Wednesday, January 27, 2010

Advocate for Medicare therapy services

Today my mother's physical therapist informed me that my mother will be discharged from PT this Friday. This was frustrating to hear, since this is the first week my mother has really felt well enough to benefit from therapy, and after 6 weeks basically spent in bed, she definitely needs therapy to increase her strength and endurance for walking and independence. So why is she being discharged? Because of the Medicare Therapy Cap:

Medicare Therapy Caps to Return in 2010 Without Exceptions (At Least Temporarily)
The Medicare therapy caps will return on January 1, 2010, although the policy will likely be in place for only one month as both health care reform bills that were passed by the House and Senate contain provisions to extend the exceptions process. These bills are being merged together for a final vote which congressional leaders have said they would like to have completed prior to President Obama's State of the Union address in late January.

Until that time, the Centers for Medicare and Medicaid Services (CMS) have reported that speech-language pathology and physical therapy will continue to share a combined cap of $1,860, with a separate cap of $1,860 for occupational therapy. As before, the cap does not extend to services provided in hospitals. Settings impacted by the therapy caps include private practice, rehabilitation agencies, skilled nursing facilities, comprehensive outpatient rehabilitation facilities, physician offices, and Part B home health agency services

Please, friends, contact your representatives and Senators to encourage them to pass the "extension to the exceptions process for Medicare therapy caps."

Colorado Bob is fundraising for Shelterbox - JustGiving

Colorado Bob is fundraising for Shelterbox - JustGiving

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Saturday, January 09, 2010

As the end approaches

My mother has been in the hospital for several weeks now. She had surgery, and after a few days, was sent to a skilled nursing facility for rehab, to regain her strength and her mobility. Her plan was to be home in 7 days (she's a tough little lady!). But after a few days there, she seemed to be declining. I called her on New Years Day, and I didn't even recognize her voice at first, she sounded so frail. I rushed over to the SNF, and, after spending a few minutes with her, listening to her cough and laborious breathing, I told them to send her to the ER. She was admitted to the hospital with a heartbeat that was way too high and irregular, plus a mild case of pneumonia.

On Sunday, she seemed to take a turn for the worse. It was so alarming to me and so dramatic, that I sent a message to my brother, telling him that it would be good if family members could call her that day. I really thought the end might be approaching.

When my dad died three years ago, it was sudden and unexpected. He went about his business that day: gassing up the car, checking his email, calling his sister. That evening, he died in his recliner, watching TV. We knew this was how he would have wanted to hospitals, no lingering. My mother remarked many times that it would have eased his mind so to know that this was how the end would come. But, because his death came unexpectedly, I felt a lot of regret that I had never told him the things I wanted to say.

So on Sunday, I sat there next to my mother's hospital bed, as she coughed and gasped for breath and moaned, fearing that death might be near. But I couldn't bring myself to start THAT conversation, because I feared that she would think I had given up hope. But obviously she was thinking the same thing, because she opened the door for me by telling me that she wanted me to have her car. Once she said that, the tears welled up, and I began to tell her so many of the things I wanted to did she. It was a conversation I will never forget.

Fortunately she turned the corner the next day and has continued to improve. She is supposed to be discharged back to the SNF today. I'm hoping that she is able to return home, and that when the end does come, it will be lingering, no hospitals. But this time, I won't be left with the regret of things unsaid.