Tuesday, January 19, 2010

Medicaide letter confuses but ALF clears it all up...

We received a letter from Medicaide that said Mom's aid level was about $390 a month.  It's good news that they processed it so quickly but I still have questions.   The letter arrived at my mothers house where my brother lives so he read it to me.   He's not very patient so I didn't ask him to read it over and must trust him when he says "it's a short letter and there's no other discussion or facts." 

Luckily, the director of Mom's ALF called this morning to tell me about the information they received from Medicaide.  She was very clear about the details, and long story short: Adding Mom's income and Medicaide, she will be $1125 short each month for her rent.  Since we paid her rent for January, that total amount is considered a credit with the ALF.  We'll divide that balance by two and use it to pay for January and February.  Come March, Mom will have to share a room.   Her room is already very small so they will try to move her to a larger room.  I expressed concern about mean or aggressive roommates and she assured me they will work with us to find someone who mom will enjoy.  I am also concerned that the room will be too crowded.  Nearly all of the residents have walkers, so with two beds, two walkers or wheel chairs and a couple of rockers or recliners and the room will be chock full!   I HATE that she has to share a room but she complains about lack of company so perhaps it will be good for her.

Now more work for me - getting things set up on direct deposit for pension checks, payment of rent and payment of pharmacy bills.   Ugh! 

Tuesday, January 12, 2010

Mom's regrets influence me now

For the past several years Mom has expressed regrets about things in her life.   Each time we're together for more than a couple of hours she comes around to talking about them.  She's told me so often that I can almost quote, word for word, what she'll say about each instance.   Th regrets aren't about physical things she didn't have, not about places she didn't visit nor things she didn't do for herself.  Her regrets are about things she did not do for others.  Her regrets are about the people in her circle of friends and family that she could not or did not help. 

She regrets her parents divorce even though she was an adult; she knows how lonely each was in their elderly years. She regrets not pushing grandmas doctor to treat arthritis pain in grandmas back. She regrets that she didn't do more for a sister-in-law with chronic and painful migraines.  She regrets that my cousin could not have moved in with them. She wishes she'd done more for her grandchildren, nieces and nephews.... and on and on....

To understand why she didn't act, you have to understand a bit about my Mom.  Unless she gets really mad, she is not a confrontational person and she tries to be very polite.  At the time these events were going on, she felt it was rude, nosy or outside of her comfort zone to question, to comment or to act. She left things alone - and that's often her biggest regret because she saw events take an emotional and physical tole on people around her.   She regrets not acting to ease their discomfort or pain.   She regrets not saying or doing things to make people around her feel loved and supported. 

It's a difficult situation for me to understand because I saw her do so much for others. I try to live "up" to her good example with family and friends.  I don't understand why she's so hard on herself so I tell her just that.   I begin each response to each regret with "You're too hard on yourself; you did what you could at the time."  Now that we've made hard decisions about Mom and her care - now that I am primarily the one making the decisions and telling her about them - I hear my husband and family repeating the same things to me and to each other.   While I regret that I don't see her more often; I regret that she's not in her own home; I regret that she's no longer agile and strong - I won't regret moving her some place where she's safe and where the helpers treat her with affection and respect.  And, I'll learn from her regrets to show love and support when I can.


Sunday, January 10, 2010

Additional information requested by Medicaide

Two weeks ago I submitted a Medicaide application for Mom to her state Department of Health and Welfare.   Last week, Wednesday to be exact, I got a call from a lady reviewing her information.   She needs MORE information from me.  I expected this request but didn't know exactly what she'd need.   Long story short, she needs information that specifically identifies Mom's expenses for medical insurance and prescriptions.   This is necessary so the state can very specifically determine how much of Mom's money will go to her basic needs, her assisted living facility, her medical insurance and her prescriptions.  Then the state will determine exactly how much they will contribute toward her room and board at the ALF.    This leaves me really stressed about two things:

First:  We need to get a signature on a form, called an "Intent to Return Home".  My brother and I are really worried over getting her signature on this form.  We fear that she'll believe it means that she can go home then we'll have to tell her all over again, why she can't.

Second:  I worry that the state will pay so very little that the ALF will require her to share a room.  I worry that she'll get a disruptive and mean roommate.   I've heard awful stories from friends and acquaintances about room mates stealing money, clothing, pooping in beds, locking themselves in share bathrooms and the like.  Yikes!!!  All I can do is pray for the best and try to make plans to reduce her stress if she gets a room mate.

Why is this "Intent to Return Home" form necessary?  Because, without it, the state might force the immediate sale of her home to pay for her care.  If my brother didn't need a place to live, if the market were better and we'd get more money for it, we'd gladly do support her.  But!  the reality is that my brother, with his own health issues and need for low-cost housing, needs to live at her home.   She would also be heartbroken to know that her home is sold; she would loose all hope.   We are letting her live in a state of denial.  It keeps her happy and supports her sense of well being.  The state WILL recoup the money they spend on Mom by forcing us to sell it upon her death.   The state will place liens on it each year for the amount paid on Mom's behalf and collect when it sells.  I have no problem with this arrangement; it means we will probably get nothing from her estate but that's okay.  She should pay her way and this way she will.  This gives us a means to ensure my brother has a home andshe feels good that "home" is there just in case she may return and the state gets it's money. 

The "Medicaide Lady" also asked for a print out of her pharmacy expenses for the past quarter, October 1 through December 31; a copy of her Medicare Card and copy of her last pension check stub.   This seems like a pain because I provided her with a list of these expenses and an average of her prescription costs based on what the pharmacy has been charging to my credit card. But, she needs evidence and she's in charge so we comply.  I understand why and it's really in Mom's best interest, she wants to ensure there are no extra prescription fees, no extra premiums for Medicare Part D and the like.  So - I have a couple of things with me and my brother will gather some of the documentation and we'll send it in.   The next hurdle will be a visit from a nurse to gauge Mom's need for assisted living and nursing care.  

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Thursday, January 7, 2010

A simple pole helps Mom be more independent.

NOTE:  This was originally posted with title that's a bit cheeky (it referred to "pole dan cin') but I got all kinds of nasty automated comments advertising porn sites so I changed the title and reposted.   It really erks me that I'm trying to do something beneficial and those rotten bastards mess it up.

Mom's ALF installed a great new device for her.  It means that she can be more independent and I have something to tease her about.   They put in a "pole"  next to her chair.   The center of it has a rubberized "sleeve" that gives her something to grip as she rises from her chair.  She still has good arm strength so can pull herself up to her feet, then she takes a small step or two and, still hanging on, pivots into her wheelchair.  It means she's able to get herself into and out of her wheel chair without help.  She feels better since she doesn't have to call for help as often and I worry less about her falling. 

The pole itself works like a giant tension rod between the floor and ceiling.  There is a flared sort of stand on the floor and a larger piece at the top where the pole meets the ceiling.

Here's a photo of the "stand" where the pole meets the floor.  It's relatively flat and not wide so Mom won't trip over it: (The news paper looks pretty messy but it's mom's favorite past time )



Here's the top of the pole, where it meets the ceiling:


I tried to find some brand name on the pole but could not.   There is a label about a distributors name but it's in the United Kingdom.   If anyone is interested in finding one of these for their home, I'd suggest asking a physical therapist or a pharmacy that also sells wheelchairs shower chairs, handholds for the bathroom and other "safety" products.   I'll try to find out more from the ALF and will share it here as I can.