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A doctor has never had to accept Medicare patients (it has absolutely nothing to do with the Affordable Care Act). The only rule is that if they accept one Medicare patient they cannot turn down othe ...Read More

A doctor has never had to accept Medicare patients (it has absolutely nothing to do with the Affordable Care Act). The only rule is that if they accept one Medicare patient they cannot turn down other patients who are on Medicare if they are still accepting new patients.

Thanks, Madge.

Most of personality disorders are generally thought to have to do with childhood or even a later trauma someone experiences. Different people response to things differently ...Read More

Thanks, Madge.

Most of personality disorders are generally thought to have to do with childhood or even a later trauma someone experiences. Different people response to things differently. Even if similar things happen to two different people they can be affected totally differently. Even bullies are thought to be a product of the way they have been treated.

I did not interpret what bookworm shared about her grandmother as being a mean person. May be a bit contrary like my dad was, but definitely not mean and nothing hoarding an inheritance.

Best to everyone.

Not necessarily. Some include the Health Care Proxy or Medical Power of Attorney with the DPOA, but not all. Some people chose to name a separate HCP/MPOA from the DPOA. You need to refer to your m ...Read More

Not necessarily. Some include the Health Care Proxy or Medical Power of Attorney with the DPOA, but not all. Some people chose to name a separate HCP/MPOA from the DPOA. You need to refer to your mother's actual document to know if it includes the health or not.

Does your POA include making medical decisions or is there a separate Medical Power of Attorney or Health Care Proxy? The medical and health concerns outweigh the others, so whoever has is MPOA gener ...Read More

Does your POA include making medical decisions or is there a separate Medical Power of Attorney or Health Care Proxy? The medical and health concerns outweigh the others, so whoever has is MPOA generally has the ultimate decision.

In the case of someone with survivorship of accounts and property, this is usually considered non-probate and is not subject to the probate court even though it is usually listed on the probate apprai ...Read More

In the case of someone with survivorship of accounts and property, this is usually considered non-probate and is not subject to the probate court even though it is usually listed on the probate appraisal.

The executor or executrix of the estate would be responsible for paying from the estate assets. Though the POA document is void with the death of the person (except for decisions involving the proper ...Read More

The executor or executrix of the estate would be responsible for paying from the estate assets. Though the POA document is void with the death of the person (except for decisions involving the proper care of the body) this could be the same person as the POA.

As far as those with survivorship on accounts and property, I am not totally sure how this all works, because it could put a hardship on a remaining spouse for instance. It definitely depends on state laws and I would consult an elder law attorney who could help if the bills are substantial.

You are not legally bound to care for another adult if you choose not to or cannot. It is not the same as being a parent of a minor child.

Has your mom been declared mentally incompetent by at least 2 doctors? If not she can revoke the first POA and appoint another one anytime and as many times as she likes. The nursing home hopefully ...Read More

Has your mom been declared mentally incompetent by at least 2 doctors? If not she can revoke the first POA and appoint another one anytime and as many times as she likes. The nursing home hopefully is only doing due diligence by honoring the first one though it does sound like they are doing it more for their own benefit and not to honor your mother's rights to appoint whom she wishes. Who has the check book in the family? The nursing home would have to have the document analyzed professionally to prove it is not your mom's signature which is quite expensive. The Ombudsman is a good place to go or a good elder law lawyer. Did a lawyer draft the POA? May be s/he can answer your questions or give some advice on how to handle this one.

It is possible to have both parents placed in the same room. Most facilities do try to place them together as long as the level of care permits it. There may be laws that protect this - I just can't ...Read More

It is possible to have both parents placed in the same room. Most facilities do try to place them together as long as the level of care permits it. There may be laws that protect this - I just can't remember exactly. My husband's grandmother was in one private room and her "baby" sister was in the private room next door in the facility they resided in.

There are several transferring techniques and I would suggest getting some professional demonstration so you will not hurt yourself or the patient. If the patient can bear some weigh, there is a tech ...Read More

There are several transferring techniques and I would suggest getting some professional demonstration so you will not hurt yourself or the patient. If the patient can bear some weigh, there is a technique that I learned from a hospice nurse which I liked. The patient hugs you around the neck while you place your hands under his/her hip area where the legs meet the buttocks with thumbs outward and the other four fingers inward cradling the bottom and sort of making a seat. Also the patients legs are locked inside your legs which gives them support as you lift them up and pivot them around. Make sure your back is straight and use your legs to lift and not your back. Have the chair as close as possible and the patient sitting as close to the edge of the bed as possible before beginning. It is easier to do if it is demonstrated rather than reading about it, but it does work.

If the patient cannot bear any weight, then a hoyer lift is required and if the home can accommodate it. You will be trained in how to use it by whomever you rent it from and home health aides.

My mom was on hospice for 16 months. I saw the good, the bad, and the ugly of hospice. It was a not for profit hospice, but as Mom lingered on and on I definitely got some attitude from the office, ...Read More

My mom was on hospice for 16 months. I saw the good, the bad, and the ugly of hospice. It was a not for profit hospice, but as Mom lingered on and on I definitely got some attitude from the office, though not from her team. They definitely liked using the Medicare excuse. They made me mad plenty of times especially because mom was totally bed bound, was not going to get any better and was terminal, but was not actively dying and yet they wanted to kick her off. Her doctor still certified her as terminal, yet they had no problems irking me about it. Sometimes I felt like they saw me as a lowly unpaid servant and they could vent on me - they did not seem to see me as an exhausted daughter in her early 30's who was losing her mother. I did end up taking her off of hospice - mostly because I had enough of them to do me a life time and I was certain my life expectancy had been decreased because of the experience. She lived another 6 months after I took her off. She was just so sick - throwing up a lot - I was fed up with her not getting the comfort treatment she needed. The problem that everyone overlooked was she had been on prednisone without an anti-reflux medicine for most of the 16 months (I did not even realize she needed it.) That steroid was eating up her stomach. So her suffering could have been eased very simply, but because hospice was acting as if there was nothing that could be done and we should just accept she was dying. They get into this mind frame because they do not want to be aggressive and tend overlook simple solutions. They were good at day to day type care, but when it came to any crisis stuff it was a good thing I had a background in medicine - but there were still days I did not think I knew enough.

Anyway, DT, I am glad your mom has such a wise and caring doctor and son, too. Even if hospice might be able to get out of paying for the transfusions, they cannot keep her from getting them. There is a way to go off of hospice and then go back on. Also she can still take her regular medications while on hospice. They only have to pay for the medicines which are related to the terminal diagnosis. Insulin was even paid for because the steroid my mom was on to keep the edema down in her brain from the tumor caused her blood sugar to shoot up. The steroid was a comfort measure - to keep the swelling down and prevent pain. If she had not had insulin, she would have gone into a diabetic coma and died. I also required them to treat UTI's and once she had pneumonia - I requested Levaquin and she pulled through. I believed in treating treatable infections and that it was a comfort measure. As long as she responded to the treatments I believed that she was not actively dying and should be treated. When it was her time, I had no problem stopping treatments and just "knew" when to say no more. Treating infections was also part of her living will she had made before appointing me as her MPOA plus she had prepared me for years for what she wanted. I also always talked to her about the decisions and let her make them as long as she could. Some in hospice believe in no treatments and stopping all medicines unless they are for comfort reasons, but they need to respect that each individual should be able to decide if and when they discontinue their medications even when they are on hospice. From a medical policy angle, hospice does allow for a lot more than some hospices want to deliver and some do get by with this because many families do not know any better and they are so overwhelmed they are not for sure where to turn.

A good resource I found on line was Patient's Hospice Alliance.

I am sorry to hear about what happened with your mom. Have you heard of Patients Hospice Alliance? It is a web site - so just do an internet search for it. It is run by Ron Panzer. You will find t ...Read More

I am sorry to hear about what happened with your mom. Have you heard of Patients Hospice Alliance? It is a web site - so just do an internet search for it. It is run by Ron Panzer. You will find that what happened to your mom is not uncommon, unfortunately. Best, Kitty

You are very welcome, DT. You have been on my mind lately. Thanks for the hug!
Best,
Kitty

I am so sorry, DT, that you and your Mom are going through this. My dad had ITP (low platelet counts of unknown reason) among other things and had nosebleeds, GI bleeds, and kidney failure. Have the ...Read More

I am so sorry, DT, that you and your Mom are going through this. My dad had ITP (low platelet counts of unknown reason) among other things and had nosebleeds, GI bleeds, and kidney failure. Have the doctors suggested IVIG treatments (intravenous immunoglobulin) or steroids?

She is very fortunate to have you as her son. When her time comes in someway and somehow she will be ready and at peace in her own way. Just as she has had her own unique outlook on life, she will have her own unique ending story - one that you will be able to appreciate like no one else can. I wish you both good things during the time you have left together - and I know that there can be good things even in the last days of life.

Thanks. I totally respect your opinion, Coach. From what I hear of the plans from the Republicans like Paul Ryan, they are coming across as not caring for the elderly, the disabled, or the most vuln ...Read More

Thanks. I totally respect your opinion, Coach. From what I hear of the plans from the Republicans like Paul Ryan, they are coming across as not caring for the elderly, the disabled, or the most vulnerable of our society. I do not see it as just not agreeing with the Democrats.

Best to you, Coach.

So would you rather have vouchers and privatization of Medicare or block grants to states for Medicaid like Senator Paul Ryan suggested instead? This one would feed you to the insurance wolves, mean ...Read More

So would you rather have vouchers and privatization of Medicare or block grants to states for Medicaid like Senator Paul Ryan suggested instead? This one would feed you to the insurance wolves, mean someone other than you are getting much richer, and there would be limited amounts states would have to provide for nursing home patients as well as children and severely disabled which would mean the cost and responsibility would "trickle down" to the states, providers, but ultimately to the families - which is the main reason Medicare was created in the first place - to ensure the elderly did not live in adjunct poverty and that their families were not overly burdened financially.

As far as unauthorized immigrants go we do not provide Medicaid for them. There is a special program in place within the Medicaid system to help reimburse hospitals for emergency care to undocumented citizens. Remember ER's are in the business of saving lives not being border patrol - they do not care where the person is from if their life is at risk and have an ethical obligation to treat emergency cases. Most of the ER services provided are for childbirth and related complications. Otherwise there are no other reimbursements through Medicaid to illegal immigrants - I know because as a former Medical Policy Specialist for Medicaid in a state with a higher unauthorized immigrant population, I have denied claims to providers where the care provided did not fall within the very limited emergency care policy. And as far as the children who have born here - they are American citizens by birthright and are eligible for Medicaid. In the over all scheme of things, it really is not the much of the budget - well under 1%. So lets not put the blame on these folks. I am tired of all the unfair, negative, and false stereotypes perpetrated against the those on Medicaid, welfare, and unemployment as well as those against unauthorized immigrants. It is sad we blame and even dehumanize the poor when we should be looking at those with the power and wealth.

I am so sorry you are dealing with this. I know it is an inconvenience, but I think before someone calls the police when he is out wandering or heaven forbid gets hurt and you are reported to adult s ...Read More

I am so sorry you are dealing with this. I know it is an inconvenience, but I think before someone calls the police when he is out wandering or heaven forbid gets hurt and you are reported to adult social services, you need to look for someone to sit with your dad while you are out. Your neighbor was very nice and caring to help your dad out, but some may not be so nice or might not be home to see that he is out. Just like you have to hire a babysitter for your children when you go out, you are also responsible for your dad who has dementia in much the same way. I know this is not an easy step to take, but for his safety you must. It is also to protect yourself. It is so difficult to admit when our parents can no longer be independently functioning adults - we have seen them our whole lives as the ones who cared for us and when they can no longer care for themselves it reminds us of our own mortality. Denial is very common from both parents and their adult children. We grieve watching this happen.

Call your local Agency on Aging for more information on how to secure your home with for a family member who has dementia. You may also want to look into care homes that deal with this kind of resident and has special security systems in place just in case you decide caring for him at home is no longer an option. It may come to that and at least you are one step ahead if the time comes.
Best to you and your dad.

I am sorry I posted without realizing the post I was reading was from 2008! It came through an email from the web site. I am not for sure what all you have been through since and I hope it did not u ...Read More

I am sorry I posted without realizing the post I was reading was from 2008! It came through an email from the web site. I am not for sure what all you have been through since and I hope it did not upset you. I still wish you the best.

Hi msTish, I am 41 years old, too. I cared for my elderly parents what seems like years ago - will it was - my mom died almost 10 years ago and Dad almost 3. I am now raising a little one. I could no ...Read More

Hi msTish, I am 41 years old, too. I cared for my elderly parents what seems like years ago - will it was - my mom died almost 10 years ago and Dad almost 3. I am now raising a little one. I could not imagine having 3 grown sons! My husband and I joke about how we are old enough to be grandparents, but could never imagine it. I am so sorry about what you are experiencing with taking care of your MIL. I could never imagine taking care of my MIL and especially if my husband did not really do much to help. If your MIL is still living at home have you considered home health care or calling a companion service? Is she a member of a church that might have some volunteers? You need to do something more some respite or you will get burned out really fast - if you aren't already. It is not good for your health. Your husband has no right making a promise for both of you without your input. It is easy at the beginning to promise when you have not gotten into the trenches yet. He needs to step up to the plate. It is not fair to you. You have so much more life to live. I used to make hand dipped chocolates and other candies when I was a teenager, but haven't done it much as an adult. I certainly hope you get back into candy making very soon! Best, Kitty

All very good answers. Neuropathy or other neurological interpretation, circulation disorders, low body weight, low thyroid, anemia and other blood issues are all the possibilities that I thought abo ...Read More

All very good answers. Neuropathy or other neurological interpretation, circulation disorders, low body weight, low thyroid, anemia and other blood issues are all the possibilities that I thought about, too. Another I would think about is low sugar or other endocrine problems. If she saids she is cold, then she is cold regardless of how her skin feels to the touch. If her doctor hasn't checked for the above, then I would suggest asking the doctor to check. Some are more easily treated than others.

Why do you refer to it as non-earned income? What was taken out of my paycheck all of those years?

I am so sorry to hear about what you are going through. I, too, have a mother-in-law who is very hateful, controlling and manipulative. It is strange that her mother (1923) was only a year older tha ...Read More

I am so sorry to hear about what you are going through. I, too, have a mother-in-law who is very hateful, controlling and manipulative. It is strange that her mother (1923) was only a year older than my dad (1924) and two years older than my mother (1925.) Her father (1919) who just died Thursday, was 5 years older than my parents. I was an orphan before my mother-in-law was. I also took care of my parents in my home where as she utilized assisted living and nursing homes. Not saying that is bad, but anytime my plight came up, she always said that I was young and could handle it. No sympathy much less empathy for what I went through nor any acknowledgment that I have MS. It was all about her and her woes. And of course, my parents were never as bad off as we said even when they were on hospice.

I totally respect you for putting up the boundaries you have with your relationship and not wanting to be around her. I have been able to do that because of distance, too. And fortunately, my husband does stand up for me for the most part. That is one of the most important things in this equation. I do think a talk is in order. Your health, sanity, and possibly your job is at stake. Everyone else seems to be falling apart and are expecting you to take care of everything, so you will need to stand up for yourself. Best to you.

Did you mom leave friends when she moved? Was she active? I am sure it must be very difficult on her to have moved recently to a totally different region and left everything she knew behind. She is ...Read More

Did you mom leave friends when she moved? Was she active? I am sure it must be very difficult on her to have moved recently to a totally different region and left everything she knew behind. She is probably grieving the loss of her home and life before. She is probably also angry (part of the grief) and may be the phone is away of indirectly saying she is angry because she can directly express that to you but not tell you she is angry? Have you had any chance to acclimate her to her new town? Taken her to see the sites?

Lilliput, I certainly sympathize with people who experience sundowner's and their caregivers. I experienced something very similar about 6 weeks postpartum. It took several months to not have these evening attacks of panic. They would start about an hour before sunset and then last until an hour or so after sunset. It was as if I did not want the dark to come. I am usually such a night owl, too. I remember once during this time the electricity was out from about 1 AM to 3 AM and I could not stand it even though I should have been asleep at this time and would not have noticed otherwise.

puckmomma,
Thank you for your concern, but you may have not read my earlier posts to the original poster (who I am not) that I am well and living my life after all of these years. I do not have ...Read More

puckmomma,
Thank you for your concern, but you may have not read my earlier posts to the original poster (who I am not) that I am well and living my life after all of these years. I do not have to clean out or part with anything that I do not want to or that I do not feel spiritually ready to let go off. It has nothing to do with healing or not healing. It is a memorial in its own right. It was a guest room before and it has been after. It is even my craft/overflow room, yet there are items in there that will always remind me of her and our precious time together. Many of the items charity would not accept - they are personal care items like the wool heel protectors she was wearing the last few weeks or her beautiful hair that I ask her to save for me when it fell out after her brain radiation treatments. She still had her long dark brown hair even into her 70's. I am not in any pain from her death. She would understand more than anyone about holding onto some things as I mentioned how she also held onto things from her parents for the rest of her life.

Just as when a mother loses a baby (before or after a birth), she should be the one who decides if and when to give or put the baby's things away or change the room, a caregiver has the right to determine when the time has come if it ever does to change.

I am sorry about your mom and what you have had to face. I wish you and your family the best.

pltrickey,
I am sorry to hear of the loss of your mother. I still have a lot of things in my mom's "room," which is our guest room. It has been 9 1/2 years. I did clean out some things and gav ...Read More

pltrickey,
I am sorry to hear of the loss of your mother. I still have a lot of things in my mom's "room," which is our guest room. It has been 9 1/2 years. I did clean out some things and gave some special items to her friends and family within the first year of her death, but for the most part cannot seem to depart with the rest just yet - though I am doing a really good spring cleaning of the house and have though about cleaning out a lot more. I will see how I feel once I get to that room.

My mom kept her father's Irish sweater for the rest of her life which was almost 40 years after he died. She had other keepsakes as well from him and her mother who had been deceased for over 50 years. She even kept their home place and would go mow the yard during the summer.

So definitely take your time and do things when you are ready and not when others are telling you to do them. Best to you.