Cost of nurses

[Alex123]

Dave, the information you are providing me is very useful. I didn't know about indeed.com. I will check the papers of my Kaiser plan because I remember them saying that if I got tracheostomy it would not cover nursing care for that. Thanks again Dave.
Alex

 

[Dave K]

Hospice care is any care needed for patient comfort. A tracheostomy does not disqualify a patient from hospice care if it is prescribed as a comfort measure to permit suctioning of pulmonary secretions that the patient's cough is too weak to expel.

 

[lgelb]

Oh, Dave, if only. On the other hand, someone has to pay for what you get.

Payors have a much narrower definition than yours, as do the agencies themselves.

Take idealism out of it; some hospices and some SNFs will accept a trached pt and some won't. As always, inquire. And you are not going to get a [life-extending] trach while in hospice.

Anyway, Alex, you're miles from hospice as well as any trach decision. I think you started this thread to talk about help at home. End-of-life care reimbursement and policy is evolving, so best to keep up to date while not planning too far ahead.

 

[Dave K]

Laurie, you have no cause or basis to correct me. Alex and I are both California Kaiser members. I'm sitting right next to a Kaiser hospice patient with a trach, 24-hour in-home nursing, and 42 hours per week home health aide care. (The hospice was forced to get extra staff from an outside agency.) She is laughing and watching the Ellen Degeneris show on TV. Did we fight for it? Yes. Was it worth it? My wife's smile says it all. Please stop telling people I am unrealistic. This is very real and I know exactly what I'm talking about. Leave negativity to the claims adjusters. We can beat them, because the power of positive thinking will always win.

 

[Alex123]

Thanks Laurie and Dave, I am taking my time on these things, but it looks like I need to do the planning myself. Right now I can still move my hands and in my opinion this is the right time to start getting as much information as I can. When the time comes, my wife is not going to understand enough about all this to be able to make good decisions for me. My disease is progressing and not very slowly, which is consistent with my age of onset. I have read that weak neck muscles are an indicator of more rapid progression. And my neck muscles are almost gone.
If I can have an alternative way to breath and postpone the tracheostomy I would do it. But we don't know what's going to happen.
I will check the Kaiser health plan to see what it says. I can imagine that depending on what the employer has negotiated with Kaiser, the plan may be have some differences compared to other Kaiser plans. Thanks again for all the information you have provided and I hope this can help other people looking at this thread to.

 

[lgelb]

It is precisely because more than Cali Kaiser members with trachs/slow progression/time/inclination to fight the battles you have, will read this, Dave, that I am adding broader context to what you have said. I'm happy that you and your wife have achieved what you have. But other people have different battles to fight on different fields. And whatever happens to Alex, despite your having the same MCO, may be different as well.

--Laurie