I hope not to offend anyone out there, but I would appreciate some feedback on taking care of young to middle-aged adults who are on medicaid. It seems that so many (I realize not all) are some of the most difficult patients to care for; they often are rude, demanding, and unappreciative of nursing care. I have cared for many who demand tests/procedures/an extra day or two in the hospital/supplies that they don't really need; doctors often admit to just giving them what they want, rather than arguing. I have had medicaid patients say to me after I suggest to them, they can probably purchase an item for cheaper at the store, "Oh I don't care, I'm on Medicaid". Recently, a woman openly admitted that she had another child because she wanted more Medicaid money. When a woman has six kids by different men, and lives off Medicaid, I asked myself, "how does this happen"; aren't there people out there monitoring this system". About a year or so ago, I was taking care of a woman - and because the census was extremely low, patient-nurse ratio was 2:1 (unusual but nice). Anyway, I took so much extra time visiting with, caring for and going way beyond what I really needed to do to ensure quality nursing care, and at lunch, her Diet Pepsi wasn't on her tray. She gets on the phone and proceeds to rant and rave about this to a friend. I could hear her end of the conversation. Yes, she was a Medicaid patient.
Wow, I was blown away and got quite upset. I can't believe these are isolated incidences. Many nurses I work with are able to identify Medicaid patients just by their behavior.
As I said earlier, I don't mean to offend, but I am interested to learn if others out there in the nursing world encounter the same type of thing. I realize it is not right to label or generalize people, and I don't let it affect how I care for people; I certainly don't like the way I feel when confronted with this behavior. Any responses are welcome.
In my experience, I havent but have you ever seen a nursing home or state Medicaid program take a $100,000 + home from someone? Do they then sell it?
MANY times over! They will put a lein on the property then auction it off and when the money from the auction runs out (which is usually pretty quick) then Medicaid will kick in.
This is what the Adult Protective Service social workers are sent out to do. They have signs up to "report elderly abuse and exploitation" and they give a list of reasons to call and report. Next step is to make a "visit." In the case of my father-in-law (who suffers from dementia with episodes of psychosis) she came out under the pretext that she wanted to see if he was being properly medicated and if he qualified for any government programs. Of course, this lead to needing information about assets, bank accounts, etc. and pretty soon we had to get a lawyer to stop the harrassment. I've posted about our experience ad nauseum so I won't bore you with details.
Also, what has happened to family responsibility.... the kids can't take care of mom, can't pay mom's bills, yet want to be able to inherit mom's property, without paying a red cent and shoving the responsibility onto the government.
I know that elder care is difficult...my own mother drives me nuts, weighes too much for me to care for. Literally well over 350 lbs, refuses to diet, refuses to exercise, and will not throw anything away even if she is no longer able to use it. I have the regular tiffs everytime I clean house, take the plastic to be recycled (well, the religious needs butter dishes to do crafts.......9 monthes ago~!!!!), try to throw out stained and damaged beyond belief clothing ( well, maybe the service center needs those underclothes - Mom, they have blood stains - but their still CLEAN!!!!!!!), throw out leftovers (thats probably still good ...at 6 weeks old). She is deaf as a post and refuses to wear her hearing aids. And last time that she had surgery, she insisted on getting up without help, despite me telling her not to, fell on the floor and ended up having to get EMS plus the police department to get her off the floor.
But I do not expect for the government to pay for her nursing home care if she needs (and she probably will), and fully expect that her assets would be sold if she needed assisted care. I may hope to get the money that I have put into her house back, but I certainly expect that the bulk would go to pay her bills, when I am unable to physically care for her.
What you accumulate in your life should be considered part of the payment for your expenses when you no longer are able to work, with the government paying only when major assets are exhausted. And that already occurs, as is right. One does not have to like it, and again, the right thing is not the easy thing.
But in 31 states the government not only expects the old person to exhaust their resources but their children as well.
Their children will qualify for Medicaid before they need it.
The tides are turning and times are changing and not for the better. The more I think about it the more depressed I get.
You can't help others when you can't help yourself. What worse fate can a person have than to become a burden to society?
Specializes in Med/surg,Tele,PACU,ER,ICU,LTAC,HH,Neuro.
The only thing that aggravates me about medicaid patients stems from when I worked as a pharmacy tech while in nursing school. When patients would come through the drive thru in their 60,000 dollar mercedes or bmws and be on medicaid. Now how the hell did they pull that off? And then they get upset when their over the counter meds aren't covered. Kiss my rear! I had no insurance at the time and had to cater to these liars. It really upset me.:angryfire
Yeah, it is common. I like the grocery checkout stand, some families buy poor nutrition food with food stamps and then have lots of cash to buy cigerettes, candy, and high grade booze.
My cart consists of canned tuna,spam, mac and cheese.
Specializes in icu, er, transplant, case management, ps.
'Are we talking medicaid or medicare? When I worked homehealth
Medicaid was much stricter than Medicare. It was near impossible to get a quadraplegic a new wheelchair.
What I would like to know is how they know these people, in their supermarket line, have Medicaid. You don't have to show proof of Medicaid in order to use food stamps. And to be perfectly honest, it is no one else's business what I purchase, be it using my own money or food stamps. No one appointed anyone of you to supervise my purchases or anyone else's. If you feel the need, why not comment on those rich people who are overweight or eat diets that are not good for them. Or not part of their treatment plan, ending up in your hospitals sicker. But wait, they pay their own way, don't they. So I guess it is all right for them to make the same mistakes.
And I've said this before, if you see someone driving a $100,000 car who received Medicaid and food stamps, why the heck don't you turn them into the appropriate authorities. You must know the restriction on their assets. NO ONE CAN OWN A $100,000 car or even be making payments on it, and received either food stamps or Medicaid. And if they are, they are cheating and you have a responsibility to turn them in as well.
the idea that the children of those who are in need of nursing home care are lazy worthless sapsuckers
these people for the most part are part of that dreaded sandwich generation..they have children at home or in college, they have not finished paying for their own home, they are trying to make provisions for their own retirment, if the parents of one or both of such a couple becomes unable to care for them selves they are not in a position to for one to quit the job and care for the parent and they may not not have the skills to handle a ill person
we are many generations from the 'walton' where the extended family lived together under one roof and canning a few extra stuff from the garden took car of everyone
Specializes in icu, er, transplant, case management, ps.
one suit of clothes doesn't fit everyone
the idea that the children of those who are in need of nursing home care are lazy worthless sapsuckers
these people for the most part are part of that dreaded sandwich generation..they have children at home or in college, they have not finished paying for their own home, they are trying to make provisions for their own retirment, if the parents of one or both of such a couple becomes unable to care for them selves they are not in a position to for one to quit the job and care for the parent and they may not not have the skills to handle a ill person
we are many generations from the 'walton' where the extended family lived together under one roof and canning a few extra stuff from the garden took car of everyone
AAAHHHH the good old days. Just put a few extra on the barbie and you can feed a family. I'll be right over for dinner.
Along these same lines, I had a pt the other day come in for a repeat c-sec. The resident comes in, says about 3 words to the parents, and walks out. Dad looks at me and says "he is not doing this by himself is he?". I assure the dad a very experienced doctor will be assisting with the section, he is reassured and all goes well. Later, I was relaying this story to some co-workers, and got a total of three responses that went like this "Well, they are Medicaid pts, they shouldn't have a say in who does the surgery. When you are getting it for free, you take what you can get"..............Needless to say, I was really ticked off. Even thought I am new at this hospital, I felt the need to say something about this. I probably ticked someone off, but jeez! And we just know that they go to the health dept. for care, not that they don't have insurance. I'm sure not ALL hd pts have Medicaid. Anyway, thought I'd vent a little!
Along these same lines, I had a pt the other day come in for a repeat c-sec. The resident comes in, says about 3 words to the parents, and walks out. Dad looks at me and says "he is not doing this by himself is he?". I assure the dad a very experienced doctor will be assisting with the section, he is reassured and all goes well. Later, I was relaying this story to some co-workers, and got a total of three responses that went like this "Well, they are Medicaid pts, they shouldn't have a say in who does the surgery. When you are getting it for free, you take what you can get"..............Needless to say, I was really ticked off. Even thought I am new at this hospital, I felt the need to say something about this. I probably ticked someone off, but jeez! And we just know that they go to the health dept. for care, not that they don't have insurance. I'm sure not ALL hd pts have Medicaid. Anyway, thought I'd vent a little!
I heard a doctor call Medicaid patients charity cases. I'm really disgusted by the lack of compassion and human decency toward poor people.
And it is so ridiculous it isn't even funny to hear about all these people driving Mercedes and wearing brand new designer clothes coming to the office on Medicaid. When I had my daughter I was on Medicaid and left the hospital in a $40,000 pick up truck.
It wasn't my truck.
And many of the people here should be ashamed of themselves, who, like I said before, are no doubt a few paychecks away from needing to be on Medicaid themselves.
Jo Dirt
3,270 Posts
MANY times over! They will put a lein on the property then auction it off and when the money from the auction runs out (which is usually pretty quick) then Medicaid will kick in.
This is what the Adult Protective Service social workers are sent out to do. They have signs up to "report elderly abuse and exploitation" and they give a list of reasons to call and report. Next step is to make a "visit." In the case of my father-in-law (who suffers from dementia with episodes of psychosis) she came out under the pretext that she wanted to see if he was being properly medicated and if he qualified for any government programs. Of course, this lead to needing information about assets, bank accounts, etc. and pretty soon we had to get a lawyer to stop the harrassment. I've posted about our experience ad nauseum so I won't bore you with details.