My mom had a stroke yesterday and has very little short term memory. Help me figure out next steps!

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Medicare pays for rehab if doctor orders it. But they pay in increments, as long as patient is improving--generally up to max 90 days.

If/when patient stops improving then the waters get murky. Medicare no longer will pay, however nursing home can't discharge a patient who doesn't have a place to go that can care for the patient. If this is the case, then they keep the patient and it becomes private pay. If patient has no money, then social worker or family member gets approval for MediCAID and rehab facility accepts that or patient must find a MediCAID bed.

Once someone is in a rehab facility things can get tricky money-wise.

This is not accurate. There is no medical improvement standard in Medicare. See Jimmo vs. Sebelius.

DP. You always post this. Yes in circumstances where rehab is necessary to prevent deterioration Medicare will pay. It isn’t likely that OP’s mom will find herself in this situation. But if she does there is still a lifetime maximum days of Medicare payment. And after sixty days there is a coinsurance. After 90 days you get to pay 100% of the Medicare daily rate. And after 150 days you get to pay 100% of the facilities actual charges.

OP’s mother might have other insurance that will change this. But point is, Medicare is a short term limited benefit. And Medicare doesn’t pay in cases where there is no progress and no risk of deterioration without professional services. And, in most cases, it makes no sense to exhaust lifetime days unless you are at the end of life.

This is entirely different info then you need to show progress for coverage. Almost everyone in skilled nursing will deteriorate without care.

[Anonymous]

Anonymous wrote:Agree about talking to the social worker. But if she doesn’t leave be prepared for a large bill. Insurance doesn’t necessarily pay just because there isn’t a safe discharge. This will be complicated by the fact that there wasn’t even an admission of you’re still with ER docs and she hasn’t seen a neurologist.

Also without a 3 day qualifying hospital stay Medicare doesn’t cover acute rehab or subacute care so you will need resources to pay for the care.

What I’m saying is you need the social worker stat because navigating this is going to depend on a lot of personal details that you aren’t likely to want to share here.

Medicare won’t pay for a subacute rehab without a three night stay, but they WILL pay for an acute inpatient rehab. But it sounds like OP’s mom was never admitted to the hospital. Was it a mini-stroke? Is your mom aware of her deficits? Are there any residual physical limitations?

I’m surprised they didn’t at least admit her under observation status and do occupational/physical therapy and neurology consults.

There are assisted livings that do short-term respite care, while you figure things out, esoecially if she is unable to take care of herself right now - but they are private pay. You can call a placement agency like Owl Be There or A Place for Mom for help. I think Brooks Grove in Olney has respite care, as do many Sunrise facilities.

[Anonymous]

Anonymous wrote:

Anonymous wrote:Agree about talking to the social worker. But if she doesn’t leave be prepared for a large bill. Insurance doesn’t necessarily pay just because there isn’t a safe discharge. This will be complicated by the fact that there wasn’t even an admission of you’re still with ER docs and she hasn’t seen a neurologist.

Also without a 3 day qualifying hospital stay Medicare doesn’t cover acute rehab or subacute care so you will need resources to pay for the care.

What I’m saying is you need the social worker stat because navigating this is going to depend on a lot of personal details that you aren’t likely to want to share here.

Medicare won’t pay for a subacute rehab without a three night stay, but they WILL pay for an acute inpatient rehab. But it sounds like OP’s mom was never admitted to the hospital. Was it a mini-stroke? Is your mom aware of her deficits? Are there any residual physical limitations?

I’m surprised they didn’t at least admit her under observation status and do occupational/physical therapy and neurology consults.

There are assisted livings that do short-term respite care, while you figure things out, esoecially if she is unable to take care of herself right now - but they are private pay. You can call a placement agency like Owl Be There or A Place for Mom for help. I think Brooks Grove in Olney has respite care, as do many Sunrise facilities.

Just saw your update! Glad she’ll go to rehab. Wishing her a smooth recovery!

[Anonymous]

Anonymous wrote:As someone else said - MAKE SURE SHE IS NOT IN OBSERVATION STATUS. talk to the nurse - say please, I need you to confirm that my mom is not listed as in observation status. If she is in observation status while in the hospital medicare will not pay for rehab. Often sometimes even the doc or nurse dont think someone is listed in this status and they are. You want them to physically check it and confirm. Even when admitted they can still be in this status.

https://www.aarp.org/health/medicare-insurance/info-2018/medicare-observation-rule-fd.html

She can go to ACUTE rehab from observation status, which is often better for post-stroke recovery. I’m a social worker and discharge people to Adventist inpatient rehab all the time from Observation/Extended Recovery (which is technically outpatient/medicare B) status.

[Anonymous]

Anonymous wrote:Update: my mom is still in the hospital and at this point the doctors give her a 50/50 chance of surviving. This is not the outcome I expected at all. She was healthy a week ago. Hug your elderly folks this holiday.

Oh no, I am the PP slowly making it through this thread and am so sorry to read this. Just take one moment at a time, that’s all you can do. Sending love to you and your mother.

[Anonymous]

Anonymous wrote:

Anonymous wrote:Update: my mom is still in the hospital and at this point the doctors give her a 50/50 chance of surviving. This is not the outcome I expected at all. She was healthy a week ago. Hug your elderly folks this holiday.

Oh no, I am the PP slowly making it through this thread and am so sorry to read this. Just take one moment at a time, that’s all you can do. Sending love to you and your mother.

Thank you. I hope and believe your posts may help others so thank you for the additional information.

[Anonymous]

Sad update…op here. My mom died the day after Christmas. We moved her to hospice about 12 hours before…they were wonderful.

Thanks to you all for the excellent advice on this thread. I wish I still needed it.

[Anonymous]

Anonymous wrote:Update: my mom is still in the hospital and at this point the doctors give her a 50/50 chance of surviving. This is not the outcome I expected at all. She was healthy a week ago. Hug your elderly folks this holiday.

So sorry you are going through this. Just dealt with a similar situation with a family member. It’s so hard. Your life changes in an instant.

[Anonymous]

Anonymous wrote:Sad update…op here. My mom died the day after Christmas. We moved her to hospice about 12 hours before…they were wonderful.

Thanks to you all for the excellent advice on this thread. I wish I still needed it.

So sorry to hear this. Thinking of you and your family ❤️

[Anonymous]

I’m so sorry for your loss, OP.

[Anonymous]

Anonymous wrote:Sad update…op here. My mom died the day after Christmas. We moved her to hospice about 12 hours before…they were wonderful.

Thanks to you all for the excellent advice on this thread. I wish I still needed it.

I am so very sorry for your loss.

[Anonymous]

OP, I’m so very sorry. Sending comfort and hugs.

[Anonymous]

I’m sorry OP. That’s hard news. I hope you have the space and support to process it and know that a quick death can be a blessing in disguise. Hugs.

[Anonymous]

I’m so sorry, OP. I hope you and your family are doing okay.

[Anonymous]

Anonymous wrote:Sad update…op here. My mom died the day after Christmas. We moved her to hospice about 12 hours before…they were wonderful.

Thanks to you all for the excellent advice on this thread. I wish I still needed it.

I am so sorry for your loss OP. It is hard to hear this but really after having a stroke and having a significant short term memory impairment it was a blessing in disguise your mom passed away.

My mom had a stroke at 76 and lost her short term memory and is living in an assisted living place and soon will move to memory care. In my mind she passed away when she had the stroke. She lost everything- her friends, her ability to live independently, to take care of herself and even her sanity (she has delusions people are stealing/entering her apartment). She went from being so social to being so isolated and miserable. It is a terrible way to live and terrible for loved ones to witness and have to deal with.