What has shocked you today?

[BigV]

Originally Posted by glatt

Thanks!

The one noteworthy thing about the end was that he was in a rehab facility. A rehab facility is meant to improve the patient. Medicare will pay 100% for the first 20 days but the patient is expected to make progress. My cousin had given up and stopped eating, so he was no longer a candidate for rehab. So on Tuesday, I met with the entire team, signed up for hospice care for him and asked that he be discharged for hospice. It takes a day or two to put in place. On Thursday morning, the rehab place did bloodwork and saw elevated white blood count and so started him on IV antibiotics. This was against the wishes I expressed on Tuesday when I said no to feeding tubes and IV hydration. But their position was that as long as he was still in their care, they had to treat him because they are a rehab place and not hospice. By starting him on a course of antibiotics, they needed to keep him for the 4 day course and couldn't discharge him until Monday. The cynic in me couldn't help but notice that Monday was going to be day 20 and Medicare would stop paying on Monday. But it backfired on them because he died on them and that has got to be bad for their numbers.

First of all, I'm sorry to hear this sad news, you and your family are in my thoughts.

As for the course of treatment and the other details, you said your POA expired, that's unusual, to my understanding. How/why was it limited? Why was it not renewed? I can't imagine it was for any cause on your part.

Anyhow, as to the treatment contrary to his express wishes, I find that part sad and frustrating. Taken to the extreme it could be criminal, think of the forced sterilizations while in a doctor's care. I don't think care provided by medical professionals should ever be contrary to a person's wishes. I find that reprehensible. I do understand the instinct borne of good intentions and long training to preserve and extend life. Those instincts by themselves are good. But not superior to a patient's wishes. I don't know the law where you live, but here assisted suicide is legal. Obviously, this was no suicide, but even less polarizing ideas like Do No Resuscitate (DNR) orders are widely accepted.

I agree with your observation that the appearance of piling on the charges is pretty obvious. I have lots of other complaints and thoughts for improvement to our current for profit healthcare delivery system, and your description of this incident fits neatly into that "thread". But I have a question, did your elderly cousin have is wishes expressed in writing? Did he have someone assigned a Healthcare POA? Saying "express wishes" and showing the people in charge of the care such a document are two very different situations, and I would expect very different outcomes.

Still, very sorry for you and your family. You probably have a lot more work ahead of you. I wish you strength and peace.

[Gravdigr]

Originally Posted by BigV

I agree with your observation that the appearance of piling on the charges is pretty obvious.

That's where I went, too.

I wonder what their mark-up is for IV antibiotic$?