When a Relative's Health Starts to Fail

[VanTrekker]

Hi friends,<br /><br />Today I had to set the ball in motion&nbsp;to get some help for my Dad.&nbsp;&nbsp;His health has been rapidly declining as well as his ability to remain completely independent.&nbsp; It was an arduous&nbsp;decision that was not made lightly.&nbsp; There will be an assessment in the coming days and the state will make a determination as to what he needs to do to stay in his home or if that is even an option.&nbsp; Thankfully, my sister is in complete agreement which is a huge help.<br /><br />For those who pray, please keep our family in your prayers and ask that God grant me wisdom and patience&nbsp;to do the right things&nbsp;to help&nbsp;Dad maintain his&nbsp;dignity and health as much as possible. <br /><br />Brad a.k.a. V.T.<br /><br /><br /><br /><br /><br />

 

[mockturtle]

Brad, I certainly will pray for you and your family.&nbsp; God bless you!

 

[VanTrekker]

Thank you!

 

[Sunny1]

Brad, I'm praying, too.&nbsp; It's a hard position to be in for both of you.

 

[She]

Praying for both of you!

 

[Pikachu711]

Brad, you &amp; your family are in my thoughts &amp; prayers! I lost my 78 year old Dad&nbsp;around 4 years ago. Within two months of being diagnosed&nbsp;my Dad passed away. I've been where you are in the past. Seeing a loved one's health degenerate is never easy.<br /><br />Hang in there!

 

[Blaker55]

Your in my prayers as I have went through similar events in the last year. It adds stress to you and your father lives. &nbsp;Talk about it with each other...... a lot.<br /><br />What I learned is that going into assisted living and or nursing homes (have done both with my parents) is not the evil thing that we tend to associate with it. &nbsp;I'm sure these places exist still, but luckily, we did not, and have not had to endure any such thing as of yet.<br /><br />My parents failing health sent them from their home, to an apt complex for seniors, then to our house (wife and I) for close to 2 years, then in my father's last 2 months, to a nursing home/hospice where he passed away almost a year ago. &nbsp;<br /><br />Now my mother has moved into an assisted living complex and has her own apt where she is served 3 meals per day and they take care of medicine, laundry, cleaning and she can come and go as she pleases. <br /><br />These are not dreary places and I honestly believe that many of these folks find comfort there as their needs are met. &nbsp;They are still treated like humans. &nbsp;I spent many, many hours with my pops there in the nursing home over a 2 month period and came away impressed with the care he received and the job these folks do for not the best wages.<br /><br />Sorry for the ramble. &nbsp;Just want you to know that although you and your father will be going through a transition, it doesn't always mean it will be a bad one.<br /><br />Think positive, check out several of these places and find the one that best fits your needs.

 

[VanTrekker]

<div>Thank you all for the kind wishes.&nbsp; No transition is without difficulty but it is good to hear that not all care facilities are dreary places.&nbsp; I just hope with what time he has left, Dad&nbsp;can be in a safe, clean, and comfortable environment.</div>

 

[Blaker55]

I may be all wet, but it appeared to me that once you get in kind of tough shape like my father was, then your needs become quite basic: Food, bathroom, shelter, sleep, a little tv. &nbsp;Although, maybe this is deceiving because people of my/our parents generation tend to endure rather than complain, unlike me, I'd piss and moan about everything.<br /><br />The nursing homes/assisted living places that I've dealt with have taken care of these needs very well. &nbsp;They also have quite a few activities, such as musicians that come in once per week, usually volunteers, bingo, ice cream days, glass of beer or wine on fridays, cards, sing-alongs, excersize sessions and I think there were more.<br /><br />I hope you find it as good a place as I did for my pops. &nbsp;I'm very grateful to the staff that care for these folks.<br /><br />I'll shut up now.

 

[yesican]

I have worked in many nursing homes and visited many assisted livings as a homecare nurse.&nbsp; Not all are good.&nbsp; When visiting, pay attention to the help--are they stressed?&nbsp; Are people just sitting slouched in their w/c's?&nbsp; Notice any odors?&nbsp; Are staff interacting with patients?&nbsp; Is it clean?&nbsp;<br />My father was in&nbsp;the county nursing home in LaCrosse, WI...they were fantastic.&nbsp;&nbsp;After raising&nbsp;16 kids, when he got to the nursing home, he felt like he gained even&nbsp;more.&nbsp; He got to&nbsp;know the CNA's families and teased the nurses.&nbsp;It still got lonesome&nbsp;for him because he was always&nbsp;a man with something to do and the more ill he got the more time dragged for dad.&nbsp;<br />&nbsp; My oldest brother did the nursing home investigation.&nbsp; He chose well.&nbsp;&nbsp;I wished I could have kept dad with me but I was living in Alaska.&nbsp; Don't miss out on the time you have left with your pop even if it seems difficult,&nbsp;you will be blessed for every second you&nbsp;have with&nbsp;him.&nbsp; I pray for your strength and guidance and your ability to give your dad what he needs at this time.&nbsp; Good luck!<br />Rae<br />&nbsp;<br />&nbsp;&nbsp;&nbsp;&nbsp;

 

[Seraphim]

Brad<br /><br />Our thoughts and prayers are with you and your family.&nbsp; We have recently been through the ordeal, and remember that you are making decisions based on your father's health and comfort.&nbsp; There are also support groups available for family members involved in such decisions, and they were a great help to DW and I when we were feeling down.<br /><br />Modern facilities are wonderful places and staffed by caring people. Those who cared for my MIL became as close as family to us, and we watched them cry as Lola passed away.

 

[VanLifeCrisis]

My sister works for a company that sends her out to basically provide everything that an assisted living home would provide.&nbsp; They also have people who can do medications.&nbsp;&nbsp; Medicare pays for it all i believe but since its a private company they raise the bar on care pretty high. &nbsp; The state sends out a 'head nurse' type chick who interviews them and assesses the level of care.&nbsp; Im willing to bet you can find something like that.<br /><br /><br />My sister is my mom's provider (low level care) and another ladies cargiver (high level, completely immobile)

 

[VanTrekker]

Thank you for the comments.&nbsp; Dazar, that's kind of where we are headed.&nbsp; There will have to be an assessment to figure out where we are at, what is needed, if my dad is willing to go this route, etc.&nbsp; Otherwise, if action is required and he refuses, there may have to be some involuntary action taken.&nbsp; It's going to be very tough.&nbsp; I am lucky to have 100% agreement from my sister (she's kind of like "It took you this long to get him help?")<br /><br />It's liable to be emotional rough going for the next few weeks / months but after my mother ended her own life, I think it's possible to handle anything.<br /><br />On the upside, I've got multiple friends who are saying they will let me crash on their couches, park&nbsp;my van on their land, etc.&nbsp;to help out if needed.&nbsp; There are so many people that don't have this "fall back plan"&nbsp;- I feel very blessed to have a home on four 16" tires.

 

[mockturtle]

My sister works for a company that sends her out to basically provide everything that an assisted living home would provide.&nbsp; They also have people who can do medications.&nbsp;&nbsp; Medicare pays for it all i believe but since its a private company they raise the bar on care pretty high. &nbsp; The state sends out a 'head nurse' type chick who interviews them and assesses the level of care.&nbsp; Im willing to bet you can find something like that.<br /><br /><br />My sister is my mom's provider (low level care) and another ladies cargiver (high level, completely immobile)

<br /><br />This is the work I did.&nbsp; The limitations of this service are manifold:&nbsp; Medicare only pays for a new condition [e.g., recent hospitalization] or an exacerbation of condition; the term of service is fairly brief, as in weeks; visits are not usually daily--aides can give baths, etc. three days a week, nurse visits dependent on the skilled needs, like IV medications, wound care, etc.&nbsp; Medicare does not pay for long-term care, inpatient or outpatient.&nbsp; <br /><br />If he is <em>Medicaid</em> eligible, there is more help available. And if, like my husband, his assets become 'spent down' as a result of nursing home costs, he will eventually be Medicaid eligible.&nbsp; <br /><br /><br />

 

[yesican]

Mockturtle is correct, Medicare (federal) pays for 60 day "certification period" but only&nbsp;if there's a need requiring skilled nursing care.&nbsp; People can be recertified for 60 days repeatidly as long as there remains a skilled nursing need.&nbsp; In each of these periods, the nurse will determine how much CNA assistance each week for personal cares the patient requires.&nbsp;The nurse is usually&nbsp;at the home one hour one or more times a week and the CNA 1-3 times a week for bathing, wound care, etc. &nbsp;Mind you that this will be a&nbsp;private company that needs a profit to continue working at providing care so the amount of help also depends on the amount of reimbursement the Medicare will pay for each diagnosis for that certification period.<br />&nbsp; There is a silver lining though...Here in Alaska (I'm sure other states have it as well)&nbsp;we have MEDICAID WAIVER, and it is state based and depends on income and assets (home not included in assets).&nbsp; People that have too much money for MEDICAID can still qualify for MEDICAID WAIVER because the individual does not get money rather services at home that help them remain out of the nursing home.&nbsp; This is most likely what Mockturtle is referring to. Still these people (PCA's - personal care attendants)&nbsp;are there for a determined amount of time each week as&nbsp;set by the state according to what the state nursing assessor finds in her assessment.&nbsp; This&nbsp;can be anywhere for 3 hours a week to 40 hours a week.&nbsp;&nbsp;<br />&nbsp;&nbsp; I am a homecare nurse and see patients in their homes for meds, wounds,&nbsp;labs, assessments, etc.&nbsp; We work with other PCA companies and assisted livings as well but Nursing compaines, Homecare PCA companies, and Assisted Livings are all different entities and are paid differently by Medicare and Medicaid.&nbsp;&nbsp;<br />&nbsp; If your father is a Vet, he may be able to get some assistance there as well.<br />Rae<br /><br />&nbsp;

 

[VanTrekker]

Thanks for the information.&nbsp; Dad does have some savings which means that Medicaid is not an option right now until those reserves are gone.&nbsp; He is a veteran so there might be some assistance available in that case.&nbsp; Dad has spoken about going to the old soldier's home in Marshalltown, Iowa.&nbsp; If that happens, I'll just move and live out in that area - have van, will travel.<br /><br />It's a tough situation and the list of options is rapidly narrowing.&nbsp; We had some non-compuslory advice as far as services that were available.&nbsp; This&nbsp;occurred&nbsp;about a year ago when he&nbsp;ignored a medical situation&nbsp;and nearly died.&nbsp; Dad then&nbsp;refused any assistance that would cost him any money at all.&nbsp; This time around it will not be optional.<br /><br />This next visit (I'm waiting for the phone call)&nbsp;will be a mandatory type of thing where he will be told what he MUST do to remain in the home... If he refuses to comply, it means the state will&nbsp;have to&nbsp;remove him.&nbsp; There are so many concerns in the home that correcting them might not happen.&nbsp; Additionally, his health has declined to where&nbsp;staying in the home&nbsp;might not be an option anyways.&nbsp; My sister told me I should just get out but I feel compelled to help in whatever way I can... he just won't let me.<br /><br />It's tough when you&nbsp;a person gets&nbsp;older.&nbsp; If I've learned one thing, it is that living in denial and avoiding situations (a.k.a. burying your head in the sand)&nbsp;can help you in the very short term but severely limits future options.&nbsp; Also, as tough as it is, you do have to draw some boundaries to keep from getting pulled into situations, even if it is a relative.&nbsp; Some times the "help" they want&nbsp;is not what is appropriate and&nbsp;can get a person in trouble.&nbsp;<br /><br />In the meantime, I'm looking at storage options&nbsp;(such as a&nbsp;tiny storage shed) in anticipation of the worst case scenario and needing to hit the road full time.<br /><br />V.T.

 

[Guest]

Brad, you need to see an elder care attorney, as soon as possible. <br />you may have already done this. as long as your father is mentally competent, that is the time to do a living will, secure his assets and any future inheritance<br />if thats an issue. the nursing home care most likely will require him to have no more than 1500$ in assets and will drain anything he has as well as claim all real estate or anything of value at some point.<br /><br />in some states, if a patient is eligible for state medicaid, there is a "caregiver compensation" program. the social worker comes out, evaluates the need, and after some red tape, approves the patient to receive a monthly stipend, which they can give to the caregiver of their choice. this would be a worthy option if decide to take his care on yourself. it is anywhere from 600$ to a little more a month.<br /><br />there is of course a whole more to all this. but i would suggest a lawyer who deals with elder care. maybe VA has one he can use for free?<br /><br />if you decide to stay and help, do so, with boundaries. firm ones. <br />family caregivers make up a vast amount of society, save a ton of money, but it can be a real challenge. support groups, and any other supportive venue, would help. its very hard to do, but if you can make your decisions based on logic vs emotion, at any point, it will help.<br />&nbsp;hugs to you Bradford, still reading your blog daily.

 

[josephusminimus]

Thanks for the information.&nbsp; Dad does have some savings which means that Medicaid is not an option right now until those reserves are gone.&nbsp; He is a veteran so there might be some assistance available in that case.&nbsp; Dad has spoken about going to the old soldier's home in Marshalltown, Iowa.&nbsp; If that happens, I'll just move and live out in that area - have van, will travel.<br /><br />It's a tough situation and the list of options is rapidly narrowing.&nbsp; We had some non-compuslory advice as far as services that were available.&nbsp; This&nbsp;occurred&nbsp;about a year ago when he&nbsp;ignored a medical situation&nbsp;and nearly died.&nbsp; Dad then&nbsp;refused any assistance that would cost him any money at all.&nbsp; This time around it will not be optional.<br /><br />This next visit (I'm waiting for the phone call)&nbsp;will be a mandatory type of thing where he will be told what he MUST do to remain in the home... If he refuses to comply, it means the state will&nbsp;have to&nbsp;remove him.&nbsp; There are so many concerns in the home that correcting them might not happen.&nbsp; Additionally, his health has declined to where&nbsp;staying in the home&nbsp;might not be an option anyways.&nbsp; My sister told me I should just get out but I feel compelled to help in whatever way I can... he just won't let me.<br /><br />It's tough when you&nbsp;a person gets&nbsp;older.&nbsp; If I've learned one thing, it is that living in denial and avoiding situations (a.k.a. burying your head in the sand)&nbsp;can help you in the very short term but severely limits future options.&nbsp; Also, as tough as it is, you do have to draw some boundaries to keep from getting pulled into situations, even if it is a relative.&nbsp; Some times the "help" they want&nbsp;is not what is appropriate and&nbsp;can get a person in trouble.&nbsp;<br /><br />In the meantime, I'm looking at storage options&nbsp;(such as a&nbsp;tiny storage shed) in anticipation of the worst case scenario and needing to hit the road full time.<br /><br />V.T.

<br /><br />VanTrekker:&nbsp; I'll preface this by saying I read your posts and generally like what you say, even though I sometimes disagree with you.<br /><br />But having said that, I'll also say that one of the reasons I made the decision a long time ago to break off contact with my family members who might be inclined to believe they've a responsibility to make my decisions for me is contained in the underlying assumption of your post.<br /><br />It's none of my business and I'm not saying what anyone else should do, but I am saying if I had a kid who believed he had any business over-riding my personal choices about my own life, the living of it, the duration of it, I wouldn't love him more for it.<br /><br />If the person's capable of cogent thought, seems to me those thoughts ought to be a part of the equation and the vital choices involving him.<br /><br />Just saying.

 

[mockturtle]

VT, Aunt Meg gave you some good advice about an elder care attorney.&nbsp; You at least need to get a medical power of attorney [this, in itself, would not require an attorney--just witnesses/notary] so that you can make medical decisions for your father if he becomes unable.<br /><br />In AZ in 2008, my husband, who suffers from a type of Parkinson's dementia [Lewy Body Dementia], had to be hospitalized for a life-threatening infection.&nbsp; He refused every medical test and treatment they ordered.&nbsp; Had it not been for my medical POA, he would not have received the care he required.&nbsp; I should point out that he was not 'ready to die' but just delusional and believed the staff were trying to hurt him.&nbsp; <br /><br />Yes, choosing the person to whom you confer this responsibility/authority involves a lot of trust.&nbsp; I have given my daughters medical POA for me and asked for no resuscitation nor life-prolonging measures if I contract a terminal illness, including dementia.&nbsp; For those who cannot trust their family members, a trusted friend would be a good choice.&nbsp; Maybe someone with no financial interest.<img src="/images/boards/smilies/biggrin.gif" alt="" align="absmiddle" border="0" /><br /><br />My husband has been in a skilled nursing facility [SNF] for over a year and a half now but I am still very involved in his daily care.&nbsp; VT, I know that with you will make the right decisions for your father as it is evident you care about him very much.&nbsp; God bless you both!