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I have a dilemma that I need input on. Mom is bedridden with Alzheimer's, Dementia, COPD, and Parkinson and one of her legs is a bit contracted. What do you do when she has to go to the doctor and they will not permit a stretcher, but even with wheelchair they will not work on her unless she is on their table; BUT they will not assist you at all to get her from the wheelchair to their table!! This is just for a podiatry visit to look at some nail fungus! To make matters worse I have to hire a private ambulance to make this visit work.


The bigger issue is when mom says she doesn't feel good but when you inquire where it hurts, she is unable to tell you exactly. At what time do you call an ambulance to take her to the ER as that would be easier then arranging for a doctors visit?

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Before mom went into the NH we found a podiatrist who made house calls. Medicare didn’t cover it since she wasn’t diabetic, so I just paid for it. I think it was about $60 per visit but Priceless to me. If your jerk of a doctor won’t even examine her in a wheelchair ( like the NH podiatrists do!) I’d get a different one.
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Medicare will pay for a podiatrist to come to the house. I use a visiting nurse and physicians service for my mom's care.
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There comes a time when we have to look at our Doctors and see if we still need them.

On a hospital visit itcwas found Mom had a thickening in her upper stomach. Had to see a specialist to determine if it was cancer. No, probably caused by her acid reflux. But we went every six months and then a year. When there seemed to be no change, her Dementia was getting worse and she was in an AL, I stopped seeing him. She had graves disease. Again a specialist. After a couple of years it seemed to be under control. By this time she was in LTC. Specialist said as long as the facilities dr. Tested her ever so often and her numbers were good he wasn't needed. He was also 45 min from her NH. Then there was her urologist. She had bladder cancer at 80. He was still at 87 doing scopes on her oncevavyear. With her Dementia we would never had put her thru the Chemo u need to go thru. So, I chose to stop him. There are things u need specialist for but after ur stabilized I think a PCP can continue monitoring.
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I'm only asking this out of curiosity - what do the staff at this *fantastically* useless doctors' practice suggest you do? Really, are they just literally standing there like cans of corn saying 'we can't help with that'? Unbelievable. Or at least I wish it was unbelievable.

Find a doctors' service that will make house calls and fire that lot. Meanwhile, take a good picture of your mother's nail on your phone, take it your friendly local pharmacist, and ask.

By the time my mother was literally bedridden only two things would have made me force her out of the house: one was an echocardiogram, which still seemed like a good idea at the time (though looking back I'm not so sure); and the other would have been, but by the grace of God this didn't happen, any injury requiring sutures or reduction. For anything else, I'd have asked them to come to us; and I'm more grateful than I can say for all the dedicated and resourceful people we had to call on.

But! - don't give up :) If you'd like any help with finding resources, try your local Area Agency on Aging or do very specific online searches. Remember, you are *never* the only one who needs the kind of help or service you're looking for, and the odds are good that some practitioner will have spotted the demand.
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Tothill Aug 2019
Country Mouse, I worked for podiatrists for 10+ years and for Physios for 15 years.

Some of the things I was asked to do:

Help tie the shoes of a women whose shoes were covered in horse manure.

Help a patient with Hep C and personal hygiene issues dress, when I was obviously pregnant. I refused this one. Nope, nadda, I am not touching you if you have a communicable disease and I do not know when you last washed your hands.

Help morbidly obese patients up and down from exam tables and treatment beds. How is one person supposed to help someone who cannot lift their own leg 4 inches off the ground?

I did help a when I could without risk to my well being. But I put my foot down at other times.

My job was to book appointments, take patients to treatment rooms, clean the rooms between patients and do the billing. I was not hired to touch patients, put my health and my unborn child's at risk, nor risk personal injury.

We had and still have in our community PT's and Foot Care Nurses that do home visits.
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When doctor visits become so overwhelming and my mother seemed to need every kind of doctor in the world, then I felt it was time for hospice. One day she was panicking and saying she needs this and she needs that from all her doctors and then even added a few more problems that needed medical attention and more doctors, I called her primary care physician and asked him if he felt she could use hospice. We had been in and out of the ER recently and he took all info into consideration and referred us to hospice. With comfort care from hospice, she is doing better, but is still eligible for their services. I just couldn’t keep up with everything anymore. Hospice keeps her good and so far we haven’t had to go out of her house for any doctors except the audiologist and skin doctor. She is not on hospice for skin cancer. (But she should be). That’s another day. Hospice supplies all medications and all equipment t my mother needs to help her.

Please inquire about hospice or at least palliative care.
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Your mom has many challenges. My mom has Parkinson’s too. With Parkinson’s you can’t second guess either. Mom’s neurologist and primary care doctor always says not to hesitate to take an ambulance to the ER with different or new symptoms. I recently had to do this. She did stay in the hospital for several days for observation and tests, then moved to the nursing home for skilled nursing rehab. Now on home health. Mom’s roommate was wheelchair bound and was doing a rehab program too. You never want to second guess and have the situation become worse. The elderly are always dealing with new issues that have to be addressed by medical professionals. When my mom went to the hospital she couldn’t walk.

My mom uses a walker and can no longer get on exam table either. Can’t they elevate her legs onto a stool of some sort?

My mom had the fungus thing before. What about home health? Ask if it will be covered under home health and if it is something a nurse can treat. The nurse mom had with home health treated certain skin issues. They may not but worth asking about. Medicare pays for home health.

There is a cream for it. Ask your pharmacist also.

Best wishes for you and your mom.
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My mother can NEVER tell you what's wrong with her, exactly, or where it hurts, or what she wants, or doesn't want, etc. etc. So I let her be. I figure if things are REALLY bad and she's REALLY hurting or in need of medical attention, she will be able to verbalize what's wrong. She has dementia, but she's not that bad.........trust me when I tell you she can verbalize everything ELSE that's on her mind, just not what she's ASKED to verbalize.

Toenail fungus is NOT something I would worry about or schedule a doctor's visit for. Palliative care is called for at this stage of life, in my opinion, and the only time mother needs to see a doctor is if she's very ill, obviously so. She lives in Memory Care and I've hired the in house doctors to care for her. If/when she needs more urgent care, I have an ambulance sent for her to take her to the ER, and an ambulance to take her back to Memory Care. She's wheelchair bound, I should add. When my dad was wheelchair bound & I had to take him to the urologist, they pulled the same nonsense with me about only taking out his staples (from hip surgery) if he was on the table, and gee whiz, we sure CAN'T help you get him ON said table. We don't even have a walker for him to use!! I swear I almost had a heart attack that day from the sheer stress of that doctor's visit. From that point on, there were ONLY in house (in ALF) doctor visits for Dad, and now the same for mom.

When Dad was alive & they both lived in Independent Living, I hired a geriatric doctor that made house calls. It was SO MUCH easier......they'd even order traveling xray companies to come out if needed, and the same with nurses to draw blood. It's just TOO MUCH to try and transport your mother anywhere in the condition she's in. The other thing I've done (recently) is hire a wheelchair van to take my mother from the rehab facility to the Memory Care facility on the day she was moved in. It cost me $100 to have her driven 4.0 miles, but hey, I thought it was worth it b/c it was 100% stress free.

I would choose my battles here........in other words, use your own good judgment to determine when your mother truly needs ER attention and when she just needs plain old attention. Otherwise, YOU are going to have a heart attack yourself!

Best of luck!!
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I tried to get phone or Skype consultation with Drs office for mother. Every time, they would tell me to "bring her in" (cuz of liability fears). Also, "house-calls" (by Drs or nurses) should be provided by every insurance company, for elderly urgencies. With our aging population, its downright stupid the way services are provided in the U.S. it would save money to help us avoid unnecessary transport or E.R. visits. (My mom frequently needed hydration, which could have been done by I.V. at home, saving thousands). There's no reason labs ect, can't be done at home, if patients are deemed eligible. Maybe I just had the wrong insurance co.
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JoAnn29 Aug 2019
When it comes to Dr office visits the patient needs to be there for the doctor to be able to bill Medicare. Thats why I stopped Moms specialist. The required her to be there for test results even though she had no idea what they were talking about.
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Goodness, many professionals in our health care system seem to have lost empathy for patients!
I would think there would be extra people to be called for help in moving patients onto tables etc. Of course I also know many times they are worried about liability.
I have no advice for you. Just wanted to say how disappointing it is to see a profession that is supposedly human oriented w little care about patients.
BTW, I teach preschool and many times have had to deal w bodily fluids. I put on gloves and deal with it.
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You didn't mention your mother's medical directives or wishes. My mother who has advancing dementia and lives in a memory care facility was hating every time she went to a doctor visit or had to go to the hospital. During her last hospital visit she was biting the nurses as a way of expressing that she didn't want them to bother her. We decided to switch her to hospice care with a medical directive of no hospitalization. The concept is that she gets "comfort care" just things to make her comfortable. Hospice helped me contact her doctors to renew her prescriptions automatically (without a doctor visit). The doctor comes to her facility for her annual check-up for her to stay in the facility. Some people even put into their medical directives that they don't want to be fed if they can't feed themselves. My mother didn't do this, and now she is at the stage where she has to be fed. As mentioned in another response, if you have medical POA you can decide which doctors she should visit and when it is necessary to do so.
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