Saturday, April 20, 2013

Questions, But No Answers

I am up in the middle of the night with more questions than answers.

To recap hubby was in the hospital from Tuesday evening through Thursday morning and this doesn't quality as "three days". I suspect that his UTI included this time or started during this time. Then when he returned to the emergency room Saturday night officially UTI was diagnosed and he was sent home with an antibiotic prescription. Imodium was added because of diarrhea from the antibiotic.

What kind of at-home care does Medicare cover? Maybe none. Maybe Preferred Care doesn't do what I need it to do.
If a patient needs skilled nursing or rehabilitation care at home, either Medicare Part A (following a minimum three-day hospital stay) or Part B (no hospital-stay requirement) can cover it. A Medicare Part C Medicare Advantage plan similarly covers home care. The care can be provided in the patient's home or anywhere else he or she stays. If a patient meets the requirements to qualify for home care (see next page), Medicare covers skilled nursing or rehabilitation care and physical and speech therapy as needed while the patient recovers from an illness, condition, or injury. Medicare also covers needed medical supplies and equipment.
If a patient needs only nonmedical home care and assistance, such as help with eating, dressing, walking, meal preparation, and housekeeping, Medicare does not cover it. However, if a patient is getting Medicare coverage for skilled nursing or therapy at home, Medicare usually pays for limited visits by an aide from a home care agency to help with personal care. If Medicare covers skilled home care for the patient, it also covers the services of an occupational therapist to help him or her relearn how to accomplish daily personal care and household tasks safely.See this link.
The primary care physician faxed an application to a nursing home that doesn't cover Preferred Care and so hubby was not admitted there. That nursing home also called the hospital which said my husband wasn't admitted. However, as I wrote in the last blog, I did check that he was admitted. Are there two kinds of admission? I have already had an end-of-the-day phone cut off from Preferred Care after being on hold for 34 minutes. I may not get answers on the weekend.

Kenny, his new volunteer caregiver and I, his wife and health care surrogate, are concerned. Others watch at a distance and are equally concerned and have suggested more help. My husband's daughter and my pastor advised that I get him physical therapy.

Again it is the weekend and there isn't much I can do. I stopped by his doctor today after returning to substitute teach (I have essentially been off two weeks) to request a "script" for home health care or outpatient therapy. At the end of the day I wasn't able to see his doctor, but just left a note.

So questions remain:

  • Why didn't the Senior Center call my cell phone on April 9th? I wasn't working that day because it was the day I set aside to attend that Alzheimer's Association support group every month. My cell phone was on.
  • Was he really admitted so our expenses will be paid?
  • Is there some kidney problem as was hinted in the first emergency room visit? He has a lot of gas now.
  • Why would my husband's doctor think my hubby was at the stage where he needed a nursing home permanently? He is still in the stage of Alzheimer's I described 7/8/12 as part one here. I have not had to write a part two yet. Perhaps it was just the circumstances of that day and the hospital visits.
  • What professional will give me definitive answers after actually examining my husband? My Alzheimer's Association support group is the second Tuesday of next month. I always go to that meeting unless something else comes up. May 14th is a long time away.
  • Was that the right hospital emergency room to take him to? Should I have driven farther? Years ago before his dementia hubby drove himself to the same emergency room after his legs were burned from setting fire to trash in the back yard. At that time he was sent home that very night from the emergency room, only to return to be admitted to the hospital the next day by a doctor. After a few days again they wanted to send him home again before he was ready. However,  they did get him outpatient therapy when he did finally return home. Why weren't we given outpatient therapy for his UTI?
Meanwhile my hubby is improving--so much better than last Sunday. Every day he is better and I can't see that he is in another stage of Alzheimer's. Yes hubby is doing well, but he could benefit from more help if he is having trouble bouncing back from the UTI. He does not have the wonderful sparkly personality I am used to.

When I left a note for his doctor Friday afternoon that he needs more care, I was talking with a patient (not a senior citizen) who can't get medicine she needs because of Obamacare. She has questions about Obamacare and I gave her this article here. We all have questions about Obamacare and what is down the road. Will we seniors receive adequate care if others are not now?

Subjective reporting here,



  1. So many questions. I hope you can get the answers after the weekend.

  2. I hope you get some answers soon. It all sounds so confusing and frustrating!

  3. I too, struggle with "second guessing" my decisions. Other than helping to shape future decisions, it is useless to dwell in the past. Carol, you are doing a fine job of caring for your husband. You will get the answers you need, and you will know what to do. You will base your decision on the info you can gather, and prayer.

    I'm so glad your husband is doing better and I will pray that he bounces back completely.