Monthly Archives: June 2013

Do you REALLY need an ambulance? I think not.

One day, over a  year ago, my 95 year-old dear, sweet, mother-in-law Marie, was having leg pain so severe, that the aides in her personal care facility, called an ambulance. The record states that ,” patient has being (sic) stages of Dementia. The pt was in pain and would have muscle spasm causing her to jump in pain…”  Now, the fact that she was ‘jumping’ at anything is quite remarkable, being 95 and all. So due to this and several other factors, the EMTs decided to take her to the local hospital. They called my husband, who was on the golf course that Saturday morning. They called me, and I was at my Wills for Heroes  pro bono attorney event which I try to attend at least twice-a-year for first responders, where we do free wills and Powers of Attorney documents for first responders and their families ( and now you know why they need these documents!). After I saw a call from the Personal Care Unit and my sister-in-law, I realized something was up. I called my 83 year-old mother to high tail it over to the hospital, and sit with Marie, until my husband or  I could get there. Yes, my go-to girl is my 83 year-old mother. She’s very peppy, as 80-somethings go, so she can high tail it to the hospital with the best of them.  As it turns out, despite Marie’s constant wincing in pain and yelping, which she really never does, they couldn’t find anything really wrong and sent her back home.

Here’s the kicker. Medicare refused to pay for the ambulance transport. I have now appealed this twice. This is my beef with this. How is a 95 year-old DOCUMENTED dementia patient in personal care, who truly doesn’t even remember how to use a telephone, supposed to be financially responsible for an ambulance transport that she did not order, ask for, or was incapable of consenting to. Sure, the EMTs got her to sign a  consent. Does that really count? I have no problem with all the good people who were taking excellent care of my mother-in-law. They were concerned, they called for medical assistance and, I have to assume the staff and the EMTs decided that for Marie’s safety and well-being, it was best to take her to the ER.

So, I’m sorry, but to try and saddle Marie with a bill for $797.20 is unconscionable. So what is the reasoning here? I’m sorry she wasn’t sick enough for you? In pain enough for you? Was at the mercy of her caregivers, trying to do the right thing, to take an ambulance ride? I’m still appealing, I refuse to let them win. and so well….sometimes you just have to laugh…..

Is it possible to do your job TOO WELL?

So I take L to the doctor last Thursday. We are there for an hour and a half and he receives very good care. The nurses and the doctor take his blood pressure, temperature, listen to his heart and lungs and review his medication in detail. Simultaneously, with this appointment that I dutifully schedule every six months, L, also happens to have a terrible cold. This causes a mini-panic because this not a SCHEDULED APPOINTMENT FOR A COLD. Yes, it is difficult for the staff to figure out how to handle that. L is in a very complex wheel chair. They know, because I have told them a thousand times,(and not always in a nice way, I must confess) that he must pay over $100 just to GET to the doctor because Medicare will not pay to transport him by wheelchair. So, on the one hand, they know they should treat him for the cold, but on the other hand that is NOT why he is here. He is here for his six month check-up. Of course, the doctor has no trouble with this, but the INSURANCE DEMONS cause all kinds of havoc when the information does not match.

“What do you mean you treated him for a bronchial infection? He was listed for a six-month check up.”

“Yes, well, when he came in for his check-up, he happened to have a bronchial infection. What would you have me do? Ignore that?”

This is how I imagine the conversation goes between the doctor’s office and the insurance demons. Of course, we get the appropriate medicine for his infection and within a day, L is feeling much better.

On Tuesday….five days later….the doctor’s office calls me:

“L needs to come in for a physical.”

“Well, he was just there on Thursday. He had his blood pressure taken, his heart and lungs listened to, his ears flushed of extra wax, and all his meds updated. What EXACTLY does he need a physical for?”

“Well that was listed as a blood pressure check, not a physical?”

“Well, I called for the appointment. I did NOT call it a blood pressure check appointment. I was told he needs a check up every 6 months, especially to make sure he gets his medication. So( and here we go….) SINCE IT COSTS HIM $100 EVERY TIME SOMEONE WANTS TO SEE HIM….unless you’re going to do something different than what was done on Thursday, he’s not coming until December.”

“Ok , well, I will tell the doctor you refused.”

“No, you tell the doctor, that I ASKED: “what are you going to do differently than 5 days ago?”

“Well, he will look at him…..”

“We were there for an hour and a half, I don’t think he needs to look at him just now. So unless  you can get back to me and explain why I need to spend another $100 to transport him there for something DIFFERENT than last Thursday, we will see you in December.”

So there it is.; can see the doctor as much as you need to… long as you make the appointment for the right thing.

Please for crying out loud just do your job!

I am the caregiver for my surrogate brother-in-law, my friend who fell down a flight of stairs and has brain damage, and until she passed away in March, my blessed mother-in-law who was almost 97 years old. O yeah, and on occasion my husband’s adorable Aunt from Australia who goes back and forth between our house and other wonderful, caring relatives.

I have been caregiving for a very long time for various loved (and unloved) ones and ultimately turned my part-time law practice into Elder Care only so that I could help those with all that I have learned….mostly outside of the law, if you can believe it.

But I find the art and act of caregiving hard and hilarious. You just have to keep your sense of humor to keep going back day after day. I have a million stories as do all the other caregivers in this world, And hopefully, we can all help one another with information and an occasional laugh.

So today I have to take my brother-in-law( hereinafter referred to as “L” )to the doctor. Actually, I will just make sure he gets on the transport safely and then drive to the doctor and meet them there. He has MS and no use of his legs. This endeavor requires a lot of planning, phone calls, referrals and big huge posted notes on L’s TV stand because he often forgets what’s happening that day. It has to be between lunch and dinner or he misses his meal in the dining room. And, although we joke that he could STAND to miss a meal, he gets very cranky if he does. So three days before the appointment, with everything in place, I get a call from the Doctor’s office :

“Hello, this is the Doctor’s office, call us back immediately”

Oh crap, I think, they are going to cancel and that is a nightmare to unscheduled and RE-schedule everything. I’ll try and call back ASAP between my job, my own appointments and just general living.

“Hello?” I say, this is Cathy returning your call about L”.

“Why are you calling?” says the Doctor’s office.

“Because you told me to”.

“Oh, ok wait just a minute please.”

Holding, holding, holding, holding…I could have cleaned my entire kitchen by now.

“Oh yes, well was he here last week?”

“No”, I say, “he is coming in on Thursday”.

“Well, it’s been THREE OR FOUR MONTHS AND HE MUST SEE THE DOCTOR EVERY THREE OR FOUR MONTHS!” ,she says to me very briskly.

“Ummm, ok? Well, like I just told you, he will BE THERE ON THURSDAY!”

“O, Ok, thank you”. She says and hangs up.

Really? You didn’t see that on your computer? You had to take precious time out of my day to yell at me and then just say ok???? Really, before you called me you couldn’t check to see if he had an appointment in THREE DAYS?????/

Please for crying out loud SOMEBODY, just do your job.