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  1. #1

    Default Hospital Wants to Discharge 92 Year Old Mother to Hospice

    Let's call the 92 year old woman "Sara" and her adult son "Phil" for the sake of flow of the story.

    Three weeks ago Phil gets his mother Sara from Indiana and brings her to Florida to live with him. She has a multitude of health problems that he wasnt really aware of the extent when he made the decision to bring her to Florida. Sara is bedridden, needs 24/7 care, has a feeding tube, etc.

    Sara is only with Phil for a week when she gets a UTI and is hospitalized. Once she is hospitalized Phil realizes that he cannot possibly take care of his mother. He is health issues of his own. So after 4 days, she is ready for discharge. Phil tells the hospital that he cannot take her home to live with him. This is where things get very messy.

    The hospital is incredulous that Phil won't take his mother home. Phil makes it very clear to hospital staff that it isn't that he won't more so that he cannot. The hospital tells him that Medicare won't pay for a nursing home. Phil is ready for this and gives the hospital social worker the approval letter for Medicaid. Medicaid will pay for a nursing home.

    After getting a copy of the Medicaid approval letter the hospital spends a few days trying to find a facility that will take Sara. They dont have any luck. They call Phil and tell him this. He tells the hospital that they cant just discharge her and she will have to stay in the hospital until a facility is found.

    So yesterday rolls around and Phil gets a call from a doctor at the hospital who is not familiar with Sara at all and advises Phil that Sara is a candidate for hospice and that Sara has dementia. The doctor is going to refer Sara to hospice. The doctor tells Phil that Sara is refusing to eat or drink. This is confusing to Phil, because the night before while Phil was visiting with Sara she drank an entire nutritional shake. This doctor wants Phil to make the decision to give the hospital permission to stop giving Sara food and water. Phil is also confused, because the entire time that Sarah lived in Indiana, saw her doctor very regularly, a diagnosis of dementia was never made.

    Sara also is not dying. Her labwork is good and her organ function is good. She is still lucid, and recognizes her loved ones. But the hospital is insisting on hospice placement. Phil refuses to withhold food and water from Sara.

    Now this evening the hospital has called Phil again and stated that they are sending her to a facility 8 hours away, where she an absolutely has no family. The hospital social worker told Phil that Sara is a "difficult patient" because she screams, is verbally combative, and no local facilities will take her.

    Phil has called several local facilities himself. Two have told him that there were spots available for Medicaid patients, and to have the hospital call the admissions staff at the facility to coordinate transfer, only for Phil to hear from the social worker that facility has no beds. "You must have been confused." "You were never told there were open beds." " there must have been a misunderstanding. " those are the things that Phil has been told by the facilities and the hospital.

    Phil thinks that the hospital is just referring Sara to hospice so she isn't their problem anymore. He is at a loss of what to do. Also, Phil has a POA for Sara.



    The questions are: is the hospital allowed to try to place Sara in hospice when she doesn't really need it? Is the hospital allowed to place Sara in a facility that is 8 hours away against his wishes? What are Phil's options for recourse about getting the hospital to assist in getting her placed in a facility that is much for close by?

  2. #2
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    Default Re: Hospital Wants to Discharge 92 Year Old Mother to Hospice

    Phil can go pick up Sara and take her to any facility he wants and that will accept her. Phil has been an ugly word for expecting the hospital to do his job of taking care of Sara. Old people can and do develop more problems the longer they are left in a hospital. Phil should count his lucky stars that the hospital has not gotten the DFPS involved.
    Don't make me quote Monty Python at you.

  3. #3
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    Default Re: Hospital Wants to Discharge 92 Year Old Mother to Hospice

    You can't just dump your mother in a hospital and let them do the dirty work, as you've found out.

    Try contacting your local Senior Services center for help.

  4. #4
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    Default Re: Hospital Wants to Discharge 92 Year Old Mother to Hospice

    Quote Quoting jamiesam26@gmail.com
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    She has a multitude of health problems that he wasnt really aware of the extent when he made the decision to bring her to Florida. Sara is bedridden, needs 24/7 care, has a feeding tube, etc.

    Sara is only with Phil for a week when she gets a UTI and is hospitalized. Once she is hospitalized Phil realizes that he cannot possibly take care of his mother.

    Sara also is not dying. Her labwork is good and her organ function is good. She is still lucid, and recognizes her loved ones.

    Phil thinks that the hospital is just referring Sara to hospice so she isn't their problem anymore.
    Her labwork is good, doesn't any organ function issues, and isn't dying, but she has a multitude of health problems, bedridden and need 24/7 care - hmmmm.

    Also, she never was the hospital's problem - she was and is Phil's. The hospital found a place for her to go, that is 8 hours away - would dying on the streets only 5 minutes away be a better option? Why did Phil get her from Indiana?

    Living and dying is tough - parents look after kids when they are young, kids have to look after parents when they are old. It's not easy on anyone. If she qualifies for hospice, she can also qualify at Phil's home and they can provide help since Phil is not able.

  5. #5
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    Default Re: Hospital Wants to Discharge 92 Year Old Mother to Hospice

    Phil acted irresponsibility. Perhaps Sara wants to die. Why would she want to live ? She knows she is in the way and a burden. My heart goes out to Sara. Phil is selfish. Shame on him. He should have left her in Indiana.

    There is a lot wrong with the story the OP gives. Obviously the OP is not Phil. I suggest the OP not believe anything Phil tells them. It appears Phil is also a liar.

  6. #6
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    Default Re: Hospital Wants to Discharge 92 Year Old Mother to Hospice

    Quote Quoting lisaj1354
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    She is probably neither ill nor in need of hospice, as people are usually over-medicated/poorly medicated at hospitals, making problems worse. Additionally, you will see that you mother is just fine within a day of bringing her home from the hospital. I saw this with my own father who began to hallucinate while in a hospital unless he was kept company at all times. I believe its called 'sundowning'..
    Rather a broad brush there... As for sundowning, it is a specific term used w/dementia/ALZ patients that has little to do with location or being kept company. And often does not include hallucinations. Those are often associated with meds/interactions and/or UTIs.

  7. #7
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    Default Re: Hospital Wants to Discharge 92 Year Old Mother to Hospice

    Hospice has many picky little rules about eligibility and continued eligibility. The patient's personal physician and the hospice physician must certify (and continue to certify every 6 months for the first year, then 90 days after the first year) that the patient remains eligible for hospice. Hospice companies are also told what is a qualifying diagnosis and what isn't a qualifying diagnosis. "Dementia" is a vague term used to qualify for hospice. That means the person will die from the disease process within 6 months if allowed to proceed naturally.

    Also, as someone who has worked in discharge planning, the hospital cannot just dump Sara on the street. She must have a safe place to go. That said, discharge planners are people first - and finding a facility 8 hours away smacks as retaliation for Phil not taking Sara home.

    I think Phil's best course of action is to bring Sara home with him, have her see her own physician and discuss if hospice benefits Sara with her regular provider. They should be the ones making the decision, definitely not the hospital. If the hospital is not working with the patient's best interest at heart, they are liable for her safety and well being. The longer she stays in the hospital the worse the outcome will be for her. Hospice admission does not go by word of mouth of a disgruntled discharge planner. They look for objective findings since hospitals chart everything, and the hospice admission team will certainly dig into her records to make sure that hospice is the appropriate choice for her.

  8. #8
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    Default Re: Hospital Wants to Discharge 92 Year Old Mother to Hospice

    Quote Quoting No_Angel
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    Hospice has many picky little rules about eligibility and continued eligibility. The patient's personal physician and the hospice physician must certify (and continue to certify every 6 months for the first year, then 90 days after the first year) that the patient remains eligible for hospice. Hospice companies are also told what is a qualifying diagnosis and what isn't a qualifying diagnosis. "Dementia" is a vague term used to qualify for hospice. That means the person will die from the disease process within 6 months if allowed to proceed naturally.

    Also, as someone who has worked in discharge planning, the hospital cannot just dump Sara on the street. She must have a safe place to go. That said, discharge planners are people first - and finding a facility 8 hours away smacks as retaliation for Phil not taking Sara home.

    I think Phil's best course of action is to bring Sara home with him, have her see her own physician and discuss if hospice benefits Sara with her regular provider. They should be the ones making the decision, definitely not the hospital. If the hospital is not working with the patient's best interest at heart, they are liable for her safety and well being. The longer she stays in the hospital the worse the outcome will be for her. Hospice admission does not go by word of mouth of a disgruntled discharge planner. They look for objective findings since hospitals chart everything, and the hospice admission team will certainly dig into her records to make sure that hospice is the appropriate choice for her.

    Phil with does not want to care for Sara or he cannot. Obviously he gave no thought to caring for her before moving her. Based on what has,been said. Sara will be on her own if she moves back in with Phil. If she does not meet hospice criteria. She needs to go back into a nursing home. Even if it is hours away. If she moves back in with Phil and he neglects and/or abuses her. Elderly Protection might be called in. Phil is not thinking of Sara,and what is best for her. So sad.

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