I've come across material that sounds pretty scary with regard to high
quads/vent users. It has to do with a discussion of the admission/transfer
process from acute care to rehab after an injury.
I quote from an article written by Suzanne Nyre and Virginia McKay of Craig
Hospital. It is in the context of preadmission screening to consider
admission into rehab, based on whether the resources are available to
provide a workable setting after discharge:
"For a patient to be discharged to a nonacute medical setting after
rehabilitation, he or she must have family/hired nursing home health care
available, financial resources for a wheelchair-accessible environment, and
durable medical equipment for life support and mobility. It is the height
of cruelty to introduce the patient and family to these options and
freedoms in the rehabilitation program, to provide that temporary life
style of increased mobility and independence, only to take it away when
lack of resources demands a discharge back to an acute hospital setting or
to an institution that cannot allow the patient out of bed, his or her
room, or the facility."
First, I want to emphasize that I consider the tone of the overall piece to
be positive and concerned with achieving the best possible result for
people.
But it also appears clear that people are making some pretty big decisions
about whether to even allow someone into rehab, based on their notion of
whether they will succeed, or just because they might be denied certain
kinds of coverage by their insurance. Which seems to mean that they'll
never even get the chance to gain strength and independence skills,
essentially locked out of rehab, and stuck instead inside a nursing home.
I expect that this happens in a minority of cases. But how, via my book,
can I help people know how to address this barrier if they are facing it?
Who of you had to fight your way to independence despite the doubts of
people having financial and medical power over you?
Feel free to respond either privately or via the list. I am searching for
usable quotes, which would not be used without your permission.
Thank you, and best regards,
Gary Karp
http://www.sirius.com/~gkarp/wheels