So the first week of CNA/daughter care went well, with me on my island and my son, DIL, and grandchild coming up yesterday. Then last night my daughter called me - my husband was slumped over and twitching. At my advice she called the next-door neighbor and they called 911 and he was sent to the hospital. Understand that here it has been well over 90 for several days, he likes his room closed with the fan running but no AC. SO I figured he migh be dehydrated and at least getting to the hospital for a couple of nights might give him some relief. By the time the EMTs were ready to take him in, he was lucid, more or less, but with slurred speech.
I caught the 10:15 ferry from the island this morning and drove straight to the hospital when we landed. He was snoring away. Very disoriented when he woke, very uncomfortable with the CNAs trying to move him around, but then ate well, but talking nonsense most of the time. The tests so far show nothing but tomorrow he has an EEG. So he's in the hospital for a second night.
I am really inclined to bring him home asap tomorrow. I know that Medicare will pay for nursing home "rehab" if he spends a certain number of days in the hospital but - and here's where I need your advice - it's 90 days max but if he stays less, but some, that will come off what he gets later if he comes home, goes back to the hospital, then back to a NH. Is this the way it works??
It seems obvious to me at the moment that he's a long way below what he was a week ago. I am going to keep a CNA on most of the time for a while, I think.
I wish I could be of more help with the medicare and medicaid but I don't use them for Lynn so I can't offer any advice. I did however want to reply to let you know you are all in my thoughts. I have had TIA strokes, and was wondering if that was something anyone has mentioned? Where he came around so quick, it reminded me of my first one, though they did get worse over time of course. Was he dehydrated? Keep us posted and Do take care, Nikki
briegull, The benefit period for Medicare starts the day you first to into a hospital or skilled NH. and ends when you have not received any hospital or skilled care for 60 straight days. The patient has to be in the hospital as an in patient for 3 days and go into the NH within 30 days of being discharged from the hospital. I would try to leave him in the Hospital for the full 3 day period if you can, just in case you need NH care. As for the NH, he would have to require skilled care or rehab care and Medicare would pay in full for the first 20 days, after that it will pay a portion for day 21-100 as long has he qualifies for the skilled or rehab care. If he reaches his max in the rehab or no longer requires the skilled care then Medicare would not even pay the complete 20 days. Example: Goes into the NH, needs skilled care for 5 days, then rehab, reaches his max of rehab in 10 days, then that means Medicare stops paying at that point. So many people automatically think they get the full 100 days but that is not true.
Yes, to your question if he does not use all in that benefit period if he goes back in before 60 days it is taken off that benefit amount, but if he waits and goes back day 61 then it starts all over again.
briegull - I am so sorry you didn't get your full respite. What stress, and now having to worry about complicated Medicare rules besides your concern for your DH. Jane - do you know why this all has to be so confusing? If you ever need to work we could hire you to figure out the insurance questions for us. It makes my head swim to just wonder how we all work with this crazy system.
Briegull, I am also sorry that your DH had to be hospitalized and your respite cut short. Hopefully Jane can help you with the financial end of things with respect to the Medicare rules. The government has to make things so complicated!
THANKS, Jane! This is just what I was wondering about. I CAN bring him home and send him to an NH WITHIN 30 DAYS iif I just can't handle it even with CNA help. I WILL leave him in the full 3 days. He went in Saturday night, so that means leave him thru Tuesday, right?
I've said all along that if I couldn't handle him myself, getting him in and out of bed, geting his support stocking on etc, then I couldn't keep him here.
I have a call into the elder law atty I've consulted - she has been on the board of the local AZ ass'n and specializes in that. The thing is, he is so panicked about his leg being hurt (he can't really bend it and nurses don't seem to understand that; they get confused with him being AZ-agitated .
I would guess he will be - how do I check? The last time he was in, 9 years ago, I never SAW the bills.. I talked at length to the case manager at the hospital today and she said keep him there through Tuesday night, which will be the 3 full days. She's very dubious that I will be able to take him home, but I'm determined to try. If we CAN get back to where we were last week, that should work.
I went in to see him today and they wanted to take him for an electrocardiogram and an ultrasound of his leg and apparently he was so uncooperative that they gave him an IV with something that calmed him down. When I saw him he was eating lunch and he ate and ate and ate and ate - even chocolate chip cookies, which he has never eaten because he refuses to eat chocolate! But he seemed relatively cheerful, if very disoriented.
They said they were setting him up with a physical therapist and an occupational therapist. Ah, sure. They can't find anything the matter with him! by all the tests, though the EEG this afternoon hadn't been read.
Despite the worries of the eldercare lawyer, the nurses, eldercare nurse, and case manager at the hospital, but with the support of the doctor, I brought my husband home today. And he's fine. Very pleasant, glad to be home, etc. Very confused but nothing new. Read "the dementia experience" (saw it on the table) but didn't comment on it. We had squash blossoms from the farmer's market for dinner, along with fresh corn, etc. And fell back into all the bedtime routines, without a murmer.
And I confess, I'm very glad he's home. The house was pretty empty without him. I'm finally recognizing that I will miss him a lot.
The visiting nurses call tomorrow to set things up. I'll let y ou know how that goes.
Briegull, I am so glad your DH is home and doing well too. Wonderful news! I am so happy that your doctor is supporting you in your efforts. He/she must feel with the added in home care it is the best thing for your DH and perhaps you too :)