She is going downhill quickly, lately. Takes two people to transfer her from wheel chair to potty, etc. She's on a waiting list at a local nursing home, but we're at wit's end trying to care for her at home, even with help. Is there any way the doctor can help us get her in the home sooner? or?
If they are living at home or in IL, and need to move to a NH, you will need to work with their MD to get the criteria in their medical history to show they need skilled nursing care and they need it NOW. Just because they are old, or have dementia or incontinent, etc. is not enough. My mom went from IL to NH and bypassed going to AL. She was able to do this as she had a critical weight loss (more than 10% in 30 days), a critical H & H and some other conditions. Her gerontolgist was also the medical director of a NH so he knew how to write up her chart to make NH happen. About 90 days before she moved into NH, I met with her MD to start the ball rolling on this. The day she hit 10% weight loss the order for NH was done, she saw the doc every 3 weeks until we got to that point. Since then she has moved to another NH and again the medical director is also part of her gerontolgy group. Sometimes the items needed are simple like MD will need to change their meds – like go from Exelon pill to Exelon patch (more “skill” to apply); or change a medication to one that needs to be compounded daily which you can’t do at home but a NH can. Just needing help with ADL's like moving from chair to potty isn't enough to need NH.
Are you going to do Medicaid to pay for the NH. Each state has it’s own criteria for NH admission under Medicaid. They will be evaluated at the NH and often those coming from home are denied because they don’t have enough “critical” conditions because there is no history when living@ home. You will have to work with NH and your parents MD’s to get whatever done to establish the need for NH if they are coming from being at home or IL. There is a whole medical appeals process in each state for this and separate from the financial appeals. My expereince has found that for those still living at home without a huge disease history, becoming a patient of the MD who is the medical director of the NH is essential as they will know how to create & write up the health history chart so that it passes Medicaid medical review for NH admission. Good luck & keep a sense of humor
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Best of Luck,
Karie H.
AgingCare.com Team
Sounds like mom is having sundowners. Well the upside of this is if she does this and falls and breaks a hip then it's into a hospital and they will discharge her to a NH for rehab and she doesn't come back to your sister's. Is her doc a gerontogist? For us it made a huge difference - my mom's old MD - an internist - literally gave her a new med every time she went in for a complaint or concern. She went to him from seeing a family medical doctor who did the same thing. I can't tell you how many bottles of old meds got thrown out when she went into IL. But I digress, she tore her rotor cuff several years ago and she went to see an orthopedic surgeon who was afflilated with the med school and he said he would do the surgery but she needed to have her MD be with the gerontolgy program and that's how it happened for us. Huge butt difference and they took her off all but 2 medications and did all the baseline tests for dementia.Her health and overall energy got better and she went into IL for a couple of years.But the dementia eventually increased and so into a NH for her.
If you think she will outlive her $$, try to find a NH that also takes Medicaid. Moving them is difficult, I did it with my mom but it does set them back.
A friend of mine put cat collars - the kind with a bell - on her mom's ankles so they could hear when she was getting up. She would say oh it's boots & barkely time when she heard it (B&B is the name for Target's pet products). Too funny!
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Also think through and do a list of mom's medical for that past 30 years or so and again do this as a file for her.They will ask her and she likely has CRS so no accuracy there. When I was first going through all this for my mom it just made going to all the doc's so much easier and I brought a copy of her medical history and it just got attached and everybody from her gerontologist, to her dentist had the same 2 page data. I'm pretty OCD so for me this works.
And I hear you about the meds, my mom was on a 40% Urea Gel for a bad nail and it was like over $ 150 a bottle and she had 1/2 dz bottles stashed about. My mom went from over a dz Rx's to 2. A couple of the Rx's she had to be weaned off of also, so if that happens with you all, it's good she is still at home so you all can monitor and enforce the withdrawal from those meds.