By Steven Buttice, Founder and President, Living By Your Design, Inc.
Emma and George are from a larger town in northern Illinois. Emma’s husband is age 89 and had a urinary track infection. As he became sicker, he became weak and did not eat. He was losing weight, also coughing as he ate when he was hospitalized. After battling the infection for about two weeks, hospital case manager wanted to talk with Emma about hospital discharge, hospice, and a nursing home admission. The hospital thought George had about one week to live.
Emma contacted a private care manager. The RN care manager suggested Emma stop by that day and look around the nursing home the hospital suggested. Look for cleanliness, odors, activities, smiles from staff, and general environment. Emma stopped in the nursing home’s location and simply said “I cannot put him in there.” There were cigarette butts all over the parking lot. The hallways were dingy, and the lighting was not bright. Residents lined up sleeping in wheelchairs, and odors were in multiple locations.
Hospital case managers do an excellent job, but a patient and their family have the ultimate say in what type of care will work for them. In this case, Emma hired the private care manager. The care manager met with Emma and George to gather information about their total situation. George is not rich, but has an upper-middle class income. While still weak, he was upbeat and wanted to try to rehab. They expected to spend money from savings for care, as quality of care was their goal.
After the Skilled Nursing Facility (SNF) assessment, it was determined that George would be eligible for a Medicare Rehab benefit. Meaning, while receiving a high level of skilled care, Medicare would pay most of his care. After he reached “full potential” (he is not able to get much better), George would be responsible for his SNF bill.
Today, George is five weeks post-admission to the SNF. Remember, George was only expected to live one week. He is now private pay, but is still receiving Medicare covered speech therapy. He is stronger and may yet make it back home. He jokes with his wife and staff and is actually feeling safe and comfortable at this location. The private care manager continues to check on George every two weeks and also when Emma calls.
So, what’s the story here? For the best outcome, people must either be a good advocate for themselves or hire one. Hiring a private care manager is probably the best money George could ever spend. How do you put a value on quality of life? A private care manager takes time to advocate for you by understanding your total situation: your health, spiritual connections, finances, family dynamics, and more.
It is important to note that hospital case managers do a good job. Without them, most people would be totally lost and the outcome would be a person not having services in a facility or home. Without these services, the person may decline and be back at the hospital emergency room before long. The message is if you are able, get off the medical conveyor belt and obtain more control of your care, your health, and your quality of life. If nothing else, become or stay involved with your loved one’s care. Get help if you need. Be an advocate and your loved one will experience better quality of life and probably less out-of-pocket expense. If you like statistics and studies about care management saving money, read our June Healthy Cells Magazine article. As always, feel free to contact our office if you want information on private care management or have questions.
For more information, contact Living By Your Design, Inc., focusing on the issues of the elderly: legal, financial, free guidance for residential placement and healthcare issues. Call: 309-285-8088. Website: www.LivingByYourDesignInc.com. Location: 809 W. Detweiller Dr., Peoria.