How do I convince the doctor my mother needs rehab?

You are in Georgia. Get the correct information from Georgia.gov for Georgia Community Care Services Program (CCSP) Medicaid Waiver .

I'm too familiar with this and its unfortunate in the state of GA. Seems like the doctors are doing that to put less responsibility on the hospital since the plan is based on his/her word. Tell them it'll be an unsafe discharge if they allow her to return home in her condition bc you can't be with her and if the OT agrees then that does hold some weight...the social worker or case manager should be working on this with you, they have info on resources. You must be firm with them and your mom has to tell the Dr this as well. You can try to apply for ICWP waiver which will take time but start the process, look into paying someone to be with her in the day(post ad on craigslist or nursing school) and couple that with a few OT home visits from a agency which Grady can arrange for you and medicaid should
pay for if nothing else

Recently there was a post regarding a parent who's SS check was higher than the amount that qualifies for Medicaid yet the person had no other income, savings, or assets and needed full time care and/or be placed in a nursing home - there was a gap in the thousands of dollars between their SS income and the cost of a nursing home. The poster was advised to look into a Miller Trust. I know nothing about what is involved but evidently this type of trust is designed specifically for this type of problem. You will need to see an elder care attorney for advice/set up but it would certainly be worth looking into.

Ambriel, I have been in your shoes a number of times, and I really recommend that you use the approach suggested by Kaycee, and stick with it, telling any professional you meet.

My situation is different, but way of explaining was similar. My disabled brother's potential for rehab help was real, but along the way was dismissed too easily within the system because I called it "potential" - rather than "need". Sad thing, I really talked like that after being brought up to be both scrupulous and polite - so I was brought up to minimize any demands on anyone, so it seemed more honest for me to try to explain all the reasons to aim for positive potential - not realizing that the healthcare system is made up of so many rushed people, that what they needed to hear was "the bottom line": is this necessary for safety or not?

When I was so busy trying to be polite and explain, it got me credibility at times, but did not the help I was seeking, for professionals did not want to put themselves on the line until need was proven, so only after things deteriorated as I was predicting, and I investigated nursing homes, and found one that was on flat land so he could walk outdoors still - it was finally clear he needed to live in a nursing home - and he went there without ever getting at home rehab help. Usually, the time of hospital discharge is the best time to advocate for help that is needed, for there is a discharge team there who will back you up, but that is only for short term care.

I think you need to change your language, and if the real situation is that she might recover at home, with ongoing OT help - then state it as a need, and don't just step up to say you will do all the home care she needs, when you really need help at home to do so.

I found later that in different healthcare systems, clients received 24 hour care even, within his former residence - but learning the requirements of each and explaining over and over, is not just exhausting, but time wasting as the person deteriorated while I worried for several years. So DO, tell your hospital discharge people that you CANNOT provide safe care reliably for your mom at home, she needs more help than you are able to give. And let them fight for the right level of services. Don't be afraid to be firm, it really is the only way to get through. When my brother was in the nursing home, I tried to tell his MD that he needed a diet nutrition plan, to stop the weight gain clearly creeping up. I know my brother and he craves support and a plan - and would have been grateful but basically reliable with any plan reinforced locally - but the MD and the nursing home kept "informing" me - that healthcare system has no plans available for weight loss in nursing homes, only weight gain plans. I was tired of arguing and explaining what he needed by then, after years of struggling to first understand the system and then advocate for him - so I let it go. Five years forward now, I hear "obesity" now listed as one of the primary conditions on the same MD's report, for my brother's brain injury with balance and mobility issues are much harder to deal with, because he has so much weight to balance as he gets up more rarely and he falls fairly often when he turns too quickly, using his rolling walker.

There may be long term options around the money issues, but it's amazing how professionals find many options, once they have accepted the definition of a need. So I really recommend from my understanding, that you are clear about your own schedule unavailability's, and talk in terms of known risks - realize that gaps in your abilities are not flaws, but the real situation, and even home care help need to be trained by OTs and that your mom needs this help.

I had a problem with my uncle telling the doctor and therapists that he had plenty of help at home and would be ok. I had just had a baby and also had 5 yr old twins. There was no way I could be there on a daily basis noe could his neighbor come in all day. I had to go back and talk to the doctors and therapists to let them know that he did not have 24/7 help and he couldn't walk up the stairs to get to his bedroom and bathroom. Explaining all this to my uncle was not easy because he just wanted to go home. Finally convinced him that rehab would be the best choice at the moment. The doctors and therapists needed to hear it from him and not me even though I had his medical POA.

Thanks to everyone for these great advise. Here's an update on what happened. The hospital wouldn't keep her and would only order home health. The home health nurse can and took one look at her and said she couldn't be left alone. She said that she would report it as neglect if there was any incident. She said I'd have to take her back to the hospital and tell them she has no where to go because I work and can't take care of her...which is what I did when we were at the doctors office, ER and hospital...nobody would listen to me. Luckily, God has blessed me with a friend who was looking at personal care home while I was going through all this...she found an assisted living for dementia patients that agreed to take her at a reduced rate...It was like GOD has smiled upon us. I still can't believe it. It seems to good to be true and I am suppose to take her there tomorrow. The problem still remains that it cost alot more than she brings in and I am going to have to pick up the rest of the tab, but I will have to make it work somehow, someway. I'm just grateful my mother will be safe and hopefully experience a better quality of life here on out. Please keep us in your prayers.

You should NOT have to pay out of your own pocket on any permanent basis. Go to your state health dept or your country senior care dept. I am from AZ and do not know GA requirements, but seems to me that Medicare supplement and denture payments should be considered medical deductions that come off her social security income, so if you are then left with $800/mo, she is way below qualifying! In AZ, one qualifies for Medicaid.....to pay for facility fees at least, with $2000 in income or in the bank or checking account per month and can still own a house and a car if they are in rehab and might come back to their home eventually.

Was Mom married to a veteran who served even one day during an authorized war? Did not even have to serve IN the war....just be active duty. If so, there is a VA benefit called Aid and Attendance that she might qualify for too. With Medicaid, generally speaking, a diagnosis of dementia means an automatic approval for help from them, even if it's not full Medicaid coverage, it would cover her rent in a facility because of her dementia. Is she moving into a personal care home that eventually would accept Medicaid? Please look into it, as it just doesn't make sense to me that she would not qualify for Medicaid, based on what I went through qualifying my Dad.

I would get a second opinion from another doctor as soon as possible. The longer it is for rehab to start, the longer it takes if at all.

Ambriel: The spend down (in the state of Massachusetts) dictates when you go on Medicaid that you only allowed to own $2K and under. And be prepared if she does apply for Medicaid for the 5 year look back (save all bank transactions).

If she or her spouse were in the military, contact the VA by phone to talk to someone in Aid and Assistance. Get information on an agent that would be near your area that will be able to get any and all help available. This program is for both veterans and spouses/widows or widowers. It's worth checking into it.

Do u mean Medicare? Is ur Mom over 65. Medicarepays the first 20days. 50% for up to100. Supplimental may pick up some. Talk with the Social Worker. Explain the situation. Is the doctor her primary or the hospital dr. If hospital, contact her primary. He should be able to placeher. Medicaid comes in when ur Mom needs longcare nursing. If she has no assets her SS will go to her care. ALs you pay out of pocket for. The two near me you need two years upfront and then Medicaid will take over.

Hi Ambriel, I'm so glad you had a friend with you, who looked into options. I'm curious - had you already taken her home, so are you taking her to the facility, or is she still in the hospital? It is not easy for many of us to stand up to professionals, who act so sure they know just what's best or what's possible - so I'm glad the Home Health Nurse showed you how it has to be done..... I find it very hard to speak firmly as she did - and I get walked over often. Once I've really seen the consequences, I can be more firm, but if there's any question, I'm too quick to go along - which takes all the burden of making any change, off of everyone else, so they applaud people for accepting the risks and saying it's all fine. I hope you find a good experience at the assisted living - I always go for the right location - and fight about the money afterwards. Much more important to get the right level of care, and find others to support her health and you can also keep saying, and make them put it on her record or find someone else to say so (find a different MD if needed - I eventually did that for my brother, much easier with respectful backing) that she needs OT assessment and support in that facility. It'll be some adjustment for her to get used to the facility, but I hope you can find things to encourage, as it sounds as if you have been so caring and helpful to her.

Just need to say, the Medicaid you get to help with Medical bills is not the same as Medicaid that pays for a nursing home. Longcare nursing care cost $10,000 a month where I live. If ur Mom has no assets then she will probably qualify, if that is what u need eventually. AL where I live go as high as $7000. Talk to the Social Worker. She could help place your Momin rehab but...that is only a fix for now. If she doesn't improve then u may need options. You need to talk to Medicaid. Call Office of the aging.

Once you speak to your local SSI office to report the change in living situation, see if they'll increase her benefit. If there's such a thing but I'd inquire. I'm glad it worked out for your mom, all the best.

Maybe you should get a different doctor. Whenever I didn't like what one would agree to, I would go to a different "specialist". Some are more understanding and humane than others.

The Social worker should be doing this for you