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The sepsis - I’m pretty sure- is the primary reason why rehab is not under consideration. The assessment also looks a her health chart not just based on whatever they asked of her during the 23 minute period Till she clears sepsis, a skilled nursing facility with a rehab sector usually won’t take this type of patient discharge from a hospital. Also Your sister Susan has a lot of health challenges as she’s on dialysis so she’s ESRD and has congestive heart failure and not very ambulatory; sepsis atop all this is really hard on her organs. She has to clear sepsis to then figure out a future care plan.
FWIW my MIL was in a NH became very ill, went to the hospital and diagnosed with pneumonia and sepsis and organ issues. She then went from the hospital to a LTACH - long term acute care hospital. It was in a building adjacent to the hospital connected by an air bridge. The LTACH are more set up for dealing with this type of care. The MD who is the hospitalist overseeing her care in the ICU would be the one to speak with to see if this might be an option for her as it’s a by referral only to get placement into a LTACH.
I’m guessing she’s younger?, like not over age 65? if so this poses it own set of issues for what long term type of placement once she leaves the ICU (or the LTACH) she may be able to get. If she is not enrolled in special category Medicare due to being ESRD, pls pls get that done for her. If the suggestion for her to go into a board & care comes up again, if there is a smaller one that can meet her many many needs, that probably is her best placement.
It seems to me that she needs to improve medically (sepsis) before she can really participate in rehab in any meaningful way. She's right that she won't ultimately be better without rehab but she's gotta kick this sepsis first, IMHO.
Rehab is not a place for someone who is suffering from Sepsis. They are not Skilled Nursing. She needs to stay in the hospital till its cleared up. Its life threatening and I personally would not want to care for someone suffering from it. I would not want the responsibility. Tell them she can't come home its an unsafe discharge. You refuse to take responsibility for her care. Don't let them tell u there is help. Once you walk out the door with her, their help stops.
If you believe it is unsafe for her to return home -you tell them exactly that. UNSAFE DISCHARGE.
But be prepared. If they do not feel that she is a candidate for rehab, you will probably have to make some fast decisions regarding Skilled Nursing Facility placement. The social worker at the hospital can help with that.
But if she can't safely go home, it is imperative that you stick statement and continue to tell them it is unsafe. They will tell you that you HAVE to take her home or that they will provide you with all kinds of assistance AT HOME.
Neither of those things are completely true. You don't have to take her home, especially if it is unsafe. And the "help" they will offer at home won't likely be enough, if anything. What they want is the responsibility back on your shoulders.
She may not be able to go to to rehab, that's entirely possible. But that doesn't mean you have to take her home either.
You don't give us much information, but I can tell you that after my late husband developed sepsis and septic shock after almost dying from aspiration pneumonia, that he was left completely bedridden and all of the PT in the world would not have made any difference in his status. I wish you and your sister well in getting this all figured out.
Thank You! This is Susan's second bout with sepsis. Her first time it took a toll on her kidneys and she now is on dialysis. Prior to that she had/has congestive heart failure and hasn't walked for a couple months. The ball has been dropped multiple times with Susan's coordinated care after leaving the hospital last time such as having a physical therapist set up to come to the house, home health care services for basic blood work/blood pressure, and wound care. They wanted to discharge her to her group care home and then set up services again. Susan said, " I won't get better if I don't go to Rehab." We just wanted to advocate for a 2nd PT evaluation because we felt it was premature. Plus it was early in the morning. We think they probably woke her up to evaluate it. That was all we wanted. They refused and said they were discharging her. I hope this helps with context. We told the caseworker, we weren't disputing the results, per day.
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.
FWIW my MIL was in a NH became very ill, went to the hospital and diagnosed with pneumonia and sepsis and organ issues. She then went from the hospital to a LTACH - long term acute care hospital. It was in a building adjacent to the hospital connected by an air bridge. The LTACH are more set up for dealing with this type of care. The MD who is the hospitalist overseeing her care in the ICU would be the one to speak with to see if this might be an option for her as it’s a by referral only to get placement into a LTACH.
I’m guessing she’s younger?, like not over age 65? if so this poses it own set of issues for what long term type of placement once she leaves the ICU (or the LTACH) she may be able to get. If she is not enrolled in special category Medicare due to being ESRD, pls pls get that done for her. If the suggestion for her to go into a board & care comes up again, if there is a smaller one that can meet her many many needs, that probably is her best placement.
But be prepared. If they do not feel that she is a candidate for rehab, you will probably have to make some fast decisions regarding Skilled Nursing Facility placement. The social worker at the hospital can help with that.
But if she can't safely go home, it is imperative that you stick statement and continue to tell them it is unsafe. They will tell you that you HAVE to take her home or that they will provide you with all kinds of assistance AT HOME.
Neither of those things are completely true. You don't have to take her home, especially if it is unsafe. And the "help" they will offer at home won't likely be enough, if anything. What they want is the responsibility back on your shoulders.
She may not be able to go to to rehab, that's entirely possible. But that doesn't mean you have to take her home either.
I wish you and your sister well in getting this all figured out.
If so , are they saying she should go to a skilled nursing facility for permanent placement ? This is what you chose as a category for your thread .
What are her chronic health issues .
Are they suggesting palliative care in a skilled nursing facility ? Have they mentioned hospice ?
If she goes to SNF and improves after sepsis , she could be reevaluated for PT and receive PT in SNF .
They wanted to discharge her to her group care home and then set up services again. Susan said, " I won't get better if I don't go to Rehab."
We just wanted to advocate for a 2nd PT evaluation because we felt it was premature. Plus it was early in the morning. We think they probably woke her up to evaluate it. That was all we wanted. They refused and said they were discharging her. I hope this helps with context. We told the caseworker, we weren't disputing the results, per day.