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Is this normal? Extreme pushiness from social workers or case managers regarding discharge planning and family meetings at short-term rehabiliation centers? Often they give me less than one day's notice and it is at their convenince, not mine. They state, "The insurance company is demanding it." Before my mother was deemed incompetent (which I question), they would come to me to make decisions for my mother, though my mother was competent. I would say, "Go ask my mother." A response would be, well I just stopped by and she is sleeping.


One facility claimed the speech therapist could deem my mother incompetent. I filed a complaint and was correct. Speech therapists can not in the state of Massachusetts deem a patient incompetent.


Honestly, I feel there is pattern. Parent is admitted to short-term rehab, they snow them on geriatric, psychiatric drug, temporary invoke the health care proxy, and then make undue demands on the proxy.


When I signed the contract to be health care proxy there is no clause about these pushy case managers/social workers. Had I known in advance I would never had agreed to be a health care proxy.


Is this all insurance driven? Some one told me the insurance companies put undue pressure on them.


Any thoughts or experience?


One had me in tears she was so pushy.

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I just read your responses. It all comes down that we have to advocate for our loved ones. 2x I have questioned blood pressure meds given. One was Mom normally she took 80mg. Because of the pain she was experiencing in the hospital it was upped to 160mg. At discharge it remain at 160mg but she had a procedure that had lessened the pain to just needing Tylenol. My Mom got home and couldn't get off the couch. In in home Nurse called the PCP and got it lowered to 80mg. My DH had AFib and was given B/P meds. AFIB gone discharge said to continue them I asked why, he does not normally take B/P meds. Again, at PCP visit she said DH was lucky he could walk and took him off.

We have to research what is wrong with our LO. Question when something does feel just right. Even get b_ _ _ _ y if needed. My feelings have been validated. What I hate is, my daughter, an RN, has to walk in with her scrubs, say the same thing I have been saying and they listen. Every family should have an RN.
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Upon discharge from a hospital or entering rehab, I was always told how many days were approved and did the math. Going forward are you able to ask how many days are approved with each admission?
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dnajaras May 2023
I find complaining or consulting to Kepro which works with medicare great. They confirmed with me in a family meeting at a rehabiilaton center after the fact, it was incorrect for a speech therapist in the state of Massachusetts to deem my mother incompentent. I questioned this in the family meeting (I was by myself with no witnesses) and said I wanted a neuro consult.

The staff at Kepro found the speech therapist's actions ludicrous. When I was able to speak to management at the rehabilaiton center later they denied the speech therapist did this. Going forward, should I tape record everything or make sure I have a trusted family witness.
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You updated your post? Don't remember all this explanation before, thanks.

My experience, never did I get a 24 hour notice for a care meeting. IMO, it should be at your convenience. If the insurance companies have anything to do with it, then Moms Rehab had a problem. I was suppose to have a care meeting within a week it took two. They named off Moms meds and her thyroid was missing why? Because some Dr at the hospital felt her labs looked good and stopped it. Never consulting with her specialist. And because of that, the Rehab did not carry thru either. If I had been told that the first week, she would have been back on it sooner.

Rehabs should not be fooling with a persons meds, IMO. And if the facility doctor thinks there should be a change the person who has health care proxy should be told why. My Uncle had a reaction to a lung med and almost died. He asked the Nurse what was the IV for and she said it was the Medication the almost died from.

I never had Rehab calling me about every little thing. Maybe the ones your are dealing with are hyper vigilant.
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dnajaras May 2023
this helps so much. If I am correct if the pushy social worker is demanding a family meeting then insurance (maybe I should call the insurance company directly and express my concerns) is and like me questioning why my mother is there. In the ER, the staff said my mother could go home. but my brother who is her live-in caregiver refused to take her home.
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Your profile says that Mom lives home. Is this APS? If so, yes they can give u 24 hrs notice.
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dnajaras May 2023
Not not APS.
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The social workers seem overwhelmed and overworked in the skilled nursing facility my mom stayed at for a month. I'd chalk it up to that.
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