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I've been trying to give advice to a loved one whose husband had a severe stroke a couple of months ago at 59. He's been in rehab, but the insurance coverage is ending. From what I know, the facility in FL has no care plan for him. They just told her he can't stay and has to go home. He can't transfer independently, and she works full-time.


I have been disabled from birth, so I know how Medicaid and long-term care works.


I wrote up some ideas, like telling them she can't safely take care of him and demanding a care plan, and she kinda got upset when my mom sent it to her. I've advised her to see an elder law attorney to see what she can do financially as to qualify him for Medicaid. From my experience and research, Medicaid is the only program that provides long-term care, whether in-home or in a facility. I also know he can only have 2K in assets, and she can keep ~130K, the house, and one vehicle.


But I do understand; they're telling her the only option is to take him home. It's like when people tell me I can do this or that in regards to working, and I want to respond "No, you just don't get it! The system won't let me without compromising access to disability services!"


I realize I can't convince her to be assertive or to seek help. I guess my main question is whether or not just releasing him with no care plan is even legal?


I worry about her health as two days ago a different loved one who has been caring for his spouse had a stroke. Thankfully, it only affected his speech and some recall, but their family is in crisis as well.

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I was a secretary for Visiting Nurses and got many calls where family was trying to set up care for someone in the hospital or rehab. I had to explain that at time of discharge a care plan will be worked out. We were limited in our services, no PT or OT which was given by in home. I would think he may get some therapy once he is home.
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I agree with Alva that since your well-intentioned suggestions weren't met with appreciation, give her space and time. It may be she is overwhelmed and now the thought of having to resort to Medicaid is a very unnerving one, on top of everything else that's happened. Bless you for your loving concern.
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Generally the care plan is done with the discharge, and arrangements for care as outpatient. I hope that the woman, a friend of yours, has supportive family member or friends close by to her in Florida (you don't say how close to them you live). More importantly you say that "she kind of got upset" by delivery, through you Mom, of some of your ideas. That would make me tend to back away a bit; your well-meant ideas seem to not have a good result for her. Do send her a kind note telling her that, if there is anything you are able to do for her at a distance, you are more than willing. It is very kind of you to be so concerned.
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When my husband had a massive stroke at the age of 48,(back in 1996) and lost the ability to walk, talk, read and write, he was in the hospital and rehab for about a month and a half, and then I had to bring him home, where PT, OT, and speech therapy were set up as outpatient, and I had to rearrange my work schedule(as I worked full-time too) to be able to take him to all his therapies. That went on for several more months.
It was certainly stressful at first, because at the time, our bedrooms were all upstairs, and he hadn't mastered steps yet, but he had no choice but to do his best with them, with my help.
I'm hoping that your friends rehab place has at least some outpatient therapies set up for her husband, as he will certainly need continuing therapy. And she may have to take a leave of absence from work until she can get things worked out for him.
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viacrusis1689 May 2021
Thank you for sharing your experience. That must have been extremely difficult, but like my parents have told people who say they could never handle a child with a disability (me) like my parents did, you do what you have to do.

She is working on getting in-home caregivers, etc. It's just hard to not being able to help her more.
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