After a stay of at least three days in a hospital Medicare will pay up to twenty days in a live-in rehabilitation facility for your loved one (LO). His/her supplemental insurance should pay for up to an additional eighty days. The following is why and how you should take advantage of this opportunity.

First, let me state the obvious. Your elderly parent needs to recover in a rehab facility. Although this should be obvious, it wasn’t to Jill and me. The first time my father-in-law came home from the hospital we thought he would do so much better in our home.

What we didn’t realize was that his sleeping patterns would be off which meant that our sleep patterns would be off. His bowel movements were irregular which meant more accidents, more laundry, more carpet cleaning. It took weeks for his appetite to come back which meant more frustrations at meal times. Plus, everything moved at even a s-l-o-w-e-r p-a-c-e. We placed an unnecessary and undue amount of stress on ourselves.

Put them in rehab. They’ll do better and you’ll can catch up on your sleep.

When your elderly LO is in rehab he/she is monitored by medical professionals. They receive physical, occupational and speech therapy on a more frequent basis. If they need assistance at night, there is a night shift to take care of them.

Here is how to pick a rehab facility.

1) Some nursing homes, like the one we used, have beds available for rehab patients. Both patients share the same dining , bathing, physical, occupational, and recreational facilities. Fortunately, there is a rating system for all nursing homes that receive Medicare funds. Go to Medicare.gov/NHcompare, plug in your zip code and see how your prospective facility rates compared to other facilities in your area.

2) Find out if the is credited by the Joint Commission, an agency that rates medical facilities. This accreditation should be on  the facilities web site and a certificate is usually displayed in the lobby of the building..

3) Call the Area Agency on Aging in your county and ask if any complaints have been received.

4) A hospital social worker referred us to the rehab facility we used. Ask your social worker to give you the name of former patients who might share their experiences with you. It’s interesting to note that while we were satisfied with the care our facility provided other patients we met were very unhappy with their care.

The more you know the better decision you can make. It is very upsetting to your elderly LO to move them to another facility. Pick the right one the first time.

In my next post, I’ll hare with you how to prepare for your inspection by knowing what to look for and what questions to ask.

For more information on elder care check out my articles in ezine.com or get a free DVD on elder care at HomeCareSurvival.com.

This was no problem for us because my father-in-law had a bacterial condition that was not treatable with anti-biotics.  It did not endanger him but it could cause problems for other people. As such he was always segregated when he was in the hospital.  Interestingly, he was not segregated when he was in the rehab facility.

The nice thing about a private room is that it is, well, private.  Your LO doesn’t have to put up with the sounds and smells that come with a room mate.  The stream of visitors, interns, doctors, residents, nurses are bad enough when they come for him/her, it is doubled when they come for the room mate.

My father-in-law was annoyed that his room mate in rehab had fallen asleep and left the TV on too loud.  He got up unescorted and with out his walker.  He fell and broke his hip which required another operation and another stay in the rehab facility.

You can also request that the number of visits from interns be limited so that your LO can get more rest.

The equality of care depends a great deal on the nurses. They see your LO more often and for a greater length of time than a doctor.  We got to know the nursing staff by name.  We brought them lunch from the deli.  We baked cookies for them.  We even called every night so we got to know the night shift.  We wanted them to know that we appreciated everything they were doing for my father-in-law.

Lastly, use the time that they are in the hospital or in rehab to get caught up on your sleep.  Or take a mini vacation.  It helps to reduce your stress and you deserve it.

For a free DVD on the secrets of elder care go to HomeCareSurvival.com

Also bring this list with you when you come to the hospital.  As a side note, a copy of this list should be in a plastic bag attached to the refrigerator.  In case you are not home and there is a reason to call the paramedics, they will need this information.

Your LO will be given pre-surgical instructions in writing.  Be sure they are followed.  NO EXCEPTIONS.

Your LO will be given discharge instructions in writing upon release from the hospital.  Follow them.  NO EXCEPTIONS.

Now you know how to pick the right outcome.

For a free DVD on the secrets of elder care go to http://www.HomeCareSurvival.com.

This is what we did when our elderly father-in-law had to have a partial hip replacements.  He broke one hip while in the hospital.  A year later he broke the other hip while in rehab.  The same surgeon did both procedures and we were very satisfied with the results.

If however it is a complicated surgical procedure you may want to choose a board certified specialist.  These doctors are peer reviewed and have to meet higher standards.  To find a board certified specialist go to the website of the American Board of Medical Specialists at www.ABMS.org

For a free DVD on six secrets of elder care go to HomeCareSurvival.com

The problem is that while in the hospital your LO could be exposed to more germs or a medical mishap that could make their condition worse.  In our case it wasn’t infection, it was falling.  He had fallen a few times during his many admissions until he finally broke his hip and it had to be replaced.

You want their stay in a hospital to make them better not worse.  You don’t need the additional stress.

To help you to help your LO, I’ll show you how to pick

the right hospital

the right doctor

the right time

the right accommodation

the right care

and the right financing.

You will then get the right outcome

Pick the right hospital

If your LO’s condition could lead to a surgical procedure (joint replacement, heart surgery, etc.) choose the hospital with the best success rate for that procedure.  Go to www.hospitalcompare.hhs.gov (a service of Medicare) to compare how well your local hospitals performs that procedure.  You will get comparisons on general conditions, types of illnesses, and medical procedures.  Everything you will need to make the best decision.

We chose a local community hospital which was a part of a major regional health network.  The hospital was convenient, well maintained, and with a high nurse to patient ratio.

All this was very important to us because we had to drive him back and forth to dialysis three times a week.

Now you know how to find the right hospital for your LO which will increase the odds that your LO will survive their stay.

How to pick the right doctor will be in the next post.

Go to www.HomeCareSurvival.com for FREE DVD on elder care.

Remember the idea is to use their assets to provide for their care.  Their assets may not be enough however to cover the expense of home care.

The first way to understand what programs are available to help you and how you can access those programs is to go to benefitscheckup.org.

Benefitscheckup.org is a service of the National Council On Aging.  You will be asked to supply information about your parent’s current financial condition, their housing situation, and their medical needs.  Based on their responses you will be given a list of the programs that are available to you in your area.  The survey takes about thirty minutes to complete but it is worth the time.

The second thing to do is to review their social security statement for accuracy to be sure that they get all the money due to them.

The third thing to do is to sign up for a supplemental medical insurance policy.  This will cover the 20% that Medicare does not cover.  Without this coverage they or you  could be stuck with huge bills.  For example, Medicare covers twenty days of rehab and a supplemental insurance policy covers an additional eighty days of rehab.  If you didn’t have that coverage you would have to pay for the rehab.

We used the AARP program and had it deducted automatically from his account.  This way there was no way the bill could be overlooked and his insurance canceled and we stuck with the bills.

Some people I know solved the problem by selling their homes, before the meltdown, and relocated to a Continuing Care Community.  They have a suite of rooms and there is no maintenance for them to do.  Should they need it they can go to an assisted living wing or the nursing home wing.

This arrangement calls for a sizable down payment and monthly payments.  Not everybody can afford it.  It does allow the parents to keep their independence and does not place an undue burden on the children.

But what do the rest of us do?

Home Instead offers non-nursing care.  We happily used them when we provided home care for my father-in-law.  Home Instead has a 40/70 rule which says that if your parent is over 70 and you are over 40 you should be talking about their plans for the future.

And if not you, then who?

And if not now, when?

This blog and the Action Program we put together is an attempt to answer that question.

The longer you put this off the more complicated it becomes.  You need to talk with them while they still have their full faculties and can make the best decision for themselves.  This is the best time to talk with them regarding decisions about money, property, housing, and the legacy they want to leave behind.

This is the best time to enlist the help of siblings or other relatives so that a crisis doesn’t force you to deal with  all of their issues as well as your own.

If there are issues regarding their care this is also the best time to have them adjudicate those issues and not have to guess as to what they would have wanted.

If you think your life is complicated now, you have no idea how complicated it will be if you don’t plan for home care for your elderly parent.

During the time we took care of my father-in-law, we had thirteen trips in the hospital and eight stays in rehab. In addition, we brought him to dialysis treatment at the hospital three times a week for two years. This meant that we were dependant on other people for the quality of his care. We dealt with dozens of very professional people and with an exception or two we felt that he was well looked after.

You probably find that taking care of an elderly parent will also bring you into frequent contact with staff members at medical institutions. There are a couple of simple things that you can do to help insure that your LO receives the care they deserve.

It starts with the mindset that the aides, nurses, custodial staff, receptionists, therapists, and administrators are professionals. That they are doing work that is difficult, demanding, and subject to constant scrutiny. That they are dealing with intimate aspects of chronically ill and sometimes demented patients. As such they deserved our respect and cooperation.

When he was in rehab, we showed our respect and thanks by first of all, showing up on time. On the days he went to dialysis I would get there a little bit earlier to see if I could help get him ready so that there would not be a constant rush to get him out. I would be sure that he was returned on time so that he would get his dinner in the dining room and the staff would not have to make special arrangements.

We also baked cookies for the staff as a way of recognizing what they do and to say thanks.

We also visited every day and Jill called every night to speak to the night nurses. She got to know all the staff members by name.

It conveyed the message that we loved him and were concerned for him and that our actions showed it. It also showed we appreciated everything they were doing for him

As a result, we felt that wherever he was he received excellent care.

]]> http://homecaresurvival.com/blog/elder-care-medical-staff/feed/ 5