What are our options when comparing tilt-in-space wheelchairs?
We have an elder in our family in the late stages of Alzheimer's/dementia + frontal lobe brain tumor, currently living in Skilled Nursing Facility (SNF). The past 5 months have been multiple hospitalizations, including 1 for pneumonia that he didn't "bounce back" from very well. After the pneumonia hospitalization, he has been in a loaner wheelchair from the SNF. He's weakened to the point that he cannot sit up straight and slumps over while sitting, therapy is no longer any help, this is just where his body is at. Due to the slumping, he has managed to toss himself over a couple times, landing on his head. SNF not allowing a seat belt because it is considered a restraint. The SNF has asked the family to purchase a custom-built "tilt in space" wheelchair costing $4,000-4,500 new, all private-pay! A used one, retro fitted, would cost @ $3,500 we've been told. There is NO insurance/Medicare coverage for this item. Anyone else had this dilemma? What are your thoughts -- is it really worth it at this stage in the game?
With Hospice I got a Broda Chair. It had a mesh seat and back so it allowed for air circulation, it did have full cushion on it so it was not just webbing. But that chair could be tilted back, had "wings" at the upper portion of the back so that it would keep the head and trunk supported. It could be tilted back in numerous positions. I am sure that Hospice could provide something like that.
If you do not want to contact Hospice a chair like you are talking about could probably be "rented" and paid for by Medicare if it were Doctor's order.
There is also another chair that I had from Hospice, it did not quite "fit" my husband and that was when we go the Broda Chair. The other chair is called a Geri Chair. Both good chairs and adjustable.
All sorts of Geri on market from the fat recliner ones to sleek bariatric with fold out table (think airline seat meets school desk) styles & all on wheels. Most Under 1k new. There's also Geri bathing chairs that are fiberglass clamshell with drainage slots & grab bars.
My mom at her NH fell pulling her wheelchair, shattered a hip & became bedfast and went onto hospice. Hospice ordered both regular Geri & bathing Geri for her along with specialized bed & pneumatic mattress. All are "rented" equipment by mediCARE under Medicare hospice benefit. If he can get hospice, they can arrange for items like these but will come from already vetted list of vendors who take Medicare. So you don't get to select style. My mom was on hospice 18 l....o.....n....g months and her equipment got swapped out during this period. So I imagine there exists a "used" equipment market that you could shop from as well if dads not hospice eligible.
Anyway, if the nursing home wants him to have one, why don't they get it? Why are they asking you to take responsibility for something that's not your responsibility?
Another question, why hasn't the insurance buying it if he really needs it? It sounds to me like something fishy is going on and I personally would call your relative's insurance provider and check into this. The question I would ask after giving the patient info is, "do you cover an item called the tilt in space wheelchair or?" If they say yes, then the nursing home lied and they're just trying to get more money out of you through fraudulent practices. You may not be the only one they're doing this to either so definitely do your homework. Another thing to check out is if the insurance may not have preapproved this item, because if they didn't, they won't cover it, (especially if insurance like Medicare or Medicaid has limited funds or going broke). If funding is limited which I think is probably true due to the various signs pointing in that direction, that explains why they don't cover much. However, if they do have the money and won't spend it, it may very well be that they may still be under limited funding and your items they need approval. This is why your item should probably be preapproved by whatever insurance you have and it would probably be a good idea to call the insurance customer matters and speak to a live operator. If on Ohio Medicaid, you can ask for member matters when you go through the automatic robo prompts. They will most likely ask for your member ID if you're on any program under Medicaid such as care source, united healthcare, etc. When you get to the point of expressing your concern, just ask them if they cover that item and tell them your nursing home approached you and said this person needs it but you don't have the money for it and neither does the patient. If they do cover it, they'll probably say it needs preapproved and they'll tell you how to get it approved if it's prescribed because there are certain paperwork that needs done by the doctor and it needs submitted to the insurance. It may also turn out that you could probably get insurance to lease you the item until the patient passes. I would check into these particular options but it's not your responsibility to be paying out-of-pocket for a very expensive item that cost as much as a new car, especially if you happen to be hurting financially.
Ray has lymphedema which means the blood pools in his legs and they swell.
So the chair I bought also has a Zero Gravity position and 60 minutes daily in the ZG position keeps the blood flowing back to the heart. At 96, we do whatever we can to keep him mobile.
I know, we all become a font of information. One day at a time.