General Medical issues thread

[Seat0B]

Well mum has had a better week. She responded well to a further round (5 days) of IV antibiotics and has finally started the rehab program this morning. We watched her intake physical assessment on Friday and could only agree with the physio's assessment of 'very low' physical capabilities. They have started suggesting that we look ahead to the likelihood that mum will not meet the safety requirements to return to her home.

This is making me very annoyed, progressing to angry and now closing in on enraged with other family members. At the beginning of the year, I thought mum was already getting pretty marginal for staying at home, and said I would go to the local residential care facility and put her on the waiting list. My sister hit the roof and said absolutely not, mum wants to stay at home. My daughter and my niece (mum's power of attorney holders) also said that I should not do that. I was bullied into not doing what I thought was right. For heaven's sake, it's a waiting list, not a compulsory evacuation! If she got to the top and did not want to go, she would not have to go. But if you are not on the list and need to go, you can't go. As soon as the dust settled after the stroke, I again suggested it might be a good idea to put her name down. Again, I was howled down by my sister - you are so negative, you are writing her off, give her a chance to recover, she does not want to go to a nursing home, you will have to respect that. The granddaughters started to waver though, as her decline and various physical deficits were starting to become obvious to them. I probably should have just done it at that point, but I was stressed, bullied and also I have been quite sick for 3 weeks now with a cold type thing that just will nor go away. So I didn't do it then either.

Well guess what, now I deeply regret my inaction. The physio said - this is how it will go. She's unlikely to meet standard to live independently. She's already been here for 4 weeks (plus 1 week in the public hospital), and soon her insurer will give an ultimatum - discharge or start to pay yourselves. No one can afford that. So we (the hospital) will try to find her a place in a nursing home, and we will almost certainly fail to do so. Next step is we will try to persuade the public hospital to take her back. Problem is, she isn't really a hospital case now - no medical issues, just old age and needs care. So they will likely refuse. Then you will be under pressure to take her home and sort it out later. DO NOT DO IT. You may have to 'abandon' her at the hospital so they have no choice but to admit her until a nursing home bed can be found. Of course in return, you will have no choice about where the facility is (could be up to an hour's drive to the other side of town), or the quality of the place, by then you will just be glad to accept anything. So get onto it now and maybe something better will happen in the (likely) 2 weeks she now has before all this kicks off.

All my recalcitrant relatives now think it is a good idea for me to put her name down at a few places. What a total cluster f#$k that is too. Here's the paperwork we did for my dad, just for one home, because of course, they all have different forms, don't they.



I am looking into using an aged care placement consultant as I just cannot deal with it. But of course, that will cost money, which mum could afford. However, I am starting to suspect that my sister has a bit of an eye to her inheritance. I will not be getting anything from mum's estate when the time comes - I have no need of it and asked her to leave it to Seat Daughter and Seat Son.

 

[blackcat20]

Well mum has had a better week. She responded well to a further round (5 days) of IV antibiotics and has finally started the rehab program this morning. We watched her intake physical assessment on Friday and could only agree with the physio's assessment of 'very low' physical capabilities. They have started suggesting that we look ahead to the likelihood that mum will not meet the safety requirements to return to her home.

This is making me very annoyed, progressing to angry and now closing in on enraged with other family members. At the beginning of the year, I thought mum was already getting pretty marginal for staying at home, and said I would go to the local residential care facility and put her on the waiting list. My sister hit the roof and said absolutely not, mum wants to stay at home. My daughter and my niece (mum's power of attorney holders) also said that I should not do that. I was bullied into not doing what I thought was right. For heaven's sake, it's a waiting list, not a compulsory evacuation! If she got to the top and did not want to go, she would not have to go. But if you are not on the list and need to go, you can't go. As soon as the dust settled after the stroke, I again suggested it might be a good idea to put her name down. Again, I was howled down by my sister - you are so negative, you are writing her off, give her a chance to recover, she does not want to go to a nursing home, you will have to respect that. The granddaughters started to waver though, as her decline and various physical deficits were starting to become obvious to them. I probably should have just done it at that point, but I was stressed, bullied and also I have been quite sick for 3 weeks now with a cold type thing that just will nor go away. So I didn't do it then either.

Well guess what, now I deeply regret my inaction. The physio said - this is how it will go. She's unlikely to meet standard to live independently. She's already been here for 4 weeks (plus 1 week in the public hospital), and soon her insurer will give an ultimatum - discharge or start to pay yourselves. No one can afford that. So we (the hospital) will try to find her a place in a nursing home, and we will almost certainly fail to do so. Next step is we will try to persuade the public hospital to take her back. Problem is, she isn't really a hospital case now - no medical issues, just old age and needs care. So they will likely refuse. Then you will be under pressure to take her home and sort it out later. DO NOT DO IT. You may have to 'abandon' her at the hospital so they have no choice but to admit her until a nursing home bed can be found. Of course in return, you will have no choice about where the facility is (could be up to an hour's drive to the other side of town), or the quality of the place, by then you will just be glad to accept anything. So get onto it now and maybe something better will happen in the (likely) 2 weeks she now has before all this kicks off.

All my recalcitrant relatives now think it is a good idea for me to put her name down at a few places. What a total cluster f#$k that is too. Here's the paperwork we did for my dad, just for one home, because of course, they all have different forms, don't they.

View attachment 516502

I am looking into using an aged care placement consultant as I just cannot deal with it. But of course, that will cost money, which mum could afford. However, I am starting to suspect that my sister has a bit of an eye to her inheritance. I will not be getting anything from mum's estate when the time comes - I have no need of it and asked her to leave it to Seat Daughter and Seat Son.

We used one of those services when my grandma needed to go into care. She was mostly ok at home until she had a fall and got an ABI. She was passed around various hospitals and rehab facilities, but once we got the broker involved, she was into a private care home close to home very quickly. It took a lot of the stress and uncertainty out of the situation.

 

[cove]

Well @Seat0B we had to get my wife’s mum into care and we used a consultant for that. The $3,000 fee was worth it and we had a referral that was great advice. We are in Perth so no help for you unfortunately.

 

[Flyfrequently]

Oh @Seat0B , will they be the ones picking up the slack if your dear Mum does go home? I think not.

My suggestion would be approach the physio that you had the discussion with and ask if they could have your above mentioned conversation with the POA +/- your sister, as they do not understand the gravity/unlikelihood her her meeting the standards for Independent Living and the scenarios of leaving acute care.
And yes, health funds do get narky for extended care.
It would not be the first time they would have heard pushback in family members.

A very stressful time on many levels for you and hope that you get over your pesky bug and give yourself some space and self care
Agree, that having a consultant do the hard yards is a very good suggestion.

 

[Katie]

Another vote for engaging a consultant/broker. My Mum and her siblings did for my Grandma 4 or 5 years ago after Grandma had a fall, went to hospital and they would not let her go home.
There may be better homes out there, but this one is 2km away from my Mum's house, and maybe 5km from my house. The brokers also know all the ins and outs of paperwork, My Aged Care, etc.

 

[Beer_budget]

Well mum has had a better week. She responded well to a further round (5 days) of IV antibiotics and has finally started the rehab program this morning. We watched her intake physical assessment on Friday and could only agree with the physio's assessment of 'very low' physical capabilities. They have started suggesting that we look ahead to the likelihood that mum will not meet the safety requirements to return to her home.

This is making me very annoyed, progressing to angry and now closing in on enraged with other family members. At the beginning of the year, I thought mum was already getting pretty marginal for staying at home, and said I would go to the local residential care facility and put her on the waiting list. My sister hit the roof and said absolutely not, mum wants to stay at home. My daughter and my niece (mum's power of attorney holders) also said that I should not do that. I was bullied into not doing what I thought was right. For heaven's sake, it's a waiting list, not a compulsory evacuation! If she got to the top and did not want to go, she would not have to go. But if you are not on the list and need to go, you can't go. As soon as the dust settled after the stroke, I again suggested it might be a good idea to put her name down. Again, I was howled down by my sister - you are so negative, you are writing her off, give her a chance to recover, she does not want to go to a nursing home, you will have to respect that. The granddaughters started to waver though, as her decline and various physical deficits were starting to become obvious to them. I probably should have just done it at that point, but I was stressed, bullied and also I have been quite sick for 3 weeks now with a cold type thing that just will nor go away. So I didn't do it then either.

Well guess what, now I deeply regret my inaction. The physio said - this is how it will go. She's unlikely to meet standard to live independently. She's already been here for 4 weeks (plus 1 week in the public hospital), and soon her insurer will give an ultimatum - discharge or start to pay yourselves. No one can afford that. So we (the hospital) will try to find her a place in a nursing home, and we will almost certainly fail to do so. Next step is we will try to persuade the public hospital to take her back. Problem is, she isn't really a hospital case now - no medical issues, just old age and needs care. So they will likely refuse. Then you will be under pressure to take her home and sort it out later. DO NOT DO IT. You may have to 'abandon' her at the hospital so they have no choice but to admit her until a nursing home bed can be found. Of course in return, you will have no choice about where the facility is (could be up to an hour's drive to the other side of town), or the quality of the place, by then you will just be glad to accept anything. So get onto it now and maybe something better will happen in the (likely) 2 weeks she now has before all this kicks off.

All my recalcitrant relatives now think it is a good idea for me to put her name down at a few places. What a total cluster f#$k that is too. Here's the paperwork we did for my dad, just for one home, because of course, they all have different forms, don't they.

I am looking into using an aged care placement consultant as I just cannot deal with it. But of course, that will cost money, which mum could afford. However, I am starting to suspect that my sister has a bit of an eye to her inheritance. I will not be getting anything from mum's estate when the time comes - I have no need of it and asked her to leave it to Seat Daughter and Seat Son.

I'm so sorry you're dealing with this, especially with family being unhelpful. Mum has dealt with similar with my grandparents earlier this year, except Qld Health were happy to find my grandmother an aged care bed - just no promises it would be anywhere nearby! We got very lucky that the first available bed was only one town over and not in Toowoomba, but it also took a month. Same thing, it was premature to be putting them on waiting lists and then all of a sudden it was too late and there was a panic about it and of course the three sons are all being useless, except to help "tidy up the house" by claiming the things they want.

 

[drron]

I am very afraid I am going to run into this problem in the not too distant future. Mrsdrron did not handle my hospitalisation well. Withdrawn,sits on the lounge and eats like a sparrow.

 

[Quickstatus]

Thank for the update @Seat0B
Are you the POA?

But if you are not on the list and need to go, you can't go.

Correct. Unfortunately family can get into an emotional fog and not think properly

soon her insurer will give an ultimatum - discharge or start to pay yourselves.

Thats what happened to my mum. She could not cope at home.
She would forget to take her meds for her rheumatoid and then her mobility decreases and joints become too painful
Admission to hospital emergency to sort it out because she started to fall and had new pains in other areas.
Pills getting given by the RN instead of her remembering to take. Suddenly she feels better - I wonder why.

Medical issues sorted within 2 weeks (which were several not just the rheumatoid but included a hospital acquired UTI plus a chest infection)

Public hospital then wanted to send her home. We said no, so they transferred her a lower tier public hospital then private hospital.
We transferred her to the Private after the lower tier hospital said nothing more acutely needs to be fixed. Go home or start paying the hospital fees. It was not possible to change status to private as public hospitals do not give priority just because the patient is private.
So I pulled a few strings with the friendly Geriatrician at a private hospital where I worked and we did the musical chair thing of discharging from the public hospital and then direct admission to the Private hospital.

This was actually to delay the discharge out of hospital but I wanted another occupational therapy assessment and we had not yet completed the NH paperwork and the Services Australia paperwork.
The occupational therapy assessment showed that the mobility and the cognitive side was then below safe discharge home - same as the one done in the public. This was to confirm to mum that she could no longer drive. She was happy to go to a NH from the outset but she wanted to keep driving. So we got her a new iphone and showed her how to use Uber.

However, the time in hospital allowed us to complete all the necessaries for NH admission including all the paperwork you alluded to for Services Australia.
This was a big issue because we discovered she had multiple accounts stashed in all 4 banks plus several other minor banks like Bendigo, and 2 countries which she forgot about. We could have used a broker, but managed to do it ourselves.

She somehow knows about the govt guarantee of $250,000 per bank account though her money was not anywhere near that per account but she forgets to take her pills???

Eventually we got her into NH. The timing was good because the private hospital then said nothing else to be done so we again did the musical chair thing and transferred her from the Private hospital direct to the NH.

Luckily there was an opening at a good NH which we had visited at the start of the hospital admission as we had an inkling that she could not go home.
Luckily no one moved into that spot in the interim
Luckily mum had the liquid finances to pay for the RAD. She never spend much of her Defined benefit super. So it was accumulating over the years.

.........

Then when Dad visited the NH after mum moved in, he liked it and wanted to move in even though he didn't need to.
He was attracted to the idea because the NH said he could come and go as he pleased. His car is parked at the NH and he can still drive.
I advised him not to because he could live at home
So he also paid the RAD and moved in quickly - no doubt partly because the RAD was going to be 90% refundable (instead of 100%) a month later.
Possibly he is using a NH spot when a more needy person would have benefited more

.....

So we children have been very lucky Lots of people don't have the finances to pay a RAD at drop of a hat. A Nh Rad is very expensive these days. It will soon exceed $1M with refund on exit <100% . And Parents who did not resist changing to a NH and no friction among the children

 

[Pushka]

I am very afraid I am going to run into this problem in the not too distant future. Mrsdrron did not handle my hospitalisation well. Withdrawn,sits on the lounge and eats like a sparrow.

Perhaps just a visit to the GP for some assistance. Maybe reactive depression and uncertainty about the future has collided for her. She might just need some medical help and time. She's such a trooper that hopefully this too shall pass.

Dealing with ageing. We are well past that now, for over 10 years for all parents. Mum was very proactive and wanted to get into appropriate care for her issues at all the various stages which made everything easy. It's likely my sons having a battle getting me into one eventually.

When Dad was terminal with cancer he'd been treated at a private hospital. He clearly was in final stages but just 10 days into hospital the admin person started talking with mum, who was in no fit state, that she'd have to move dad into advanced care somewhere, basically anywhere but where he currently was. MrP and I had a solid talk with that admin person, and told them never to discuss anything like this with my mother again, that he would stay put until his private health cover did run out (another couple of weeks) and that we would cover the cost after that. He was already on morph drips and could not be discharged. Of course our intuition was right, he had passed within the week. But damn that bloody private hospital for trying this on my mum. It eventually went into receivership a decade later. I cheered.

 

[VPS]

Well mum has had a better week. She responded well to a further round (5 days) of IV antibiotics and has finally started the rehab program this morning. We watched her intake physical assessment on Friday and could only agree with the physio's assessment of 'very low' physical capabilities. They have started suggesting that we look ahead to the likelihood that mum will not meet the safety requirements to return to her home.

This is making me very annoyed, progressing to angry and now closing in on enraged with other family members. At the beginning of the year, I thought mum was already getting pretty marginal for staying at home, and said I would go to the local residential care facility and put her on the waiting list. My sister hit the roof and said absolutely not, mum wants to stay at home. My daughter and my niece (mum's power of attorney holders) also said that I should not do that. I was bullied into not doing what I thought was right. For heaven's sake, it's a waiting list, not a compulsory evacuation! If she got to the top and did not want to go, she would not have to go. But if you are not on the list and need to go, you can't go. As soon as the dust settled after the stroke, I again suggested it might be a good idea to put her name down. Again, I was howled down by my sister - you are so negative, you are writing her off, give her a chance to recover, she does not want to go to a nursing home, you will have to respect that. The granddaughters started to waver though, as her decline and various physical deficits were starting to become obvious to them. I probably should have just done it at that point, but I was stressed, bullied and also I have been quite sick for 3 weeks now with a cold type thing that just will nor go away. So I didn't do it then either.

Well guess what, now I deeply regret my inaction. The physio said - this is how it will go. She's unlikely to meet standard to live independently. She's already been here for 4 weeks (plus 1 week in the public hospital), and soon her insurer will give an ultimatum - discharge or start to pay yourselves. No one can afford that. So we (the hospital) will try to find her a place in a nursing home, and we will almost certainly fail to do so. Next step is we will try to persuade the public hospital to take her back. Problem is, she isn't really a hospital case now - no medical issues, just old age and needs care. So they will likely refuse. Then you will be under pressure to take her home and sort it out later. DO NOT DO IT. You may have to 'abandon' her at the hospital so they have no choice but to admit her until a nursing home bed can be found. Of course in return, you will have no choice about where the facility is (could be up to an hour's drive to the other side of town), or the quality of the place, by then you will just be glad to accept anything. So get onto it now and maybe something better will happen in the (likely) 2 weeks she now has before all this kicks off.

All my recalcitrant relatives now think it is a good idea for me to put her name down at a few places. What a total cluster f#$k that is too. Here's the paperwork we did for my dad, just for one home, because of course, they all have different forms, don't they.

View attachment 516502

I am looking into using an aged care placement consultant as I just cannot deal with it. But of course, that will cost money, which mum could afford. However, I am starting to suspect that my sister has a bit of an eye to her inheritance. I will not be getting anything from mum's estate when the time comes - I have no need of it and asked her to leave it to Seat Daughter and Seat Son.

Good luck - the paperwork is overwhelming so a consultant is an excellent idea.

 

[Seat0B]

When Dad was terminal with cancer he'd been treated at a private hospital. He clearly was in final stages but just 10 days into hospital the admin person started talking with mum, who was in no fit state, that she'd have to move dad into advanced care somewhere, basically anywhere but where he currently was. MrP and I had a sold talk with that admin person, and told them never to discuss anything like this with my mother again, that he would stay put until his private health cover did run out (another couple of weeks) and that we would cover the cost after that. He was already on morph drips and could not be discharged. Of course our intuition was right, he had passed within the week. But damn that bloody private hospital for trying this on my mum.

This is EXACTLY what happened with my dad except we did all the paperwork. He also died within days of this flurry of administrative bull dust that ate up our final days with him and caused a lot of stress.

 

[Seat0B]

I’m just back from an appointment with the GP - I have a chest infection and a sinus infection and now taking antibiotics. My BP that is usually 130/85 (I know because I am on medication and have to take it regularly) was 165/110 on the first reading and 149/92 on the second reading. He attributes this to illness and stress. No cough Sherlock!

But he is also Mum’s GP and said he will have a talk to the manager of the preferred local nursing home as he said he is hopeful there can be some strings pulled. He knows how much time and love we have put into Mum’s last few years and said that even if she does not want to go into NH, she cannot safely be sent home with bowel in continence and a history of UTIs.

Spoke to the consultant and she advised getting an interim hospital discharge report (which apparently can take quite a lot of pressure to get) and doing the Centrelink form as there will be no admission to a NH without both of those. Only then is it worth filling out individual application forms.

 

[Seat0B]

Are you the POA?

No, neither my sister nor I is the POA. This is because of historical disharmony between us - where my sister dislikes anything I say bout any topic, ever. So the POAs are my daughter (39) and my sister’s daughter (35). They have previously done a very good job, but were both bullied by my sister persistently spouting “mum does not want to go into a home. I will not countenance my steps in that direction. She’s capable of making that decision and it’s hers to make.”

I’m sure that is all true, but in my view, at some point mum’s wishes have to be measured against reality, safety and dignity. She is totally incapable of caring for herself, even on a level 4 home care package and for me I think that means her natural wish to stay t home needs to be overridden for her own benefit. And if we had put her name down earlier, there would be more choice about where she ends up, and if she did not need the place, well no damage done. Now we are scrambling + and it’s me that is doing most of the scrambling because the PoAs both work and my sister doesn’t see the need. Except that it would be bd for mum and horrible for me, I’d just let my sister take her home and deal with it on her own. Oh and BTW, my sister is to have total knee replacement in mid September. This situation is very stressful.

 

[Pushka]

I’d just let my sister take her home and deal with it on her own. Oh and BTW, my sister is to have total knee replacement in mid September. This situation is very stressful.

Just maybe should the need arise, your sister does exactly that. She might work harder to get a better resolution. And that knee replacement deferred.

 

[ellen10]

Oh dear @Seat0B , what a very stressful time you are going through and with you unwell yourself.

A friend went through similar and was getting the run around with the nursing homes
She engaged a broker?
Who seemed to able to get insider information for vacancies. The situation was solved quickly and far less stressful for all concerned.

Maybe make some initial enquiries with a broker, while waiting to see what the GP can do.

Thinking of you and sending hugs

 

[Quickstatus]

There are significant changes to NH fees from 1 Nov 2025

RAD. The NH deducts 2% per year up to 5 years from the RAD. Upon exit only 90% is returned.

The means test fee has changed as of 1 Nov 2025. It includes
1) hoteling fee which does not have a lifetime cap but a daily cap. Currently the cap is $22.15/day
2) non clinical contribution of lifetime capped at $137917 or 1460 days whichever comes first. This is $94.46 per day for the first 4 years . However the daily cap is $107.32 which means fully fee paying clients will reach their lifetime cap in 3.5 years

Services Australia determines the amount of both depending on one's "means".

The Basic daily fee remains the same at 85% of the aged pension = $72.91

....

So someone who is full fee paying will have to come up with
Day 1: $900,000 RAD or whatever it is
First 3.5 years $22.15+ $107.32+ $72.91 = $202.38 per day.
coughulatively $258540 over 3.5 years.

So approx 1.2 million at a minimum is needed to fund Nh placement if the client is fully fee paying.


After 3.5 years the ongoing fee reduces to 95.06 per day.

 

[prozac]

There are significant changes to NH fees from 1 Nov 2025

RAD. The NH deducts 2% per year up to 5 years from the RAD. Upon exit only 90% is returned.

The means test fee has changed as of 1 Nov 2025. It includes
1) hoteling fee which does not have a lifetime cap but a daily cap. Currently the cap is $22.15/day
2) non clinical contribution of lifetime capped at $137917 or 1460 days whichever comes first. This is $94.46 per day for the first 4 years

Services Australia determines the amount of both depending on one's "means".

The Basic daily fee remains the same at 85% of the aged pension = $72.91

....

So someone who is full fee paying will have to come up with
Day 1: $900,000 RAD or whatever it is
First 4 years $22.15+ $94.46+ $72.91 = $189.52 per day.
coughulatively $276,699 over 4 years.

So approx 1.2 million at a minimum is needed to fund Nh placement if the client is fully fee paying.


After 4 years the ongoing fee reduces to 95.06 per day.

I am a bit lost with some of the acronyms. What are RAD and NH?

 

[Quickstatus]

RAD and NH?

Residential accomodation deposit - the lump sum required to secure the room.
It can also be paid partly via a lump sum of progressive payments but the progressive payments have a high interest rate.

This is means tested. Clients with no means are subsidised by the govt


nursing home

 

[DejaBrew]

I am a bit lost with some of the acronyms. What are RAD and NH?

Guessing NH = Nursing Home and RAD = Refundable Accommodation Deposit? Not 100% though.

 

[Hvr]

Oh dear @Seat0B , what a very stressful time you are going through and with you unwell yourself.

A friend went through similar and was getting the run around with the nursing homes
She engaged a broker?
Who seemed to able to get insider information for vacancies. The situation was solved quickly and far less stressful for all concerned.

Maybe make some initial enquiries with a broker, while waiting to see what the GP can do.

Thinking of you and sending hugs

I know when Mum needed a nursing home we used a broker who was magnificent. The broker guided us through the process and did all the paperwork. We'll worth the cost. When a vacancy arose at Mum's preferred nursing home she grabbed it from the list, apparently it had only been there for seconds!

Rang us and confirmed we wanted it, of course we did. You then have a very short time to move into the nursing home. Again the broker assisted us dealing directly with the hospital.

The broker liaised with the nursing home re payment of various fees ensuring it was all correct, and most importantly ensured all of the CentreLink paperwork was completed.

When Mum's died I sent the broker an SMS to let her know and probably (hopefully) grab the room for another of her clients.

The broker and Mum's lawyer were total professionals working together. The broker again liaised with the nursing home to get the RAD refunded along with prepaid fees, ensuring that the money was quickly available for the estate.

My sister and I worked together which made life a lot easier for all concerned.