Are you sure you want to exit? Your progress will be lost.
Who are you caring for?
Which best describes their mobility?
How well are they maintaining their hygiene?
How are they managing their medications?
Does their living environment pose any safety concerns?
Fall risks, spoiled food, or other threats to wellbeing
Are they experiencing any memory loss?
Which best describes your loved one's social life?
Acknowledgment of Disclosures and Authorization
By proceeding, I agree that I understand the following disclosures:
I. How We Work in Washington. Based on your preferences, we provide you with information about one or more of our contracted senior living providers ("Participating Communities") and provide your Senior Living Care Information to Participating Communities. The Participating Communities may contact you directly regarding their services. APFM does not endorse or recommend any provider. It is your sole responsibility to select the appropriate care for yourself or your loved one. We work with both you and the Participating Communities in your search. We do not permit our Advisors to have an ownership interest in Participating Communities.
II. How We Are Paid. We do not charge you any fee – we are paid by the Participating Communities. Some Participating Communities pay us a percentage of the first month's standard rate for the rent and care services you select. We invoice these fees after the senior moves in.
III. When We Tour. APFM tours certain Participating Communities in Washington (typically more in metropolitan areas than in rural areas.) During the 12 month period prior to December 31, 2017, we toured 86.2% of Participating Communities with capacity for 20 or more residents.
IV. No Obligation or Commitment. You have no obligation to use or to continue to use our services. Because you pay no fee to us, you will never need to ask for a refund.
V. Complaints. Please contact our Family Feedback Line at (866) 584-7340 or ConsumerFeedback@aplaceformom.com to report any complaint. Consumers have many avenues to address a dispute with any referral service company, including the right to file a complaint with the Attorney General's office at: Consumer Protection Division, 800 5th Avenue, Ste. 2000, Seattle, 98104 or 800-551-4636.
VI. No Waiver of Your Rights. APFM does not (and may not) require or even ask consumers seeking senior housing or care services in Washington State to sign waivers of liability for losses of personal property or injury or to sign waivers of any rights established under law.I agree that: A.I authorize A Place For Mom ("APFM") to collect certain personal and contact detail information, as well as relevant health care information about me or from me about the senior family member or relative I am assisting ("Senior Living Care Information"). B.APFM may provide information to me electronically. My electronic signature on agreements and documents has the same effect as if I signed them in ink. C.APFM may send all communications to me electronically via e-mail or by access to an APFM web site. D.If I want a paper copy, I can print a copy of the Disclosures or download the Disclosures for my records. E.This E-Sign Acknowledgement and Authorization applies to these Disclosures and all future Disclosures related to APFM's services, unless I revoke my authorization. You may revoke this authorization in writing at any time (except where we have already disclosed information before receiving your revocation.) This authorization will expire after one year. F.You consent to APFM's reaching out to you using a phone system than can auto-dial numbers (we miss rotary phones, too!), but this consent is not required to use our service.
✔
I acknowledge and authorize
✔
I consent to the collection of my consumer health data.*
✔
I consent to the sharing of my consumer health data with qualified home care agencies.*
*If I am consenting on behalf of someone else, I have the proper authorization to do so. By clicking Get My Results, you agree to our Privacy Policy. You also consent to receive calls and texts, which may be autodialed, from us and our customer communities. Your consent is not a condition to using our service. Please visit our Terms of Use. for information about our privacy practices.
Mostly Independent
Your loved one may not require home care or assisted living services at this time. However, continue to monitor their condition for changes and consider occasional in-home care services for help as needed.
Remember, this assessment is not a substitute for professional advice.
Share a few details and we will match you to trusted home care in your area:
This was after his stroke and 3 weeks of rehab. He needs 2 people to help with transfers and we want him to improve so he can live at home with his wife.
My husband is in the same position as yours. Medicare Advantage paid for 21 days of rehab after he fell and broke his hip. He hadn't made hardly any progress during that period so I had to contact an Elder Law Attorney and he has set up a Miller Trust Account and has filed for Medicaid for my husband. They use the Hoyer lift to transfer him from bed to wheel chair etc. There is no way he can come home because I am 75 years old and can't handle that responsibility. We miss being together, but I have no other choice. We don't have any money to hire help here in the home since he would require 24 hour care. My only consolation in this is that he is in a very nice NH and it's less than a mile from my house so I can visit every day, even twice a day when I can. It's true that Medicaid is using more than half of his pension to help with the cost of his stay there and it's put me on a very tight budget which I'm working on still. Had to cancel lots of things that I couldn't afford any more but it has to be done. He would do the same for me if our situations were reversed.
Is he trying? Or is he not trying and continues to be "dead weight". Three weeks of rehab should have already shown much improvement--they are not going to keep him forever. It sounds like he's on the road to a nursing home. Hiring a caregiver is extremely expensive and Medicare will not pay for any of that and a caregiver will not be able to handle "dead weight" and will have to use a Hoyer lift for any kind of transfers. A Hoyer lift will do nothing for strength. It is simply a lift for dead weight. If you hire a caregiver off the street and not from an agency--the caregiver hurts their back on your property they can sue the estate due to lack of insurance.
Appeal it w Medicare. If they feel he didn't make progress though (by asking nursing home), then they won't pay. You can private-pay for it indefinitely, yet it's expensive. A 2-person transfer is difficult to care for at home. Is he incontinent? Then even more so.
As soon as my dad couldn't walk and incontinent, it was over. He had to live in a facility. It was twice as expensive to have 24-hr home-care at the house (heavy-wetter at night).
You really need to talk to the therapists about whether there is still progress in therapy. Have you had a care meeting? Do they believe that dad can live at home with substantial assistance?
If he still requires two people MAXIMUM assistance after three weeks he may not be able to improve..and if he has not been trying but been a total burden to staff, he just bought himself a ticket to the nursing home. Face it he won't get any better at home if he can't get better at a rehab center. Dead weight is dead weight.
Is his wife in a position to care for him? Even with equipment that will help him to stand can she do what needs to be done. Is the house accessible for someone is a wheelchair or using a walker? Grab bars in the bathroom? Carpeting that is a trip hazard? Stairs into the house or a 2 story house? Bathrooms large enough for a walker or wheelchair? ADA height toilets? There are a lot of things to think about getting someone home. How is the rehab going? Is he participating fully? Is he improving? Do the therapists think he will continue to improve? And will you be hiring a caregiver to come in to help out? is it possible that someone could come in in the morning to help him get up, showered, dressed then return in the evening to help get him to bed. But this also leaves changes during the day that either he will have to do or his wife. Depending on the situation is a move to Assisted living for both of them a possibility? They will get help with ADL as needed. But this would work only if he is able to transfer himself. Most Assisted living will not permit the use of equipment for transfers equipment like that is used in Nursing Homes.
Countrymouse, did that and no help. In the state I live in, if the person is essentially on medicaid through a help at home program, the state will okay an extended short term stay, but the level of physical therapy leaves a lot to be desired. It is a slippery slope when you are at advanced age. If you aren't on the program already, it is more likely that you are discharged and put into a dangerous situation. I experienced that with my other parent; he ended up sustaining injuries because he truly wasn't well enough for a safe discharge. Little by little the program is being whittled down. For example, they used to allow the diagnosis of failure to thrive to qualify one for hospice (some very old people die with that diagnosis, they are really ill, their bodies are just worn out). That has been taken away. I have to wonder what of medicare will be left when I am at the age to require their service.
Three weeks seems a bit quick off the mark to decide he can't make meaningful progress at rehab. How well has he recovered so far? - can you point to significant improvements since the stroke? If so, Savitaa's advice to contact Medicare seems the way to go; but if the reality is that he's unlikely to recover well enough to be cared for at home, maybe it would be better to concentrate on finding the best possible choice of facility.
I should have mentioned that a person with only one usable arm/leg (such as with stroke) or no leg strength at all (advanced MS, paraplegia, leg neuropathies, etc.) can still be very independent if they have the right assistive products to help them. Not sure why a two person assist (for transfers) is needed- would it be possible to provide a bit more information?
Medicare will pay 100% for the first 20 days. Medicare pays all but a daily co-insurance for days 21 -100. Does he have a secondary insurance? They will pick up the remaining costs through day 100.
All this is moot if he is not showing measurable progress. He may not show progress due to physical inability or an unwillingness to do the work. Either way Medicare requires measurable progress or they will no longer pay. So you need to confirm WHY they are discharging him. If they feel he has reached his maximum capability, you may want to find a NH for him to reside in. Around the clock care at home is terribly expensive. And it is doubtful that his wife could care for him on her own given his inability to help in his care. She would need to turn him multiple times a day to avoid bedsores and change bed linens multiple times on some days and nights when his bed becomes soiled.
I know, you probably do not even want to think about a NH. If he was fairly healthy before the stroke this is all coming at you too quickly. We have all faced these same fears and emotions. You are on a tough, demanding path, and you have no choice but to rise to the occasion.
Have a care meeting with his rehab team and discuss his progress and the motivation behind their recommendation for discharge. If it is solely due to reaching the maximum of Medicares full coverage he can pay the remainder out of pocket or use secondary insurance if he has it. If they simply feel his physical ability will not improve further, you need to consider a nursing home as the possible best option for him.
By proceeding, I agree that I understand the following disclosures:
I. How We Work in Washington.
Based on your preferences, we provide you with information about one or more of our contracted senior living providers ("Participating Communities") and provide your Senior Living Care Information to Participating Communities. The Participating Communities may contact you directly regarding their services.
APFM does not endorse or recommend any provider. It is your sole responsibility to select the appropriate care for yourself or your loved one. We work with both you and the Participating Communities in your search. We do not permit our Advisors to have an ownership interest in Participating Communities.
II. How We Are Paid.
We do not charge you any fee – we are paid by the Participating Communities. Some Participating Communities pay us a percentage of the first month's standard rate for the rent and care services you select. We invoice these fees after the senior moves in.
III. When We Tour.
APFM tours certain Participating Communities in Washington (typically more in metropolitan areas than in rural areas.) During the 12 month period prior to December 31, 2017, we toured 86.2% of Participating Communities with capacity for 20 or more residents.
IV. No Obligation or Commitment.
You have no obligation to use or to continue to use our services. Because you pay no fee to us, you will never need to ask for a refund.
V. Complaints.
Please contact our Family Feedback Line at (866) 584-7340 or ConsumerFeedback@aplaceformom.com to report any complaint. Consumers have many avenues to address a dispute with any referral service company, including the right to file a complaint with the Attorney General's office at: Consumer Protection Division, 800 5th Avenue, Ste. 2000, Seattle, 98104 or 800-551-4636.
VI. No Waiver of Your Rights.
APFM does not (and may not) require or even ask consumers seeking senior housing or care services in Washington State to sign waivers of liability for losses of personal property or injury or to sign waivers of any rights established under law.
I agree that:
A.
I authorize A Place For Mom ("APFM") to collect certain personal and contact detail information, as well as relevant health care information about me or from me about the senior family member or relative I am assisting ("Senior Living Care Information").
B.
APFM may provide information to me electronically. My electronic signature on agreements and documents has the same effect as if I signed them in ink.
C.
APFM may send all communications to me electronically via e-mail or by access to an APFM web site.
D.
If I want a paper copy, I can print a copy of the Disclosures or download the Disclosures for my records.
E.
This E-Sign Acknowledgement and Authorization applies to these Disclosures and all future Disclosures related to APFM's services, unless I revoke my authorization. You may revoke this authorization in writing at any time (except where we have already disclosed information before receiving your revocation.) This authorization will expire after one year.
F.
You consent to APFM's reaching out to you using a phone system than can auto-dial numbers (we miss rotary phones, too!), but this consent is not required to use our service.
You can private-pay for it indefinitely, yet it's expensive.
A 2-person transfer is difficult to care for at home. Is he incontinent? Then even more so.
As soon as my dad couldn't walk and incontinent, it was over. He had to live in a facility.
It was twice as expensive to have 24-hr home-care at the house (heavy-wetter at night).
Praying for the best for you and your family.
Is the house accessible for someone is a wheelchair or using a walker?
Grab bars in the bathroom? Carpeting that is a trip hazard? Stairs into the house or a 2 story house? Bathrooms large enough for a walker or wheelchair? ADA height toilets?
There are a lot of things to think about getting someone home.
How is the rehab going? Is he participating fully? Is he improving? Do the therapists think he will continue to improve?
And will you be hiring a caregiver to come in to help out? is it possible that someone could come in in the morning to help him get up, showered, dressed then return in the evening to help get him to bed. But this also leaves changes during the day that either he will have to do or his wife.
Depending on the situation is a move to Assisted living for both of them a possibility? They will get help with ADL as needed. But this would work only if he is able to transfer himself. Most Assisted living will not permit the use of equipment for transfers equipment like that is used in Nursing Homes.
All this is moot if he is not showing measurable progress. He may not show progress due to physical inability or an unwillingness to do the work. Either way Medicare requires measurable progress or they will no longer pay. So you need to confirm WHY they are discharging him. If they feel he has reached his maximum capability, you may want to find a NH for him to reside in. Around the clock care at home is terribly expensive. And it is doubtful that his wife could care for him on her own given his inability to help in his care. She would need to turn him multiple times a day to avoid bedsores and change bed linens multiple times on some days and nights when his bed becomes soiled.
I know, you probably do not even want to think about a NH. If he was fairly healthy before the stroke this is all coming at you too quickly. We have all faced these same fears and emotions. You are on a tough, demanding path, and you have no choice but to rise to the occasion.
Have a care meeting with his rehab team and discuss his progress and the motivation behind their recommendation for discharge. If it is solely due to reaching the maximum of Medicares full coverage he can pay the remainder out of pocket or use secondary insurance if he has it. If they simply feel his physical ability will not improve further, you need to consider a nursing home as the possible best option for him.
See All Answers