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My sister is in an acute care center we have been trying to bring her home for months. We have round the clock nursing care they won't send. We have all the equipment in place and skilled nursing around the clock. What can we do to bring her home?
Your sister has MS, her husband is bed-bound and they are living in the US (Arizona).
Your sister is currently in acute care for a recent issue and wants to go home, but they are not discharging her because there is no capable person currently at her home. Your sister has a trach.
You are willing to provide the 24/7 care and they have financial means but you are currently in Costa Rica. So, there is no one in place to transport her and care for her once she gets home as of right now.
Is this a correct summary of the issues?
If your sister is mentally capable but cannot drive, and her husband is "bed-bound" and can't drive to get her, and no one can go get her and the center thinks she is an unsafe discharge because there won't be a capable person in the home to help her, then they are rightfully keeping her in place.
Why is her husband 'bed-bound"? Who is helping him while she is at acute care? This is a very confusing story so more info would be very helpful.
Step 1 is to determine what the patient's will actually is. How has this been done?
You can have all of the equipment and all of the services in place at the patient's home; but if her medical team believe that her needs can't be met outside the acute setting, and if the medical team has no way of determining what the patient's wishes are, then they are acting in her best interests by refusing to discharge her.
Do you have: Her wishes set down in writing, for example in an advance directive? Medical proxy, or power of attorney for health and welfare, or guardianship, or any other kind of formal, legal authority to make decisions on her behalf? Her own word for it being currently expressed? Other grounds for believing that she will be better cared for at home than where she currently is?
These situations are usually negotiable. What reasons are being given for refusing to discharge her home?
i am sorry I wrote new answers can you read them. She wants to come so that her brother can take care of her. I can take car of her trac , her wound care they didn't come from home but acute care centers. I love my sister and I want to take care of her. Her mental state is fine I talked to her tonight and she said I thought that I was going home today...
If you really want to take care of her, you actually have to be there to receive her at home.
They can not discharge her to someone in Costa Rica that plans on coming when she gets home. What happens until you get there?
If one of her children opposes your presence I would bet they are telling the discharge planner that dad is bed bound and you are in another country, that would put a stop to discharge. As it should.
From what you've written, I wouldn't discharge her either. You have to go if you really are going to be her caregiver, there is no other way to make the hospital believe the plan except by implementing it.
Angel, if you are the 24 hour nursing care and you aren't there, I don't see how anyone would discharge a wheelchairbound person with a trach to someone who is is bedbound.
I am sorry but taking care of a trach and wound care should be done by professionals. Are you an RN or trained medically at all?
In the US if its considered an "unsafe" discharge, then by law the Rehab cannot release her. Her husband being bed bound means he is of no help. Are the children for bringing Mom home? For round the clock care you need to be sure the persons caring for sister are dependable. Again, also have to trained in trachs, catheters and wound care. CNAs are not medically trained so at least an LPN probably better an RN. Very expensive in the States.
yes I am trained and nurses follow what I do. I am sorry but all her bed sores were given to her by trained professionals they have to many patents Trained care diver $30 an hour and aRN with trach experience $65 to $100 with her husband between $60,000 to $80,000 a month. Private pay. one patent to 9 caregivers. Is a better ratio we even have an RT for a couple of hours a day to take down al the information from the ventilator and check on her condition
Why did your sister end up in the acute care center? Why does she need 24/7 skilled nursing care? Who has POA for your sister? What reasons did the acute care center discharge person give for not releasing your sister?
I am sorry for my mistakes her tonight it's past 4am I got up 20 hours ago. It wasn't until earlier today that I found out that she wasn't coming home. Her husband has been working on it and he is bed bound and he doesn't handle stress well. My sister asked me to help and my brother in law was happy when I told him that I would help him if he wanted
They have already been to the home twice. and to the person who asked if she was coming to Costa Rica, no she is going to her home of 43 years in Mesa AZ. Yes I have spoken to them in person. I am a US citizen my wife is a Tica. The US Embassy has been closed for 2 years now and not giving any visas. I have been away from my wife for almost a year out of the last 2 years. It's been difficult without our Lord it would have been impossible.
Angel, if your sister is mentally fine and able to communicate, all she needs to do is tell her medical team that she is going home. She can discharge herself.
That doesn't make it a good idea, mind. Who is actually going to project manage this?
Are you on sister's HIPPA paperwork as someone the staff can talk to? I think what you may need to do it get to Phoenix and talk to the Rehab personnel face to face. You are getting conflicting stories. The facility says she has a fever, sister says she doesn't. They can't release if there is a sign of fever. You should have no problem in Phoenix finding someone who speaks Spanish.
You need to personally see what has been set up for sisters care at home. Maybe sister can assign u POA just to handle this for her.
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.
Your sister has MS, her husband is bed-bound and they are living in the US (Arizona).
Your sister is currently in acute care for a recent issue and wants to go home, but they are not discharging her because there is no capable person currently at her home. Your sister has a trach.
You are willing to provide the 24/7 care and they have financial means but you are currently in Costa Rica. So, there is no one in place to transport her and care for her once she gets home as of right now.
Is this a correct summary of the issues?
If your sister is mentally capable but cannot drive, and her husband is "bed-bound" and can't drive to get her, and no one can go get her and the center thinks she is an unsafe discharge because there won't be a capable person in the home to help her, then they are rightfully keeping her in place.
Why is her husband 'bed-bound"? Who is helping him while she is at acute care? This is a very confusing story so more info would be very helpful.
You can have all of the equipment and all of the services in place at the patient's home; but if her medical team believe that her needs can't be met outside the acute setting, and if the medical team has no way of determining what the patient's wishes are, then they are acting in her best interests by refusing to discharge her.
Do you have:
Her wishes set down in writing, for example in an advance directive?
Medical proxy, or power of attorney for health and welfare, or guardianship, or any other kind of formal, legal authority to make decisions on her behalf?
Her own word for it being currently expressed?
Other grounds for believing that she will be better cared for at home than where she currently is?
These situations are usually negotiable. What reasons are being given for refusing to discharge her home?
They can not discharge her to someone in Costa Rica that plans on coming when she gets home. What happens until you get there?
If one of her children opposes your presence I would bet they are telling the discharge planner that dad is bed bound and you are in another country, that would put a stop to discharge. As it should.
From what you've written, I wouldn't discharge her either. You have to go if you really are going to be her caregiver, there is no other way to make the hospital believe the plan except by implementing it.
Who is in the home caring for the husband?
In the US if its considered an "unsafe" discharge, then by law the Rehab cannot release her. Her husband being bed bound means he is of no help. Are the children for bringing Mom home? For round the clock care you need to be sure the persons caring for sister are dependable. Again, also have to trained in trachs, catheters and wound care. CNAs are not medically trained so at least an LPN probably better an RN. Very expensive in the States.
How old are sister and BIL?
Why did your sister end up in the acute care center?
Why does she need 24/7 skilled nursing care?
Who has POA for your sister?
What reasons did the acute care center discharge person give for not releasing your sister?
Wherever she is, they may need to send someone to your home to make sure that it is safe.
That doesn't make it a good idea, mind. Who is actually going to project manage this?
You need to personally see what has been set up for sisters care at home. Maybe sister can assign u POA just to handle this for her.