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Assistance with hospital bed/not swallowing
Lelematos
Posted: Tuesday, February 13, 2018 10:30 AM
Joined: 2/19/2015
Posts: 9


 Hi good morning,

 I am new to this my father has Alzheimer’s and it seems to me that it’s progressing. I am very ignorant to this horrific disease. But I have some concerns with my father he just recently is starting to drool and won’t swallow his saliva. we have to constantly remind him to swallow he is having a hard time getting up and down from anywhere(bed, sofa, chairs). I just asked his doctor if he can help us out with getting him a hospital bed. If anyone can please give me or help with any information. It will appreciated. What is the process with the hospital bed with the doctor? With swallowing I don’t know what else to do. His neurologist said to cut his sleeping pill in half? Will that even help... please anyone out there with any info???? 


ruthmendez
Posted: Tuesday, February 13, 2018 10:51 AM
Joined: 9/8/2017
Posts: 1140


hospital bed:  I would request prescription from doctor and check online medicare DME suppliers https://www.medicare.gov/supplierdirectory/search.html and call nearest supplier if your father has medicare.

I did the exact thing for a hoyer lift and transport chair for my father, my father only has medicare. 

If your father has other insurances it might be quicker for the doctor to get it for you, but I really don't know.

It took a while for me to get the equipment I needed because the doctor's office system was down for two freaken weeks and then I had to wait for the doctor to fill out the forms the supplier needed for him to fill out and send back to get medicare approval.

 

 


Marta
Posted: Tuesday, February 13, 2018 11:25 AM
Joined: 6/3/2013
Posts: 619


From the few details you have provided, it seems your father may be ready for Hospice (unable to swallow properly, unable to get up).  Ask your father's PCP - s/he can order Hospice.  A hospital bed would be delivered likely on the same day your father qualifies for Hospice.
Jo C.
Posted: Tuesday, February 13, 2018 11:40 AM
Joined: 12/9/2011
Posts: 8879


Hello Lelematos; there are a couple of different issues here.   I will discuss hospital beds first as you have asked and there are many readers who also need such information; but I will write a second Post about another approach.

Your father will fit criteria for a hospital bed because of his inability to swallow and his likelihood of aspiration.   For coverage, he will need the bed to be elevated at least 30 degrees or higher and pillows to do that are ineffective.

Also, hospital beds that allow the height of the bed to vary are covered for patients that require this feature to permit transfers to a chair, wheelchair, or standing position.

A semi-electric bed is covered for a patient who requires frequent changes in body position and/or has an immediate need for a change in body position.  (Your father immediate changes in position secondary to aspiration and choking would be your rationale.) 

The doctor must prescribe the hospital bed AND he MUST document the reasons:  Inability to swallow and aspiration and need for the head of the bed to be at 30 degrees or higher and permitting transferring the patient as well as need or immediate changes in position.   You will also want to be sure the bed is ordered through a durable medical equipment provider that accepts Medicare assignment.  If you do not, you will have to bear the costs up front.  You can call DME companies near you and ask which ones have an agreement with Medicare.  They can also help to direct you.

As for costs; every year, in addition to your monthly premium, you will have to pay whatever amount Medicare requires out of pocket; like a deductible, and then 20 percent of all approved charges if the provider agrees to accept Medicare payments.  

Medical equipment providers are not allowed to waive this 20 percent or your deductible without getting penalties from Medicare. There are allowanced for financial hardship.

  • If you have a supplemental insurance policy, that plan probably picks up this portion of your responsibility after your supplemental plan's deductible has been met.   You can check the supplemental insurance coverage.
  •  I will write a second Post responding to the salive/swallowing issue and more.

    J.


    Jo C.
    Posted: Tuesday, February 13, 2018 11:58 AM
    Joined: 12/9/2011
    Posts: 8879


    Our wonderful Marta beat me to it; her advice is spot on.   If your father is far along in his disease process, and it sounds as though he may be, Hospice may well be your best answer to necessary care, equipment and support.  

    Hospice can be wonderfully supportive and they do pay for all medically necessary durable medical equipment; wheelchair, hospital bed and even a patient lift if one is required, and for medications that are for the principal diagnosis that was the reason for admission to Hospice care.

    You will have an RN assigned to your father, a bath aide two to three times a week to bathe your father and conduct hygiene including shaving and light housekeeping of the patient area; you will have an assigned Social Worker as well as a Chaplain if you would like one.   You and your family will also receive much support.  Medicare covers this and it can really be a wonderful service.

    However, if by some chance, your father is not at that level of care need but has swallowing issues, then there is a different approach.  This happened with my mother; she had swallow difficulty for more than a year before she was Hospice certifiable and needed evaluation as she was not yet a Hospice candidate.

    In such an instance, one would want to have a swallow study done.  This is conducted by a Speech Therapist in an outpatient radiology setting.  The patient sits on a guerney; nothing touches the patient.  However, there is a fluroscope in front of the patient, and while the Therapist gives small amounts of water, applesauce, cracker, etc. she/he can observe the tongue, mouth, chewing, swallowing, etc. all the way down.  This then enables the Therapist to identify just what the issues are.

    One does NOT put a Loved One through such a study if the patient is a Hospice candidate.

    From what you have written, it appears that your father may well fit Hospice criteria.  You will need a doctor's order for this, and sometimes a family will call various Hospice agencies to get a feel for which one they like best first, and the Hospice can then call and get the doctor's order to come out and evaluate your father.

    This is a difficult time and hard to know what to do; but if you put it in the hands of the professionals, you will soon have things in order for both yourself and your father.

    Please do let us know how you are and how things are going; we will be thinking of you and we truly do care.

    J.


    Lelematos
    Posted: Tuesday, February 13, 2018 9:56 PM
    Joined: 2/19/2015
    Posts: 9


    @Jo. C Thank you so much for the information i appreciate it. Its so helpful getting feed back from other people that are going thru the same thing..
    erivey
    Posted: Wednesday, February 14, 2018 9:21 AM
    Joined: 1/14/2018
    Posts: 3


    We have recently begun hospice for my mother and it has been a godsend! She has become basically immobile and they have supplied a lift, hospital bed and specialized wheelchair, along with extra nursing and aide support. She too is experiencing to swallowing/eating issues. You will not regret contacting hospice.
    Lelematos
    Posted: Wednesday, February 14, 2018 1:24 PM
    Joined: 2/19/2015
    Posts: 9


    @marta Thank you for the information..
    JJAz
    Posted: Wednesday, February 14, 2018 3:12 PM
    Joined: 10/21/2016
    Posts: 1797


    Don't forget to interview as many Hospice companies as you need to so that you find one that is compatible with your needs.  Also, you don't need to wait for Doc's orders to call Hospice.  Call them directly, explain your Dad's situation and they will send a nurse to do an assessment.
     
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