Home Care or Convalescent Care after a hospitalization, do I have a choice?

Ok, so Mom broke her hip and had to go to the hospital for surgery. Two days after surgery the doctor tells you that she will be ready to leave the hospital soon and someone will come to help you decide where she will go when she leaves. Wow, you weren’t prepared for this. Mom’s not even able to walk further than the bathroom. Dad is 70 years old and can help at home but he can’t do it all. You work, your siblings all work and besides that you don’t know how take care of her.

In today’s hospitals the length of stay is getting shorter. Sometimes it almost seems as if they are throwing you out before you are ready. The reality is they are sending you out before you’re exposed to something that may make you sicker. So back to the issue, where IS mom going to go when she leaves the hospital?

First you need to know that you may have options, depending on your insurance. If Mom is on Medicare then she has a few options, check the Medicare.gov web site for current skilled nursing facility coverage and costs. If she has private insurance or state provided insurance (Medicaid) then your options are limited to what facilities accept your insurance and your co-payments will vary. You should check this out before you agree to anything so you don’t end up paying for all of it. If you don’t have insurance your options are very limited. My best advice in this case would be to apply for a social worker to assist you with state aid or to check with your local church to find a charity that will help.

Ask at the hospital for a case manager or discharge planner, they can help you get the information you need to make an informed decision. They should be able to provide you with a list of skilled nursing facilities that take your insurance. After you get the list you can go look at the facilities. If Mom really doesn’t want or need to go to a skilled nursing facility but still needs skilled help from a nurse or physical therapist ask your case manager for information on home health care and ask whether or not the patient qualifies. If they do qualify the doctor will write an order for the physical therapist and/or nurse to come to the house once a day to help with care. It is important to note that they are only there for a short time and are there for the purpose of performing specific duties such as wound care, exercises and progressive physical therapy. They are not there to help feed or bathe the patient unless they have specific skilled needs in those areas (for example a speech therapist helping the patient learn to swallow or speak).

If you need someone there for more hours of the day or for basic needs like feeding and bathing the only insurance that will cover this is long-term care insurance. Most people don’t have long-term care and end up paying out of pocket for the extra help that may be needed.

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