Monthly Archives: September 2013

No matter where I go….

Caregivers, Humor, Uncategorized, , , , ,

So I volunteered to be on an advisory board for a Catholic elementary school. I know, I know, REALLY? You need to do more volunteer work? But my really good friend, the principal of the school asked, and whenever she asks me to do something I say yes and have regrets later. But THIS time, I figured it’s about little kids, no elders, no Medicare, no Social Security, no nursing homes. Yay….little kids.

The parish priest leads the first meeting, and after we open with a prayer (and boy do I need all the prayers I can get), he tells this quick story.

“So, I’m a power of attorney for one of our parishioners who is 90 years old.”

Oh MY GOD (i’m thinking) REALLY, SERIOUSLY, THIS CANNOT BE HOW THIS MEETING STARTS.

“AND,” says Father, ” he was rushed to the hospital a few days ago, so of course, the hospital called me right away.  I went over there to make sure everything was fine, and they were going to keep him for a few days and then send him to rehab to one of two possible facilities.”

So I’m thinking: okay, he probably had some problem getting him in to the facility that he wanted. Or the elder parishioner had some unexpected medical condition. Nothing new here. And, by the way, I have not yet confessed to this group what my background is.

Father continues:

“The dear man is in the hospital for three days, and I’m waiting for a call because they have told me that he will likely be moved today or tomorrow. So I’m sort of hanging around, trying to stay close to home in case they call or need me for anything. Finally at 2:30 in the afternoon the nurse contacts me and says:

“Hello, Father?”

“Yes? I have been waiting for your call.”

” Well, I guess we should have called you sooner, like BEFORE we released your parishioner from the hospital.”

“REALEASED HIM???!!!! WHERE DID HE GO? He’s 90! He doesn’t drive and I’m the only one who transports him. WHERE IS HE?????

“Oh, he was transported by ambulance to a rehab center.”

“WHICH ONE…. where did you send him?????”

Poor 90 year-old guy, when he got there, he had no idea where he was, why he was there and what was going on. NOT BECAUSE HE HAS DEMENTIA…..he doesn’t……BECAUSE NO ONE TOLD HIM OR HIS CAREGIVERS.

Yup, true story (and I asked Father if I could put it in my blog and he gave me his blessing …and said yes, too)

You just have to laugh…….

Cathy Sikorski

Trick or Treat…Mother Nature’s Halloween joke.

Caregivers, Humor, Medicare, Multiple Sclerosis, Uncategorized, , , , , , , , , ,

One beautiful crimson and golden day in October, and I mean beautiful, I was required to go on a ‘shopping spree’ for a rehab center for my brother-in-law, “L.”  He was recently hospitalized and needed a few weeks or months to get his strength back, so he could return home. The first place they sent him was too challenging, and they basically kicked him out for not trying hard enough to get better. Who am I to judge? The guy has MS, and he knows what it means to exercise or not exercise, the choice is his. But they said, “nope, you’re not trying hard enough and it ruins our success rate.” Well, ok they didn’t say the last part, but we all know that’s what’s going on.

So I had to find a new place and quickly, because he would be booted in a day or two at the most. My Mom and I spent a very long day looking at five different facilities, trying hard to stay with in a 10 to 20 mile radius, so that I could be there on a regular basis to check on him and make sure he was not being neglected.

O my God, what horrific nightmares are out there. The first place was in this absolutely gorgeous, wooded, bucolic setting. And every resident was passed out, drooling, and not engaged in anyway. AND THAT WAS IN THE LOBBY!  The staff was setting up for a Halloween party, and the decorations were as shabby and pathetic as the lobby. The next place, it smelled….and not good.  The next two places were over-crowded, had teeny, tiny therapy rooms and were dirty. O mon Dieu! Je ne sais quoi! Yes, I was thinking in French because I couldn’t even process this in my native tongue.  Finally, we get to the fifth place, and it is okay. And I really mean just okay. I would like it to be cleaner. I would like to hear less commotion in the hallways, with residents who are clearly distressed. I would like there to be more visible staff. But the therapy facility is enormous, the therapists seem very knowledgeable and have specific tools for dealing with MS patients. And there are some younger men here. L gets a private room because there are so few men in rehab. So all in all, we’ll take it. I’m running out of time, I’m exhausted, and I have seen the worst so “okay” will suffice for now. If I need to keep looking, I will, but it’s just temporary and even though it’s the furthest from home, I will come every day in the beginning, to make sure he is properly cared for.

We take hours to complete all the paperwork to get him in there tomorrow. Ugh….me and my Mom are pooped. This is how I thank  her:

“Don’t you dare go to the hospital tonight. I don’t care that you are perfectly healthy.  If anything happens to you, don’t call me. Call your brother, call all of your other five children or any of their offspring, But I cannot deal with one more hospital, medical team, or medical issue for at least three days.”

Mom just laughs at me. She’s perfectly fine and there’s no reason to think otherwise.

The next day, Saturday, I go out to run a few errands, and it begins to snow. ON OCTOBER 29th, WE HAVE A FULL BLOWN BLIZZARD. Now normally, that wouldn’t be so crazy to have snow in October. But we have so much snow and the trees have not yet lost all their leaves. Trees begin to bough and cover everything, and break power lines and hearts with their cruel, beautiful snow-covered, orange and gold autumnal CRAP. I live in the woods. I can’t get down my driveway, until I call my husband who says: “Shake the trees, Cath, the snow will fall off.” (he’s like a genius)

AND THEN, AND THEN, AND THEN, the phone rings.

“Hi, this is Grandma’s assisted living place.” (of course they don’t say that, but you get the idea)

No big deal, I think, they always call me for Depends, or toothpaste, or nicely scented body wash. HA! Nice try.

“Um, your mother fell and is being ambulanced to the hospital 20 miles away (in a blizzard) because she may have hit her head and that’s the only head trauma unit.”

“Ok,” I say weakly, because I forgot to tell my 93 year-old mother-in-law not to dare go to the hospital today.

My husband comes home, and off we go, in the blizzard to the hospital. She did indeed break her hip and will have surgery(and then I will have to find a rehab for her).  Five hours later, we slowly drive home on snow-covered roads, reach our driveway, which now has broken snow-covered trees all over the place. We park in the street, walk gingerly through the snowy trees, and least you think this is some Robert Frost romantic moment,we find out we have no electricity and no heat.

You just have to laugh…..

Cathy Sikorski

I am ready for my close up, Mr. DeMille

Caregivers, Humor, Multiple Sclerosis, Uncategorized, , , ,

You probably have noticed that whenever you go to the doctor now you must have a photo ID. And said photo ID must be valid and up to date, especially if you are a Medicare patient. So don’t even THINK that  you are going to pass muster if you have that dirty old expired driver’s license, a left over ID on an old ratty lanyard from two jobs ago, where there was actual security or that expired passport that you haven’t used in 20 years because you’re now 85 years old.

So this can be a dilemma for the old, infirm or disabled. Here is the story of my brother-in-law, “L”, who continues to be and will forever be wheel-chair bound with Multiple Sclerosis.  This photo ID requirement is fairly new. I remember going to L’s house, struggling to get him down the stairs, into an electric wheel chair in the basement, into his manual wheel chair and out to the car for a doctor’s appointment. And I remember the first time they asked for a photo ID. Now, he didn’t drive to the appointment, and for some reason we forgot his wallet, so there we were, high and dry. But since it was the first time they asked for photo ID, and he had been a patient there for FIFTEEN YEARS, they were willing to wait for his next visit to keep a copy of his lovely face. It was probably because he also was not on Medicare at the time and so they wouldn’t get in any trouble for not recognizing a patient from a decade and a half and requiring that pesky photo.

Okay, so lesson learned. Now, for the past five years or so, I always take that photo ID. But about two years ago, I noticed that his ID, which is his driver’s license, was about to expire. L doesn’t drive anymore. He can’t. He would be a menace to society, and he took that driving privilege pretty darn far. But, and thank God, they still send him a driver’s license. I was perfectly willing to get him a ‘government issued ID’, until I discovered the requirements. In order to get this ID, he would relinquish his driver’s license and apply for the ID, but he must show an electric bill, or a rental agreement, or a deed, to show his valid address. Never mind the fact that his valid address is on the driver’s license which they gladly give him without any of those requirements. L is in a facility. He doesn’t pay an electric bill, he doesn’t really have a rental agreement and he only has an apartment number within the facility for his mailbox. So I asked myself: “Is it easier to go through this craziness for an ID, and perhaps be left without one, OR is it easier to just go get his picture taken and keep the damn driver’s license?”( Since no one is saying he can’t drive and/or even asking if he does drive).

Well, of course, I will just take him to the photo center, wheel him right up to the camera, and SNAP, we’re done. NOT SO FAST, CRAZY CAREGIVER. Now that he is wheelchair bound, and I truly can’t lift him or  help him in and out of a car, I have ordered wheelchair transport for him for all of his appointments. He has to pay for this because Medicare won’t pay for  you to go to the doctor. They will only pay for you to go in an ambulance (and even that is suspect…see my blog ‘DO YOU REALLY NEED AND AMBULANCE….I THINK NOT posted 06/28/2013). So you see you can’t keep yourself from getting sick, or take good medical care of  yourself. Insurance just wants you to get really, really, really sick and THEN you can go to the doctor.

So we pay for transport. Okay, fine. I call the transport company:

“Hello? I need a transport.”

“Okay, to where?”

” I need to transport L (they know L, he’s a regular like on Cheers!) to the driver’s license photo center, so he can get his photo ID.”

“Oh, sorry, no we can’t do that,”

” What? What do you mean you can’t do that?”

” We can only transport him to any medical facility or for any  medical necessity. Our insurance does not permit us to transport for any willy-nilly reason.”

“Hmmm,” I say as I restrain myself from ripping out a hunk of my hair,” but we pay privately. WE PAY EVERY PENNY FOR HIS TRANSPORT. OUR INSURANCE WON’T PAY YOU.”

“Yes, I know, I understand what you mean, but I’m talking about our liability insurance. We can only transport for medical reasons. We are an ambulance company.”

“Ok, fine. Do you know any transport company that is NOT an ambulance company that will transport L for reasons that do not appear medical?”

“Ummm, no sorry.”

“Really? You’re in the transport business and you don’t know anyone else who can help us?’

“Nope.”

“Well, thanks, that’s just swell.”

So I suppose the alternative one…the ‘government issued ID’ is the way I have to go, or he won’t be allowed to go to any doctors or hospitals.  I just have to figure out how to meet their requirements to show  his valid address. I want to scream… wait, I think I am screaming and no one hears it. AND THEN THE GOOD SAMARITAN ARRIVES.

L and I had an appointment the next day with the ambulance company for a LEGIT doctor’s appointment. I couldn’t help myself. I lamented to the driver that I couldn’t get L to the photo center, and it was kind of a medical necessity because he needed that ID to get treatment anywhere. So after the doctor’s appointment, we made a quick stop at the photo center, rolled right in there where no one was waiting. SNAP! took the adorable photo of L…and we’re good to go for another four years. Can’t wait to see how I tackle this one the next time around…..O SNAP! Thank you good Samaritan.

You just have to laugh…….

Cathy Sikorski

Who knew? Grandma has great legs!

Uncategorized

I am spending a lot of time thinking about my mother-in-law. She was a kind, sweet, funny and charming woman. Everyone loved her, wherever she went. I was so very lucky to have her as a mother-in-law and friend for over 28 years. When we had to look for assisted living for her two years ago, I was less worried about her adjusting to a new home, as I was about her burning down her current apartment and everyone in the building. She left the stove on unattended one too many times, to the point where the fire department probably looked at the address and sighed, “O, Marie…..”. As a veteran of researching assisted living and nursing home facilities, I knew she would be loved and appreciated if we chose the right place. So after we narrowed it down to two places, we took her on a ride to see them and have some input herself.

On some level, we realized we had probably waited just a tad bit too long to engage in this search and move, but we were trying our very best not to subject her to change, as I knew the elderly just don’t do change very well. But it was just too painfully obvious from her losing weight, only having coffee for most of her meals, and a refrigerator full of food that we often had to throw away, that she was no longer safe, healthy or cared for properly.

So we found two really nice places, and took her for a look see. At the first place, Keystone Villa, we were warmly greeted by Donna, the marketing lady. She took great care to talk to and look at Marie. You have no idea how much credence I put on that. I am so sick and tired of the elderly being summarily dismissed without LITERALLY so much as a , “how do you do?” Donna asked Marie about her interests and her hobbies, and we began to move onto the tour. It’s a lovely facility. With lots of glass looking out on a busy highway on one side and a nature trail on the other. This gives the residents much to look at while dining, reading the paper, or ‘hanging out’ in the lounges. It’s supremely clean and smells good. A BIG PLUS!

So as we continue the tour, Marie is very positive and seems to like what she sees. I notice that a bad smell starts to creep around, and I think, “Oh well, they probably have to keep up with that challenge.” We continue on, up the elevator, into a few of the available rooms, and find a charming room overlooking the fountain and nature trail next to the nurses room and the near the elevator. It is very similar to her apartment in it’s proximity to the elevator and we think this will be reassuring and a memory issue that will help with transition.

But that smell is following us. And now I’m a little dubious because I was sure they had that under control. I ask my mother-in-law if she needs to go to the bathroom. In fact, I’ve already asked her that about three times. But she insists that…no….she doesn’t and she’s perfectly fine. So we finish the tour, the smell is getting stronger and following us everywhere now. But since we are done, it is a point that we will be discussing later.

My dear sweet mother-in-law takes a seat in the lobby, and we go into the office for a few minutes to fill out some paperwork. When I come out to see if she’s ready to go, I look down at her feet, and there is brown ooze coming out of her trousers onto her shoes. Really. I’m not kidding. And I feel so bad for her, because she is still completely  oblivious to this. So I take her in the bathroom, which thank God, is huge and has PAPER TOWELS, not just one of those air drying things, because I’m pretty sure I can’t hold her up there to dry off her butt like Michael Keaton in Mr. Mom. I stage whisper to my husband in the lobby to ask the desk clerk for some Depends and maybe a wash cloth. I help her remove her trousers and underwear which are covered like a baby who ate prunes, and I just start cleaning her up with a TON of paper towels. One of the aides appears with Depends, wipes and more  paper towels and asks if there’s anything else I need. I ask for a plastic bag for her soiled clothing, which appears promptly.

Thank God it’s winter, because Marie has a winter coat with her that she was not wearing at the time. It’s what we lovingly refer to as a ‘car coat’. It goes to about right above the knee, so you can get in and out of the car comfortably. So we gently put on the Depends, all the while reassuring her that it’s ok, no harm, no foul (ok it’s pretty foul); yell out the door to my husband to go pull up the car to the front door, so we can high tail it out of there without too much fanfare, and put on the car coat. So now Grandma has a pretty silk scarf, a nice wool coat, and sneakers (which I also washed), and bare legs. And damn, if she didn’t look adorable, like she was wearing a mini-skirt just one last time, and BAM….looking good Grandma…..you got great gams!

You just have to laugh……..

Cathy Sikorski

What I won’t do for $62.00

Caregivers, Humor, Medicare, Uncategorized, , , , , , ,

My sister and I recently had the pleasure of taking my Mom to renew an acquaintance of her’s from the 1950’s. My Dad was in the military and during that time, my mom made some pretty intense relationships with other military wives. That show “Army Wives” seems to indicate that not much has changed in 50 or 60 years, in that military spouses, especially those who are not in the military themselves, are bound and determined to make good friendships on bases, even if they know they are only short-lived.

So we trek down from Pennsylvania to Washington, D.C. to meet up with these dear people who haven’t  seen my mom since 1955. It was absolutely delightful. Their son was kind enough to bring them to a restaurant in town so that we could spend two or three hours together. Reminiscing for the older people, getting to know them for us, “the kids”, for the son and I were not even born when they knew each other. Nonetheless, as the parents are in their eighties, and we are in our fifties, the topic turned to health, health insurance, and “what do you do?”

As I began to relate my caregiving stories, I told their son, the lawyer, how frustrating it is for me to see the elderly getting ripped off all the time by their own health insurance. And that brought about the tale of the $62.

I have told my mother, mother-in-law, aunts, uncles, disabled brother-in-law, cousins and pretty much anyone who would listen, that JUST BECAUSE YOU GET A BILL FROM A DOCTOR OR MEDICAL PROVIDER, DOESN’T MEAN YOU HAVE TO PAY IT. As you can imagine from the capital letters, this advice often falls on deaf ears. (Like, why would I who practices elder law, medicare law and has been a caregiver for sick people for over 20 years know anything about this?!!) AND, so the unsuspecting relative, friend, client, pays the bill and then brings it to my attention…ever so much later! Of course, this sends me into a tizzy. Yes, I said tizzy. I rant and rave and get on the phone with the offending billing department, which I KNOW, will be receiving proper payment from all the insurance they have and they will owe nothing.

One such scenario went like this:

“Hello?, you sent my mother-in-law a bill, and her insurance has paid you already.”

“One moment please. Do you have the account number? The date of service? Her insurance card number? Her OTHER insurance card number? Her date of birth? Her astrological sign? (okay they didn’t ask for that, but if they did would you really be surprised?)”

“Well, yes I see that she has other insurance, but you will have to get a new bill from her doctor showing this, that and the other thing to clear this up.”

So I call the doctor. And they are very nice, and more than willing to send me a new bill showing this, that and the other thing for proper credit so that I can get my mother-in-law’s $62 returned to her. But the desk clerk leaves me with one thought:

” Good luck getting your mom’s $62 dollars back, that almost never happens.”

“Oh,” I say, “you don’t know me.”

Next week the $62 check comes to my mother in law, who insists on splitting it with me because of the fine legal work she has witnessed. But  here’s the thing. I would do that again and again for $1 for every elderly person who is paying these bills they shouldn’t pay, likely living on a fixed income, and their insurance does, in fact reimburse the doctor, but the patient never sees their money come back to them. Truth be told, I’d probably make a million bucks doing it!

You just gotta’ laugh…. (and fight with insurance companies and medical providers)

Cathy Sikorski