Home healthcare services

Hey there, experts,

I’m looking for some insight regarding what kind of coverage or rights someone actually has when they're discharged from the hospital to home care—assuming, of course, they have health insurance.

Basically, if someone is stuck in bed because of injuries or just can't move certain parts of their body, is there a specific service—or anyone at all—who steps in to help them out while they recover at home? Since they're incapacitated, they obviously can't manage everything on their own.

Any specific info would be much appreciated. :-)

Dave

p.s. If this topic has already been covered, my apologies to the mods ;-)

Your primary care doctor or a visiting nurse is your best bet here. If you qualify for home assistance, the doctor will give you a referral that you need to take to Blue Cross Blue Shield to get authorized.
Fingers crossed for you.
If the person coming home from the hospital can barely move:

Make sure to watch their lungs. They need to breathe deeply—all the way down into the belly—and really cough from deep in the chest.
Massage every possible area: the buttocks, tailbone, hips, neck, heels, and elbows.
Keep turning them from side to side, or onto their back, then to the other side every two hours while massaging.
Get as much fluids into them as possible.
Don't be afraid to put on some gloves and get stuck in. This stuff is critical. If things take a turn for the worse, pressure sores can open up fast, and trust me, nobody wants to deal with that mess.
Until you get everything sorted through insurance, call a local private home health agency in your area. Have them come out to explain exactly what you need to do.

I used to do this for a living, so I know the drill. If you're unsure about anything, just ask. Otherwise, I'll be online from 8 AM to 2 PM.

Look, you can definitely qualify for home health care in certain situations, but honestly, I think it’s pretty limited—maybe like half an hour a day, up to five times a week, plus an extra thirty minutes if they need help with bathing. On top of that, you might be able to get a physical therapist sent over too, provided your doctor thinks it's actually necessary. There's a whole bit of paperwork involved, though—a visiting nurse has to write up a report, and then you have to take that along with a certified request, discharge papers, and medical history to the review board. In our case, since we were dealing with the terminal stage of cancer, the request just got automatically renewed every month, but I'm guessing in other scenarios, you might have to head back to the board for approval again.
You can also reach out to the Red Cross to see about getting some "helpers" who can come by to tidy up, cook a few meals, or run errands to the grocery store—I believe there's a fee for that, but it shouldn't be too crazy. Also, if the person is completely immobile, the family member acting as the caregiver might be eligible for some social assistance, but there are specific rules there—from what I understand, the person has to be totally bedridden so they don't start factoring in everyone's household income.
And hey, you're also entitled to things like medical gauze via prescription; for things like adult diapers if there's incontinence, or for orthopedic aids, IV fluids, or catheters, you usually have to go through the review board for those. I don't know what your primary care doctor is like, but with ours, they didn't really volunteer much information—we basically had to ask for everything ourselves.
Check out this site: http://www.hospicefoundation.org/info.asp?sif=29
I really think they can give you some extra pointers and advice.

If you’ve got someone who’s going to be stuck in bed for a while and can't really shift themselves around, seriously—grab a pressure ulcer prevention cushion right away. In my experience, those ring-shaped ones that keep the tailbone hovering just off the surface are absolute lifesavers. You can get those high-tech air mattresses too, but honestly, even with those, you might still end up dealing with heel sores by morning—so make sure to grab some heel protectors for them as well.
I’m not entirely sure if Blue Cross Blue Shield will cover the cost upfront, but you should definitely keep all your receipts because you can usually claim them as a medical deduction on your taxes.

Thanks for putting in all this work—honestly, there's a ton of incredibly useful info here.

BIG THANKS!

Can someone tell me if they’ve dealt with home healthcare services before? Where do we even start... my wife is sick near a >. She doesn't have health insurance and she's in no condition to make it to a private doctor's office.

Quote:... she doesn't have health insurance and isn't mobile enough to make it to a private doctor's office.

Roger Kern3 says: Can someone please tell me if anyone has experience dealing with home healthcare services regarding where to reach out? We have my wife who is ill in a Small town in rural America

Unfortunately, without insurance, you're essentially flying blind when it comes to coverage rights. Your best bet might be finding a private residential care facility willing to provide those kinds of services. I'd suggest running a Google search for local options.

Angela Wright said:Quote:... she doesn't have health insurance and isn't mobile enough to make it to a private doctor's office.

Roger Kern3 says: Can someone please tell me if anyone has experience dealing with home healthcare services regarding where to reach out? We have my wife who is ill in a Small town in rural America

Unfortunately, without insurance, you're essentially flying blind when it comes to coverage rights. Your best bet might be finding a private residential care facility willing to provide those kinds of services. I'd suggest running a Google search for local options.

Thanks... which is exactly why I'm posting here—to see if anyone actually knows more about this. I've found plenty of private facilities that work closely with the public sector, but they only come to your house if a doctor from a state hospital orders it. They won't show up just because you ask. Please, if anyone else knows anything... I'd really appreciate it.

It’s going to be a whole lot easier and way less confusing if you just lay out your question in a clear, readable format.
I mean,

Basically, list it out like this:
-how old they are
-what specific diagnoses we're looking at
-which medications they're currently on for those conditions
-their mobility level—whether they're walking fine, struggling, or completely bedridden
-their mental clarity—are they sharp and communicative, or more disoriented and incoherent?
-their financial situation, like any pension, income, or property they own (since that matters if we're talking about placing them in a foster home or assisted living)

Just give us some actual data to work with...

And obviously, you'll need to get in touch with the local Department of Social Services and the local Medicare office to make sure their basic health insurance is all squared away.

Maybe we can figure something out...

- Person is 76 years old.
- Dealing with diabetes, heart disease, and chronic bone and joint pain. That joint pain is the real killer here.
- On meds for the diabetes and heart issues, but nothing touches the bone pain.
- Mobility is shot—can't walk any decent distance, legs and spine are incredibly weak.
- Mentally sharp and communicates fine, but needs constant help (provided by her husband) because she just can't move around on her own.
- Husband handles all the finances and provides for them.

The issue is there’s zero specialized medical staff in the nearby towns where they live, and their Medicare coverage is tied to another state, so traveling there isn't an option. She simply can't handle the travel without his help, and even then, it's a massive struggle. Anything that could allow for house calls or home visits would be a lifesaver.

So, I’d say start with a house call from their primary care doctor just to get eyes on the situation firsthand.
He can put in a request for home health care—assuming they haven't cut those programs entirely lately—but honestly, you’ll probably want a specialist's referral too, like a physiatrist or a neurologist, if you're looking at getting physical rehab done right there at home.
The United States, or specifically Medicare, definitely has some kind of reciprocal agreement or coverage framework with neighboring countries in the region. 🤔

As for how the healthcare network is set up over there, I know from what I've heard that things are pretty spread thin, which is a real shame. 😢

But, looking at everything you've described, it feels like there isn't much more that can be done given the circumstances. 🤷
You really ought to look into finding a solid placement with a proper foster family or a specialized caregiving home.

Bottom line: you need to get in touch with Medicare to sort out the insurance status first; that's the only way to kick things off.

Thanks a ton for all the work... we'll look into it...

Hey there,

I’m looking for some advice regarding home healthcare.
We're dealing with the recovery needs of a man following prostate cancer surgery.
Does anyone have recommendations for private agencies, or maybe know what kind of coverage we can actually get through Medicare?
Thanks,