Welcome Medicare Nation!
After last week’s show with Dr. Jeffrey Burns, I wanted to bring a guest on the show that could talk to us about her experience with the lack of care coordination with Medicare.
Melissa’s Mother fell and broke her hip before Christmas. At only 67, ended up having surgery and being in the hospital and then in a skilled nursing facility. At home she had outpatient therapy.
Melissa shares the following about her Mother’s experience:
- She went to stay with her Mother during this time - she lived 4 hours away
- She felt like she would just provide companionship and help her Mom get back on her feet
- She quickly realized she would have to be a patient advocate for her Mother
- She found out that the care for her Mom was good, but communication was terrible
- She tried to follow up on her Mom's care on a daily basis, but it was overwhelming
- Melissa wasn’t exactly sure of the medicine her Mother took on a daily basis
- Melissa didn’t have all the information available about the Doctors that her Mom sees
- Mom had an app on her cellphone that had all her medical info and also allowed her to call 911
- Mom lived alone and fell late at night when she was in her garage
- 1 in 3 people 65 and over will fall and a hip fracture is the #1 injury from that fall
- She and her Mom text every night and every morning since her Mom lives alone
- Surgery on the hip was successful, but there were some blood clots to deal with
- Mom has a high tolerance for pain, but yet still seemed to be in a great deal of pain
- Melissa found out that there was some miscommunication between the nurses and her Mom regarding pain meds
- The hospital staff thought that Melissa's Mom had refused one of her pain medications
- Actually Mom only questioned it because she thought she couldn’t have the 2 meds together
- It wasn’t a refusal of medication, but her Mom just didn’t understand the issues and was confused
- Constantly ask questions. Write them down as you remember them. Ask the questions to every staff member at every shift.
- Her Mom spent a week in the hospital before she went to rehab. It felt like they wanted to release her too soon.
- The clinical coordinator for the hospital didn’t have a lot of information on placement options in a city 45 minutes away
- They used the online site ratings through Medicare to find a skilled nursing facility
- Minimum requirement is 3 overnight stays in the hospital to qualify to go to skilled nursing facility
- medicare.gov has the resources to check ratings of skilled nursing facilities.
- Private Institution ratings are not available on www.medicare.gov
- Transportation to the skilled nursing facility, 45 minutes away, wasn’t handled by the hospital because the facility she was moving to was out of their "network."
- The family had to arrange transportation through a private medical transportation service, where Mom could transported in her wheelchair.
- In the skilled nursing facility, her Mom was there for 5 days before she even saw the nurse practitioner.
- The physical therapist never actually showed up due to scheduling conflicts.
- It’s important to find out the schedule that the Doctors will be keeping and seeing your family member and make sure you are there when they make the rounds.
- Melissa found out that her Mom got confused about what meds she was taking for what ailments, so she wasn’t a help to sort things out.
- Medicare allows Physicians to write prescriptions for home care therapy and it is provided at no cost to you. As long as a Dr. writes a prescription and the Physical Therapist is an approved Medicare provider and the patient can’t make it out to traditional therapy, it will be provided on most Medicare plans free of charge.
- Melissa was shocked at how important it was for her to be involved in her Mother’s care and recovery.
- The outcome for Melissa’s Mom was good, but there were so many times along the way that could have gone terribly wrong, if Melissa wasn’t there to advocate for her Mom.
- If you are not physically able to be with a family member during a crisis, you may need to inquire about hiring a Patient Advocate.
The Official Medicare website is a starting place for finding skilled nursing facility ratings.
Getting a patient advocate is a good idea if you aren’t prepared or able to assist your loved ones during a medical crisis.
Do you have questions or feedback? I’d love to hear it!
I may answer one of your questions on the air!
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Find out more information about Medicare on Diane Daniel’s website!