Tuesday, August 17, 2010
Insurance is great when you fit neatly into criteria. Unfortunately, Mom does not fit neatly into the "typical" stroke pattern and the criteria for inhospital rehab. Fortunately, I am a social worker and can advocate strongly for my mother just like I do for my clients. The hospital social worker, Brenda, has been awesome and spent all day working on a possible discharge to Mount Carmel West inpatient rehab. Insurance denied coverage and doctors are fighting for us as Mom's potential to learn is now and needs to be intense. It was finally decided that the rehab team will come tomorrow to do an assessment (they were to come today). In our favor for inpatient rehab is that Mom has regressed and is very quiet and still today. She had a terrible headache yesterday afternoon and a CT scan revealed no new bleeding. EEG was abnormal. We, of course, were not surprised by that finding. The physical therapist (PT) and occupational therapist (OT) found significant change today that should qualify her for inpatient rehab. Her balance is very off when they walked with her and OT assessment for cognitive skills revealed that she will need 24 hour supervision, cannot follow written instructions, will need hazards removed from the environment, and will not be able to set up or administer her own medications. The OT worked on a sewing example and Mom was not able to follow the pattern, recognized it was wrong, and did not care! Definitely not Helen's perfectionistic sewing. She talked a lot at 4:30 when I came in this morning but has not talked much since that time and has been sleeping off and on. She has not slept much while here so definitely needs it. We continue to have hope that tomorrow is a new day and that the assessment team will find that she qualifies for the inpatient rehab as it is an intensive program that is our best hope for improvement.