I REALLY Don't Like To Be Browbeaten

If you see my profile, I'm taking care of my older sister. Because she is homebound (or couch bound now) she gets Doctor On Call. She hadn't been eating full meals for months (it's usually applesauseand blueberry waffle for breakfast and that's it. I could sometime tempt her with mixed veg that I get will meals that I'd brought but not very often.)

Anyway, myself and two family friends had warned her about the weight loss and suggested that she go to the hospital. She wouldn't listen. Luckily, I finally got an appointment with her doctor for Doctor On Call (who's been her doctor for about a year). He took one look at her and called for an ambulance to take her to the local hospital. She tried to baulk (as she did to the family friends and me) however, he's a forceful person and overruled her. 'No choice' he said.

(My own doctor did something similar 3 weeks ago, I went to see him in the morning because of diarrhea and vomiting (so I’d skipped my breakfast and breakfast pill, since it has to be taken with food) One look at my 315 glucose reading and I was in the ambulance and on my way to the hospital. I was there for 10 hours.) And yes, my sister was fine (misunderstood what has happening when I'd called her and she told the family friends, who visited me, what happened. I don't think blood pressure go up to 310 ;-))

Therefore, she'd been at the hospital (emergency area, not admitted ) and a Social Worker came by, questioned her, and suggested her to be placed in a nursing home. He started to question my sister and she said she could move around (not that much, she did make it to the kitchen one time but if I hadn't been with her (I'd just returned from work) as she tried to walk back to the couch she would had fallen.

I was only trying to correct her statements to the Social Worker and he accused me of influencing her. I'd stepped back (rather than argued) and he put the curtain around the bed to talk with her alone. She didn't actually agree with him about the nursing home (she said she looks forward to hearing my keys in the door when I come from work.)

I usually put out her breakfast (the after mentioned applesauce and blueberry waffle) and V-8 juice and give it to her (after I'd prepared my own breakfast) before I leave. There's a bucket near the couch (I'd brought her a walker, which she had yet to use, still using her cane when she does try to walk) And yes, now that she's out of the house I will get a bedside commode next paid period for when she comes home.

The EMTs that picked her up said the environment is not good which is why the NH was suggested. Since Medicaid will cover 20 days (after 3 days admittance in hospital) in NH it will give me (and the family friend) time to clean up the apartment.

I did bring that point up to the other Social Worker who shows up the 2nd day of my sister stay at the hospital. He was more reasonable (he said the first Social Worker was his boss and his attitude seem to be expected) And took steps to get my sister admitted (she was today)

What irks me is the first Social Worker talked to me saying I was more concerned about the cost to me than the care of my sister. (I get $1,600.00 a month without overtime. My sister gets about $800.00 a month from state and SSI benefits) I add $500 to her $800 to pay the rent of about $1300.00.

So, according to him, it would be fine for my sister to be comfortable at the NH (providing she could pay for it, remember the $800.00 a month) but it would be alright that I no long have her check to cover the rent and I would be out on the street. No doubt, my sister would be happy to have that happen to me (I'm being sarcastic)

This is more to vent than anything else but as I said above I DON'T like being browbeaten. Luckily, the second Social Worker was easier to talk to. Thanks for letting me blow off steam.

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Tripp, you're in NYC. Medicaid will pay for 24/7 aides in the home if that's what your sister needs.

Just remember that. Tell the SW you know that it's the case.
Helpful Answer (1)
Tripp224 Mar 2019
Remember I do come home from work.  So it wouldn't be 24/7 since an aide wouldn't be needed once I come home.

(I feel sorry for the aide, if she gets one.  Even when she was mobile, all she did was lay on the couch and watch TV and hobbled into the kitchen for her meals.  Would be very boring for the aide)

At the moment they're still looking for a bed (will have to starting visiting her after work instead of mornings, I'm running out of leave).  Hopefully before Medicare's 90 days limit.
The bucket next to your sister...what was that for? To use to void into? She has no bedside commode? Do you think this caused the EMS team to question sister’s ability to be at home alone? It’s a high rise apartment- has a elevator I assume? If not EMS could have suggested this too presents a safety risk for your sister.

I see your predicament about if you lose your sister’s income you will probably have to move, as you said. This happened to my brother in that he lived (lives) in a two BR HUD apartment & now since my mother passed away he would never be able to qualify for a 2 BR anywhere else and can thankfully stay where he is because it’s been that way (2BR) for years. He won’t qualify for anything but a one BR apartment. It’s hard to give up the extra bedroom.

The SW you spoke with appears to be myopic but in their defense they probably are geared more toward SNF placement for families that can’t care for their elderly thus it’s hard for the SW to think out of the box.

I sincerely hope your sister gets better and can come home. What is her age? I think it was very unprofessional for the social worker to suggest you are somehow keeping your sister from getting care she needs because as roommates you depend on her contribution to make rent.

The “bucket” concerns me however. If sister can’t get to the BR unassisted she needs a bedside commode. I don’t think insurance pays for this - a BSC costs about $50.

Good luck to you both.
Helpful Answer (0)
Tripp224 Mar 2019
A bedside (or rather couch side, I don't think I can talk her into going into the bedroom because of the greater distance to the door) commode will be brought for her to use by the time she comes home.  Actually Walmart have them at $30-$40.  If a doctor can write up a prescription for it then Medicaid would pay for it.

By the way, the bucket was my sister's idea when she realized it was becoming difficult to walk down the hallway (even with her cane) to the bathroom.

It was mentioned that was Woodhull's primary goal when someone like my sister is admitted is to transfer to NH.  But as I said in the update hopefully it will be temp.

 I don't think I got that far with the explanation with the 1st SW.  I simply said we couldn't afford it and he shut down on me. Yes the apartment has an elevator, we're on the 17th floor.  My sister is 84. 

The current SW is female and again, I hate to be sexist but we are doing better with her.
There are low income apartment rentals that don’t go above a certain percentage of a person’s income.

There can be a wait list so it would be a good idea to inquire now. In New Orleans their is a program called Unity.

This non profit organization helps low income. homeless, people on disability, etc.
You will have to see what is available in your area.

In some cities hotel rooms are even used as temporary shelter until a permanent home can be found, not done in New Orleans because we rely so much on tourism and have nice hotels that are suited to the tourist making them too expensive to use.

With all of the air B and B’s around there may be a possibility of temporary housing for a brief time at a much lower rate, just like Uber compared to cabs. The cab/taxi drivers are suffering in our area since Uber. Lately I have noticed Uber really hikes up prices for special events too, such as Louisiana Jazz and Heritage festival.
Supply in demand sort of thing.

But just inquire if there is such a program in your area.
Helpful Answer (3)

If you or sister cannot afford past the 20 days, ask about Medicaid paying for the other days. Medicare will pay only as long as sister needs therapy. If she hits her plateau she will be discharged
Helpful Answer (0)
Medicaid is the same as Medicare, they will only pay for rehab if she is improving.
Sorry for the delay. I'm logged in on my work computer since
it's easier to do posts on a computer than a tablet.

This is the update. My sister was admitted into the hospital
since it was over 3 days Medicare will allow her to be
transfer to a rehab facility (which Medicare will pay for 20 days,
I may be able to scrap $164.00 for 21 days to make it an
even 3 weeks)

I got a list of rehab facilities, which I'm going over. There will be a separate post on asking for advice on picking the right one.

Everyone seem to believe it will be temporary. Once she regain her
movability and the apartment is clean up and walker friendly she will be allow
to return home. Moreover, she will finally use the walker and not the cane.
(When she was moveable with her cane, she went to the kitchen
to make waffle and go to the fridge for the applesauce and juice)
I will have a bedside commodore for her when she comes back.

That's the main reason she pefer staying in the living room instead of the bedroom is because the door is closer and easier to answer (less distance to cover) Hopefully when she's back to using her legs again she'll used the walker and go back to answering the door.(the two family friends has the keys and can let themselves in the apartment for the time being)

Since I have 3 weeks to myself I'll see about being a POA or medical rep  (along with cleaning the apartment.)  Thanks for the support.
Helpful Answer (1)

Here the rough breakdown of the
current finances: my check: $829.00 per 2 weeks (without overtime)
monthly: $1658.00
my sister benefits (SSI & state): $858.00 monthly 
($1658.00 + $858.00 = $2516.00 monthly
Current rent: $1354.00 (it might go up once the recerfication is reviewed)
($2516.00 - $1354.00 = $1162.00)
Now if it was just me: $1658.00 - $1354.00 = $304.00

Granted lf it would only be just me if my sister go permently to a NH. In that
case I would no longer be living in a 2 room apartment but a 1 room or suite
so it would be a different rent amount. Also, losing my sister as roommate
means the $400.00 deduction for a disable and/or senior tenant would also be gone.

(Overtime usually bring in about $100 to $200 extra per paycheck depending on how many hours I put in. But being a goverment worker, ever time congress hassle over the yearly budget the overtime is canceled. It may take up to 2 months before I can work overtime again.)

But again, it looks like my sister's stay will be temporary.
(Her SSI check is not endangered unless it goes past 3 months. Once I get the
paper works I'll take a copy to the local SSA office just to be safe)
Helpful Answer (0)

Social workers are like any other profession in that there are good ones that make it their business to know as much as possible about options and variables, look at the family as a whole and integral part of the patients well being (for better or worse) going out of their way to help and those who do the bare minimum and not so well as well as everything in between. The problem is people are their job so the not as good ones stick out like sore thumbs and of course they are all overworked and probably underpaid which doesn't help. I have found in particular those "care coordinators/social workers in the hospital can have tunnel vision and are more apt to not consider the big picture. Your sisters happiness is going to affect her health as well but if you are your sisters POA or appointed representative with her permission to be involved in her medical care on file with the hospital (or simply because she says she wants you present when he walks in) you are well within your rights to step into their side of that curtain and insert yourself into the discussion. It's one thig for him to say or indicate that he prefers to hear answers from her (a doctor in particular but may SW might be testing other things this way) and another to accuse you of using your sister and not wanting what's best for her after his 5-10 min visit.

Providing your sister has given you that status don't worry about insisting you be a part of every discussion. That's not to say you shouldn't consider moving her, only you and she (maybe) really know f it's time to consider that but you also know her needs and what you can or can't meet when it comes to those needs and it sure sounds to me as though you love your sister and care about her wellbeing before considering yourself. Don't internalize everything even the "professionals" say, even they have differing opinions and it sounds like that particular SW wasn't being so professional.
Helpful Answer (0)

Social Workers don't like it when they're trying to interview a potentially vulnerable person and the person isn't allowed to speak for herself. It's a red flag. We can tell that your sister isn't at risk from you; but how was he to know that?

It sounds as if he went on to make assumptions he shouldn't have made without investigating properly first; but the communication had got off on the wrong foot to start with. I'm glad it's improved now, and I hope they'll find the right kind of support for both of you.
Helpful Answer (1)
Tripp224 Mar 2019
I hate to sound sexist but the 2 current SWs on my sister's case
are female and I seem to have less problems (as in no conflict at
all at the moment)
See 1 more reply
I know it’s scary to think that the future may not look like the present. But maybe if your sister does go to a long term care facility for 24/7 care, you could downsize your apartment to something more affordable? I don’t know where you live but in my area $1300/mo is a very expensive rent.
Helpful Answer (3)
JoAnn29 Mar 2019
For a two bedroom apartment where my Daughter lives, she is paying close to 1300 in a complex. Private rentals maybe cheaper.
See 2 more replies
I really don't care for Social Workers. For me, they don't think out of the box.

You and sister live together. And yes, you rely on each other to be able to live. His concern should be for both of you. There are a number of families that rely on each others income. When one income drops off, it puts a burden on others. He should be looking at the whole picture.

It maybe time for Sister to have 24/7 care. Her SS will go towards her care. I think the SSI drops off because its state aid and so is Medicaid. Now its you. How old are you? Do you collect SS? Do you have Medicare? My answers were depend on these questions.
Helpful Answer (1)
Tripp224 Mar 2019
Just turn 60 in February so no SS or Medicare yet.  As mentioned above I'm a government worker.  She's going to rehab and it seem to be a temp thing (crossed fingers)
What would happen if there was a fire? Or another emergency in which your sister, barely mobile and alone in the apartment, needed to get out?

You are living with your sister and between you, you can make rent. Your sister appears to need a higher level of care. She will no longer be able to share the burden of rent with you.

Tall to the SW about what low cost options there are for you, going forward.
Helpful Answer (9)

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