<p>Oh. My. God. LVKris: Do you know my mom? In the past my mom has called the local senior/low income bus for rides to the mall, etc. I will admit that the public transportation where we live now is lousy compared to where we used to. And you have to call 24+ hours in advance for a ride. And that’s tough for her. Because suppose she’s tired. Or she’s having cramps and has to have a bowel movement. You just never know. </p>
<p>She hasn’t called in 2 years. Because according to my mom, the lady who answers the phone doesn’t like her. They cancelled on her the last time she made an appointment because they didn’t have enough drivers & they give preference to people who have to get to work and/or have a doctors appt. And the time before that they apparently showed up (we think to a different building in her apt. complex) didn’t see her & left. So that means that the lady who answers the phone has it out for her and it’s not worth calling. Plus, you know, sometimes they don’t answer the phone right away, and then you get that menu: press 1 for this, press 2 for that. Who has time for that?</p>
<p>My BFF & I have decided our #1 deciding factor when we move to our “last” house will be proximity to consistent and convenient senior transportation.</p>
<p>Well, sometimes transportation can and does change from when you start out to what it becomes a budgets get cut. It seems important to have enough money to have options and be able to hire cabs or whatever you need to get where and when you need, as that is more reliable than services that depend on city budgets.</p>
<p>My MIL won’t even apply for the transportation service for the disabled that she’s surely eligible for – because she’s heard from random strangers that the bus or van or whatever it is doesn’t come on time, makes lots of stops, elderly people wet themselves because they’ve been on the bus for so long while it makes all these stops, etc. She can go on at length about the horrible service of this thing she’s never actually tried. We say, “well, why don’t you try it for yourself and if it really is that bad, of course you wouldn’t have to take it?” But that would be too reasonable.
So we say, “Okay, then take a car service to the doctor.”
“No! It’s much too expensive!”
“We’ll pay for it.”
“No! It’s too expensive! I won’t let you waste your money that way.”</p>
<p>No, she’d much prefer that we waste our time. It seems reasonable to her that my husband or I should spend hours in traffic to come to her neighborhood to take her to the supermarket, rather than that she should pay a couple of dollars to have groceries delivered.</p>
<p>Yes, it is exactly the same with my mother. We tried years ago to set her up with the local transportation service but she heard someone comment in a doctor’s office that they waited almost an hour to be picked up so she refuses to even consider using it. It is so frustrating.</p>
<p>Seems as though the transportation thing is universal. </p>
<p>When my mom and dad sold the car (under duress, of course) I suggested they open a separate account and use it for taxi rides (you can get a lot of taxi rides for the price of a Buick LeSabre). </p>
<p>When my other elderly couple sold the car (under duress, of course) I suggested the same thing. </p>
<p>Both accounts still have all the money (less some that was used for NON transportation expenses).</p>
<p>Meanwhile, I am driving my vintage Toyota Sienna with 200,000 plus miles to take these four goofballs to appointments. </p>
<p>Of course they hand me “gas money” but really what they should do hand me the money in both accounts so I could buy a new car. Sometimes I do get a little resentful.</p>
<p>My father used to drive himself to the hospital with chest pains or pneumonia symptoms. I think he didn’t want to “bother” with an ambulance. Or pay for it? Whatever. He would go to the emergency room and then call my brothers (who lived in the same town) to tell them he was there.</p>
<p>Of course, he was never allowed to drive himself home after one of these hospital stays, so it meant an extra person to pick up the car. </p>
<p>:rolleyes:</p>
<p>Now he’s moved to senior living and I think the car is about to go away.</p>
<p>My folks both have cars and both drive. In fact, for a while they had four cars, each of which cost more than all our cars combined. Mom was just in a car accident (not her fault - she was rear-ended by a SUV with such force it plowed her into the SUV in front of her) which totalled her brand new car that had less than 700 miles on it. Fortunately, they opted to just keep the money from the insurance from the totalled car, since now that they have given away a car, they are now down to just two cars. </p>
<p>Fortunately, they do “allow” us to drive them far distances and at night. Mom also has a new friend who is about 10 years younger and enjoys driving. She drives mom & another friend all over the island. Mom just has to drive herself from our home to and from a shopping center which is less than 3 miles from her home to meet the friends.</p>
<p>Mom is my hero–she started putting 3 WEEKS after the accident and at 4 weeks was back to playing golf and pretty much her regular schedule which includes exercise with friends, walking an hour/day, golfing 4x/week, and other activities. The fractures really didn’t keep her down long at all; the doc pressed against all of them at her 3 week check and she didn’t grimace or complain, just mildly commented that the fracture sites are “a bit sensitive.” Thanks for asking, ECMx2!</p>
<p>Can someone plz explain the differences and similarites between board certified pain mngmt docs and board certified palliative care docs? We are being offered a palliative care consult under hospice mngmt and the rehab claims their pain mgmt doc provides palliative care whereas the hospice folks (associated supposedly w/ the rehab but obviously there’s some turf stuff underway) want to send in their own doc as a clinical subspecialty for a review of meds. They claim their care (basically if i understand it their use of strong morphine) would be better than the vicodan oxy routine mom is on as she transitions from a true rehab patient to one who is chosing comfort care.</p>
<p>So we have a set of doc’s prescribing for mom in the rehab and another set of doc’s can be called in on a consult to shift the med’s around supposedly making her less sleepy but still comfortable. Why is this one set of doc’s vs. another? Why is it a fellowship and board certification for one style of pain med vs. another? I’m confused and struggling to be compassionate towards the medical system that seems to be jerking us around while my mom is dying.</p>
<p>Hospice seems to be a dirty word to mom so palliative might just be more pallatable.</p>
<p>While I can’t speak to the specifics of your situation, Hugcheck, I have navigated hospice drs. interfacing with skilled nursing and assisted living care and trying to prevent turf battles. Pain management while maintaining wakefulness and minimizing confusion proved a moving target for one of my relatives. I found it helpful to hear different points of view and treatment options to arrive at the best result. I also found my knowledge of patient’s history and medication reactions was useful to the physicians. I always framed it in a collaborative way, presuming cooperation amongst all parties. If additional input would have required something of our frail patient, I weighed the cost/benefit of energy exertion on her part. </p>
<p>This should not be a competition. That said, I understand how those assuming primary, daily responsibility for a patient would want to be comfortable with the treatment plan they are implementing. Sorry I can’t address the differing certifications precisely, though it seems that palliative care could include aspects beyond pain management. It is possible that what will matter most is the individual providing the information and how they approach it. No matter who is driving the care, there can be a bit of trial and error to find the right balance. Best to you. These are trying times.</p>
<p>I said the words “assisted living” to my mother-in-law last night, and for the first time ever, she did not freak out. Her Medicare-supplied homecare will end soon and then I think I am going to have to hire an aide privately for at least one day a week. She doesn’t really need help with getting dressed, showering etc.; what she needs is company, help with laundry and shopping, and a little light cleaning. These aides are really not ideal, though. She’s been through four of them at this point. One was great, one was crazy, two were okay. They all get sick or find better jobs or decide they can’t deal with the commute (their commutes always seem to take hours and involve multiple subway and bus transfers). I don’t think they have issues with my MIL, because I think she is pretty nice to them, probably overly nice. They tell my MIL sad stories about their boyfriend troubles and she tells them to lie on the couch for a while. I know they make very little money and I’m sure their lives are hard, but still.</p>
<p>Oh Hugcheck - I am so sorry to hear how difficult this has been for you. </p>
<p>Simpkin - do you have a Visiting Angel agency in your area? We have been very pleased with the one in our area. They interviewed me before picking people to assign to my other elder responsibility and because someone would be coming every day picked two women to alternate to minimize in the hope that if one were not available the other could fill in.</p>
<p>Our state also has a “Meals on Wheels” program where people volunteer to drive & deliver meals to homebound SRs. They often offer some companionship along with the meal and may be one of the few forms of interactio these SRs receive during the day. It can be pretty lonely for them, especially if they’re not up and around much.</p>
<p>She won’t go for Meals on Wheels; I don’t know why but she is adamantly opposed to it. The agency we are working with now is called the Visiting Nurse Service of NY, and they seem to be pretty good. The actual visiting nurse is wonderful, and they also send a psychiatric nurse and a social worker. Unfortunately, this is all coming to an end. I believe the homecare aides come from a different agency that works with the Visiting Nurse Service. Things with my MIL seem quite stable for now, but I worry about what happens when all this support goes away.</p>
<p>Simpkin- If you are pleased with the Visiting Nurse Service, they may be able to recommend an individual or private agency that does in-home care. Also, a local assisted living facility may have good suggestions for reliable, certified people to help. It is hard to predict how elders will fare with less support. My approach is usually to have resources in place, with an understanding that it is easier to back off on help than procure reliable assistance in a crisis. Many areas have “aging in place” resources or Councils on Elders that could provide ideas. Good luck with the transition.</p>
<p>simpkin, she sounds more like a candidate for Independent Living than Assisted Living (at this point). You may want to take her to visit one or two. She might be pleasantly surprised.</p>
<p>Once again I owe my brother for being there to help, while I’m living in comfort and ignorance out of town. :eek: I called my father to say hi and found he was at Urgent Care for 3 hours this afternoon because his back hurt so badly from a fall last week.</p>
<p>He thought his back was fine and x-rays showed nothing, but it hurt so much today he called my brother to take him to the doctor. I bet that was a fun Sunday afternoon. :(</p>
<p>My father isn’t in “assisted living”…he just has daily assistance from his sons. Don’t know how long they can keep this up.</p>
<p>Mommusic - at least you appreciate and acknowledge what your brothers do! My sister-in-law lives out of state and she is very, very appreciative of all that my DH does for his mom. She makes sure when she is in town to take on at least one big project to give DH a break. That means a lot to the two of us since we are the ones on call for the routine stuff.</p>