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I'm about to have joint replacement surgery and then I have to have a non-malignant tumor removed and all the while I have to be in P.T. and I'm not allowed to drive because of the drugs I have to take and my leg recovers from surgery.


My husband is supposed to be my support system, but he's showing signs of early dementia and won't talk about it and won't get any kind of help. I need someone to talk to for me, but I can't afford $200 or more/hour.


HELP!

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Your question/post asks one question and your profile asks a totally different set of questions.
for you..
Contact your local Senior Center and ask if they have a counselor/therapist that works on a "sliding scale" fee basis.
Another option for you one that is FREE.
The Alzheimer's Association has a FREE toll free line that is answered 24/7 and there are people that you can talk to any time day or night. 1-800-272-3900
And
You should look for a Support Group in your area. One that meets in person. That will be a safe place for you to express what is going on and get help from people going through the same thing,
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NelleHtur May 2023
I'll check with the associations you've suggested.
Thanks
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Could your Primary Doctor prescribe therapy or counseling so insurance might pay for it? Check with your insurance plan to see what is required for counseling to be covered if it is possible at all.
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Are you eligible for Medicare? If so, Medicare Advantage will pay for travel costs to medical appointments. Check with whichever insurance program you have any supplemental Medicare insurance with, or call one of those numbers on television to see if you can get this coverage due to a new need. I have had knee surgery and 3 kidney stone surgeries and was able to not have to rely on others for transportation. It was a real blessing. Talk with your doctor about Medicare coverage itself. Medicare provides for in-home services while you're recovering or if you can stay at home while needing medical services, but you have to have written proof from your doctor that you need it. Is your husband a veteran of a war for at least a day or two? He didn't have to serve in the war itself, just be enlisted and even shuffling paperwork. Get on the list for Meals on Wheels while you're in recovery so you don't have to worry about meal prep. Get youself situated so you don't have to worry about him not helping out when you need help yourself. Then you can focus on his needs again. Since you're online here, I believe you can access online therapy. It became readily available during COVID and there are lots of therapists available with many financially supplemented ways to pay. Then you don't even have to worry about how to get yourself to an appointment. As I'm talking, there's a box advertising free care option services from a Care Advisor. Click that box that says Get FREE Help and see what happens. Good Luck to you. Your situation is a lot like the steps you have to take if there's and emergency on an airplane and the air masks drop. Put yours on first, then take care of your child, or adult who needs help.
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Igloocar May 2023
Many Medicare Advantage plans do NOT pay for medical transportation. Each Medicare Advantage plan wants to have some distinctive features so people will purchase it. My Medicare Advantage plan does not cover any medical transportation (which I knew when I enrolled in it). It has other features that are useful for me.
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Unfortunately, these types of services that many people need the most are out of financial reach for many. Then... we, as a society, waste / spend millions on 'rehab' (and prison) for those needing mental health counseling services, including housing, addiction, depression ... when many could have been helped initially with AFFORDABLE counseling services.

You write: "he can't know that he's the problem" which IS part of the problem. Seak with "I" statements... you are not accusing him of anything.
Do not address the issue of "You don't xxx..." or "you this and you that ... " (as)
He will be-come more resistant and defensive (causing both of you more frustration and not getting your needs met.)

However, if he is in denial of his mental abilities / brain changes / inability to support you as you need, you must make decisions. (And, part of the disease is that he will be in denial --- "he doesn't know what he doesn't know" (or perhaps he does at this stage-although denial is certainly a common response).

* You need couples counseling / support; not just for you.

* Ask your MD (and his) for support and guidance.

* Check into schools offering counseling interns hours. Their fees will be less and they are supervised.

* Check into group therapy.

* Peer support (group) may be better than nothing (try Next Door, Church, dementia organizations).

You have several 'issues' / needs here to address:

1. Your physical (and otherwise) needs requiring a care-giver.

2. Your husband's denial of his brain changes. And, by way of you wanting to 'not let him know, you are being a 'co-dependent' - of his dis-ease.

He doesn't want to believe he cannot function as he used to and certainly, he feels frustrated and sad not being able to support you as he wants and likely has for decades. This is a harsh / hard reality for anyone to face, individually and as a couple.

3(a). The relationship between you / stressors / communication / fears.
3(b). How you move forward in this relationship, as both of you change.

This is a lot on your plate. Not easy.

It appears to me that you first need to deal with your need for care after your surgery as this is a timely need. If he cannot support you as you need, arrange to have a caregiver in for several hours a day. Or you may need to go to rehab to recovery (if possible).

Gena / Touch Matters
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As others have suggested, I suggest you list your concerns and talk to your PCP about it. He/She can refer you to a social worker who can help find resources to help you clear your mind so that you can focus on your upcoming surgery and recovery.

About your husband, take a piece of paper and start listing all the things (not situations) that your husband CAN do. Then take another piece of paper and list all the things he cannot do. To go on the "cannot do" list, he should exhibit that behavior more than once. Be specific. Try to be honest with yourself and your husband and beware of your biases.

Review both lists often. Modify it as you learn more about his behaviors. Then partner with your husband and utilize his strengths. Make sure you use both lists when you come up with your care plan with the social worker.

As time marches on, these lists will be helpful for dealing with his dementia and where professional care givers can assist you.
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Maybe your primary care physician can point you to free or low cost counseling . Some of the online virtual counseling are lower cost as well . Your profile says you live in Great Neck . That’s very populated . I used to live in Suffolk County . Maybe look at your Nassau County website , maybe there is a health services, social services link. Or check with local hospitals. You have a lot of hospitals there , check for free or low cost counseling . Also sometimes Universities have free counseling by students under the supervision of full fledged counselors . Maybe Adelphi or Hofstra university, Farmingdale . . There are other colleges too .
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NelleHtur May 2023
I actually live in Phoenix, AZ.
We're probably coming back to MA, but not till we get some medical questions straightened out.
Thanks for the options
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So, what it "costs" to see a therapist varies widely and involves a lot of factors.

If you look on the Psychology Today website, you will see lots of therapists who accept no insurance and charge $200-$300 per session.

If you call your PCP, or a local Women's Health Center or organization like your local Area Agency on Aging or a mental health referral line, you are more likely to get a therapist who accepts Medicare and your supplement.

I pay $15. per session to see my Licensed Social Worker. In NYC.
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Thank you all.
I'll begin to check out our available organizations.
There is also Jewish Family and Children's Services.
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My DH saw a counselor who was actually doing her 'hands on therapy training' before she could graduate as a psychiatrist.

The cost was not $200 an hour, in fact, I think insurance covered most of it.

She was GREAT because she cared, for one thing, and also because she was being 'mentored' by a couple of professors.

We have a teaching hospital here and he went through that. I wish she had stuck around after graduation--he really clicked with her.

If the 'problem' is your DH--and you need him to drive you--maybe you can reach out to family, friends or even take an Uber to appts. My DH knew that after therapy appts I was always 'raw' and he didn't WANT to be involved.

I wish you luck in this. I'm a firm believer in having a therapist you can trust to talk to. Mine was wonderful and she gave me many skills to work with. I hope you can work this out.
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I'm not sure what the focus is on first?

Do you need to work out safe & supportive after surgery care?

If your Husband cannot provide that service/support, then look beyond him.

Have you asked your medical team what options there are? Eg rehab instead of straight home? Or even residential respite care?

If home, what services can come to you? Home health aides? PT? Can you take a taxi or uber while you can't drive? Other patients must have been in similar situations right?

Regarding your Husband seeking advice or therapy for himself - if he lacks insight of any issues, he won't see the point. No therapy will cure dementia or help retrain him.

But advice & therapy can be very useful for YOU. Calling a Dementia or Alzeimer's organisation could hopefully have more resources & ideas for you.

This will be a big time of change. Surgery & illness does happen... but hopefully with support you will do great!

Do you have any family members or close friends you can lean on?
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