We learn that the facility essentially uses the first two weeks to "assess" new patients. It is typical too for it to take a few weeks for a person to get "acclimated" to that environment.
Mom was fortunate and had an empty room for about the first 4-5 days. Then we were very blessed to get a super roommate for her. A charming woman in her 70's recovering from a near death and bout in the hospital and now battling recovery and ovarian cancer. She is very mobile, just very thin and weak. This mobility surely inspires Mom.
Mom made progress as by the second week she was sitting up with assistance and then able to use the walker to walk to the bathroom! We actually could see "HER" in her eyes again!
There were moments of confusion the first few weeks and then the facility wanted to have a
"family meeting"the second Friday of Mom's stay there. This meeting was attended by the facility Administrator, the Social Worker, the Therapist and the Nurse. Later we had to get the Medicare person in to answer some questions.
They told us that Mom had refused some therapy that week. Once was just Friday (January 23rd) morning when Mom "refused" the occupational therapist about taking a shower. We learn that Mom was confused and thought it was nighttime and said she didn't shower at night. So, that went down as ONE refusal. There are THREE therapists -- the occupational therapist that works with a patient in daily activities like personal hygiene and dressing; then the physical therapist that works her in exercises to rebuild her strength ; then last is 'speech therapist' which also works on cognitive skills and assesses her mental state.
If Mom refuses any one of these therapists 2 or 3 times consecutively, then that therapist will discontinue work with her. If all 3 therapists discontinue her, then Medicare will no longer pay for her to be there. But.....what about "must show progress"? Mom is certainly getting therapy because she is making progress -- Therapist says, "Yes, but she's doing it with the nurses or on her own". Well, what about Mom getting "skilled nursing" too? Well, she's not really - now if she gets a UTI and we have to treat the infection, then that is considered "skilled nursing".
We discuss Mom's mental state and discuss her 'depression'. Well, YEAH, she probably is depressed -- she was driving 5 weeks ago and living independently, her hair hasn't been done in over a month and she thinks she's dying and she's on all kinds of medicines. So, they are going to start her on Remeron which is an antidepressant that also stimulates appetite. It will take 2-4 weeks to know the affect.
Ok -- so if she does not participate in therapy but we're starting her on an antidepressant -- does that mean we get 2-4 weeks to see if it works? Well, no. So starting her on an antidepressant is not considered "skilled nursing"? Nope -- she could take drugs at home.
But - if the facility is going to discharge her, the would give us 5-days notice. If we need longer we could go to private pay @ $218 per day. Oh -- and you would have to pay one month security deposit and first month in advance -- fully refundable though.
Ok.
Off to see Mom and she looked great! Good to see those eyes again. Explained to Mom that should can't refuse these people anymore. She must agree to do whatever they ask otherwise Medicare won't pay. Oh -- and they agreed to let your hairdresser come in to do your hair, since the facility is between hairdressers right now.
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