Nursing homes: as sleazy as ever?

Last Monday my PCP was going to talk to the social worker about my exit plans. Yesterday she was talking about me becoming a permanent resident. She’s worried about me needing fulltime nursing care. Huh? All I need is to be able to use a walker, which I haven’t been able to do because of my broken foot, foot wounds. and crappy knees. Now the break has mended and the wounds are closed (they were bad). All I need is Cortisone shots to the knees, which was delayed until the wounds healed. My home is better set up for me than it was. If I need to I’ll just buy a used Hoveround to get around better. I’m not a prisoner and what i need are the shots, a couple more weeks for the new skin to thicken, start using a walker, and I’m gone.

What would motivate her to say that? I think it’s because the state’s checks haven’t bounced and they noticed that I’ll be on Medicare in a month and their checks won’t bounce, either.

Did you ask her why she was suggesting that?

(I agree. Get the hell out while you can.)

Yes, get out. You’ll quickly notice the lack of smell of urine.

It depends on how much money you are willing to spend. There are a lot of “assisted living facilities” that have spacious rooms and even a few good sized apartments, nice dining rooms, excellent food etc. Buuuuuuuuut, you basically have to give them all of your money at the outset, and once its gone, so are you. Locally to me, these places start out at around $4500 and go up from there.

Run, just as fast as you can. Which is a tall order with your feet and knees. Get help from kids, get in a wheelchair. Have the getaway car revved up and sitting on go. And leave. They can’t make you stay.
Since I owe you a big solid, let me know and I’ll come break you out. We can go on the run like Bonnie and Clyde.:slight_smile:

Nah, I’ll stay here until I’m ready to go, then I’ll go. And if they choose to throw me out when my insurance stops, I could leave today. Okay, two weeks.

But I have my eye on them. I feel like my PCP here betrayed me.

Aw, man. I was up for a road trip.:wink:

I used to know these things but my memory is a bit hazy. Permanent resident = full time nursing with no time limit, like maybe you’re over your allotted time as a rehab patient, insurance-wise, and this is how you would extend your care until you don’t need it anymore. Your PCP judges that you need full time nursing now and this will continue for a future period of time. Your social worker arranges this care for you. Impending Medicare probably does have something to do with it. You can find out.

Why didn’t she just say that?

I’ve come to realization and have confirmed with several doctors that a good part of medical diagnoses is based on statistical data. It may be that statistically, someone of your age, in your condition is likely to require full time care and the recommendation for you to be admitted is a CYA. Better to have you admitted now, rather than have you return home and get worse, possibly claiming that they shouldn’t have released you.

Also, I don’t know about other states, but in Hawaii, admittance to the good, reputable nursing home is difficult to get. My Mom went from the hospital to a private nursing home for a few months, but as she got better (i.e. wasn’t completely bedridden), we were given a time limit before she had to leave. Note that we paid almost the monthly bill ourselves, but she had to leave because they needed the room for someone else in more dire need. Yes, there’s an argument to be made that the next person requiring more care would bring in more money, but it was an emphatic no that she shouldn’t stay.

We were blessed to find a private full-time care home for the bargain price of $4000/mo, whereas other homes were asking for several thousand more. Part of the reason for the lower cost was because at the time of admittance she wasn’t completely bedridden and able to generally wash and care for herself. The last few months of her life, she did become completely bedridden, but the caregiver didn’t ask for an increase despite the owner of the home/company asking for one.

This is a classic case of get it in writing and get a second opinion if there’s any questions. Doctors, like lawyers have at least two types of speeches. One they use with other professionals and the other they use with laypersons. Have her detail the reasons for her recommending extended care for you in writing and have someone versed in the field go over and explain it in detail to you.

Especially when we’re emotional about something or have a preconceived mindset, we tend to hear things, both positive and negative differently.

When my Mom was in the hospital with pneumonia, the doctor verbally explained the severity of her condition and the options, basically do nothing and let her recover best as she could at 87 or perform a surgery to remove the fluid from her lungs with a 50/50 chance of survival and a 50/50 chance of the fluid returning away.

After explaining it to my sister twice alone (during which she was in denial that my Mom didn’t have long to live in either case), he reluctantly sat down with her and myself for a third time and explained it to both of us. Even then, my nature being analytical and my sister’s nature being emotional, we both picked up on different things, but we ultimately agreed to explain to my Mom why a painful surgery with a 50/50 chance of survival wasn’t a choice we’d recommend. She didn’t have to surgery and recovered as well as an 87 woman could and lived for nearly two more years.

Borrowing from the post above, maybe she did, and you heard it as you’re never going home. You wrote it though as she is concerned that you need full-time nursing right now and into the future. Nothing about that is false. So it’s likely not much has changed, and whatever the case you have every right to go looking for definitive answers.

She speaks tersely and I try to remember conversations verbatim. I will try to get a clarification, if not from her then her PA, who is a native English speaker.

A luxury facility starting at $4500 a month? hahahahaha. My moms nursing home is costing her 10K a month, which is what she had to spend to get to “not totally horrid”. And that’s not counting actual medical care, though Medicare picks up most of that. And this isn’t even in an expensive area, just a mid-sized city in the Mid-South.

If you have 30 days left on Medicare, yeah, she may not entirely have your best interests at heart. But when Medicare runs out, if your assets are safe and they can only get Medicaid for you, they’d just as soon you go home and never come back.

Thats a small 1 bedroom apt. With “you don’t actually need any help but your old enough or alone enough to want someone on hand 24/7 just in case” level of care
Plus, Idaho, good chance the cost of living is over all lower here than there

I think my doctor doesn’t understand my home stuff and plans, though I’ve explained that Middle was her mother’s nurse for a number of years. She has preconceptions of me being an old man who lives alone and will just go home to rot and die. She doesn’t know I’m working at getting that customer service job, or want to be there when they vinyl side my house, or want to zip around on my almost street legal electric scooter, or finish my tricycle so I can pedal and build up my legs to their former majesty. She hasn’t asked, so I need to volunteer that info.

No, I’m on Medicaid with Medicare kicking in in three weeks.

I spent some time at one of the nicer assisted living facilities up here. You buy your residence and then you pay a monthly fee for services. It’s staggering only if you don’t know what a regular nursing home costs per month. In this one, a 2BR 2 bath in independent living was $3500 a month or so, the highest it gets. They have a huge number of residents and a massive philanthropy fund, meaning even if residents do deplete their assets over time, even when moved to nursing care if that is needed, that’s their home and they stay there throughout. That’s not all that shocking I guess for a decent organization, but I had no idea.

Now in retrospect, all the residents from faraway states make more sense to me.

I think that, same as many primary schools warn parents of incomings that their kids may need special education at some point (regardless of the actual kid; and both because a lot of kids do need some sort of help at some point and because the sooner you get parents who’ve never thought about it to think about it, the better), many facilities which serve both as short-term clinics and as long-term homes do provide the information on their long-term services routinely.

When my mother was in the hospital and later in such a facility, at different points the nurses and the social service worker checked with my brothers and me on what kind of arrangements were available once she got out: part of the reason she was moved from the hospital to the clinic was because at that point the home situation would have been a worse option, she was released fully (with home nurse visits) once she was well enough for her domestic arrangements to work. Having a walk-in shower was a plus; that it’s small was a minus. Having neighbors who she can call and two sons who live nearby were pluses; a tendency to leave her emergency button anywhere was a minus. And so forth.

In your case, you’ve already thought about what is it you need and you already have a house that’s prepared for someone partially disabled; for many other people, that information is a life-saver.