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PATIENCE, PLANNING AND SUPPORT: REFLECTIONS ON DEALING WITH AGING FAMILY MEMBERS
that may have available beds and
can assist in finding a placement for your family member. I knew all of
the social workers where my parents were typically hospitalized at the hospital. On several occasions, my parents had post-hospitalization rehabilitation stays. The social workers arranged these placements. The social workers are well-versed in the Medicare rules and can speak with the physicians regarding whether a post-hospitalization rehab stay would be beneficial.
In contrast, after my mother-in-law fell
on the ice in Minneapolis, a resident
at the county hospital discharged
her with a fractured patella before a
three-night hospital stay. I had asked
to speak with a social worker when I got to the hospital.
But the overworked county hospital where she was taken, because she had no insurance information in her billfold and no family contact information in her billfold, would not hold her. My husband and his siblings tried unsuccessfully to
care for her at home for a few days. She was only about 90 pounds, but with the fractured patella and family untrained in how to transfer her, the experiment of caring for her at home was unsuccessful. My husband started calling nursing homes, trying to arrange a placement, but it was impossible without a referral from a social worker. Finally, I called an orthopedic surgeon who agreed to admit her to a different hospital just so that the hospital social workers could arrange an appropriate placement for her. If your family member is hospitalized and you think they might need post- hospitalization rehab, ask to speak with the hospital social worker early on in the hospital stay.
The social workers are also aware of other programs that might be helpful. My parents were hospitalized in what is considered a rural hospital, and both of my parents could
utilize the hospital swing beds for
a period following discharge. The Social Security Act permits certain small, rural hospitals to enter into a swing bed agreement. The hospital can use its beds to provide acute or skilled nursing facility care. As defined in the regulations, a swing bed hospital is a hospital or critical access hospital participating in Medicare that has
CMS approval to provide post-hospital skilled nursing care and meets certain requirements. Medicare Part A (the hospital insurance program) covers post-hospital extended care services furnished in a swing-bed hospital. Again, the social workers know these programs and whether your hospital participates. https://www.cms.gov/
Medicare/Medicare-Fee-for-Service-Payment/SNFPPS/ SwingBed.
5. Be your parents’ healthcare advocate
Your parents may need you to be their healthcare advocate. For the most part, my parents received excellent care throughout their numerous illnesses and hospitalizations. But there were two situations where I had to advocate for them. One was near the end of my mother’s life when she was in hospice. While hospice generally discontinued all life- extending drugs, there was a drug that her physician thought she should have for comfort care. Although it was not on the hospice-approved drug list, with the help of her doctor,
I advocated that she be allowed to receive the drug. I had suggested I remove her from hospice to receive the drug, and it was approved.
The other times I needed to advocate related to my dad’s diagnosis of colon cancer in 2015. My dad was 93. He was still living alone in his home. He was still driving his F-150 pickup. When the doctors asked him if he was retired, he would say “no.” He was unexpectedly diagnosed with colon
We do the best we can and always wonder if it was enough.
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