What do you do if your parent is bedridden and must use a wheelchair or stretcher to go to any kind of doctor appt?

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What do you do if your parent is bedridden and must use a wheelchair or stretcher to go to any kind of doctor appt?

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I have a dilemma that I need input on. Mom is bedridden with Alzheimer's, Dementia, COPD, and Parkinson and one of her legs is a bit contracted. What do you do when she has to go to the doctor and they will not permit a stretcher, but even with wheelchair they will not work on her unless she is on their table; BUT they will not assist you at all to get her from the wheelchair to their table!! This is just for a podiatry visit to look at some nail fungus! To make matters worse I have to hire a private ambulance to make this visit work.

The bigger issue is when mom says she doesn't feel good but when you inquire where it hurts, she is unable to tell you exactly. At what time do you call an ambulance to take her to the ER as that would be easier then arranging for a doctors visit?

Care Decisions Medical Care Mobility

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My mom was in the same boat. She weighed 200 lbs & was dead weight...it would’ve taken professional body builders to put her on the table. Her Dr. would do all the basics with mom in her wheelchair, but if a UTI was suspected it meant a trip to the ER just to get a clean urine sample.

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Sorry to hear you are having these problems. When my Mom was declining and difficult to get to the doctors’ offices I somehow found a foot doctor that made house calls, we used him several times. Prior to that we went to a foot doctor where all the staff seemed really careful and helpful to Mom who was in a wheelchair and had some difficulty walking. Maybe you could ask around or call a couple of offices and see if anyone might make house calls. Towards the end we found a doctor/physician assistant that made house calls. Unfortunately she broke a second hip and had to go to a nursing home before we could take advantage of the house calls. I hope you can find some caring doctors to take care of your mother. Care giving is difficult. Knowing when to go to the ER can be challenging, sometimes it felt like all they do is give out medicine. Good luck.

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Toenail fungus is not deemed a medical emergency. An urgent care clinic may handle this if explained well, e.g. why the patient didn't go to the podiatrist.

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My mom was able to sit in her wheelchair while they did work on her so look around for other dr who will help - start asking around at senior centres because those on the ground know where to get help or will steer you where to get help because they have a friend who needed too

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Are there any mobile doctors / nurse practitioners in your area who could visit at the home?

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I used to pick my mother up and place her on the table at the Drs office.

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You are strong! I wouldn’t be able to do that. Good for you...

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Hello redroseman; I have a podiatrist come right to my house to trim my mom and Aunties toenails!! Their alot of podiatrists do this .....because it it a necessary but difficult task you do not have to leave home just look on line for podiatrists that do home visits and its covered by medicare!! The podiatrist that comes also treats other ailments eith the feet and we NEVER HAVE TO LEAVE THE HOUSE!! GOOD LUCK!!

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Alright. I'm sure you've had this question answered in the comments (I haven't read them), but I'll say what I would do if I were you.

1. Rent a wheelchair that reclines if she doesn't already have one. Or change her wheelchair to this type. That way she doesn't have to get on tables at doctors appointments, they can just recline her in the chair and then you can raise legs with the leg rests.

2. Have someone go with you to her appointment to help her get on the table.

3. If all else fails, then an ER trip is something you have to do. I've learned that an ER trip is perfectly okay to do for whatever is going on. Just because it's not something major, it's still something that needs to be looked at. She needs care and so you should take her any place that will do so.

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Is it possible a "convenient care" clinic could be used instead of an ER? This would make it less expensive and would save the ER staff for emergency situations.

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I have same exact problem so my mother has private pay Aide & she transfers mother from wheelchair to his chair. His chair goes up & down & arm swings out of way. My mother has dementia & can’t walk or stand. She had big toe infection. He put her on clindamycin & a cream. I had to clean it first 2X day , then once a day & it’s better. My mother screams, yells & carries on like she’s being murdered. I thought podiatrist was making a Federal case out of one freaking toe, but I went along with it until he said it’s not infected anymore. Also my mother didn’t always want to take her oral antibiotics. I asked him what if she refuses...he said to take her to ER!!! Well, I wasn’t going to take her to ER just for a toe. Well, that’s my story. I couldn’t understand why podiatrist couldn’t treat from wheelchair & she raise her feet on his chair...? Probably for liability reasons. Oh I almost forgot to you, I had podiatrist come to the house, but she left as soon as my mother started screaming. The one she has to go out of house for is not easily frightened by her... he used to treat her when she was walking....& b4 dementia.
Hugs 🤗

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It sounds like your M is a candidate for Hospice care. Ask her Primary Care Physician for a referral. Now to the podiatrist: if she can sit in a wheel chair and could move enough to get her into the front seat of a car, you should hire a Home Health Aide to help you take her into the Dr. office and transfer her to the table as required. Probably the reason the Dr. or nurse won't assist you is for insurance liability reasons. Although a podiatrist may have her seat in a chair like a dentist chair while the feet are being examined. Anyway having a Home Health Aide who is trained and used to moving people should be able to cope.

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I would find a new medical provider

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I finally had to accept that my loved one (LO) needed doctors that would come to the house. You may be at that stage too now. I don’t think you will have too much trouble finding a podiatrist who makes housecalls. This had greatly reduced the need to run my LO to the ER.

If she can’t tell you when/where it hurts, it can be an excruciating decision as to what to do. I wish there were easy answers to this one.

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We use a home health service for my grandparents. Medicare does cover the doctor/nurse practitioner PCP. I think we pay 50 or 60 for the podiatrist, but transport would be so much more expensive and it's always an ordeal for my grandmother.
I also have to say, that doctor's office doesn't sound very good. Even when we could still get my grandmother to offices in a wheelchair, there was no way we could get her up on the table. When a doctor needed her there, they would call for a couple of techs to help. We never had a problem with that.
Best of luck with your Mom.

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I have the same problem with podiatrist...often wondered why they didn't help me get her on their chair (from wheelchair) even when I ask for help. The assistant gets you to the room and then scurries away for a bit. Seems to return once she knows you have wrangled her onto their chair. The most difficult part is their chair is huge and there is only a small area to position a wheelchair to get it close, help lift mom, and then move the chair while holding her up. Other doctors do the exam while she's in her wheelchair. Perhaps it's just a common liability thing for podiatrists...who knows. Last time I took her I just said, I can't do this by myself so look at her feet while she's in the wheelchair.

As for calling an ambulance to go to ER - ask others in your area how it works. In Houston, they have tried to stop people from abusing ambulance transport and if doesn't appear you are dying, they will tell you to call a cab. Mom has history of spinal compression fractures and had to call them at one point when she could not get up, walk, and I was unable to lift her onto wheelchair. First the firetruck comes - they tell me I can put her in the car and take her to her dr. Explain I can't lift her. Next ambulance comes and we go through same conversation and which point I tell them if I could lift her into a chair and take her to dr I would have already done it - I weight 113 and she's nearly 190 - I manage what I physically can without help and this one is too much - explain compression fracture history again. Finally after explaining this to EACH man who was on firetruck and ambulance, they agree to load her up. At 95 years old and looking at situation, no one should have to beg them to take her to er.

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2cents, I probably would’ve punched them out after the first explanation ...then the police would have to come & arrest me...& would never get the mother to ER!!! You probably just have to make up a more serious problem..,like she has excruciating pain or she having trouble breathing or acting aggressive from possible UTI. Hugs 🤗

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It's unfortunate that podiatrist's offices don't have a hydraulic lift--a small version of what the auto mechanics use. Then the wheelchair could be raised a few feet so the podiatrist wouldn't need to work at floor level, and it would obviate the need to transfer the patient.

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see if your area has visiting physicians. we have that for my mom and they come to see her at her home

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It sounds like you need to put her on hospice. They can supply all the routine medications. My mom is on hospice and I get her all her routine meds through them; now her insulin and insulin needles are regular prescriptions through Express Scripts, but hospice filled that as well. Should you ever get your mom in the ER or hospital, a hospice consult can be made. You may want to try CALLING your mom's primary doctor and ask for hospice.

I don't know how old your mom is, but nobody has ever died of toenail fungus. I treated mom's toenail fungus with over the counter topical stuff -- it took about 10 to 12 months of daily treatments twice a day but it went away.

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With the conditions you list she would be eligible for Hospice. Then you would have a Nurse that comes to you. If a Doctor would be needed they would come to you, or they would arrange transport to their facility or to the hospital if that would be necessary.
With Hospice you would also get a CNA that would come in and help bathe, dress, order supplies....And you would also get a Social Worker, Chaplain if you wish as well as other services.

Oh, the nail fungus...don't worry about it it does not cause pain and most "cures" either take a year to work or they don't work well and if it is the oral medication it is toxic to the liver and she would probably be required to have blood tests every few months.

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This happened to my father, so he had to switch doctors...and for his radiation treatments had to do it at the hospital versus the cancer center. as far as podiatry goes, we had one come out to the house, as well as the rehab center, and they had no problem cutting his nails from the bed or wheelchair. So ask around...maybe there are better podiatrists who will work with a wheel chair bound person. Us too with the ambulance to get him there, as he wouldn't walk down the stairs...The ER? Possibly, but you know how the ER goes, you'll be there for Hours.

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There are also many podiatrists who make house calls. Check with the ones who visit local nursing homes. Ours accepts Medicare

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Medicare does not cover nursing homes, unless it is for rehab (for a limited time) and only after hospitalization. Most podiatrists do NOT make house calls.

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I was able to locate a wonderful doctor that a nurse from a visiting nursing company suggested. This doctor came to the house once a month and more often if urgent. She took care of all my moms needs, Levy bodies dementia with Parkinson’s and mom was unable to walk. I was also told that the local hospital would give recommendations for doctors that treat only the home bound. She accepted Medicare and we had to pay no additional costs. Blood work and xrays both came to the house. Best thing we ever did concerning moms care.

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After my dad had surgery on his femur and hip, we had him transported to the surgeon's office on gurney via a company that provides rides for medical appointments. Here locally it’s called MedRide. It was not cheap but necessary in his case. They also provided wheelchair rides. The drivers would help with assisting him on the table when necessary. And even the doctor helped. Your podiatrist needs to be fired. But personally I think worrying about a nail fungus at this stage of your mom's condition is not necessary. It’s ugly but hard to cure and it will not affect the quality of her life. Plus you have to throw away any shoes she wears as it will just reinfect her. Give it up and move on to more serious matters. And don’t feel guilty.

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I don't understand why someone would not allow a stretcher unless it is due to the size of the exam rooms and hallways. I would ask for clarification on that point with the doctor - not the staff. Ambulance personnel do not leave without their stretcher which means they are always available (in the waiting area) for lifting if necessary.
Perhaps there is someone who would make a house call in your circumstance. Again, I would ask the physician if this is possible. Or if your mother is in a facility, is there a podiatrist on the staff?

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This was a huge dilema for me with my mom until she was on hospice. When she was more mobile, I was dismayed that doctor's offices had these stationary tables that were impossible for her, or many elderly people to climb onto. The need to have drawers in the table to store paper gowns seem more important than patient needs. At least her doctor then would examine her in the wheelchair. Dentist chairs go up and down, why can't doctor's exam tables???!!
The problem of getting my bed bound mom to the doctor in a wheelchair and hiring a van all went away when she was on hospice. The time before that was terribly rough, so I fully understand where you are coming from.
If anyone is listening that could invent an exam table that goes up and down, please do so! You could make a bundle as this is badly needed!

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I just went to a doctor last week who had a table that started out super-low! She had be sit down and then raised it. Also, there was still a drawer at the end! I'm able to get up and down, but now that I know these tables exist, I don't know why offices that deal with elderly patients and/or disabled patients don't all have these. I'm guessing it has to do with expense. Plus, the table was more comfortable when I needed to lay down, which would be so great for older patients.

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You didn't mention your mother's medical directives or wishes. My mother who has advancing dementia and lives in a memory care facility was hating every time she went to a doctor visit or had to go to the hospital. During her last hospital visit she was biting the nurses as a way of expressing that she didn't want them to bother her. We decided to switch her to hospice care with a medical directive of no hospitalization. The concept is that she gets "comfort care" just things to make her comfortable. Hospice helped me contact her doctors to renew her prescriptions automatically (without a doctor visit). The doctor comes to her facility for her annual check-up for her to stay in the facility. Some people even put into their medical directives that they don't want to be fed if they can't feed themselves. My mother didn't do this, and now she is at the stage where she has to be fed. As mentioned in another response, if you have medical POA you can decide which doctors she should visit and when it is necessary to do so.

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Goodness, many professionals in our health care system seem to have lost empathy for patients!
I would think there would be extra people to be called for help in moving patients onto tables etc. Of course I also know many times they are worried about liability.
I have no advice for you. Just wanted to say how disappointing it is to see a profession that is supposedly human oriented w little care about patients.
BTW, I teach preschool and many times have had to deal w bodily fluids. I put on gloves and deal with it.

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I take my mother to the pediatrist every nine weeks, and she stays in her w/c. The w/c reclines to 50 degrees. I tilt her about 30 degree.. I place a bulky pillow under her legs. The doctor is ok with this. He does not have to struggle to cut her toenails and he saves his back.

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There comes a time when we have to look at our Doctors and see if we still need them.

On a hospital visit itcwas found Mom had a thickening in her upper stomach. Had to see a specialist to determine if it was cancer. No, probably caused by her acid reflux. But we went every six months and then a year. When there seemed to be no change, her Dementia was getting worse and she was in an AL, I stopped seeing him. She had graves disease. Again a specialist. After a couple of years it seemed to be under control. By this time she was in LTC. Specialist said as long as the facilities dr. Tested her ever so often and her numbers were good he wasn't needed. He was also 45 min from her NH. Then there was her urologist. She had bladder cancer at 80. He was still at 87 doing scopes on her oncevavyear. With her Dementia we would never had put her thru the Chemo u need to go thru. So, I chose to stop him. There are things u need specialist for but after ur stabilized I think a PCP can continue monitoring.

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I tried to get phone or Skype consultation with Drs office for mother. Every time, they would tell me to "bring her in" (cuz of liability fears). Also, "house-calls" (by Drs or nurses) should be provided by every insurance company, for elderly urgencies. With our aging population, its downright stupid the way services are provided in the U.S. it would save money to help us avoid unnecessary transport or E.R. visits. (My mom frequently needed hydration, which could have been done by I.V. at home, saving thousands). There's no reason labs ect, can't be done at home, if patients are deemed eligible. Maybe I just had the wrong insurance co.

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When it comes to Dr office visits the patient needs to be there for the doctor to be able to bill Medicare. Thats why I stopped Moms specialist. The required her to be there for test results even though she had no idea what they were talking about.

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Medicare will pay for a podiatrist to come to the house. I use a visiting nurse and physicians service for my mom's care.

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What do you do if your parent is bedridden and must use a wheelchair or stretcher to go to any kind of doctor appt?

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