What has shocked you today?

[Gravdigr]

Sorry about your cousin, dude.

[infinite monkey]

Aw crap, glatt. You did good by him. I know there is more to do but you are entrusted because you are you...a good person. Hang in there.

[Griff]

What they said and a pat on the back.

[Clodfobble]

From what you've told us about here, you were clearly a huge help to him over the last couple of years. It's natural to be wired, but even if something falls through the cracks for a bit, it's not the end of the world. You'll be okay.

[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.

[classicman]

Sorry for your loss. You did a TON for him even though you weren't really, as you've said, "close."
That further shows what a great person you are. Good on you.

[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$?

[glatt]

My POA expired the instant he died. Not before.

He had his wishes spelled out in an advanced medical directive, and I was named as the official decision maker in that same document. I had already verbally told them no feeding tube and no IV for hydration, and those were dictated for him in the document if he was in a coma OR if death was imminent. It was all very clear.

I think the key was that this was a rehab facility. They are the opposite of hospice. I think they crossed a line when they delayed his move to hospice.

None of it really matters. They took good care of him and he was comfortable. So he died in their bed instead of someone else's bed. What they did was "wrong" in my opinion but it didn't harm him in any way. They bilked the taxpayer out of several hundred dollars though.

[classicman]

In my understanding, this is not uncommon. DNR's are routinely "ignored" at many/most care facilities - hospitals, rehabs homes etc.
The providers are under such scrutiny that they err on the side of life - virtually every time. Wrongful death lawsuits abound and there is no coming back from the dead. This leaves the individual providers and the institutions very leery about it all. I have seen this firsthand and experienced it through several friends in the TBI/disabled community.

[monster]

http://www.mlive.com/news/ann-arbor/...rt_river_index

This is my kids' school. I know both of these boys. They are Hockey Boy's former teammates in high school hockey and grade school soccer. The nice, polite boys, not the trouble-makers.

I'm sad that -if they did this- they are just the wrong side of 18 and might pay a colossal price. Already they are named. Even if they turn up innocent, who will hire them? Which colleges will take them? One had a full scholarship to a pretty decent local State School to study business. I doubt he will now. His dad was so proud.

[xoxoxoBruce]

Sound like two perfect candidates for an MBA.

[glatt]

Well, that sucks. Dumb decision. Otherwise good people do stupid stuff sometimes.

Their clothing and masks shows premeditation and intent. That won't be good for them.

[sexobon]

Originally Posted by monster

... they are just the wrong side of 18 and might pay a colossal price. ...

Maybe they'll get one of those judges who'll give them a choice of going to trial; or, going into the military and being shipped off to Afghanistan where they're always looking for new IED detectors.

[monster]

forced to create yet another account for yet another website that really doesn't need password protecting etc ......very surprised it let me use "fuck" as a password. Usually, one has to create an 8-char min letter, number, uppercase, symbol combo just to see the weekly ad at the local grocery store! I hate the company, but that's almost enough to make me consider buying something from them.

(it's a school team thing)