Windows: A Caregiver's Salvation

Windows can bring fresh air into difficult care issues

I recently learned of a woman caring for her husband who brought him home after a hospitalization only to discover that his care needs were more than she could manage.  The concept of “rehab” care had not been discussed by the hospital doctor or by any discharge planner. Since the wife had already been caring for her husband at home and the issue that brought him to the hospital was resolved, he was cleared to go home.Yet like most people who leave the hospital, he wasn't as strong as when he went in. That was complicated by the fact that his overall health issues were degenerative.

However, it soon became evident that his care needs were more than she could provide. She was among the fortunate who already had a relationship with a social worker who had been involved with her husband’s care. The social worker was able to tell her that there was a ‘window’ option she could consider. There is a certain amount of time after a hospitalization where a patient can be eligible for rehabilitative care. It’s a window of time. At first, she was told it may be 14 days, but the social worker would confirm. Later she was told it was 30 days. When the caregiver heard of the 14 day time limit, the she knew she had to move quickly. She had the help of the social worker who knew how to start the process for qualification quickly. It was handled through Medicare and he was placed within a few days.

            There are a few different caregiver nuggets to glean from this example. 

First, involve others in your caregiving team. Caregivers should not go through their duties alone. Whether you’re dealing with private insurance, Medicare, or VA health benefits, determine what kind of social work services you can access - and use them. It may be that the benefit falls under counseling or mental health benefits. If so, don’t let that ‘label’ for ‘mental health’ stop you. Even if there is a co-pay for such a benefit, again, try to work out using it. It may be that it’s “Dad’s” appointment, but you go with him and get the information too, or share part of the session.

Make sure the social worker is one that deals with your specific area of need and is not just seeing every kind of patient. Granted, they’re trained, but some specialize in geriatric issues. Many “geriatric case managers” are licensed social workers. Getting insurance to pay for their services as “geriatric case managers” might not work, but, applying for payment or authorization of services based on social work/counseling may. This is when a little time and work on the front end of a situation pays off with lots of time saved later on. 

The next nugget is to look for windows. Many people assume that once discharged, a patient cannot receive services or referrals from the hospital. Whenever you leave a hospital setting, make sure to get the discharge planner’s card. This is the person who comes in to see if you need home health or any other services. You may only see this person once, but learn to recognize this role. If problems arise after a hospital stay, call that person. Let them know that home care is not working and ask if they can help you find other options for care or secure more services. It might not be a rehab placement, but it might be the addition of home health services to help with bathing when your loved one has trouble with that and you can’t do it yourself until he or she gets stronger. 

Windows are helpful. Caregivers don’t know all the windows they can open to get fresh air into a stressful situation. By involving others in a care team, not only can they educate you about the windows available to you, they can help you opened them.    

Golden Nugget for Caregiver: When your caree is in the hospital, ask the staff to run a TB (Tuberculosis test) upon admission. The results of a TB test are required before a patient can be placed in any kind of skilled care facility and they take 2 days to get results. Even if you don’t anticipate a rehab stay, as the situation above illustrates, you need to be prepared. If you leave the hospital before the test results come in, plan to go back to the records department (with healthcare POA in hand) and ask for a copy of the results. The results of the test are only considered valid for 30 days. Whether you think you need them or not, getting them may save you time when you need it the most.