Insurance running out

Daisy7July 22, 2008

I'll try to be brief. I have no place to turn. Maybe somebody has had to deal with this?

Brother, age 47, has waged a battle with cancer for the past year. He's done all the chemo, all the radiation, there is nothing left to try. After six months, he went back into the hospital, and they found it had spread to his brain. They gave him radiation to keep it from swelling, which left him deaf in one ear and blind in one eye. Then they sent him home.

He fell several times, cut his arms and they got infected with MRSA. Back to the hospital.

They did surgery on his arms, they are cleaning and dressing them twice a day.

Now the hospital tells us the insurance has run out. They can keep him three more days.

His wife won't take him home. Even if she did, hospice has told her they won't do wound care. It's not the kind of care a lay person can do. He has to be heavily medicated first.

The nursing homes in the area won't do wound care either.

Can the hospital just put him out on the sidewalk? We siblings can't do anything... the wife has the control....

I've tried researching the hospital website and can't find anything dealing with insurance or indigent care.

Can somebody offer some advise? Please....

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Hospitals have people who can counsel with you about problems like that and I have forgotten what they call them. I was told I could talk to one of them when I had a problem with my husbands care. check that out and see what they recommend.

    Bookmark   July 22, 2008 at 4:29AM
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Remind yourself over and over again, that while you feel a moral obligation to your brother, you DO NOT have a financial responsibilty, so don't look at that route.

And No, the hospital won't put him out on the sidewalk. That's just not done. So don't worry about that. The wife will be billed for it. If she won't take him home, he will be cared for in the hospital. The Social Services or some similarly named Department will advise her as to the best course of action. If this were to be a long term condition, it would be one thing, but his time is running out.

Your definition of "Wound Treatment" may not be what it really it. The wound would be kept clean, bandaged, etc at a Hospice or nursing home, But it would not be TREATED with the view of curing it. The hospital treatment of wounds is to cure. In his condition, cure is not going to happen.

I know that this seems so hard for you, but it is a common thing. The patient has no money and no where to go. Therefore he stays at the hospital. At some point, he will be eligible for State Aid. Now is the time for HER, not you, to start the ball rolling, filling out applications, etc.
The wife may feel that it will end very soon and there is no point to trying to cope with it herself.

    Bookmark   July 22, 2008 at 9:50AM
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I thought of another thing that the wife may not know about. Some States have a medically indigent program, that is, it will pay the bills for those that are not really indigent, but have medical bills much higher than can be paid. She needs to find out if your state has one and what she would have to do to enroll him.

And I hate to mention this, but if they own their own home, the hospital may expect her to take loan out on their equity.

Would care is a tricky thing. Even under the best of care, they don't get better. Reading your original post, I am assuming that you are talking about Hospice at home. I can't believe that a hospice that takes in patients would not care for a wound on a terminal patient. If he needed to be sedated, he would be. It's not unusual to have non-healing wounds on that type of patient. They couldn't (and wouldn't) just let them lie there without care. That's not what Hospice is about. Hospice Home care works a little differently. Sedation to dress the wound would require staff oversight that usually wouldn't be available in the patient's home.

    Bookmark   July 22, 2008 at 10:13AM
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Thanks to you both for taking the time to help me.

Stargazzer, the siblings have met with those people but ultimately, the decisions have to be made by the wife. Which btw, is MIA. She has abandoned him. She wants nothing to do with the situation or the family, won't answer our calls. Yet she will not authorize any of us to do anything because it will make her look bad in her town. We are god-smacked by it all.

Agnes, indeed it is wound care. Sorry for the confusion. And yes, it was Home Hospice. Since your answer, I have tried to find Hospice Homes in Little Rock Arkansas or the surrounding area, to no avail but I will tell my sister who can check with the hospital.

Thank you both.

    Bookmark   July 22, 2008 at 12:46PM
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I don't think they can make her take out a loan on her home, I think all they can do is put a lien on it. The home can't be taken by anyone except the IRS or the mortgage company. She also should see if a division of assets will work in this case.

    Bookmark   July 22, 2008 at 7:29PM
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stargazzer is correct. I wasn't thinking all the way about this. They would probably take a lien against the house and if she died or sold the house, they would come first before the family would see any money.

This is such a difficult situation for a family. Legally, the wife will be the one responsible for him.

    Bookmark   July 22, 2008 at 9:31PM
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The family could also hire an attorney and go to court, if you can prove that she has abandoned him. Someone else can be appointed guardian over him, this does not mean they are taking on financial responsibility, just over seeing his care. Talk to an attorney, talk to the Social Worker at the hospital, stick together as a family and this can most likely be worked out.

    Bookmark   July 23, 2008 at 6:41AM
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modern life interiors

lindajewell is right about the guardianship route.

Make sure one of the siblings is appointed not the wife. She is handling his care badly.
Guardianship supercedes any paperwork she might have. power of attorney, etc.
The wife might be stressed out from this dilemma which means she is incapable of deciding what is best for her husband.

In other words she could be detrimental to his health.

The worst is when the state steps in and takes over. (protective services for adults.) God forbid!

Look for an eldercare lawyer.

There are pro bono lawyers (no fee) who specialize in this sort of thing.
Income and assets don't play into it.

You might find an organization or an association that might help you.

If your brother is in ny I can make referrals.

This is who might be able to help at the worker, patient advocate.

If the hospital decides to send him home request the form to appeal the decision.

They will keep him there until a decision is made from higher ups at the hospital.
The decison can take awhile.
This has nothing to do with insurance.

You can also file complaints against the hospital thru a regulatory agency. They might stop the whole discharge.

    Bookmark   July 24, 2008 at 2:01PM
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If he is still alert and mentally capable, wouldn't he have the capacity to give his medical power of atty to one of his siblings? The same thing would hold true for any power of atty, if his wife deserted him. He can simply have an atty draw up the new documents and sign them. Of course, this assumes that he still has his mental faculties.

    Bookmark   July 24, 2008 at 5:01PM
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I have forwarded all info to my sis. Everything suggested up to gitangnoel's post had already been done. Hospice House told them they would only accept him for his final two weeks (how would they know that) and the lawyer they contacted told them to save their money because of the length of time it would take. Social workers, patient advocates have been of no help.

I have forwarded the info re the eldercare lawyer and the rest.

Londondi," Of course, this assumes that he still has his mental faculties." Sadly, he does not. He only recognizes my sis at times, since she has been with him so much, and our other brother even less, who has also been with him.

Will let you know what happens. Thanks all.

    Bookmark   July 24, 2008 at 5:24PM
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My advice is to get another attorney, pronto! If the wife indeed is not taking care of him the hospital can and will notify the state, in which case the state will appoint a total stranger as do not want that!! State appointed guardians do not and will not look out for the patient like family does.

    Bookmark   July 24, 2008 at 5:40PM
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modern life interiors

There is an arkansas section on their forum. There is also arkansas guardian forum on that website.

    Bookmark   July 24, 2008 at 6:34PM
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Very sorry you all are in this kind of situation. I will be thinking of you all.

    Bookmark   July 24, 2008 at 7:40PM
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Wanted to do an update.

I forwarded all your answers to my sis, and I don't know yet what worked or why, but they are keeping him in the hospital and re-evaluating him every week.

Blessings on you all.

    Bookmark   July 29, 2008 at 11:51AM
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