Okay, instead of starting yet ANOTHER thread about Mom, I'm blogging. It's been my therapy to write down what's going on. But another thread?? No.
I just got a call from the nursing home, and mom is being discharged on Sunday. She still has, like, 47 Medicare days left, but they explained they would have to commit fraud in order to keep her. In Medicare's eyes, they tell me, Mom is "stable." Though she needs very carefully monitoring with her diuretics, that can be done at home. When I questioned why she's considered "stable," they explained that, since there's no cure for her...no plan to treatment to wellness...Medicare will not just use up the 47 days. She has to go home or be private pay.
I'd already come to terms with her being private pay. It's around $9,000 a month. She will exhaust her funds, then Medicaid will begin paying.
The doctor explained that, when she first got congestive heart failure, there was a really big window where she'd be just fine. That window has been closing...until now, there's a very small opening in that window. Having taken diuretics for 10-or-so years, her kidneys have been damaged. Diuretics stop her from filling up with fluid. AND they make her kidney function worse. As her kidneys get worse, she needs still more diuretics. Vicious circle.
The doctor told me the other day that at least 50% of people in her situation are gone within six months to a year.
I spoke with the Nurse/Manager today about Mom, and she said, "If she were my mom, I'd take her home, let her do anything/everything she's capable of doing within reason, and, when medicine tweaks no longer work, keep her on diuretics and let her go. Get hospice involved at that time." It sounds cold, but she was very compassionate.
It came as a shock to me to realize that the Home Health Care Nurse mom had last fall was "into" doing exactly that. She came to see mom twice a week. She said I should begin to consider hospice (comfort care only) for mom at THAT time. One day, I woke up (as in "woke up") and said, "I'm not giving Mom one more pill until I've talked to the doctor. I think I'm poisoning her." Poisoning her from the standpoint that the diuretics were working too well. (She was on TONS of them.) She was sleeping allll the time, wasn't eating much AT all, would hardly drink water. The nurse IMMEDIATELY cut back on her diuretics after a call to the doc. And we kept cutting back until she got balanced. She did really well for months -- until she fell and broke her hip.
The nursing home knows Mom's good for at least a year of private pay. I interviewed their Admissions Coordinator and toured the facility last week. The Nurse I spoke with today, the one who suggested above, didn't even mention admitting her into the facility. As a private payer, that's high motive to get new people. I'm reading between the lines. And trusting what she's telling me even more because of that.
I'm still not sure I can handle Mom at home. Her bathroom trips and transfers from wheelchair to bed -- if she can't stand up, and I'm not sure about that -- are going to be neigh onto impossible. But my conscience tells me I have to try. I've got oxygen already set up at home. She's not on much, but needs it at rest. I'm getting a hospital bed. And Home Health Care will start the day after she gets home.
I think it's time to let her go. I think that's what everyone's "telling me." It's hard.
I just got a call from the nursing home, and mom is being discharged on Sunday. She still has, like, 47 Medicare days left, but they explained they would have to commit fraud in order to keep her. In Medicare's eyes, they tell me, Mom is "stable." Though she needs very carefully monitoring with her diuretics, that can be done at home. When I questioned why she's considered "stable," they explained that, since there's no cure for her...no plan to treatment to wellness...Medicare will not just use up the 47 days. She has to go home or be private pay.
I'd already come to terms with her being private pay. It's around $9,000 a month. She will exhaust her funds, then Medicaid will begin paying.
The doctor explained that, when she first got congestive heart failure, there was a really big window where she'd be just fine. That window has been closing...until now, there's a very small opening in that window. Having taken diuretics for 10-or-so years, her kidneys have been damaged. Diuretics stop her from filling up with fluid. AND they make her kidney function worse. As her kidneys get worse, she needs still more diuretics. Vicious circle.
The doctor told me the other day that at least 50% of people in her situation are gone within six months to a year.
I spoke with the Nurse/Manager today about Mom, and she said, "If she were my mom, I'd take her home, let her do anything/everything she's capable of doing within reason, and, when medicine tweaks no longer work, keep her on diuretics and let her go. Get hospice involved at that time." It sounds cold, but she was very compassionate.
It came as a shock to me to realize that the Home Health Care Nurse mom had last fall was "into" doing exactly that. She came to see mom twice a week. She said I should begin to consider hospice (comfort care only) for mom at THAT time. One day, I woke up (as in "woke up") and said, "I'm not giving Mom one more pill until I've talked to the doctor. I think I'm poisoning her." Poisoning her from the standpoint that the diuretics were working too well. (She was on TONS of them.) She was sleeping allll the time, wasn't eating much AT all, would hardly drink water. The nurse IMMEDIATELY cut back on her diuretics after a call to the doc. And we kept cutting back until she got balanced. She did really well for months -- until she fell and broke her hip.
The nursing home knows Mom's good for at least a year of private pay. I interviewed their Admissions Coordinator and toured the facility last week. The Nurse I spoke with today, the one who suggested above, didn't even mention admitting her into the facility. As a private payer, that's high motive to get new people. I'm reading between the lines. And trusting what she's telling me even more because of that.
I'm still not sure I can handle Mom at home. Her bathroom trips and transfers from wheelchair to bed -- if she can't stand up, and I'm not sure about that -- are going to be neigh onto impossible. But my conscience tells me I have to try. I've got oxygen already set up at home. She's not on much, but needs it at rest. I'm getting a hospital bed. And Home Health Care will start the day after she gets home.
I think it's time to let her go. I think that's what everyone's "telling me." It's hard.
