Geriatric Care Management

When to Transfer Assets to Qualify for Medicaid?

Maria — Tue, 10 Jan 2012 12:00:28 +0000

It’s a topic I’ve not yet covered on this blog, but one that I’m asked about consistently by adult daughters and sons alike:

When should I transfer assets so that my aging parent qualifies for Medicaid?

The most recent person to broach the subject with me was Michael from New York City. His mother had a stroke in 2009 that left her with severe short-term memory loss.

She can’t drive, plan meals, or cook for herself.
She despises Meals-on-Wheels.
She takes some medications to prevent seizures and others to help with the memory loss.
She lives in a condo and wants to stay there with supportive services (no live-in caregivers thank you very much).

BUT…

Michael’s sister is insisting on moving mom to an assisted living facility. Michael feels this is premature and will wipe out mom’s assets and send her to a nursing home earlier than necessary.

“So,” he asks me, “should we transfer assets so that she qualifies for Medicaid?”

My answer to Michael would be the same for anyone else: Maybe. But not without some legal guidance and a clear understanding of the problem you’re trying to solve.

Yes, Medicaid pays for nursing home care. But qualifying for this type of Medicaid is not as easy as removing funds from a bank and closing an account.

Think about this from the state’s perspective…

With mom’s blessing, Michael removes money from her account and then what…?

The state foots the bill for mom’s nursing home bed through the end of her life?

No way.

Instead, the state wants to be certain mom can’t contribute to the costs.

To get that assurance, they do what is commonly known as a “look back” – a financial audit that can stretch back as many as five years.

One guess what they do when they find the transfer mom authorized Michael to make…

They call a foul and tell mom that she can’t qualify for Medicaid until she spends the transferred money.

If she’s in a nursing home, they let her pay for the cost of those services until her money is spent down to the Medicaid limit and then they reconsider her application.

If she’s not in a nursing home, she’s invited to spend down her money in other ways until she reaches the Medicaid limit.

Are there ways of sheltering assets so that Medicaid will pay for the nursing home and Michael and his sister can inherit something?

Yes.

But don’t kid yourself. This is legal territory. Don’t venture into it without a lawyer.

In the meantime, Michael’s mom is in need of help at home. The really good news in this scenario is that she is open to help so long as it doesn’t come in the form of a live-in caretaker.

Knowing that, I’d advise Michael to ensure that mom gets the kind of help she’s open to right away to see if it makes a positive difference.

If it does, maybe a higher level of care can wait.

If it doesn’t, it may very well be time.

When Your Mother-In-Law Wants to Move In and It’s Not What You Want

Maria — Fri, 06 Jan 2012 12:00:10 +0000

A reader I’ll call Margaret got in touch recently to ask about the mother (pun intended!) of all planning care conundrums: her mother-in-law wants to move in…

Dear Maria,

My mother-in-law has decided she doesn’t want to live alone any longer and wants to sell her big house. My husband and I agree completely (her short-term memory is getting really bad, the house is very big and remotely located).

Without consulting us, she planned to “rent a room” in our home. However, when she shared this plan, my husband said no – for a variety of legitimate reasons. Now we don’t quite know what to do. She is adamantly opposed to the following:

assisted living communities

apartments in a senior development

buying a smaller, more manageable house near us

Any suggestions on how to proceed?

We want her to be safe, healthy and happy, but there don’t seem to be any “good” options.

It almost goes without saying, but THIS ONE IS A DOOZY.

Now that I’ve said that…

The first thing to do in any planning care situation is to openly acknowledge the pluses…

Here are the pluses I see in this scenario:

Mom recognizes that her current living situation is not working…
She instinctively knows that she benefits from being around others as opposed to being alone and…
She feels ready to do something about 1 & 2 above. And not just something; she’s ready to sell her house. This is a huge step and one that lots of folks don’t ever get past
Margaret and her husband are in agreement that mom moving in is not workable (I wouldn’t point this one out to mom, but it is a very important plus!)

Next, do as Margaret’s husband did and…

Have a conversation with the older adult in which you acknowledge the situation’s pluses AND your own limits

Will the latter half of this be uncomfortable for you? Most likely.

Might it cause your mother to become upset, which in turn may make you more uncomfortable? I’m going to say yes to this one.

But understand that agreeing to a plan that you know in your gut is not sustainable will only hurt you and the older adult in the long run.

So you’ve honored the pluses and your limits…

Next you’ve got to give your mom/dad some time to absorb what you’ve said.

This isn’t likely to happen in a half hour or even overnight. In a situation like Margaret’s where the truth hurts (I’m assuming that mom heard the “No” from her son as a big OUCH), it may even take a few months.

Don’t despair. Let the dust settle. Keep your defenses down and the lines of communication open…

The best sign of progress would be that mom agrees to humor Margaret and her husband and check out a few assisted livings or continuing care retirement communities (CCRCs). In other words, she agrees to rethink the alternatives to which she was adamantly opposed.

ACKNOWLEDGE ANY MOVEMENT IN THAT GENERAL DIRECTION and keep your seatbelt on.

What Do Family Caregivers Need Most? In a Word – Support.

Maria — Tue, 03 Jan 2012 12:00:59 +0000

A few weeks ago a reader I’ll call Cara got in touch to tell me about her mom Jeannie. Recently divorced and concerned for her father’s health, Jeannie moved her father into her home.

Immediately, there were benefits.

Dad liked the companionship he’d been missing since his wife died, and Jeannie liked biding adieu to the thrice-weekly one hour drives to dad’s house that had become the norm.

It’s six months later and Jeannie is happy with her decision; her father’s health has even improved.

But something isn’t working in this caregiving scenario and that something threatens the whole arrangement. The problem is this:

Jeannie’s siblings (who promised otherwise) have all but left the picture.

Jeannie’s brother, who lives ten minutes away, looks for excuses not to visit. Her sister, who used to visit regularly, cancels at the last minute without explanation or apology.

All of this is upsetting to Jeannie and has, in turn, become upsetting to Cara…

“I wondered if you had any advice on how I could best make my mom feel special and appreciated. Hallmark cards are getting old and I know I sound like a broken record on our nightly venting calls…”

My advice to Cara — and to anyone else who may be caring for a caregiver — is this:

Keep lending your ear and whenever possible, your hands. Don’t assume that the primary family caregiver has things covered. In other words, don’t step back – especially if that primary person is your sibling.

Make a point to recognize and appreciate what they do.

Whether you live close by or far away, practice being a soft place to fall and also someone who lightens the load every now and again. Family caregivers need support most.

How To Overcome Feeling Overwhelmed

Maria — Sat, 31 Dec 2011 15:05:00 +0000

Last week I cracked the crown on “tooth #30″. It hurt. But not as much as the pain that would have come with replacing it with my out-of-network dentist…$750.

“No way,” said my husband.

I shared his sentiment and so the hunt for an in-network dentist who would see me fast began. I was lucky to find a good one who patched me up a few days later.

So here’s what I left out of my little intro story above…

The cracked crown brought me to tears. Big ones. There was some sobbing involved too which was accompanied by the feeling of being completely overwhelmed. But why?

I’ve decided to share my meltdown story with you because I think a lot of people can relate. It was so obviously not about the crown.

Life is packed with to-dos and for many of us, the pace is unrelenting. Months can fly by like weeks, and at the same time, a particularly tough week can feel like two.

Like a cup that fills up one drip at a time, it is incredibly easy to lose track of what we’re carrying until there just isn’t room to carry anymore. The only thing left to do is to empty our cup…

So as the tissues dwindled, I put pen to paper and wrote down the things on my mind in that moment. I just let them spill out of me like the tears.

And you know what surprised me? It wasn’t long until I had listed eight things. Eight!

Something else surprised me too…the act of naming my worries – of transferring them to the page – instantly made me feel lighter. The tears stopped and I began to feel more in control.

Have you tried this? Do you know how long your list would be?

Respite: A Lifeline For Those Overwhelmed By Caregiving

Two Reasons to Hire A Geriatric Care Manager Now

Maria — Thu, 08 Dec 2011 12:00:33 +0000

I have the utmost respect for geriatric care managers, but I’m also a realist about the fact that not everyone can afford one.

However, even when money is tight, there are a few instances in which the cost of a geriatric care manager is well worth it.

Below are the top two reasons to hire a geriatric care manager now:

1) Your family is completely dysfunctional and all discussions end with no clear path forward. If you think you’re in this boat, you probably are.

Here’s what it looks like: You think your mom needs X, your brother thinks she needs Y, your sister is completely checked out of the picture, and your youngest brother thinks everything is fine. Oh, and mom has dementia so no longer has the capacity to make decisions for herself.

Hell might freeze over before everyone agrees on what should be done and the chances of you being able to bring everyone to consensus (sort of?) are slim. But a geriatric care manager? Well he/she can be the objective, professional, voice of reason.

Think your brothers might be more apt to consider the suggestions of a professional over your suggestions? Even this only child knows the answer is a resounding YES!

2) Your concerns for mom/dad are growing and you find yourself wishing that someone could help you make sense of what you’re seeing.

In other words, you’re overwhelmed by the complexity of the picture. Mom isn’t showering anymore. The doctor has started her on a depression medication that she’s refusing to take. You can’t put your finger on when you first noticed a decline in her, but it’s clearly in full swing now and the avenues you’ve tried haven’t made anything better.

I’ve said this before and I’ll say it again:

One of the best ways to utilize the services of a geriatric care manager is to hire them for a consultation only…

They come in, they meet mom, they walk through the house, they hear the back story from you on what’s led up to your growing concerns, and they help you to understand what you’re looking at and what the next steps should be. If you find an experienced geriatric care manager, this is money well spent to help you get a handle on what’s going on.

So there you have it – two reasons to hire a geriatric care manager now. If you hired a geriatric care manager to help you with mom or dad, what was it that finally made it happen?

Three Things You Should Know About Sub-Acute Rehab (SAR)

Maria — Mon, 05 Dec 2011 13:47:40 +0000

Picture it: Your 89 year old father falls, breaks a hip and spends a week in the hospital. The discharge plan is not to home, but to Sub-Acute Rehab (SAR) — a fancy term for short-term, low-intensity rehabilitation that most often occurs inside of a nursing home.

This is a scenario that plays out thousands of times every day across the country. If your aging parent is in this boat, below are three things you should know…

1) Sub-Acute Rehab is not the same as Acute Rehab — find out for sure which one is being recommended because there is a BIG difference…

Acute Rehab is intense — 3-4 hours of rehabilitation per day
Sub-Acute Rehab is far less intense — approximately 30 minutes per day

So who determines whether your aging parent is recommended for Sub-Acute Rehab vs. Acute Rehab? Good question!

That would be the Physical Therapist (PT) in the hospital.

As discharge approaches, “PT” will visit your aging parent at bedside and attempt to get Mom/Dad out of bed with the goal of taking a stroll in the hallway. Much of the decision is based upon how far (i.e. how many steps) your mom or dad can walk. If it’s not many, Sub-Acute Rehab will likely be the recommendation.

(Heads up though: if Mom/Dad can walk over 100 feet, he/she may not qualify for either.)

2) If your aging parent has Medicare and has been in the hospital for 3 or more days, there should be no out-of-pocket costs for a Sub-Acute Rehab stay BUT…

If you remember nothing else about Medicare, remember this: it only pays for short-term services (i.e. a few weeks to a month or two at most). Here’s why that fact is REALLY IMPORTANT when we’re talking about Sub-Acute Rehab…

Imagine for a moment that it’s day 25 of your father’s stay in the Sub-Acute Rehab after breaking his hip. He isn’t much better. Let’s say, for argument’s sake, that he’s worse. Being away from home depressed him. He didn’t like the food. He didn’t engage in the rehabilitation that was offered. Instead, he stayed in bed and slept a lot. After a few solid weeks of this, it’s now tough for him to get up at all.

And while Medicare was happy to foot the bill thus far, they will not continue to pay. So dad has come to a fork in the road. He can:

Go home (but because of his physical state he’ll need more help than ever before to bathe and dress, etc.)

or he can…

Stay and transition into a long-term, nursing home bed. (The cost of this could be as much as $14,000 per month. Unless Dad has Medicaid, it will be his responsibility to pay.)

Think the prospects of an indefinite stay in the facility and the depletion of his savings are enough to depress Dad even more? Yeah, I’ve seen that once or twice.

For those of you who are still with me, you’re probably wondering what the third thing to know about Sub-Acute Rehab could possibly be, so here it is:

3) There is an alternative to Sub-Acute Rehab that’s not often talked about: going home with home care.

That’s right, folks. Just as Medicare will pay for a brief stay in a Sub-Acute Rehab it will also often cover the cost of Physical Therapy at home. Typically this “home PT” occurs several times a week. And, it may also be possible to get Medicare to cover the cost of a home health aide to assist with activities of daily living during the same service window.

Of course there could be reasons why Sub-Acute Rehab may make the most sense for your aging parent. Maybe he/she has medical needs that complicate the picture so that a discharge to home – even with home care – really would be unsafe.

But do I think you should ask the Physical Therapist and/or the medical team to explain why home PT isn’t best?

You bet I do.

This Is Me, Giving Thanks

Maria — Wed, 23 Nov 2011 15:21:50 +0000

Creating this website was as big a goal as I’d ever set. It seemed difficult and improbable. I wasn’t sure where to begin or how I’d find my way. I didn’t want to pay someone to show me.

During this time I e-mailed other bloggers a lot. Most responded with encouragement, but two in particular offered words of advice that stirred me up inside. I quickly printed their e-mails and taped them to the wall above my desk for inspiration.

Elise Bauer of Simple Recipes was first. I’d found her website through an article that appeared in Redbook about inspiring female bloggers. Not only are Elise’s recipes delicious and her photography stunning, but it turns out she’s also a really nice human being. Her advice was straightforward and simple.

Buy an Apple computer. Acknowledge that the learning curve will be steep and you’ll have to work hard at this before you begin to see results. And, go for it because your goal is within reach.

That last part really grabbed me because she didn’t have to say it. But she did…

Tim Carter of AsktheBuilder.com responded within hours of Elise Bauer. I’d found Tim through a Wall Street Journal article that profiled people who were making more than a million dollars a year through their websites. He’d built his site from scratch and it gave me hope that I could do the same. In a weak moment I asked the builder what to do with the doubt I was feeling with this project. He responded by issuing me a challenge.

“How badly do you want this? If you want it badly enough you will not let anything stop you. Only people with diligence, discipline and determination make it. Are you one of those?”

Strong words from a stranger that gave me the final kick in the tail that I needed. I launched the site a few months later having taught myself how to build it.

Along the way, there have been many other people whose support and encouragement have been invaluable. My husband, of course. My mother. Several friends and extended family members…

But these days I’m happy to report that it’s also the readers — everyday folks who stumble upon this site and take a moment to leave a comment after a post or reply to an e-mail to say thanks for a response I’ve provided to one of their questions.

Here’s some of the comments that have inspired me most:

“Maria, thank you for answering me so quickly. Your advice was spot-on and I will relay it to my brother and sister-in-law…”

“Your post really nailed-it.”

“I’m so glad I found this site!”

And the absolute best is when caregivers pitch in to help one another in the comments.

A reader named Anne writes:

“I got my mother a shower chair with a transfer bench recently. She won’t use it because she can’t figure out how to get the shower curtain around the chair so the water doesn’t get all over the bathroom floor. Ideas?”

Another reader uses the comment section to help…

“This is for Anne in regards to the shower curtain issue: Just cut 2 slits in the shower curtain, one on each side of the bench seat that extends outside the tub. Then just slide that “middle” piece of the shower curtain down into the bench seat crack, which allows the whole shower curtain to remain inside the tub. It takes a little practice because some of the bench seat cracks are wider on some shower transfer chairs than others, but it does the trick just perfect. Hope this helps.”

All of this — the words that inspired me to get going and the ones that keep me going — helps to convince me that I’m on the right path. I take them as small signs of a community that is just beginning to grow. One that I intend to nourish with everything I’ve got.

So HAPPY THANKSGIVING to everyone who’s reading this. I hope this website helps you to manage whatever caregiving challenge you may be facing and that you’ll come back again.

Maria

No related posts.

When Dad Eats Little and Often the Wrong Things

Maria — Tue, 22 Nov 2011 03:05:18 +0000

Thanksgiving, the day when most of us throw caution to the wind and eat until we’re uncomfortable or until the Tryptophan puts us to sleep — whichever comes first — is just days away. That makes this question from Barbara in Elyria, Ohio so timely.

She writes: “My father who is 94 does not want to eat much. He likes very few foods and most of the foods are not healthy foods. I really think it is effecting his quality of life. What can I do?”

There are no one-size-fits-all answers here, but this much is certain: for many people, eating is one of the great joys in life and when that joy is lost it can be hard to get back.

(If any of you nutritionists out there want to chime in as to why our appetites change as we age, please have at it in the comments.)

So what might be going on here for Barbara’s dad and what can she do?

For one thing, his medications may be playing a role. They may be inhibiting his appetite or causing him to crave certain foods over others. Sharing this information with his doctor isn’t a bad move. He may be able to modify the medications or add an appetite stimulant.

Another possibility is that Barbara’s dad has depression. Depression among the elderly is a real thing; a reduced appetite (and subsequent weight loss) are among the earliest signs. If you’re concerned that your aging parent may be depressed, talk to him or her about it and mention it to the doctor. An anti-depressant may help to curb the symptoms and stimulate his /her appetite.

Lastly, and this goes hand-in-hand with the possibility of depression, Barbara’s dad may not be eating much because he is lonely (i.e. socially isolated). Perhaps he never learned to cook and isn’t interested — at the age of 94 — in learning how. And let’s just say for argument sake that Barbara’s dad was a gourmet cook in his day. Poor mobility and decreased strength would make any one of us lean toward the prepackaged, ready to eat foods. Can’t blame him there.

So how can Barbara help her father in this situation?

We’ve already discussed having a conversation with the doctor to ask about medication adjustments, an appetite stimulant, and/or an anti-depressant if appropriate. But Barbara might also consider signing her dad up for Meals on Wheels. Or even better (and if possible) she might try to find a senior center nearby where he could eat a meal among his peers.

In fact, the more opportunities to eat with others the better. Think neighbors, grandkids, great-grandkids, etc. Anyone who might be enlisted to stop by and sit down for a bowl of soup or even a sandwich with dad would be doing an incredibly powerful thing. So often social stimulation leads to appetite stimulation…

I’ve seen it more times than I can count.

How to Help Dad Let Go of the Car Keys

Maria — Thu, 10 Nov 2011 12:00:47 +0000

If your aging parent has dementia (and even if he/she doesn’t), the thought of him/her driving is most definitely enough to keep you up at night.

What if they forget the route home?

What if their reflexes aren’t so good and they get hit by a speeding car from the side or worse, they hit and injure someone else?

If these are the thoughts running in your head, you’re probably wondering how to proceed. My best advice is slowly and with the utmost respect for the complexity of this situation.

Your aging parent is an adult and he/she does not want to feel like a child. For better or worse those proverbial car keys are as much a symbol of independence and possibility now, as they were when they first found their way into his 20-something year-old hands. Giving up something that is that valuable – particularly when you don’t share the belief that it’s the best thing – is very challenging. The ego is involved BIG TIME here and we need to tread lightly.

Below are some tips to a successful conversation about letting go of the car keys…

1) Check your tone – don’t be condescending or the conversation will be over before it even starts

2 ) Be clear about the message which is: I’m concerned” not “You’re incompetent.”

3) Acknowledge the difficulty in what you’re asking for. In other words shoot for:

“I know how hard what I’m asking you to do is. It must seem like I’m asking you to give up your freedom,”

instead of…

“C’mon, Dad. You know this has to happen. We can’t have you go on like this.” (Notice how the second statement implies that this is an easy decision that Dad just ought to hurry up and make already.”

4) Don’t make this “all or nothing.” If dad agrees to stay off the highways at first, understand that this is progress. You can and should tell him if you think that isn’t enough, but don’t push. If the decision is to stick, it has to be his.

5) Consider (and offer) the alternatives. Beware of ending this conversation with no alternatives. That is completely deflating and depressing. Instead, find a family member to help you with some basic research on senior services in the area.

6) Understand that if mom/dad has Alzheimer’s or another form of dementia, this conversation is going to need to be had more than once. This will be harder on you than on your aging parent because he/she won’t remember the last talk. Rest up and repeat exactly what worked for you the last time.

Have you had the car keys conversation? Got some tips and/or thoughts to share? Did it not go so well and you want some feedback? That’s alright! Let me know about it in the comments below.

Does Your Aging Parent Try to Walk All Over You?

Maria — Thu, 03 Nov 2011 11:00:43 +0000

I loved my paternal grandmother, but I didn’t like her much. That’s the truth, and now that I’ve written it I’m certain that my mother will gasp when she sees these words. Not because she felt all that differently than I did, but because it isn’t nice to say.

Sorry, Mom. Sometimes Grandma wasn’t nice.

She’d grown up with a sense of entitlement that was full-blown by the time she’d reached her 80′s and it wasn’t pretty. When she’d stay with us at Christmas she insisted on having a bell at her bedside so she could summon help. On one such occasion I remember Mom running toward the bedroom some 20 feet away upon hearing the ringing. The problem? Grandma’s clock was facing the wrong way and she couldn’t tell the time.

Oh the horror…

And while Grandma did have her good points (she was instrumental in getting my dad a job that he loved until he died and she managed to marry an amazing man who was a Grandpa to me in ever sense of the word), instances involving the bedside bell and others tainted my memories of her in the later years.

Growing up it seemed that Grandma reserved Sundays for guilt trips.

Mom would arrive at Grandma’s apartment early and get to work doing laundry, shopping for groceries, making meals and cleaning so that the money for the home attendant would stretch as far as possible. Also, at Grandma’s request, Mom made sure that the top drawer of the coffee table was sufficiently stocked with Salems and that a lighter in working order – much like the bell – was close at hand.

And did I mention liquor? Oh yeah. There was that too.

As the day would wind to an end my mother would pass across the kitchen threshold one last time to be sure she wasn’t leaving anything behind. And just then, like clockwork, a voice from the living room would cry out…

“Please pour me another glass of wine if I’m going to be alone.”

And there it was. My grandmother’s attempt to guilt my mom for leaving her – perhaps even an effort to get her to stay the night.

In her book Caregiving: Helping an Aging Loved One, Jo Horne acknowledges the guilt that family caregivers often experience in the midst of caregiving.

Right #5 reads: I have a right to reject any attempts by my relative (either conscious or unconscious) to manipulate me through guilt, and or depression.

I’m happy to report that my Mom did reject my grandmother’s attempts to make her feel guilty. Mom would pour the glass of wine, tell my grandmother she’d call her later, and close the door behind her. She knew she was doing her best and there was nothing more to give.

I Want to Talk. Will You Listen? What People with Alzheimer’s Are Communicating Through Repetition

Maria — Mon, 31 Oct 2011 16:21:09 +0000

It’s really, really hard. In the course of an hour, mom may have asked you the same question 60 or more times. You’re tired and deflated. You don’t know how to manage the situation or to move on with her to something else. You’ve learned through experience that trying to reason with her, to convince her that she remembers the answer you gave one or five minutes ago, is futile and sometimes escalates things.

Maybe this video will help. The trainer is Teepa Snow, an occupational therapist with 25 years of experience in working with people with Alzheimer’s and other forms of dementia. Listen to what Teepa advises and resist the temptation to tell mom you’ve heard it before. There might be a way to turn repetition into reminiscing…

Go Ahead, Be Angry. It’s Really Okay.

Maria — Mon, 24 Oct 2011 17:45:52 +0000

I attended an event this past week where a published author asked me to share a bit about my blog before offering up some thoughts on the type of book I might write related to my chosen topic of elder care.

“I think a book that compiled a number of uplifting stories related to caregiving would be really well-received. I know I enjoy spending time with my 92 year old grandmother on a weekly basis and I think I’d like to read about others who are having similarly positive caregiving experiences.”

Really? I thought to myself.

You would go to a bookstore and leave with an anthology of positive stories about caregiving under your arm to read in your spare time? Are we talking about a coffee table type-book to share with others or one that rests on your nightstand and evokes the warm fuzzies before bed?

Honestly, I didn’t get it. And having thought about it for the past few days, I still don’t.

Of course there are many positive attributes of caring for an aging parent; with a saint for a mother, you’ll never catch me arguing otherwise.

But life experiences – like people - aren’t one dimensional. Instead they’re often complex, and prickily. They can be positive and uplifting and can also evoke difficult, messy feelings. And yes, this happens even when you love the person you’re caring for (and maybe even because you love the person).

In her book Caregiving: Helping An Aging Loved One Jo Horne touches on the notion of having “difficult feelings”. In fact, she goes so far as to add this point to her Caregivers’ Bill of Rights. Right #4 says:

Caregivers have a right to get angry, be depressed, and express other difficult feelings occasionally.

To this I say, AMEN.

Amen to books that celebrate the complexity of caregiving.

Amen to authors who encourage caregivers to be where (and who) they are without guilt and who offer up their insights within that particular space.

I’m hoping I have the courage to write a book like that someday…

I think it’s in me.

No related posts.

You Have A “Right” to A Life Separate From Caregiving

Maria — Thu, 13 Oct 2011 11:00:50 +0000

This is week three of my nine-week countdown of the caregivers’ bill of rights discussed in Jo Horne’s book Caregiving: Helping An Aging Loved One.

Did you miss weeks one and two?

I can recap them in just a few words: You Have a Right to Take Care of Yourself and A Right To Seek Help From Others so that you don’t drown.

This next one goes a bit deeper though…

Right #3: I have the right to maintain facets of my own life that do not include the person I care for, just as I would if he or she were healthy. I know that I do everything that I reasonably can for this person, and I have the right to do some things just for myself.

If you’re caring for an aging parent (and presumably, you are or you wouldn’t be here), do you allow yourself to have a life separate and apart from caregiving?

Do you feel you deserve it?

I’m asking sincerely…

For a lot of you I’m willing to bet that the answer is no. In fact, I’m sure a good number of you don’t know where caregiving ends and you begin anymore.

It shouldn’t be that way.

It can’t stay that way.

Perhaps one of the most important things I can use this blog to tell you is that you matter. You matter just as much as the person you’re caring for.

And you need a life that’s yours with people and places and moments and laughter that have nothing at all to do with caregiving.

So here’s to you finding and claiming them. Whatever they are for you…

Is Your Aging Parent’s Doctor Good Enough?

Maria — Mon, 10 Oct 2011 21:11:13 +0000

As we get older, having a good doctor (or a team of them) in our corner becomes incredibly important.

And you don’t want just any doctor for your mom/dad (or for you!). Smarts, signs of basic compassion and a few other things are essential for the relationship to work…

Good Doctor Quality #1: Listening skills

Picture it: Your mom’s doctor’s office. 10AM Tuesday. She reaches into her pocket for her list of three concerning symptoms she plans to mention, IF she can get a word in edge-wise.

(I’ve got to tell you…this is not looking good.)

And yes, what the doctor knows and can tell with his/her instruments is important.

But so is what your mom knows. About the symptoms she is experiencing. In her own body. Enough said.

Good Doctor Quality #2: Reachability

Think it might be easier to score the latest iPad on the release day then it would be to get your aging parent’s doctor on the phone when you need to?

Yeah. That’s definitely a problem.

Simply put, stuff happens as you get older. Your aging parent may wake up feeling dizzy. He/She may develop a cough that hangs on despite cough syrup and enough hot tea with lemon to drown a camel.

When this is the case your mom/dad is going to need advice over the phone, and if the situation warrants, an urgent appointment. If you ask me, this one is non-negotiable.

Good Doctor Quality #3: Thorough check-ups

There are basic tests that should be done as part of a standard physical. These tests are both diagnostic and preventative.

So none of this, “Well, we took blood last year, you’re probably okay.” or “That scan does look a bit abnormal but it’s probably nothing.”

Unless your aging parent’s doctor can articulate a logical reason to forgo basic testing and/or prolong a further work-up when one seems warranted, it might be time to move on.

Good Doctor Quality #4: Explains the big picture

Let’s say your mom’s blood pressure is high despite taking her medication most of the time. Think it would be good for her doctor to remind mom about the importance of taking the medication exactly as directed?

You bet.

But you know what would be even better?

Reviewing why mom takes blood pressure medication in the first place. How about a 20-second tutorial on how keeping blood pressure low will reduce her risk of heart attach and stroke?

Look for doctors who help your parents understand the big picture.

Good Doctor Quality #5: Takes mom’s/dad’s insurance

So you know of a doctor who is most certainly “good enough” for mom/dad? WOO-HOO!

But before we break out the champagne, answer this one little question for me: Does he/she take Medicare, Medicaid, or whatever insurance your mom or dad has?

If the answer is no, your aging parent could end up paying through the nose.

So call ahead, have dad cross his fingers, and if the doctor accepts the right insurance but isn’t accepting new patients, consider waiting until that changes!