Today I spoke to the social worker and case manager at Sharpview. They think that Aetna will try and discharge Jim very soon. He has only been there for 3 weeks. But, he still needs maximum assistance. So, according to insurance logic that means he should be discharged to languish at home.
I can't move Jim by myself. He needs a special airbed that raises and lowers. He needs a hoyer lift to get put into his wheelchair. And he really needs daily physical and occupational therapy. Not to mention catharization and a bowel program...
I don't know why the insurance companies just don't hand out suicide pills when they pull this stuff. I don't know how I will be able to care for Jim at home. I guess Aetna would let us have a home health aide a couple of days a week. Maybe they'd let him have a physical therapist come to the house occasionally - with no equipment, of course.
The sad thing is that he is actually getting better and progressing slowly. But his progress isn't fast enough for Aetna. All the doctors and therapists have told us that the recuperation period is at least a year. In the past TIRR used to keep spinal cord injuries for over a year.
The staff at TIRR told me to take one day at a time and not to buy a special van or install ramps in my house. I guess they were totally wrong. I'll have to scramble to get these done before Jim comes home.
Tomorrow we have a meeting at Sharpview. If Aetna doesn't kick him out this week, then we will have to face this threat every week from now on. There is an insurance review every week.
The good news: I am not crying and totally distraught. I am very upset but I'm not just feeling numb.
In 2 years Jim will be eligible for medicare. If the Republicans leave medicare alone, then Jim will be able to get better care. Insurance companies require big jumps in functionality but medicare acknowledges the smaller steps in between. I guess that's why skilled nursing facilities are just full of old people. Private insurance boots out the younger people. Who says we don't need national health care?
I don't see the senior citizens rallying to repeal medicare. Medicare works and it is a national health insurance program. Who would be crazy enough to sign a "repeal the health care bill petition?"