Beyond Palliative Care – A Best Buy

The past week has been a difficult one for Cindy’s care.  In the wake of her coming off hospice I had to make decisions regarding her Medicare coverage and procurement of a hospital bed.  The bed we were using had been rented through hospice from Doyle’s Medical Supply.  The agencies associated with Cindy’s care were displeased with Doyle’s for “double dipping,” as our case manager at CCCI called the situation, which caused the “Scottish” in me to look for alternate solutions.

Under a private program one could rent a bed from Doyle’s Medical for three months, then pay a buy out price, or rent the bed for a full year to own.  Having been placed in a hospice program, Medicare instead paid the rental for the bed we used for 55 months.  The “double dipping” that irked our case manager and others involved Doyle’s Medical getting paid for the cost of the bed many times over through Medicare, then seeking to charge us directly under their private rental guidelines.

Unhappy with this arrangement, I initially went with an offer from a friend in town to use a hospital bed she owned for as long as needed. The problem with this solution was the inconvenience to Cindy of breaking down one bed and putting up the other on the same Thursday.  As we grew closer to Thursday I grew uneasy about this solution, pinching pennies (hundreds of dollars actually) when I should be putting Cindy first.  Then on Wednesday, the day before the switch would be made, Cindy came down with a fever.  That convinced me to buy out the bed already in place from Doyle’s Medical, so as not to disrupt her.  That is when this post started percolating in my mind.

I “compromised” a little on costs by using the gel mattress our friend could provide, in lieu of the alternating pressure mattress I would otherwise buy out from Doyle’s.  That led to colossal misfortune.  By Friday a large red area appeared near her coccyx and by Saturday Cindy had open sores.  I called the VNA to come in for a visit and bought a brand new alternating pressure mattress from Amazon.

The irony in this is that Cindy’s open sores may place her back on Medicare supported visits from the VNA, though hopefully we can get her wounds closed up soon now that I have her back on the right mattress.  I fancied Cindy’s lack of skin problems over these past few years was due to my attentiveness: the diet I provide, the outings in the sun with the stroller and the immediate treatment of small red spots that occasionally appeared.  I was shocked and humbled to see how just one and two days of being bedridden on an ill-suited gel mattress could deteriorate the skin.

Other caregivers beware!  In Cindy’s advanced state of deterioration I know her skin heals more slowly than for most of us, but good grief!  Even if you anticipate yourself being bedridden for only a few days an alternating pressure mattress may be one of the best purchases you can make.  The hospital bed I will try to donate to somewhere needed when this is all over; the mattress and motor I’m keeping. You just never know.

The Scottish in me insists upon providing one other lesson.  I bought the new alternating pressure mattress and motor from Amazon for $51, just a fraction of the cost for buying the hospital bed and something I was glad to do.  Doyle’s Medical had offered a buy out price of $90 for essentially the same mattress, except we already had used and rented the motor for 55 months.  Read those numbers again and determine how you may want to include or exclude Doyle’s Medical Supplies from your own caregiver strategies.