Local sibling has POA papers my parents created about a decade ago – it’s a question of how/when to use it. Do we need to start documenting “decision anomalies” ? We were thinking maybe finance person should be warned that this may start happening and we’d want to know.
I’ve never heard of this either.
BUT you have to be sure the place where your parent is takes Medicaid…and hope that a Medicaid bed is open. Where my mom was, the Medicaid folks were on a different floor than the full pay folks.
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Yikes.
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My father is currently using up the end of his money doing a spenddown before the skilled care facility switches him to Medicaid. He had been full pay at his AL for several years and I guess that is counting. He will only be at this facility for a couple of months before the money runs out. I don’t really know details, as an elder care lawyer has worked this all out for him. Timing has worked out though, his AL contract ends today, his rehab stay ended yesterday and he was just moved to a long term bed in that same facility. Pretty sure they kept him in rehab until a bed opened up for him, but it all worked out.
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The facility I worked for in AL (the state) was skilled care and rehab. the rehab side was upscale, almost hotel looking, with carpet in the hallway and sitting areas - all private beds, almost all with private shower (en-suite). There was a shorter hall in rehab that had shared room with en-suite; often those beds could be more of the ‘holding’ for a bed to open up on the skilled side. The skilled side had much more of a hospital look, but the private rooms could look very home like with the furnishings the family had delivered. Even a shared room could be warmer with the bed cover and other room accessories.
I do think sometimes the ‘bed available’ in skilled care at our facility was based on the balancing of enough full pay to offset the lower level of Medicaid reimbursement, and perhaps also the level of spend down time before getting to Medicaid.
One also does need to be aware of staffing levels and being able to maintain staff. We were part of a privately owned chain that began with one family owned facility and grew to most in our state but clusters in 3 other neighboring states (each cluster with 5 facilities - the management and cost to operate structures was set up that way as they found that success in home state, Alabama). We have our own CNA training program (Certified Nursing Assistant) so that we had a supply of trained employees; there were good benefits with the company, but the CNA or NA position is high turnover - and especially with the rise in other employment opportunities.
There’s a big COVID outbreak at my dad’s facility, ugh. He had it a few months ago. I hope it’s enough protection. He was lucky last time.
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Some happy news: my 93-year-old Dad’s PET scan indicates that his cancerous sinus tumor has shrunk significantly. He will continue with immunotherapy, which, in his words is “as easy as falling off a log.” He got new permanent dentures so he can eat better, although there have been some ups and downs (they are not very comfortable). He seems to have adjusted ok to assisted living. I am going out to see him on Sat. over my spring break and I will do his taxes and meet with his preparer. I am concerned about whether he has lost weight. He is definitely somewhat confused on the details of life. I suspect he has some degree of vascular dementia; he’s had a series of “mini-strokes” over the past couple of years. However, he still knows what’s the what, even if he doesn’t know what day it is. I haven’t laid eyes on him since Jan. 21.
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I’m wondering what other people would do in my situation:
My mom (early 70s) lives with us and definitely doesn’t consider herself taken care of by me. But she has a lot of health issues, she doesn’t drive, and relies on me for transportation. Also, she does need a bit of help around the house because her memory isn’t great (leaves the stove on, misplaces things she needs daily & needs help to find them, etc.).
Last week she was in bed with a headache all day (headache unusual for her; staying in bed all day not unusual). The next day (and since then) she was up and around but
- Her balance has been terrible. She is walking like she’s on a boat or drunk.
- Her hearing seems noticeably worse.
- She is talking loudly and much more animatedly (waving her arms when she talks, going on about things she doesn’t normally go on about).
I’m frankly concerned, because it is weird. I think we have a virus going around the house (kids have a bit of a cough/slight runny nose), so maybe she has an ear infection that doesn’t hurt?
I’m hesitant to say anything because she is usually very suggestible and a bit hypochondriac, but the PT she sees once a week was concerned and said if she felt bad she should go to the ER. But she doesn’t feel bad, she’s just…off balance and weird. But also the fact that she doesn’t seem worried given how bad her balance is is concerning.
What would you do? Say something? Just keep an eye on her?
Can you schedule her for a checkup? Id do that and mention these concerns to her MD when you make the appt.
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If she has already known health issues I would def call her doc and explain what’s going on - and hopefully they’d see her. Maybe something as simple as an ear infection which can and should be treated - or if it’s something else or nothing else you can at least rule out.
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H’s mother hasn’t answered the phone in a couple weeks. He talks to his sister, who visits her daily, so he was aware that she has been going downhill. But we weren’t prepared for how bad it was when we finally got through on her Echo Show today. She already can’t hear (hearing aids aren’t helping), but the level of cluelessness during our conversation went beyond that. She was unable to follow the conversation at all. She did remember something pretty random, only because it’s something she wants to micromanage even after she dies - long story. She’s really gotten so much worse since we visited a month ago. H is preparing himself for the inevitable.
She makes all her own appointments, so I’d need to suggest to her that she should do it.
I’ve asked her about how she feels, but she just laughs and says she can’t seem to stand up or walk straight. (Which, again, isn’t like her.)
Tell her her behavior is not normal and for her safety in your home you’d like her to check with her doctor. Offer to go with her to the appt.
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Great news @NJSue
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OK, hopefully that conversation will go okay. 
Thanks!
ETA: Talked to her. She wasn’t mad but now she is worried. 
She’s going to call her doctor tomorrow.
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I’d be very concerned that she had a mini stroke (not being able to stand straight could be due to one side of the body being weaker). Only a doctor examining her can provide a diagnosis, of course.
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She should be tested for a UTI also.
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Well I am the same age as your mom! (My mother just died at almost 96 so that puts me in the age range of some of your parents!).
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get a test for UTI given the unusual behavior
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get a referral to ENT and/or PT for vertigo…could be BPPV, which can be fixed fairly quickly with a simple exercise that the PT can do and teach you. For vestibular neuritis or labyrinthitis there are different exercises that take a bit longer.
ENY an also evaluate for infection or inner ear issues.
My mother and I have both had a variety of types of vertigo and PT was most helpful, but one specializing in this is preferable. We went to a “Center for Balance.”
For BPPV ear crystals have been dislodged and the exercise puts them back. You sit straight up on the edge of the bed, turn your head to the left, then quickly fall down to the right onto the bed (face now facing ceiling approx.). You wait for the dizziness to pass, count to 30, then sit straight again, wait for dizziness to pass, count to 30. Then other side. This can also be roughly diagnostic (if it causes extreme dizziness).
For vestibular issues you can do things like hold a face card in each hand and have your mom look back and forth, then up and down, several times. There are others.
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She was able to get in to see her doctor, who doesn’t seem as concerned as I am but is going to run a few tests. (No ear infection; did a basic neurological exam which was no change from normal for her.) Having blood, urine tests and an MRI (she has to have them yearly anyway), but “no rush.” I’m not impressed with the doctor because today at home after the appointment my mom’s leg slid out from under her on the hardwood floor several times. But we’ll see how the tests come back.
Glad you were able to get her into the doctor!
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