mardi 5 mars 2019

Hospital Wants to Discharge 92 Year Old Mother to Hospice

Let's call the 92 year old woman "Sara" and her adult son "Phil" for the sake of flow of the story.

Three weeks ago Phil gets his mother Sara from Indiana and brings her to Florida to live with him. She has a multitude of health problems that he wasnt really aware of the extent when he made the decision to bring her to Florida. Sara is bedridden, needs 24/7 care, has a feeding tube, etc.

Sara is only with Phil for a week when she gets a UTI and is hospitalized. Once she is hospitalized Phil realizes that he cannot possibly take care of his mother. He is health issues of his own. So after 4 days, she is ready for discharge. Phil tells the hospital that he cannot take her home to live with him. This is where things get very messy.

The hospital is incredulous that Phil won't take his mother home. Phil makes it very clear to hospital staff that it isn't that he won't more so that he cannot. The hospital tells him that Medicare won't pay for a nursing home. Phil is ready for this and gives the hospital social worker the approval letter for Medicaid. Medicaid will pay for a nursing home.

After getting a copy of the Medicaid approval letter the hospital spends a few days trying to find a facility that will take Sara. They dont have any luck. They call Phil and tell him this. He tells the hospital that they cant just discharge her and she will have to stay in the hospital until a facility is found.

So yesterday rolls around and Phil gets a call from a doctor at the hospital who is not familiar with Sara at all and advises Phil that Sara is a candidate for hospice and that Sara has dementia. The doctor is going to refer Sara to hospice. The doctor tells Phil that Sara is refusing to eat or drink. This is confusing to Phil, because the night before while Phil was visiting with Sara she drank an entire nutritional shake. This doctor wants Phil to make the decision to give the hospital permission to stop giving Sara food and water. Phil is also confused, because the entire time that Sarah lived in Indiana, saw her doctor very regularly, a diagnosis of dementia was never made.

Sara also is not dying. Her labwork is good and her organ function is good. She is still lucid, and recognizes her loved ones. But the hospital is insisting on hospice placement. Phil refuses to withhold food and water from Sara.

Now this evening the hospital has called Phil again and stated that they are sending her to a facility 8 hours away, where she an absolutely has no family. The hospital social worker told Phil that Sara is a "difficult patient" because she screams, is verbally combative, and no local facilities will take her.

Phil has called several local facilities himself. Two have told him that there were spots available for Medicaid patients, and to have the hospital call the admissions staff at the facility to coordinate transfer, only for Phil to hear from the social worker that facility has no beds. "You must have been confused." "You were never told there were open beds." " there must have been a misunderstanding. " those are the things that Phil has been told by the facilities and the hospital.

Phil thinks that the hospital is just referring Sara to hospice so she isn't their problem anymore. He is at a loss of what to do. Also, Phil has a POA for Sara.



The questions are: is the hospital allowed to try to place Sara in hospice when she doesn't really need it? Is the hospital allowed to place Sara in a facility that is 8 hours away against his wishes? What are Phil's options for recourse about getting the hospital to assist in getting her placed in a facility that is much for close by?


Hospital Wants to Discharge 92 Year Old Mother to Hospice

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