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Topic Home Health came today... Go to previous topic Go to next topic Go to higher level

By dkleinert On 2009.09.17 21:38
Today Joe had an assessment from Occupational Therapy and Physical Therapy. Sounds like Medicare/United Health Care will only cover 3-4 weeks of visits......and I am grateful for that....but the OT person told me that they will set goals (which I had learned from all of you would happen), and they must see improvement during the 3-4 weeks, but that it would end. So with PD, there is usually not a great deal of improvement over time - things slide downward not upward, so how can they expect what they expect? Are there things I should be saying or doing to extend the time they will come out? What are your suggestions for their visits to go longer than 3 weeks? Both OT and PT agreed that my husband needs lots of help with lots of things.....We found out yesterday that he is going to have to have a knee replacement in a month or two. If this round of OT and PT stops in 3 weeks, can it be restarted after the surgery? Or is there a finite limit to what Medicare will cover? THANKs in advance for everything you all give to all of us.

By bandido1 On 2009.09.18 17:09
I have had three days of fatigue also known as"off" days so please excuse any typos and a brief reply.

I am perplexed-the answers you're getting are inconsistent with my experience as a Medicare and United Healthcare parkinson's patient. You mention occupational therapy and physical therapy which are limited to specific weeks. However, my Home Healthcare for stage three or stage four Parkinsons has never been limited. There seems to be some communication breakdown that needs to be resolved. Keep trying! Bob C

By annwood On 2009.09.18 17:11
Same here. My husband had PT & OT for a year. I believe it is all in how it is coded and how the progress notes are written.

By Emma On 2009.09.19 05:49
We have been getting PT, OT, Nursing and Social Work for a couple of weeks now (paid for by Medicare and our private insurance). They told us that they can initially provide service for up to nine weeks, but that can be extended. They also told us that services can be reinstated at a later date if need be. I think that when they say "improvement" they mean in skills, not condition. They have been working with my husband on dressing, showering, getting out of bed, walking, balance, using his walker, even some basic cooking. Also some exercises to strengthen his neck and upper body. He is actually learning and showing "improvement" by using the techniques and tools that they are giving him. For example, he is able to take longer steps and stand up straighter when using his walker by using the techniques they are working on. He is also doing better with his shower by following the suggestions of the OT. Mind you, these are not big major improvements, but they are improvements none the less. So the point is, don't despair, you may end up getting more time.

Hang in there.

By bandido1 On 2009.09.19 15:41
Emma: thanks for the update. Again, this is not one of my better days, but I am dedicated to providing the best advice patients can offer to caregivers. In this case, it seems that everything boils down to communication. You have mentioned both occupational therapy and physical therapy contacts. Your recent post indicates you are receiving what amounts to Home Healthcare. In Texas these are completely separate functions. While it seemed logical and restrictions on continuation of OT and PT would be based on "improvement" reports, it makes no sense to apply that standard to Parkinsons Disease. There will be no improvement! Your Dr. and any neuro know this and should be indicating this fact in their reporting. I encourage you to continue your efforts. Sooner or later the truth will out and your patient will be receiving what he's entitled to ---essential Health Care! Good luck. Bob C

By annwood On 2009.09.19 15:50
Bob, I hope tomorrow is a better day for you. Hang in there!

By dkleinert On 2009.09.20 11:10
Bob, Emma and Annwood: THANK YOU soooo much for your input. I am going to print these posts and use them when I talk to Home Health. I made no sense to me that there had to be "improvement" or they would discontinue coming......as you said, that does not happen with PD. I will continue to pursue this for Joe (and for me). He so deserves this care and help. He tries so hard and wants to be his best with what he has now. You all will never know how much you mean to me.

Bob: I hope you have MORE "on" days instead of "off" days. You are the BEST!

Hugs to all of you.

By Emma On 2009.09.20 15:35
Donna, I forgot to mention in my earlier post that another benefit I've found with the Home Health people is that they will do stuff for you. The nurse who comes to see my husband found a problem with his blood pressure and she called the doctor for me and got his medication changed. She also called the pain clinic he goes to and got him in for an earlier appointment after they told me there was nothing available. The OT ordered a bedside commode and a gizmo to help him with buttons and she took care of all the Medicare paperwork. All I had to do was open the door when it was delivered. Gotta love that! Those may be little things, but as you well know, we all have a hundred "little things" to deal with every day and to have someone else do one or two of them is a HUGE blessing.


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