How do we get the HMO to work with us?
January 8, 2006 7:20 PM Subscribe
My parents are members of an HMO, but our dealings with them have been frustrating, and we need help. (*Catheter references inside.)
posted by evil holiday magic to health & fitness (6 answers total)
My parents are members of a popular HMO, and my mom has multiple sclerosis. She has been luckier than many who have it, but a product of it is that she's been catheterized. She's been good about flushing the hose with saline, but sediment from her vitamins and medications does cause it to eventually clog -- usually earlier than the monthly schedule issued by the HMO.
When she first started the catheterization program, my parents would go off to the hospital (exposing themselves to germs) to get the catheter changed. A nice nurse later revealed to us that all along my mother was qualified to have a nurse come to the house to do it when necessary. This worked well for a while.
More often, however, we end up with a nurse (we'll call her the 'bad nurse') who we don't think has much regard for us. We were told by a couple nurses at the HMO that the standard change schedule is one month, and anything off that schedule must be requested on a case by case basis.
* On several occasions, my mother's made requests for changes, only to have days pass, before my father (who received a perfunctory training on this) finally had to change the catheter himself late after work.
* We've asked several questions of the the bad nurse, only to get contradictory answers. We've checked up on simple requests we've made for standard supplies (which she agreed to) only to find that they were never followed up on.
* I noticed the bad nurse's case notes were completely wrong regarding the nature of my mother's incontinence.
* My mother has complained that the nurse's method of installing the catheter is painful/disturbing by comparison to that of the other nurses.
* My mother's questions or comments are often met with unexpected accusations of her not taking her medications.
We want to get a different nurse to come in (several kind and gentle nurses, who've gotten along well with my mother and the rest of us, have offered to be the one to come here each time), but the 'bad' nurse also happens to be the case manager, and is the most local to us; so even when we request someone other than the bad nurse, from her superior, we often end up with her anyway.
We don't know what our rights or options are, and the bad nurse is stonewalling us.