After my mom’s stroke in 2005, her life shifted dramatically. Driving was no longer an option. On top of that, it became necessary for her to move from her husband’s condo (second marriage) to a more supportive community with socialization possibilities. The condo was no longer feasible because she was virtual prisoner without the ability to drive. She knew, reluctantly, that was time to move. We were lucky, we were told, that the stroke affected the occipital region of her brain.
This meant that her peripheral vision was affected, but in other respects, she appeared to be intact. She equated the day that “they” came to take her 1987, yellow Oldsmobile away, as the most depressing day of her life next to the death of loved ones. As a caregiver and only child, this period smacked my consciousness with a brand-new reality. My mom’s independence was waning, and I needed to step up to the plate.
What to do? My mother’s resources were exceptionally limited, and I had no way to subsidize her care, especially alone (just a little guilt). Working every day with other people’s parents, I was struck with the necessary compromises that are required to affect change in later life. Geriatric care managers are called upon to make our clients’ parents happy even though “happy” does not always enter into the equation.
How can there be “happy” when one’s life is contracting, the capacity to function autonomously is diminishing, and friends are dying? But what we can shoot for is the best possible quality of life given the circumstances. The compromise we made was for my mom to move to an “independent” subsidized apartment house. Here she would have one meal a day. And this meal forced all residents out of their respective apartments into the community dining room.
There was someone to contact me (at an extra fee) about whether my mom showed up in the dining room. But, most importantly, there were tons of folks who my mom knew from the past, including several from her graduation class of 1938. At least this was familiar territory. Was she happy? Not exactly.
But she did report that she had some wonderful friends. As caregivers, we are always riding the roller coaster of caregiving. Sure, there are tons of defeats. But every once in awhile there is some tangible success. When I heard my mom say that there are people she really enjoys, I scored. I went into my geriatric care manager mode after that move. I began working on her care plan. It’s great that I knew that my mom would get a dinner.
Sure, I would hear, “Bevy, this food is hellacious. What are they trying to do, kill us? I’m not used to eating these heavy meals. How can they serve us knockwurst and brisket when it’s 90 degrees out?” And, having tasted the food, I totally agreed with her. The bottom line is that every day, my mom would get dressed at about 4 pm and get ready for dinner. It gave her a reason to get dressed every day. But what was my mom doing the rest of the day? There are minimal activities at this place. People sat in the lobby all day waiting for dinner. My mother’s physical condition and stamina were diminishing before my eyes.
I tried everything. I bought her a membership at the senior center a few hundred feet from her apartment. But my mom would not go. She said, “I can’t get up in the morning and go over there.” My mom was becoming housebound. Sure, there were all her looming medical conditions to contribute to her sedentary lifestyle. There was a laundry list including COPD, peripheral artery disease, an abdominal aortic aneurysm, osteoporosis, atrial fibrillation, to name most of it.
But my mom was still behind her eyes. She continued wanting me to call when I got home, her grandsons were delighted with her, and she still did my Christmas cards each year. What could I do for this woman? After all, I do this for a living, and this is my mom. During a Fearless Caregiver’s Conference in which my company had a table, I visited other vendors. We were all there to disseminate information about our respective businesses.
As is my routine, I visited with the other companies there. One offered physical therapy in the home under Medicare Part B. My mom could get an extended amount of physical therapy and her Medicare benefit would foot the bill. My mom could have a “personal trainer.” Now, I just needed to sell this idea to her. During our next visit to her gerontologist, I told the doctor about my concerns. I felt compelled to let him know that my mom had increasing difficulties with fatigue and her walking distance was becoming even more limited than before. I wanted him to know about my physical therapy idea. When I shared this with him, this is what happened:
Mom: Bevy, I am doing just fine. Why don’t you let me get in a word? I don’t need any help. What good would it do?
Doctor: Mrs. Fastman, your daughter is just trying to help you. You know, with all your medical conditions, you could go down really fast! I think that anything that you can do to increase your stamina is a good idea.
It was quite a scene. My mom did not want to hear from the peanut gallery. I, on the other hand, had things to say that were important for the doctor to know. Also, the doctor’s way of communicating left something to be desired. I think the phrase “going down fast” still haunts me. But at least when we left the doctor’s appointment, I had a prescription for physical therapy in hand.
Within days, my mom called to let me know that “Lorie” would be coming to see her. And then it became “my new friend Lorie is coming twice this week.” My mom referred to herself as busy because of her physical therapy. She boasted that she gave my brochures and business cards to her friend Lorie and showed her my picture. My mom became my best publicist. Although my mom has limited funds, she is adamant about having traditional Medicare and a Medigap policy.
Without it, this at-home physical therapy would not have been possible. And this caregiver got to place another mark on that elusive scorecard. I had found another way to help my mom. Tips for Caring Medicare subscribers are bombarded by Medicare options.
Besides the Medicare Part D benefit for medication, the choice of traditional Medicare vs. a Medicare Advantage Plan is an important decision. Medicare Advantage Plans work very much like an HMO. Medicare subscribers are seduced with free lunches and promises of reduced premiums. Make no mistake about it, this is a free enterprise system and companies are trying to capture an extremely lucrative market. Medicare Advantage Plans typically pay for some services not covered by traditional Medicare.
They can also cost less money. But there are important distinctions between these two options. The most important distinction has to do with unencumbered access to care without going through a primary physician. While this is not the case for all Advantage Plans, it is true for many of them. Another distinction is that many providers choose not to participate in these plans. Medicare Advantage Plans take control of the Medicare money of the enrolled subscriber and manage the spending of this money. Physical therapy centers, nursing homes, physicians, and it was quite a scene. My mom did not want to hear from the peanut gallery.
I, on the other hand, had things to say that were important for the doctor to know. Also, the doctor’s way of communicating left something to be desired. I think the phrase “going down fast” still haunts me. But at least when we left the doctor’s appointment, I had a prescription for physical therapy in hand. Within days, my mom called to let me know that “Lorie” would be coming to see her. And then it became “my new friend Lorie is coming twice this week.”
My mom referred to herself as busy because of her physical therapy. She boasted that she gave my brochures and business cards to her friend Lorie and showed her my picture. My mom became my best publicist. Although my mom has limited funds, she is adamant about having traditional Medicare and a Medigap policy. Without it, this at-home physical therapy would not have been possible. And this caregiver got to place another mark on that elusive scorecard. I had found another way to help my mom. Tips for Caring Medicare subscribers are bombarded by Medicare options. Besides the Medicare Part D benefit for medication, the choice of traditional Medicare vs. a Medicare Advantage Plan is an important decision.
Medicare Advantage Plans work very much like an HMO. Medicare subscribers are seduced with free lunches and promises of reduced premiums. Make no mistake about it, this is a free enterprise system and companies are trying to capture an extremely lucrative market. Medicare Advantage Plans typically pay for some services not covered by traditional Medicare. They can also cost less money. But there are important distinctions between these two options.
The most important distinction has to do with unencumbered access to care without going through a primary physician. While this is not the case for all Advantage Plans, it is true for many of them. Another distinction is that many providers choose not to participate in these plans. Medicare Advantage Plans take control of the Medicare money of the enrolled subscriber and manage the spending of this money. Physical therapy centers, nursing homes, physicians, and other providers can elect not to become preferred providers. The company controls the reimbursement rates and determines who can get the therapy and for how long.
This is different than traditional Medicare. Recently, one of our clients was in a nursing home that did not accept her Medicare Advantage Plan. The choice was either to leave the nursing home and move to another one or change insurance plans during an open enrollment period. A Medicare Advantage Plan can pose problems such as this. Selecting a Medicare plan is a choice that should be carefully reviewed.
If a decision has been made, you can always elect to change your mind. Just remember that there are open enrollment periods when this can take place. Check with the companies to find out about these periods. The kind of care and its quality can be affected by this important decision. Discuss this decision with your parents. Talk to health care professionals, read through every contract, or discuss this choice with a geriatric care manager.
It could mean the difference between doors opening or doors closing. In the meantime, my mom’s “personal trainer” is making a big contribution to her functionality. And in addition to attending to her physical dysfunction, she has gained someone who listens and cares. That kind of intervention cannot be measured.
She will always have her health conditions, but her ability to function with them can and has improved. My mother’s concern about change served her well in this instance. She was unwilling to give up an insurance plan that was tried and true for something unknown. The free lunch approach did not sell her that bill of goods. My mom and I stand together in this situation. And I get to hold my head up high knowing that I found a means of helping her.
Advocare Care Management is focused on providing outstanding aging life care in South Florida. We are elder advocates that help you to make the process of caring for a loved one easier. We offer a range of services including assessments, resources, tools, and advice. We serve all of Palm Beach, Broward, and Miami-Dade counties. You can relax and help your loved one with our 24-hour support. Contact Advocare Care Management today and learn about how we can make things easier for you.
Reprinted with permission from Aginglife.org. Contact Advocare Care Management and see what we can do for you.