplished:

1. Your mother returns to rehab to improve her physical health.
2. Meanwhile, the adaptations and aides recommended in the report are largely implemented.
3. Support is arranged in time for her return home.

So, in order to get to where you want to be, you need to negotiate those things.

It is important to recognise that, objectively speaking, the people who have got your back up are not in fact the enemy. They want your mother to be safe, well and content too. The reason they appear to be so unhelpful and antagonistic is that their approach is different from yours, and also includes certain criteria that satisfy their organisational and reporting requirements and have nothing directly to do with serving your mother. For example: your mother - not unreasonably - wants to deal directly with her doctor. But the subject under discussion is not part of the doctor's remit, it is handled by the nursing team; hence the nurses keep sticking their faces in and being annoying. Could the doctor make any necessary decisions and arrangements? Sure, hypothetically; but that's not how the organisation is set up, and because the nurses do have the necessary competencies they're not going to budge on it, either.

If your mother is a competent, consenting adult then the NH cannot keep her in custody. But if she discharges herself against their and against medical advice, she has to understand that they will absolutely, and quite rightly, refuse to take any further responsibility for her care.

It sounds as though one important difficulty for you, yourself, is that your mother keeps getting into fruitless arguments that distract everyone from the primary objectives and alarm her care team. Can you get your mother to agree, Scout's honour, to allow you to act as her advocate, so that you can go back to the drawing board and negotiate her way home?
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Once APS is involved they will try to dictate certain modifications if they feel the patient is not safe in their environment. Whether they can force you to I don't know - I too would get an attorney as you have raised several issues that appear complicated and an attorney to help sort it out would be optimal.
As stated above once the patient is in a NH the NH Medical Director becomes her PCP.
Doctors can fire patients for non compliance with the doctor's recommended treatment plan but there is often months of noncompliance that needs to be documented. In that case the physician usually sends a letter stating the patient will be released from the doctor's care and has usually 30 days for the patient to find another provider. Sometimes they give a list of nearby providers for the patient to choose from. The old PCP will usually provide the patient with 30 days of prescriptions until the patient secures a new provider & may offer to send her medical records to the new provider after the family/patient gives them permission in writing due to HIPPA laws. I believe that's how it works.
The cellulitis if from lymphedema or another chronic disease state may be very hard to heal and often becomes recurrent if the patient doesn't elevate their legs or use compression dressing/hose of some sort. It can become a chronic condition as well.
I see your statement above about you mother refusing physical therapy. Can she be discharged home to the house she is buying & be independent? Is this the home APS stated is unsafe for her?
I would pay for a consultation with an attorney as again there are several complicated issues in your post.
Good luck!
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On Medicaid and in a nursing home, the nursing home MD becomes your primary doctor. So the old primary won't write Rx because he is out of the picture.
If the home needs wider doorways, grab bars, etc., this must be done for the safety of the patient. APS will step in if the situation is unsafe.
It might help you to contact the facility Ombudsman for assistance.
ALL of her income will go to the nursing home, except her $30 a month personal needs allowance. So if you intend to stay in the house, you must now pay the mortgage and utilities by yourself.
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I'd seek a consult with an attorney. It sounds very complicated. I've never heard of others forcing someone to do so many things against their will if the person has not be found incompetent by the Court. Does she have a Guardian?
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