Ask Mike - I want to be able to nurse my daughter
Dear Mike,
I have a 28 year old daughter with epilepsy and learning disablities.
She has had a Licensed Practical Nurse (LPN) for 8 years that has been caring for her. I just found out that I can care for her instead of the nurse who is not the best choice for our daughter. I went through the requirements asked of me and the Nursing brokerage had me signed on to start. I have been denied from the Ohio home care program. My daughter has been nearly seizure free and I have been the person to train the nurses anyway. We want to take her care level down from nurse-to-home health aide. The reason quoted on my denial papers read: Personal care aide services are not medically necessary, consumer needs can be met with Skilled Nursing Services.
The nurse we have now is overweight and has already had 2 nervous breakdowns and is heading towards the 3rd. I do not want to go through having a stranger back in my home. I want to care for her and do the things that since her recovery, have made her more aware and alert and able to do more active things rather than sitting in front of the TV after I leave for work.
Help. What should I do for this hearing?
Thank you,
Caring parent
Dear I can nurse,
I am sorry I cannot always respond, nor guarantee a response, quickly enough to help in certain situations such as your hearing. Have you already had the hearing? I will share some ideas, that if not useful for your hearing, may be helpful in understanding the situation.
From your message, it appears that your daughter's disabilities are not physical in nature, but rather are cognitive/intellectual disabilities and health related disabilities. If this is so, then the problem could be a question of the purposes of the various programs.
It appears that the purpose of the LPN services you have been getting is to monitor the health status and safety of your daughter as it relates to her seizure disorder. Also, even though the person providing the direct assistance is an LPN, I strongly suspect the she is supervised by an RN. This is why it is called skilled nursing. There is an RN supervising the service.
Personal Care Aide type services are often services designed to assist with Activities of Daily Living (ADLs). ADLs are usually defined as assistance with bathing, dressing, grooming, toileting and transferring. Other ADLs can include such things as, assistance with mobility or getting around, and assistance with incontinence. Typically these ADLs are further defined in terms of functional limitations with physically performing these tasks. Some more progressive states are including needing assistance with supervision or cuing of these activities, but many programs are only for physical assistance. In other words, unless your daughter has physical disabilities, she would not be eligible for the PCA program. From the reason quoted on the denial letter that you shared, I suspect that this is the case.
If this doesn't help with the hearing, I hope it helps you with understanding the situation a bit more.
Yours very truly,
Mike Oxford