Parents caring for the parent support thread (Part 1)

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1721

<p>dragonmom, I understand both the sides of your parents’ sale. And I echo that it is WELL worth it to get a professional estate sales person in. It took me quite a while to find a person in Mom’s small town, but eventually i got someone. Ask around in lawyer offices that specialize in conservatorships… turns out that when the court takes control of a person, they hire out the estate sale and the people who do it have to account for their pricing so they get good at it.
Our sale hasn’t happened yet, but the sheer relief of having someone else take stuff to good will or decide to sell it (and for how much) was just SUCH a relief.</p>

<p>This was my grandma’s house that they moved into in 1965 and Mom moved into in 1979 when she divorced Dad. … LOTS of memories there, too. The market is too depressed to try to sell, so we will rent it hopefully, once it is cleaned out and up.</p>

<p>And in the good news even though it is bad news category, Mom’s long term care insurance finally kicked in. They pay a flat rate, but it helps a lot right now. Is it cynical to think they held off paying until I just paid one more annual premium?</p>

1722

<p>esobay -
Congratulations on getting the LTC insurance to kick in, your perseverance is paying off.</p>

1723

<p>Good for you esobay!</p>

<p>So, I guess I knew the “honeymoon” wouldn’t last with my parent’s new situation. I got a call from the retirement center about several incidents that were noted with both my parents. They have “noticed.” Nothing serious at this point, but they want to discuss how home care and the clinic can get involved. This is good news in a way as it shows the place they are in are very attentive. But, I was hoping independent living would last for quite some time. For now, I think it will be assistance with meds. Apparently my dad “doesn’t see a need” for his Alzheimer’s meds. Fortunately, they now understand my sense of urgency for them to see my mom and check if any meds can be removed/added to help with her rapid cognitive decline.</p>

1724

<p>GT- I am sure that there is also a new environment that they have to get used to. Adding home care sounds like it would be helpful and necessary.</p>

1725

<p>A while back I mentioned I had trouble figuring out what to do with my mothers mail now that the temporary time (6 months) is up for forwarding it to us. I was afraid some mail like medicare info would be missed. This is an FYI for anyone else that wants to give it a try. </p>

<p>After investigating multiple times on the internet web sites of both social security and medicare of how to change a mailing address but not a physical address, I finally called them. Medicare told me that all changes had to be done through social security ( also on the website). Social security told me that they do not recognize POA and that they have their own version of it, which only allows one agent only. We discussed my mother situation and the representative told me there are four regions of medicare and that I was not in the region- if I tried to change the mailing address to me - I would not want to see what mess that would cause. He recommended if at all that my brother is several states away but in the same region. I really don’t want to do this, since I have been handling the medical stuff. </p>

<p>I also figured out that if I put in a change of address permanent to me for her mail that after one year the the mail received would get the new address sticker sent to them for the next 6 months- at which time social security would get this and then assume a change of address and possibly put her money on hold.</p>

<p>I also asked about a PO box (mine) instead of a physical address and he said that the PO box must be in the same location as her home address.</p>

<p>Oh joy, I decided to go with temporary extensions with a gap between them, as required, would be the best option. I don’t anticipate much important mail coming in as most has been changed over by us already. I am hoping she keeps the mail that comes her way in the gap times.</p>

<p>The phone wait on hold was 30 minutes but the phone conversation was very pleasant.</p>

1726

<p>I can’t remember if I’ve posted any of this, and I’m too exhausted to go back and look, so forgive me if some of this is a repeat.</p>

<p>Starting 5 or 6 weeks ago (I think), my dad had a rash of falls, at least 6 over the course of a month, and 3 in the space of one week. In the last fall, long story short, he broke his ankle. That weekend I had a conversation with his Assisted Living and they felt they simply couldn’t keep him safe any more, and that’s obvious to me too. We had to first get him out of there immediately, and then start looking for a higher level of care. </p>

<p>So Dad’s been in skilled nursing for 10 days (private pay, since there was no 3-night hospital stay), pending a visit to the orthopedist and a frantic search for housing. We’ve been working with a senior placement person who has led us to a couple of attractive Board & Cares. We were about to pull the trigger on one of them, planning to move Dad as soon as this weekend and Mom within the month. But the ortho visit today changed everything once again. </p>

<p>He needs immediate surgery, it turns out, and that’s scheduled for tomorrow. When he’s discharged, I’d guess he’ll be in a cast for 6 weeks or so, and then will need really intensive therapy for some weeks since that much downtime will have atrophied what little muscle he has. </p>

<p>For a small, compliant person, I can see that a B&C might be able to manage this, but Dad is neither. First, he’s a tall guy and can bear almost no weight and assist only feebly with only one arm. Transferring him from, say, bed to wheelchair is like moving a 6’2" 180-lb bag of sugar, and every transfer today required two people. I don’t see how one female aide at a B&C is going to be able to manage him. Second, he is determined to get out of bed and walk around. Even today after they’d splinted him, he was saying, “I’ll have to figure out how to walk with this thing.” The only way they’re keeping him in bed at the hospital is with a bed alarm and room camera on him. So it seems to me that he’s going to be too much to handle for a Board & Care until he’s recovered and at least somewhat rehab-ed. But that’s just my guess – does anyone have more knowledge?</p>

<p>In the meantime, I guess our search for a Board & Care is on hold for now. Mom is fine to stay at AL until Dad’s ready to go to a B&C. I do see a couple of silver linings to this new wrinkle. If I can persuade the hospital to keep him for 3 nights, then skilled nursing will be covered by Medicare. And our search for new housing can proceed in a slightly less panicky way than it has been for the last week.</p>

1727

<p>I hope they will keep him for 3 days Las Mas. They did do that when MIL broke her femur. So what is the difference between Assisted Living and Board and Care?</p>

1728

<p>You have been through quite a bit with your parents. Try to speak with the case manager at the hospital asap. They can start to work on rehab placement. Bring documentation of the falls and assessment from the AL. Is your dad in the hospital now? I think that he should be kept for the 3 days. His stay in rehab will give you a litttle breather to arrange future placement. Discuss this with the case mgr. at the hospital and also at the rehab facility, they may know of some options that you can explore.</p>

1729

<p>My MIL is probably about 180-200# and it AHmazes me how well these little tiny, often Philippino, girls can transfer her by herself. MIL had a bad fall a few years ago and broke her ankle so badly that it was touch and go whether she would lose the foot, as in amputation. She is no help in the transfer, no instincts and no ability to recover from any wobble.</p>

<p>If a certain level of care is indicated, don’t rule it our based on assuming they cannot transfer him until you speak to them.</p>

1730

<p>LasMa, make sure they ADMIT him into the hospital. Mom was in the hospital for 4 days under “observation” and that limited us to where she could be moved for rehab. Hospitals like to use the observation code because they get paid more money from medicare (?).</p>

1731

<p>LasMa, Do they know why your father is falling? My mother had some incidents with falling and her doctor “prescribed” an eight week session with a physical therapist. It really helped her with her balance, and was good mental stimulation as well. Of course it sounds as though your dad has a long period of recovery ahead, probably including PT for his injury.</p>

<p>All assisted living (including board and care) facilities in California are required to have a doctor’s assessment of potential residents before they are accepted. It is the responsibility of the facility to determine whether they can provide adequate care. Your dad doesn’t sound unusually large, the staff should be able to manage him. It’s amazing how professional caregivers use leverage to move their clients about, they are trained for that. </p>

<p>I spoke with a caregiver agency representative recently and she said that quite a few of her staff are working in assisted living facilities providing extra care for people at risk for falls. The facilities check on residents every 2 hours, but if someone is falling a lot they either have to move or hire an independent caregiver for more frequent oversight.</p>

<p>GTalum, I think board and care is usually in a single family residence with only 4-8 residents and a full time staff. Lots more individual attention without the institutional atmosphere. It’s a very good option for Alzheimer’s patients too.</p>

1732

<p>Question for all of you who have been through this. Grandma (97) goes into nursing home under the Medicaid, then transfer to Medicare space bed in different facility (though after 8 months she is still “being approved” under Medicare). Grandma is then transported from nursing home last night to hospital, semi-conscious. She is given fluids for dehydration and IV antibiotics for a severe bladder/kidney infection. Today she looks better than she has the past several months in nursing home. Hospital says they will keep her probably 3 days and then back to the nursing home.</p>

<p>Is she still a Medicare patient or does the clock start over because she’s been in the hospital 3 days? Does she have to go back to the home she was in? If we wanted her moved to a different nursing home, how does that process work?</p>

1733

<p>Class2012 - My understanding is that the clock starts over as to the 90 days. I am sure she can be moved to another home, but there are only so many that allow Medicaid patients. </p>

<p>Some good news in meeting with the folks at my parent’s retirement center, they get a free 90 days in the rehab/nursing home in addition to the medicaid eligible services. It will certainly help in situations in which they are sick, but not admitted to the hospital.</p>

1734

<p>momsquad, the falling is a combination of things. He has poor balance and coordination, he has dementia and forgets to use the walker, he’s in denial about how bad off he is, and his stubbornness and male pride come into play as well. When I asked him just yesterday why he continued to try to walk when every doctor, nurse and PT told him not to, he said, “How will I know how much I can do unless I push myself?” Then he told me that he knows his own body better than the orthopedist does, so he can disregard doctor’s orders. I also think there’s an element of game-playing here. I really think that any time he gets away with walking without the walker, he feels like he’s “won” something, and if he falls, that’s the price he’s willing to pay for victory. </p>

<p>So this is the “logic” we’re dealing with, and it’s not going to change, ever. There is zero chance he will ever use the walker, do the exercises, listen to his doctors, or use common sense to keep himself safe. He must have a minder close by, 24/7, which AL simply can’t do.</p>

<p>He was having a PT come in twice a week, but he won’t do the exercises in between visits, so it wasn’t helping at all. He did have a doctor’s evaluation when he came into the AL, but that was 3 1/2 years ago, and none of us foresaw the extent of the deterioration which he’s had, both physical and mental.</p>

1735

<p>Thanks, GTalum. </p>

<p>Can I just say how much this elder care sucks? One should not be in tears because your loved one did not die and therefore has to return to the pee-smelling, soul-sucking hell that most nursing homes are.</p>

1736

<p>classmom. hugs. And it isn’t even the pee-smelling etc that is really the cause of the tears. My Grandma had Alzheimers and my mom took care of her in Grandma’s home. Grandma lost her speech, wore diapers, … and when she got a blood clot in her leg, Mom had to face the debate for trying to fix it … or not. Result was that Grandma had to be tied to bed because she never knew that her leg was cut off. No one should hope that a clot moves out of the leg to the heart either.
And now Mom is in AL, not at her “home”. But she has happy days and did attend my niece’s wedding in July. Nevermind that she called last week asking when we were picking her up to take her there.
“Love is the only house big enough for all the pain.”</p>

<p>edit to add:
LasMa I agree that you should get the hospital senior service people AND social person of the AL place involved ASAP. They will tell you the ins and outs of the tricks for medicare and insurance. Their expert help really can make $100s if not $1000 of difference. And if you know your insurance agent at all for the medicare supplement, involve them. Sometimes they have different ideas of ways to interpret 'rules".</p>

1737

<p>^^ LOL, I like your edited to add, eso. I just spoke with the case manager, and they are keeping him until at least Saturday, so that will be the magic 3 nights. No battles necessary this time. Whew!</p>

<p>Class and eso and anyone else who needs it this morning – group hug time. It is indeed soul-sucking. And love is the only place we can now live with them. Thank you for that quote; it’s beautiful and true.</p>

1738

<p>Took D2 down to see my parents for a few days this week, since they missed her HS graduation due to mom’s stroke. And… they were pretty awful. Dad accused us of pulling up trillium in their yard after D and I spent a couple of hours weeding in the hot sun (we did NOT pull any trillium, we know what they look like and were very careful – there were none in the part of the yard he was complaining about to start with). :frowning: Mom criticized our hair, clothes, makeup, etc. in rotation every day. When she wasn’t (loudly with the windows open) talking about the “fat neighbors”. Sigh.</p>

1739

<p>Well intparent you said you expected the insults. i guess just because D knew the comments were coming and blew them off does not mean she will want to run back to visit anytime soon.</p>

<p>i got to the point with my mother who is also very critical and down right mentally abusive at times, that i visit her alone. i realized D’s seeing her did no one good and i came just to look after her. she also makes terrible comments about 'F-A-T 'people like they can not spell!</p>

1740

<p>eso, I wanted to tell you that I visited my dad at the hospital this evening, and I thought about the house of love quote. All the problems and irritations fell by the wayside for a little while, and I was able to just enjoy him. Tomorrow I’m taking Mom out for brunch, something we do far too seldom, and I intend to take the house of love with me for that too. Thank you.</p>