By: Cindy Hasz, Geriatric Care Manager
Geriatric Care Managers specialize in the delivery of care and not just the illusion of care. Many in the “elder care industry” specialize in the appearances of care rather than care itself. Granted, it’s hard to deliver substance when insurance companies only reimburse for delivering the minimum standard of care… if that. Take the instance of rehabilitation for post-stroke elders.
If you have an elder loved one who has suffered a stroke and they’ve come home after hospitalization no doubt they will either be attending outpatient therapy or be having visiting therapists through a “home health” agency. Your home health therapists as wonderful as I hope they are will not be able to stay long per MediCare regulations.
Unless your loved one makes what is considered significant “functional progress,” (a subjective metric to be sure) they will be discontinued rather quickly. Even if they make what the therapist thinks is “significant progress,” home health is not designed to actually take the patient to the next level of their rehabilitation. One therapist I was speaking to recently said that they’re goal is just to “tweak” their home health patients. That comes as a real surprise to many patients and their families who expect substance and not tweaking.
Medicare used to be able to stay in place longer while the patient was making good progress but now MediCare cannot afford to pay for this longer-term rehabilitation. From what Geriatric Care Managers see on a regular basis in the community, they’re even having problems providing adequate short-term rehabilitation!
The length of time that home health agencies will stay on to provide therapy varies somewhat however three times a week for a few weeks to a month is not unusual. This simply does not give the stroke patient the best shot at recovery of their optimum function.
Clearly, stroke rehabilitation takes longer than a few weeks. Stroke patients can continue to make good progress for months to literally years after the event with the right help. A broad body of clinical research has been gathered over the past two decades showing that the brain has far more capacity for healing or “neural plasticity” than was previously thought. I have many stroke patients that have continued to recover function years after their stroke. They have achieved their true optimum function and highest possible quality of life due to skilled advocacy, intervention and private therapy.
There are options. You can call us for help in getting the skilled assistance you and your loved ones deserve.