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Recently, I became aware of a case of an older man who has spent the last six months in a rehab facility following two surgeries he had. One was colon surgery and he has ended up using an ostomy bag. While in rehab he fell and broke a bone and has been using a walker. Neither of these episodes would seem to require six months of rehabilitation. He had been living independently with his wife. They have no children and his wife has been living alone for six months. She doesn’t drive and has had to get rides to see him.
They are a very middle class couple who has saved their money and own their home. They have had enough money to pay for the nursing rehab facility since Medicare’s coverage ended after 20 days, but they have been paying about $10,000 per month.
The rehab staff recently gave the patient three options for the future. One was that he could stay in rehab! The second was for him to go to an assisted living facility and the third was to go home with twenty four hour care. This gentleman wants to go home, not only for himself but to be with his wife who has been alone. He also doesn’t want to have twenty four hour care with someone in their home all day and night. He hopes to become independent again and would accept some nursing help at home for a while.
He really needed a navigator or advocate to help him because he wasn’t sure of his rights or how to assert them. When the rehab center told him he could go home with twenty four hour care, which he didn’t want, he felt they were saying that was his only option to go home or else he would have to stay there or move to an assisted living facility.
Of course, he can go home with help whenever he wants as long as he is not in danger, which he wouldn’t be with his wife there. He has been offered help from his local church and others who will now advocate for him.
Many times, we hear of patients not be provided enough discharge planning with services arranged before they are sent home from a hospital. Here is a case of a person who is being given more care than he wants and the social work staff may have not been anticipating or acting on his wishes, thereby causing a great deal of unnecessary stress with the separation of the patient and his wife. The fact that he was told one option was to stay in rehab and keep paying while his wife is home alone is a cause for concern and may be putting the financial interests of the facility to have a private pay resident ahead of the quality of life of this man and his wife.
Would he have stayed there if he had children or someone to advocate for him? A patient navigator or advocate certainly would have been on top of the situation and worked to find a plan that was in the best interests of the patient – to go home as soon as he was able to function there.