Home Health Care

[Guest guest]

In our area, the Visiting Nurses Association will provide this service a

couple of times a week, I believe. The doctor must issue an order

(prescription) for this. It is all so difficult to accomplish, but if you

can find just ONE advocate at either the doctor's office, the MediCare

office, the Insurance office....stay with them and continue to pursue. It

takes time, but once in place it is in place. Good luck and God bless you.

Elaine Grimmesey

[Guest guest]

In our area, the Visiting Nurses Association will provide this service a

couple of times a week, I believe. The doctor must issue an order

(prescription) for this. It is all so difficult to accomplish, but if you

can find just ONE advocate at either the doctor's office, the MediCare

office, the Insurance office....stay with them and continue to pursue. It

takes time, but once in place it is in place. Good luck and God bless you.

Elaine Grimmesey

[Guest guest]

We were able to get home care for Ned that was covered by his insurance, and

is now covered by mine. The insurance company approved an LPN, not an aide,

because Ned needed his blood pressure checked regularly and eventually needed

to be cathed etc. I know we are very fortunate but it might be that your

doctor needs to write an order with a letter justifying why help is needed

(not just an aide to help bathe, etc.), from a medical standpoint. Also,

what probably helped us 10 years ago was that Ned was going on disability

from his work. We started out just having a nurse 4+ hours/day and are now

up to 10 hours a day because he can no longer be left alone (needs

suctioning, has oxygen, etc.). If you have more questions that you think I

could answer, don't hesitate to email me either through this list serv or

privately at jhbiedenha@.... Judy B.

[Guest guest]

We were able to get home care for Ned that was covered by his insurance, and

is now covered by mine. The insurance company approved an LPN, not an aide,

because Ned needed his blood pressure checked regularly and eventually needed

to be cathed etc. I know we are very fortunate but it might be that your

doctor needs to write an order with a letter justifying why help is needed

(not just an aide to help bathe, etc.), from a medical standpoint. Also,

what probably helped us 10 years ago was that Ned was going on disability

from his work. We started out just having a nurse 4+ hours/day and are now

up to 10 hours a day because he can no longer be left alone (needs

suctioning, has oxygen, etc.). If you have more questions that you think I

could answer, don't hesitate to email me either through this list serv or

privately at jhbiedenha@.... Judy B.

[Guest guest]

,

Your question is about homehealth. This is what I understand. Homehealth

is governed by Medicare guidelines. The homehealth agencies are allowed to

do only what is allowed by Medicare/or your private insurance company. It

does not help to move from agency to agency. I understand that sometimes

these guidelines may be a little different from state to state (I do not

know why.) Those guidelines generally say that a patient may have services

for 6-8 weeks and no more, unless there is a new event.

The only suggestion that I have is try to get your Dad's doctor involved to

help get more services. If the doctor can legally write a prescription for

homehealth they may pick him up as a patient again. For example, if your

Dad should have a fall that provides some injury, if he should be

hospitalized, if he develops pressure sores, etc. the doctor can legally

request home health services.

The medicare/private insurance expects the family to care for regular needs,

such as feeding, bathing, etc. unless there is a greater medical need. We

(my husband first and then I took over once he was unable to do so) the

in/out catherization 4-6 times daily for more than two years. The only

assistance Medicare would allow was one trip by the nurse to teach us how.

Sometimes there are resources to help people who really have very little

money. Talk to people at social security office about SSI, your county

welfare office (Department of Human Services), churches in their area.

If our experience is anything close to your folks, your Mom desperately

needs help and support.

Sometimes I get on my soapbox, here I go.

My husband was the MSA patient. He left this tragic illness behind in a

bed at Vanderbilt Hospital on October 4, 2002. I was his care giver (Well,

sometimes I wonder, if that was really true.). I am responding, because I

see your need and that of your folks from a different perspective than you

might. I hope my thoughts will be of help to you. I am 63 and my husband

was 70 in April. Our sons are between 36-41 who are very caring, but also

have very demanding jobs, plus wonderful families. In addition (but thank

goodness) they want to spend lots of time with their own children/wives. We

want them to do so.

So we can see the strong " PULL " of emotions, physical needs, guidance

and so on that comes from the parents who were 'smacked in the face with

this illness' and all of the circumstances that go with it, plus the needs

of our sons with growing, but young families. Our sons will do anything for

us, but we do hate to ask them. I will say that in past few months, I was

less hesitant to ask.

I will include some ideas that I have written previously for others. I

hope they will help you. My husband and I may be a little more/less needy

that other families, because I had major coronary problems within the year

following my husband's diagnosis (two heart attacks, angioplasty and finally

four bypasses. Now congestive heart failure) I do not think that my health

problems had anything to do with my husband's diagnosis. My problems are

genetically oriented, but my weakened health has probably made me some more

dependent upon my children than others may be.

I would suggest to you. Don't leave it to your parent to tell or ask

you anything. He/she may want to but be unable emotionally/intellectually

to tell/ask.

I have no idea how your mother (at her age) could possibly do what I

did to care for Speedy for the past two years.

1. This is the most important gift that you can ever give your parents, but

it takes time and commitment. Don't just say, " I love you " . Show them your

love. You may have to make major changes is your lives today, but remember

they made major changes in their lives when you needed them as an infant.

That may be exactly what your ill parent has become, an infant.

2. No matter where you live or where they live, go to your mom and dad.

Stay for a period of time. This trip leave your children at home. Neither

you nor your parents need the distraction of children. Don't just drop in

for an hour. Stay long enough to see what really is going on. Take things

in your own hands, but remember they have a routine going. It will take

time to change old habits. Some of those very things that you disliked the

most in your home when you were a child may be the very things that they

want to hold on to now. Remember it is their home, it is their life.

3. Make it a point to go with your parents to the doctor. It always helps

to have more than one set of ears. Doctor's offices can be very stressful.

Even though my husband and I are both of sound mind (we think), we sometimes

hear two different things when we are at the doctor's. This happens for

either one or both of us. If it is not possible for you to actually go with

them, get written permission from your parents for the doctor to meet with

you to discuss your parent's condition.

4. Make arrangements for you and/or your spouse to help your healthy parent

care for your ill parent on a regular basis. If that is impossible find

someone to help on a regular basis, whether they think they want the help or

not. Find someone to clean house, cook a few meals, sit while your well

parent runs errands, etc. Be sure it is going to happen week end and week

out. Your own family may have to pay for these costs if your folks can not

afford. Another alternative is nursing home serrvices. I was never able to

do. But if that would work for your parrents and they have little income,

Medicaid might pay all costs. Talk to the doctor.

5. The most important thing your healthy parent needs is your support and

love. He/she is already grieving for the loss of his/her ill spouse (as

she/he has known him/her), the loss of his/her own life (as he/she knew it),

and many other aspects of their life together. Your healthy parent may well

be in a psychological shock without being able to recognize it. She/he may

need some medical care her/himself.

6. Put all of your energies to loving your parents and showing that love to

them in actions and not just words. Do all you can to make their life

comfortable.

7. A young friend who was my employee prior to my retirement is dealing

with her own parents. The mother has Parkinsons. The doctor has said to the

dad that he must get away. His prescription for the spouse is to have

outside help at least 8 hours a day, one weekend a month, and one week every

two months. I¹m not sure that either my husband or I would ever be willing

to this much time away from each other, but I am seeing the need for help.

My thoughts come from the fact that the members of this list are mostly

caretakers and patients. In most cases, we are not medical professionals.

We all care for each other, but we also see that the illness is different in

each case.

I will be happy to discuss other issues if you like. Please know that I

care for you and your parents. My thoughts and prayers are with all of our

families each day. If you live anywhere close, I would be happy to meet

with you or your parents.

Best wishes to you on your journey.

Marilyn in TN

[Guest guest]

,

Your question is about homehealth. This is what I understand. Homehealth

is governed by Medicare guidelines. The homehealth agencies are allowed to

do only what is allowed by Medicare/or your private insurance company. It

does not help to move from agency to agency. I understand that sometimes

these guidelines may be a little different from state to state (I do not

know why.) Those guidelines generally say that a patient may have services

for 6-8 weeks and no more, unless there is a new event.

The only suggestion that I have is try to get your Dad's doctor involved to

help get more services. If the doctor can legally write a prescription for

homehealth they may pick him up as a patient again. For example, if your

Dad should have a fall that provides some injury, if he should be

hospitalized, if he develops pressure sores, etc. the doctor can legally

request home health services.

The medicare/private insurance expects the family to care for regular needs,

such as feeding, bathing, etc. unless there is a greater medical need. We

(my husband first and then I took over once he was unable to do so) the

in/out catherization 4-6 times daily for more than two years. The only

assistance Medicare would allow was one trip by the nurse to teach us how.

Sometimes there are resources to help people who really have very little

money. Talk to people at social security office about SSI, your county

welfare office (Department of Human Services), churches in their area.

If our experience is anything close to your folks, your Mom desperately

needs help and support.

Sometimes I get on my soapbox, here I go.

My husband was the MSA patient. He left this tragic illness behind in a

bed at Vanderbilt Hospital on October 4, 2002. I was his care giver (Well,

sometimes I wonder, if that was really true.). I am responding, because I

see your need and that of your folks from a different perspective than you

might. I hope my thoughts will be of help to you. I am 63 and my husband

was 70 in April. Our sons are between 36-41 who are very caring, but also

have very demanding jobs, plus wonderful families. In addition (but thank

goodness) they want to spend lots of time with their own children/wives. We

want them to do so.

So we can see the strong " PULL " of emotions, physical needs, guidance

and so on that comes from the parents who were 'smacked in the face with

this illness' and all of the circumstances that go with it, plus the needs

of our sons with growing, but young families. Our sons will do anything for

us, but we do hate to ask them. I will say that in past few months, I was

less hesitant to ask.

I will include some ideas that I have written previously for others. I

hope they will help you. My husband and I may be a little more/less needy

that other families, because I had major coronary problems within the year

following my husband's diagnosis (two heart attacks, angioplasty and finally

four bypasses. Now congestive heart failure) I do not think that my health

problems had anything to do with my husband's diagnosis. My problems are

genetically oriented, but my weakened health has probably made me some more

dependent upon my children than others may be.

I would suggest to you. Don't leave it to your parent to tell or ask

you anything. He/she may want to but be unable emotionally/intellectually

to tell/ask.

I have no idea how your mother (at her age) could possibly do what I

did to care for Speedy for the past two years.

1. This is the most important gift that you can ever give your parents, but

it takes time and commitment. Don't just say, " I love you " . Show them your

love. You may have to make major changes is your lives today, but remember

they made major changes in their lives when you needed them as an infant.

That may be exactly what your ill parent has become, an infant.

2. No matter where you live or where they live, go to your mom and dad.

Stay for a period of time. This trip leave your children at home. Neither

you nor your parents need the distraction of children. Don't just drop in

for an hour. Stay long enough to see what really is going on. Take things

in your own hands, but remember they have a routine going. It will take

time to change old habits. Some of those very things that you disliked the

most in your home when you were a child may be the very things that they

want to hold on to now. Remember it is their home, it is their life.

3. Make it a point to go with your parents to the doctor. It always helps

to have more than one set of ears. Doctor's offices can be very stressful.

Even though my husband and I are both of sound mind (we think), we sometimes

hear two different things when we are at the doctor's. This happens for

either one or both of us. If it is not possible for you to actually go with

them, get written permission from your parents for the doctor to meet with

you to discuss your parent's condition.

4. Make arrangements for you and/or your spouse to help your healthy parent

care for your ill parent on a regular basis. If that is impossible find

someone to help on a regular basis, whether they think they want the help or

not. Find someone to clean house, cook a few meals, sit while your well

parent runs errands, etc. Be sure it is going to happen week end and week

out. Your own family may have to pay for these costs if your folks can not

afford. Another alternative is nursing home serrvices. I was never able to

do. But if that would work for your parrents and they have little income,

Medicaid might pay all costs. Talk to the doctor.

5. The most important thing your healthy parent needs is your support and

love. He/she is already grieving for the loss of his/her ill spouse (as

she/he has known him/her), the loss of his/her own life (as he/she knew it),

and many other aspects of their life together. Your healthy parent may well

be in a psychological shock without being able to recognize it. She/he may

need some medical care her/himself.

6. Put all of your energies to loving your parents and showing that love to

them in actions and not just words. Do all you can to make their life

comfortable.

7. A young friend who was my employee prior to my retirement is dealing

with her own parents. The mother has Parkinsons. The doctor has said to the

dad that he must get away. His prescription for the spouse is to have

outside help at least 8 hours a day, one weekend a month, and one week every

two months. I¹m not sure that either my husband or I would ever be willing

to this much time away from each other, but I am seeing the need for help.

My thoughts come from the fact that the members of this list are mostly

caretakers and patients. In most cases, we are not medical professionals.

We all care for each other, but we also see that the illness is different in

each case.

I will be happy to discuss other issues if you like. Please know that I

care for you and your parents. My thoughts and prayers are with all of our

families each day. If you live anywhere close, I would be happy to meet

with you or your parents.

Best wishes to you on your journey.

Marilyn in TN

[Guest guest]

Sharon:

As you may know, in California, Medical will pay for Nursing Home care

and allow the spouse to retain a lot of income and resources. You might call

them and ask about the state where your brother lives.

Barbara

[Guest guest]

Sharon:

As you may know, in California, Medical will pay for Nursing Home care

and allow the spouse to retain a lot of income and resources. You might call

them and ask about the state where your brother lives.

Barbara

[Guest guest]

Dear :

I had the same problem as your parents when Ken was alive. You can

get help from the government paying for care in a Nursing Home, but it is

very hard to get if you keep the patient at home. I had full-time paid by me,

help for ken for the last five years of his life. He was in a Nursing Home

where they said he would not get better, and I decided to bite the bullet and

take him home with help. It was financially very hard, but we did have the

resources for which I am eternally grateful. I now carry long-term insurance

for myself, so I will not burden my children. If your family does not have

the resources to handle in-home care, you will have to look into the Medicaid

rules in your state. The possible alternative would be if your father is

close enough to the end that he would qualify for Hospice. Hospice gets

between three and four thousand dollars a month from Medicare to pay for a

patient's care, and they provide almost everything that is needed. It is not

necessary for the patient to die within six months as people believe; he must

be on only comfort medications and his condition must be terminal and he must

continue to decline. This applies to almost all MSA patients when you think

about it. Hospice helped us for over six months before Ken's death during a

time when our paid helpers were not even enough, and we needed extra help

with bathing and other things. You must sign a do not resuscitate order and

agree not to call 911; you call Hospice instead.

I will be thinking about you and your family as you go through these

very hard times.

Love, Barbara

[Guest guest]

Dear :

I had the same problem as your parents when Ken was alive. You can

get help from the government paying for care in a Nursing Home, but it is

very hard to get if you keep the patient at home. I had full-time paid by me,

help for ken for the last five years of his life. He was in a Nursing Home

where they said he would not get better, and I decided to bite the bullet and

take him home with help. It was financially very hard, but we did have the

resources for which I am eternally grateful. I now carry long-term insurance

for myself, so I will not burden my children. If your family does not have

the resources to handle in-home care, you will have to look into the Medicaid

rules in your state. The possible alternative would be if your father is

close enough to the end that he would qualify for Hospice. Hospice gets

between three and four thousand dollars a month from Medicare to pay for a

patient's care, and they provide almost everything that is needed. It is not

necessary for the patient to die within six months as people believe; he must

be on only comfort medications and his condition must be terminal and he must

continue to decline. This applies to almost all MSA patients when you think

about it. Hospice helped us for over six months before Ken's death during a

time when our paid helpers were not even enough, and we needed extra help

with bathing and other things. You must sign a do not resuscitate order and

agree not to call 911; you call Hospice instead.

I will be thinking about you and your family as you go through these

very hard times.

Love, Barbara