for release February 15, 2002
The Sandwich Generation . . . Helping Your Aging Parents
by Carol Abaya, M.A.
Are you juggling doing errands for your aging parents, your children, yourself and working at the same time? Are you tired, stressed out and upset that your once vibrant parent is now frail and needy?
Do you feel alone? Rest assured you are not alone! The Sandwich Generation is dedicated to the 50 million Americans who may have elder/parent care concerns and/or responsibilities.
HOSPITALS CANNOT ARBITRARILY DISCHARGE YOU
Question: My mother, 82, had pneumonia and was in the hospital only three days. The hospital discharged her - against our wishes - and now she is back in the hospital very, very sick. We're very upset.
Answer: You have a right to be upset. Hospitals cannot legally discharge a person if the family and/or doctor oppose it.
Medicare beneficiaries have the right to dispute a perceived early discharge from a hospital or acute care setting. A Medicare beneficiary, whether through direct Medicare or an HMO, is guaranteed the right to file an immediate appeal if the family feels the patient is not yet ready to return home or be moved to a lower level of care.
When a family informs the discharge planner that "I am going to file an appeal of discharge" the discharge process stops and the family is not responsible for the cost of the additional time in the hospital while the case is reviewed. The appeal must be filed by noon of the day following the notification of discharge or the right to appeal is waived.
After an appeal is filed, the case is reviewed by an independent physician. The hospital and Medicare beneficiary will then be informed of the decision.
Each state has a different name for the agency that handles the review process. They are generally called "Peer Review Organizations."
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Question: My father, 83, has terminal cancer. We've asked the doctor how long he might live. He refuses to answer our questions. We have a right to get answers.
Answer: Medically speaking it is very difficult to project how long a person might live with terminal cancer. So it is very difficult to give a specific time frame.
For hospice help purposes, the criteria is that the person "probably" has less than six months, given the normal (whatever that it) progression of the illness. Even that prognosis can't account for an individual's condition and frame of mind. Many live longer than any one would have thought, often because they have a positive state of mind and have been happy people. And others go quicker than projected, sometimes because of their negative state of mind coupled with the illness.
In a study from the "Annals of Internal Medicine," less than 40% of doctors said they'd give a candid survival estimate. In 23% of cases, doctors said they wouldn't give patients any estimate, even if specifically asked. 75% said they'd paint a recovery picture more positive than they actually believed possible.
Do ask more questions, and try to get the doctor to talk about all the prognosis indicators.
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Question: My husband, 67, has terminal lung cancer. We want to keep him home. I can't do everything myself. Is there help?
Answer: Medicare will pay for home hospice care. Your family will get task help as well as great emotional support.
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Do you have a question? Send it in. Although letters cannot be answered individually, appropriate letters will be answered in this column whenever possible. Letters may be edited. Send letters to Ms. Carol Abaya, c/o Name\Address of YOUR newspaper (or mail direct to her at PO Box 132,Wickatunk, NJ 07765-0132) or e-mail her at SandwchGen@aol.com. Carol also has a web site: thesandwichgeneration.com.
Carol Abaya is an international-award-winning journalist and creator of the unique magazine The Sandwich Generation: You & Your Aging Parents.
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©2002 by Globe Syndicate, all rights reserved.