Submissions from Readers

Intensive Rehab

by Valerie-Rita's daughter
(Massillon Ohio )

Question: My mom had a massive hemorrhagic stroke 3 months ago and I need help to determine a care plan and course of action to rehabilitate her to the greatest capacity! I am not wishful in my thinking. I understand my mother as I knew her April 17 the night before her stroke is gone...but she has a lot of life left and has worked hard to overcome these obstacles in front of her...as have i and the rest of her family!

I and her therapists here in the skilled nursing facility have tried to provide the best chance into getting into a quality intensive rehab to help! I am not willing to stop seeking somewhere for her to be rehabbed because no one is willing to take her in an intensive rehab because she will not be HOME READY in under 16 days (that varies by facilities on amount of days but 16 was the top)! The rules within the medical and insurance companies truly are horrible! They want more 3 hr a day therapy to get them to take her, but insurance wont pay that in a skilled nursing facility and either way she will have to go home after her 100 days are up! She was bed bound in a reclining wheel chair tiring after a short time out of bed with a trach including oxygen and tube feed and now she is standing with assistance up all day board sliding eating drinking helping with self care standing/pivoting with help as examples! Accomplish the impossible to make it!
I want and need a second opinion and help to give my mom the best possible chance at some quality of life after this stroke! I'm not interested in what the insurance company will or will not pay as we can handle the cost either way I am interested in a doctor and therapy team willing to help my mom regain every single ability she can find the strength to achieve with treatment that is centered around her not the outcome being needed to keep their stats boosted! Please can anyone help me navigate this.
I sit with her 16 hrs a day giving her a repeat of her limited therapy moving her talking to her! She has only the nursing home doctor and the neurologist she saw in the hospital! Her OT therapist worked in an intensive stroke rehab and said she can handle intensive therapy and even broke the rules and had the whole therapy team create a 3 hr intensive day, but because of the guidelines now they still won't take her because she wouldn't be home ready in 2 weeks? Any input would appreciated. I just want my mom to have the best chance...she has already beat the odds. They said she would NEVER move her left side and she can left her knee off the wheel chair a half inch on command with a lot of focus and side to side 1/4 in and slightly kick her foot out as well as slide her left arm an up and down 1/4 inch cause I have been working with her so much! Any insight would be appreciated! Her stroke was right side in the thalamus hippocampus region if that matters!

Answer: You can contact the Patient Advocate Foundation. Their website is www.patientadvocate.org. They provides patients with arbitration, mediation and negotiation to settle issues with access to care among other things. You might look into hiring a private pay therapist to work with your mother in addition to the therapy she gets at the SNF if finances are not an issue. You would normally have to get the permission of the SNF to do this which might be a problem, but maybe they would work with you given the circumstances. Sometimes what facilities or well meaning employees tell you is a "rule" is really just their policy rather than an insurance requirement (usually based on how the facility can best make and not lose money). The Patient Advocate Foundation should be able to help you navigate the system and understand what the actual rules are or aren't.

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