CF Patients & Nursing Home Placement

[LisaV]

Rip was in a nursing home for short term rehab after his gall bladder was removed (a surgery that came when he was already pretty weak and which was complicated by cdif etc). It was a lousy lousy placement and came about only because he wasn't able to fend for himself at all at home and needed serious PT to get his legs back AND because our insurance refused to pay for care at a long-term care hospital with special pulmonay care (a much better placement). Even the nursing home agreed that it was a bad placement so the next time he was discharged from a hospital he went inpatient for rehab at the special pulmonary hospital. Not that that placement was much better because that's where he got sepsis and died.

I asked both places where they would recommend that an adult CFer go if their care was too difficult or dangerous (because of weight etc) for family members - or if there were no family members). Neither place had a clue of a good safe placement. And actually both said "there are no adult CFers" (IDIOTS!!!!)

I think this is a very good question to be asking and we need to find out a GOOD answer because (as much as we don't like to think about it or admit it) it can end up being impossible for family members to care for a large adult with real end stage pulmonary disease. I'd be curious to know what CF centers say in answer to the question.

 

[LisaV]

Rip was in a nursing home for short term rehab after his gall bladder was removed (a surgery that came when he was already pretty weak and which was complicated by cdif etc). It was a lousy lousy placement and came about only because he wasn't able to fend for himself at all at home and needed serious PT to get his legs back AND because our insurance refused to pay for care at a long-term care hospital with special pulmonay care (a much better placement). Even the nursing home agreed that it was a bad placement so the next time he was discharged from a hospital he went inpatient for rehab at the special pulmonary hospital. Not that that placement was much better because that's where he got sepsis and died.

I asked both places where they would recommend that an adult CFer go if their care was too difficult or dangerous (because of weight etc) for family members - or if there were no family members). Neither place had a clue of a good safe placement. And actually both said "there are no adult CFers" (IDIOTS!!!!)

I think this is a very good question to be asking and we need to find out a GOOD answer because (as much as we don't like to think about it or admit it) it can end up being impossible for family members to care for a large adult with real end stage pulmonary disease. I'd be curious to know what CF centers say in answer to the question.

 

[LisaV]

Rip was in a nursing home for short term rehab after his gall bladder was removed (a surgery that came when he was already pretty weak and which was complicated by cdif etc). It was a lousy lousy placement and came about only because he wasn't able to fend for himself at all at home and needed serious PT to get his legs back AND because our insurance refused to pay for care at a long-term care hospital with special pulmonay care (a much better placement). Even the nursing home agreed that it was a bad placement so the next time he was discharged from a hospital he went inpatient for rehab at the special pulmonary hospital. Not that that placement was much better because that's where he got sepsis and died.

I asked both places where they would recommend that an adult CFer go if their care was too difficult or dangerous (because of weight etc) for family members - or if there were no family members). Neither place had a clue of a good safe placement. And actually both said "there are no adult CFers" (IDIOTS!!!!)

I think this is a very good question to be asking and we need to find out a GOOD answer because (as much as we don't like to think about it or admit it) it can end up being impossible for family members to care for a large adult with real end stage pulmonary disease. I'd be curious to know what CF centers say in answer to the question.

 

[LisaV]

Rip was in a nursing home for short term rehab after his gall bladder was removed (a surgery that came when he was already pretty weak and which was complicated by cdif etc). It was a lousy lousy placement and came about only because he wasn't able to fend for himself at all at home and needed serious PT to get his legs back AND because our insurance refused to pay for care at a long-term care hospital with special pulmonay care (a much better placement). Even the nursing home agreed that it was a bad placement so the next time he was discharged from a hospital he went inpatient for rehab at the special pulmonary hospital. Not that that placement was much better because that's where he got sepsis and died.

I asked both places where they would recommend that an adult CFer go if their care was too difficult or dangerous (because of weight etc) for family members - or if there were no family members). Neither place had a clue of a good safe placement. And actually both said "there are no adult CFers" (IDIOTS!!!!)

I think this is a very good question to be asking and we need to find out a GOOD answer because (as much as we don't like to think about it or admit it) it can end up being impossible for family members to care for a large adult with real end stage pulmonary disease. I'd be curious to know what CF centers say in answer to the question.

 

[LisaV]

Rip was in a nursing home for short term rehab after his gall bladder was removed (a surgery that came when he was already pretty weak and which was complicated by cdif etc). It was a lousy lousy placement and came about only because he wasn't able to fend for himself at all at home and needed serious PT to get his legs back AND because our insurance refused to pay for care at a long-term care hospital with special pulmonay care (a much better placement). Even the nursing home agreed that it was a bad placement so the next time he was discharged from a hospital he went inpatient for rehab at the special pulmonary hospital. Not that that placement was much better because that's where he got sepsis and died.

I asked both places where they would recommend that an adult CFer go if their care was too difficult or dangerous (because of weight etc) for family members - or if there were no family members). Neither place had a clue of a good safe placement. And actually both said "there are no adult CFers" (IDIOTS!!!!)

I think this is a very good question to be asking and we need to find out a GOOD answer because (as much as we don't like to think about it or admit it) it can end up being impossible for family members to care for a large adult with real end stage pulmonary disease. I'd be curious to know what CF centers say in answer to the question.

 

[JazzysMom]

Thank you Lisa for sharing that. I do think its an important ??. Adult CFers is still "new" so these are things that need to be addressed.

I will address it with my CLinic to hear their feed back.

 

[JazzysMom]

Thank you Lisa for sharing that. I do think its an important ??. Adult CFers is still "new" so these are things that need to be addressed.

I will address it with my CLinic to hear their feed back.

 

[JazzysMom]

Thank you Lisa for sharing that. I do think its an important ??. Adult CFers is still "new" so these are things that need to be addressed.

I will address it with my CLinic to hear their feed back.

 

[JazzysMom]

Thank you Lisa for sharing that. I do think its an important ??. Adult CFers is still "new" so these are things that need to be addressed.

I will address it with my CLinic to hear their feed back.

 

[JazzysMom]

Thank you Lisa for sharing that. I do think its an important ??. Adult CFers is still "new" so these are things that need to be addressed.

I will address it with my CLinic to hear their feed back.

 

[kybert]

<div class="FTQUOTE"><begin quote><i>Originally posted by: <b>Wheezie</b></i>The insurance wouldn't authorize the prescription IV meds to be used in the home.</end quote></div>

wtf? not only can they decide whether you can or cant have a drug, they also decide where you can have it? now thats odd! especially considering doing home iv's would save them money.

 

[kybert]

<div class="FTQUOTE"><begin quote><i>Originally posted by: <b>Wheezie</b></i>The insurance wouldn't authorize the prescription IV meds to be used in the home.</end quote></div>

wtf? not only can they decide whether you can or cant have a drug, they also decide where you can have it? now thats odd! especially considering doing home iv's would save them money.

 

[kybert]

<div class="FTQUOTE"><begin quote><i>Originally posted by: <b>Wheezie</b></i>The insurance wouldn't authorize the prescription IV meds to be used in the home.</end quote></div>

wtf? not only can they decide whether you can or cant have a drug, they also decide where you can have it? now thats odd! especially considering doing home iv's would save them money.

 

[kybert]

<div class="FTQUOTE"><begin quote><i>Originally posted by: <b>Wheezie</b></i>The insurance wouldn't authorize the prescription IV meds to be used in the home.</end quote>

wtf? not only can they decide whether you can or cant have a drug, they also decide where you can have it? now thats odd! especially considering doing home iv's would save them money.

 

[kybert]

<div class="FTQUOTE"><begin quote><i>Originally posted by: <b>Wheezie</b></i>The insurance wouldn't authorize the prescription IV meds to be used in the home.</end quote>

wtf? not only can they decide whether you can or cant have a drug, they also decide where you can have it? now thats odd! especially considering doing home iv's would save them money.

 

[LisaV]

I believe the new Medicare drug benefit pays for iv meds (like vanco for mrsa) but Medicare itself does not cover nursing care at home to administer the iv if the patient is too ill/weak/whatever to do it themselves and there is no one in the home to administer (and the "no one in the home" includes situations where there is an adult living in the home but that adult is at work some or all of the times the ivs need to be administered).

see <a target=_blank class=ftalternatingbarlinklarge href="http://www.calnurses.org/media-center/in-the-news/2006/january/page.jsp?itemID=27530072">http://www.calnurses.org/media...ge.jsp?itemID=27530072</a> .

private insurance often follows Medicare's lead on these things. Rip's private insurance (through my job) did agree to VNA for home IVs eventually because (as you rightly point out) it was cheaper than inpatient care. I had to play hardball though and <i>refuse</i> to administer (since the only way I could have met the schedule was to quit work which would have totally impoverished us and left him without any insurance coverage that was pretty easy to do) which the VNA as an institution "got" (and rightly attributed to my being unavailable because of my work schedule )but some VNA nurses did not.

 

[LisaV]

I believe the new Medicare drug benefit pays for iv meds (like vanco for mrsa) but Medicare itself does not cover nursing care at home to administer the iv if the patient is too ill/weak/whatever to do it themselves and there is no one in the home to administer (and the "no one in the home" includes situations where there is an adult living in the home but that adult is at work some or all of the times the ivs need to be administered).

see <a target=_blank class=ftalternatingbarlinklarge href="http://www.calnurses.org/media-center/in-the-news/2006/january/page.jsp?itemID=27530072">http://www.calnurses.org/media...ge.jsp?itemID=27530072</a> .

private insurance often follows Medicare's lead on these things. Rip's private insurance (through my job) did agree to VNA for home IVs eventually because (as you rightly point out) it was cheaper than inpatient care. I had to play hardball though and <i>refuse</i> to administer (since the only way I could have met the schedule was to quit work which would have totally impoverished us and left him without any insurance coverage that was pretty easy to do) which the VNA as an institution "got" (and rightly attributed to my being unavailable because of my work schedule )but some VNA nurses did not.

 

[LisaV]

I believe the new Medicare drug benefit pays for iv meds (like vanco for mrsa) but Medicare itself does not cover nursing care at home to administer the iv if the patient is too ill/weak/whatever to do it themselves and there is no one in the home to administer (and the "no one in the home" includes situations where there is an adult living in the home but that adult is at work some or all of the times the ivs need to be administered).

see <a target=_blank class=ftalternatingbarlinklarge href="http://www.calnurses.org/media-center/in-the-news/2006/january/page.jsp?itemID=27530072">http://www.calnurses.org/media...ge.jsp?itemID=27530072</a> .

private insurance often follows Medicare's lead on these things. Rip's private insurance (through my job) did agree to VNA for home IVs eventually because (as you rightly point out) it was cheaper than inpatient care. I had to play hardball though and <i>refuse</i> to administer (since the only way I could have met the schedule was to quit work which would have totally impoverished us and left him without any insurance coverage that was pretty easy to do) which the VNA as an institution "got" (and rightly attributed to my being unavailable because of my work schedule )but some VNA nurses did not.

 

[LisaV]

I believe the new Medicare drug benefit pays for iv meds (like vanco for mrsa) but Medicare itself does not cover nursing care at home to administer the iv if the patient is too ill/weak/whatever to do it themselves and there is no one in the home to administer (and the "no one in the home" includes situations where there is an adult living in the home but that adult is at work some or all of the times the ivs need to be administered).

see <a target=_blank class=ftalternatingbarlinklarge href="http://www.calnurses.org/media-center/in-the-news/2006/january/page.jsp?itemID=27530072">http://www.calnurses.org/media...ge.jsp?itemID=27530072</a> .

private insurance often follows Medicare's lead on these things. Rip's private insurance (through my job) did agree to VNA for home IVs eventually because (as you rightly point out) it was cheaper than inpatient care. I had to play hardball though and <i>refuse</i> to administer (since the only way I could have met the schedule was to quit work which would have totally impoverished us and left him without any insurance coverage that was pretty easy to do) which the VNA as an institution "got" (and rightly attributed to my being unavailable because of my work schedule )but some VNA nurses did not.

 

[LisaV]

I believe the new Medicare drug benefit pays for iv meds (like vanco for mrsa) but Medicare itself does not cover nursing care at home to administer the iv if the patient is too ill/weak/whatever to do it themselves and there is no one in the home to administer (and the "no one in the home" includes situations where there is an adult living in the home but that adult is at work some or all of the times the ivs need to be administered).

see <a target=_blank class=ftalternatingbarlinklarge href="http://www.calnurses.org/media-center/in-the-news/2006/january/page.jsp?itemID=27530072">http://www.calnurses.org/media...ge.jsp?itemID=27530072</a> .

private insurance often follows Medicare's lead on these things. Rip's private insurance (through my job) did agree to VNA for home IVs eventually because (as you rightly point out) it was cheaper than inpatient care. I had to play hardball though and <i>refuse</i> to administer (since the only way I could have met the schedule was to quit work which would have totally impoverished us and left him without any insurance coverage that was pretty easy to do) which the VNA as an institution "got" (and rightly attributed to my being unavailable because of my work schedule )but some VNA nurses did not.