My mother can no longer walk and stand and is in hospital bed at home. She has 24 hour day help at home but we still need to get her to Dr appointments.
I think she has approval for Access wheelchair van but it is still going to be a major job getting her there. She will not be able to stand if the procedure calls for her to stand and she is entirely unable to control bodily functions so I don't know if she will remain clean while we try and get this visit accomplished. Also to add to the issue, I have a 2 hour drive each way. I'm not even sure this test they want to do is even going to be beneficial at this point.
I don't mind the drive and the work but if it's of no benefit and too hard for her is it worth the effort? Both my brothers work but my husband will help but we almost need 3 people to get one person to an appointment. I'm sure we are not the only ones in this predicament but it's sure stressing me out big time.
How have you handled the difficult transportation with a totally disabled LO?
That was about 18 years ago; the cost was $40 each way. I don't remember if the driver picked up my father and put him in a wheelchair or on a lift, or if Dad walked into the vehicle, but I do remember thinking the driver was very considerate and helpful, and physically strong.
When I needed a ride for post-cataract follow-up, I hired a local ambulance company that also provides non-emergency rides. Same basic cost, but mileage was also charged; I think it was $3.00/mile. It wasn't cheap, but it was much safer than driving with only one available eye.
You might also check out these:
https://www.cms.gov/Medicare-Medicaid-Coordination/Fraud-Prevention/Medicaid-Integrity-Program/Education/Non-Emergency-Medical-Transport
https://www.yellowpages.com/atlanta-ga/non-emergency-medical-transportation
This gives you an idea of what's available in one area. But try searching on "non-emergency ambulance services" for your own area.
Some large cities have point to point bus service, and these can handle wheelchairs but I'm not sure if they have enough support for someone who's unable to stand.
You might also ask your medical team if they can recommend a company. A Senior Center staffer might have advice, or you could call the local Jewish Family Services or the local Alzheimers' Assn. I've found both very helpful with general questions.
When the Area Agency on Aging in this area sponsored annual caregiver expos, there were always representatives of companies providing just this kind of service. Unfortunately, those expos were canceled (in my area) a few years ago.
Good luck; I hope you find a service that's reasonable.
I would not have put my Mom, who suffered from Dementia, thru this. Especially in the condition ur Mom is in.
Transport
Nurse/CNA support
Test requirements
I would start with the requirements of the test.
Does the doctor who ordered the test know your mother’s current condition? If you question this, why not see if you can arrange a telemed appointment so that the doctor can see your moms condition and you can discuss in detail the issues you are facing and any alternatives. I would want to fully understand what the test would offer. Since the pandemic we have done several telemeds.
If it’s decided she will go would it be possible for her aide to accompany her to help keep her clean?
Having family living in rural areas, I am very accustomed to traveling for better medical care. Many services simply aren’t available in small towns where more and more hospitals are not available. In my experience I could drive to better care and save time overall. My mothers doctors were three hours from her home. My aunts were two hours away. Once in the car, the hard part was done. But I realize not everyone is up for the commute. I’ve made many a trip with a frail elder by myself so great that your husband is available to help you.
I always had the good fortune of being able to arrange it so that I could schedule all my moms appointments on the same day. I let the doctors know up front that we would make the trip once a year. This worked for many years. All her routine blood work etc was done through home health. If your mom isn’t eligible for hospice, I would ask her doctor for home health to help manage her care.
The transport services sound wonderful if available. It never occurred to me to ask for that level of help. I couldn’t do today what I did then. I understand the desire to get your mom the best care possible but with Covid and her condition I would really need to understand the potential benefits of the test and what further treatment might be suggested after the doctor had the test results.
Good luck and let us know how it goes. We learn from one another.
Perhaps since your mom is now bedridden it's time to get hospice involved. That way she won't have to go for any unneeded appointments, and the hospice Dr or nurse practitioner will come to the house to access her needs. And if for any reason she would need transport, they would provide it with an ambulance. And of course all of that is covered 100% under Medicare. Best wishes.
The only way to do it, is your mother will have to be brought by ambulance to the doctor's office. The paramedics will get her up, on a stretcher, and in the doctor's office. They will get her home and back in bed too. Her aide will drive herself to the appointment and meet the paramedics there. You don't have to go.
As for her maybe not staying clean when there, send diapers and wipes with the paramedics. They will bring them with her. If she soils herself her aide can insist the doctor's staff clean her up and change her. That's what I did and they'll do it. There was no way I could change her diaper and clean her up on the ambulance stretcher, and they couldn't get her on the exam table so she had to stay on the stretcher for the whole visit. Her doctor's staff had a real time of it too trying to get her undressed and cleaned up on a narrow ambulance stretcher. They were the ones who insisted she come for a totally unnecessary office visit. I spoke to her doctor's office ahead of time and explained to them that should she soil herself or something else happen that they would be responsible for her while she is at the appointment they insisted on. Talk to her doctor's office about this before setting up her appointment and transportation. Going by ambulance is probably the only way your mother will be able to get there. Check with her insurance to see if they cover it. I know with my client the family used to have to pay $350 out-of-pocket for the ambulance transport to a doctor's appointment.
At one dermatology appointment, the doctor said "we have to get her up on the table". I sat there. Finally, doc called in one of his nurses; she and the aide got my mom up on the table and back down again. Amazingly, at the next appointment, doc didn't see the need for mom to be on the table!
Aide took care of bathroom issues.
Everyone seems to be doing Telemed appointments these days; I would ask carefully about any procedure they want to do and why it is necessary. For my mom, only the fact that we all suspected that her skin issue was melanoma (which she had had before) caused us to go to the lengths that we did to get mom to the office.
Doctors will keep saying they want to see your mother in the office as long as they get paid. You already are questioning the benefit of the visit and procedure. What procedure and why is it medically necessary? Go with your gut. Only you have your mother's comfort and best interests at heart.
Focus on her quality of life. Her doctors may be focusing on her quantity of life. Sadly, many doctors treat Medicare like a cash cow.
Her Dr Is only 10-15 minute drive from her home,
we have had two virtual appointments over the phone. One went great and the other not so good. My signal was bad that day and mom has never had the internet.
i am currently trying to get hold of the primary care Dr to see what the benefit of the radiological procedure they are requesting is. She has many health issues and so there are many procedures she needs. I also know she has difficulty following the instructions they give her or she cannot hold still if that's what the procedure requires.
I have applied for California medicade (medi-cal) for her and am waiting on that status.
also will need to talk to lawyer about activating power of attorney. Doctors are hesitant to provide the letter stating she is no longer competent to care for herself even though the dementia doctor could tell she had declined drastically since her evaluation a year ago.
Thanks all for your input. I read so many posts and I say "Wow, that sounds familiar".
it helps to know I'm not the only one navigating this difficult road.
I don't understand why a doctor would not be willing to write a letter of incompetence. I am in SJersey and my POA was never questioned. People saw where Mom was not quite with it. Not sure if I needed a doctors letter.
By the way, we got only about 4in of snow. Township roads were not cleared but 295 was.