Category Archives: Caregivers

What I won’t do for $62.00

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

Hi Ho Hi Ho, it’s off to the pharmacy we go…..

Normally my time would be spent talking about my elder care experiences and the craziness that is insurance, clothing, finances, people, food, and anything else in an ‘ordinary’ day.  But caregiving, as I continue to find out, runs the gamut across all ages and time…for the caregiver, that is.

Yesterday, my 21 year-old daughter woke up with a pain in her eye.

“Mom, what does a scratched cornea feel like?”

“Well,” I said, “let me put it this way. I would rather go into labor 10 times with 10 babies 10 days in a row, than EVER have to feel a scratched cornea again.”

“Well, my eye hurts every time I close it, so I think I might have that.”

Since she wasn’t writhing on the ground in pain, screaming for an emergency room or an epidural, even though not pregnant, I was pretty sure it wasn’t a scratched cornea. But since she was leaving for college in 4 days, and I didn’t want to drive 5 hours in 5 days when she called me writhing in pain, I decided we should see if the eye doctor could squeeze us in. Of course, as with every one of my emergencies…this was a FRIDAY, so if not taken care of today, we would be in the emergency room tomorrow. Good, or tired, or worn-down caregivers learn to hate Friday NOT Monday.

After a thorough eye exam, the doctor tells us she has GPC. Weirdly, that’s a new one on me. I was pretty sure I could sit for a Medical Boards Exam by now. It’s a form of conjunctivitis that is not contagious, but must be medicated 5 times a day, then 4 times a day, etc. for a month. And you really should wear your glasses not your contacts because the medicine has to be put in without contact lenses in your eyes for at least 15 minutes each time. Well, you might as well have told this 21 year-old college girl to get a Cyclops eye, a Freddy Kruger mask and a mermaid tail to wear back to college. She does NOT have time for ugliness or inconvenience. Tough s***t, says mummy.

Now, before we even leave for the two prescriptions she must get in her EYES (yup, it’s in both eyes, the other done just didn’t hurt yet), we beg the eye doctor to send in our claim to insurance. We don’t have vision coverage, but this is a medical problem. So we will see. I know if I had taken her to the emergency room or the regular doctor, this would be covered. Call me crazy, but my doctor does not have all those zippity-do-dah eye machines to look into my daughter’s eyes and see what’s going on there.  And I asked the doctor if we could see it ourselves, and she said, “not unless you have a microscope.” So I will keep you good readers informed about THAT insurance result. Can hardly wait.

After we leave, we need to go see “L” my brother-in-law who has MS and I care for, which, was the ONLY thing I had to do today. HAHAHA. But first I need to stop and get him a few things on his list. I need to call his caregivers to give me an extra hour tomorrow to dress him for a family party. I need to call my sister, who is picking him up. And, when I finally get to see him, I find that we need to change his password for his retirement fund and BTW his computer has crashed.

SO THEN, I finally get to the pharmacy, where, coincidentally they know me by sight, don’t even ask for my name and go right for the drugs that have been ordered for me or any family member.

“Sorry, Cathy” says Rich (yea me and the pharmy are on a first name basis), but I only have one of your scripts.”

He sees my face fall…because remember, the college girl is going back to far, far away college in 4 days.

“BUT,” he quickly adds, cause he has also seen me melt down on just such occasions as this before….because there have been MANY of them, ” you can go to the pharmacy down the road and I’ve already put your order in there, where it’s been filled.”

“Yay!, and thanks,” I say, so kindly and enthusiastic.

I drive the extra 20 minutes, go into the NEXT pharmacy, and enter a fiasco with another poor customer whose insurance company randomly cancels her son’s much  needed insurance every  90 days. I feel so bad I want to pay the $70 for her medicine and I think I would have, but the pharmacist assures her she will be reimbursed, if she just pays for it now and comes back after a few phone calls. (More like 927 phone calls in  my experience).

AND FINALLY WE GET THE MEDICINE AND IT’S ONLY THREE HOURS OUT OF MY DAY!

You just have to laugh…….

Cathy Sikorski

About that Invitation……

Okay, I know you think you are doing a kind and generous thing by inviting my wonderful disabled L to your event. But here’s the thing, you are more than willing to put out that invitation and I will even go so far as to say, that you are doing it with the most generous of hearts and spirit. You know that this person you love is severely disabled, but you want to include them to show your love and acceptance. But the truth of the matter is, you really give very little thought to what an invitation means to the caregiver.

It is not for one minute that the caregiver does not want their charge included. It is extremely unlikely that the caregiver does not love this person as much, if not more than you do.After all, they are the caregiver.  But, but, but…….really…….what will this invitation entail? Will the caregiver need to acquire appropriate clothing so as not to embarrass you or the loved one on this special occasion of yours? Will the loved one’s schedule of care, bathing, medicine, toileting, assistance for dressing, undressing, getting out of bed, getting into bed, eating, drinking or sleeping work with your event? Have you considered in any way, how will my loved one get there? Does it require special transport? Who will make that happen? Who will pay for that? Have I tried to put any of that into place, or am I just sending out this invitation?  Am I also inviting the caregiver? So do THEY have time to get ready, get their loved one ready, get to your event? Is the event the appropriate venue for my disabled loved one? Will they be able to stay for any length of time? Will the caregiver just barely get there and then have to leave because the venue doesn’t work, there aren’t appropriate toilet facilities. it’s too hot, it’s too cold, there’s no food for them?????? And that, my friends, is the short list.

You see what I mean? In your zeal to be inclusive and loving, you may, in fact, be setting up the caregiver for an over-the-top horror show. And often, the caregiver loves you too and doesn’t want to disappoint you OR the person they so desperately CARE for. And more often than not, the one who is being cared for, wants to go. Of course they do. They want to get out. They want to engage with old friends and family.They also do not really want to consider the ups and downs of turning down an invitation. Likely because, all those kind and well meaning people who have sent out the invitation, never or hardly ever make the effort to come see or spend time with the disabled loved one. Life is busy, life is hard…..I know…..I’ll invite them to our special party!!!! That way we can see them, spend time with them and (God forgive me, feel less guilty, perhaps?)

Are you really thinking this through? Could you possibly change that invite to a special birthday, wedding, anniversary or graduation, to a special visit where you go see your disabled loved one. Take them a special meal, take them out for dinner, take a load off the caregiver.

Perhaps it’s not an invitation that is so welcome, as much as it is a two-by-four upside the head that says, “Duh…..maybe I have a better idea…..”

Cathy Sikorski

Shingles

Aunt J, our 90 year-old Australian darling, came down with shingles about four months ago. Sadly, right as we were burying our dear, dear, dear, mom, mother-in-law, grandma, friend, aunt and all around great gal (that’s all one person, don’t panic.) Aunt J and Grandma had been sisters-in-law for almost 70 years. So I think the stress of losing her dear friend and companion, as well as just being 90, herself, sent her a bit over the edge.

As it happens, SOME people, not all people, but some very unfortunate few people, get something called post herpetic neuralgia  after the rash of shingles disappears. This is basically a continuing shooting, stabbing, painful discomfort associated with shingles that may last long after it seems you no longer have shingles, or a life or a mind.

Of course, at 90 years old, Aunt J has post herpetic neuralgiaUp until this point, she was only taking two medications. She had heart surgery back in the ’80’s (not her 80’s THE 80’s) and is by all accounts a pretty terrific old gal. She is amazingly charming, has that adorable accent, and has wonderful tales of her times in New York City and travelling.

So she was on her way to a grand ancient old age. But this shingles thing has changed the game and it’s disheartening, unfair and just plain crap. She does her best, most of the time to be a trooper. She will go out to lunch, go shopping, watch TV, fold laundry and participate in every way. But when there’s not much to do, or she has a day that just gets her down, the nasty pain that travels around from her back to her side to her front is frustrating for everyone. It becomes the topic of the day:

“I just don’t understand why this won’t go away, Mate ( I just added that so you wouldn’t forget the Aussie accent).

“Well, Aunt J, it’s just a nasty bugger that can last months, even though there is no rash”, I tell her, keeping to myself that this damn thing can last months and months or even years.

“But why did it go away and come back? I took all my medicine. I was a good girl!”, she whines.

“I know, I know, but the shingles don’t always work that way. They can just hang around as a painful reminder as long as they want. I’m really sorry. ”

“O dear, O dear, O dear, O dear. I don’t know what I’m going to do……” , she trails off with a wince of pain.

And this is where it just starts all over again. The same conversation, the same laments, and the same ineffective answers I have given her time and again. We have tried various other medications, but they have had nasty and dangerous side effects. So here we are.

“I know”, I say, “let’s go get ice cream!”

She looks at me with a jaded eye. We are both thinking the same thing. Can it be that easy?

“Okay!”, she says.

You just have to laugh……..

A long ago tale from Social Security

My sister is the beautiful age of 62! That is the magic number in Social Security. If you so desire, you can apply for your Social Security benefits at age 62. You will give up a certain amount by starting to take them early,but it’s a crap shoot. Who is going to live the longest, you or the Social Security Administration? My bet is on you. So, if your situation makes sense to take your benefits early, take your money and run. This is exactly what my beautiful 62 year-old sister attempted to do. Oh but little did she know this was shark-infested waters.

She trots herself off to the office of Social Security:

“Hello, beautiful 62 year-old sister! Can I help you?”

“Why  yes, I would like to apply for my Social Security benefits!”, she says with aplomb and great delight.

“Oh…sorry you can’t do that here.”

“Excuse me, is this not the sacred Social Security Administration office?”

“Why yes, yes it is..but you need an appointment. I don’t have an appointment here for “my beautiful 62 year-old sister”,but you can apply online from the comfort of your own home!”

“Well, I did not know that. I will go home and apply online, which I am CERTAIN will be easy and have absolutely no glitches! Yay government!”

You see it coming, don’t you? Well at least you THINK you do. In fact, she goes home and applies on line quite successfully. She even receives a  phone call from Social Security with a question about her place of birth, which is seemingly cleared up with no real problems. The representative says, “everything looks fine, it should process in a few months.”

Two days later, on a Saturday,( because I am absolutely convinced that all Social Security mail is purposely retained to be mailed for receipt on Saturday so that you can’t talk to anyone about it) she receives a letter at her childhood home in her maiden name, where our Mom still lives after 41 years, addressed to my beautiful 17 year-old sister, from 45 years ago, saying :

Since my sister has no recollection of ever receiving Social Security, hasn’t lived at that address for 40 years, and hasn’t even had that name for at least 24 years, this is a conundrum. Our best guess, since we can’t call anyone for at least two days,(and if you have EVER tried to call Social Security on a Monday morning, you know it will be three or four days before you can talk to anyone……because EVERYONE who got a crazy letter on Saturday is on that phone first thing Monday morning) is that when her mother died, her father was receiving Social Security benefits for her for about a year, and likely was overpaid by one month. But her father, my step-father died in 1998, and my mother, her step-mother has lived there since 1972 and never saw any Social Security letters addressed to my sister.

Lucky for the beautiful 62 year-old, the letter was sent to our Mom after 45 years, SINCE IT HAD HER SOCIAL SECURITY NUMBER PLASTERED ALL OVER IT. Is it whistle-blowing to call these idiots out as they are randomly sending out letters with Social Security numbers likely to people who have moved, are dead, or maybe even in a nursing home suffering from Alzheimer’s disease. Would one have to move to Russia to bring this to the world’s attention a la Mr. Snowden?

So we do call Social Security on Monday afternoon and hardly wait at all for that annoying MUZAK to stop. We speak to a delightful young lady who informs us that a new law has just been passed foregoing any previous statutes of limitations on the Social Security Office’s right to collect on overpayments. Ever. Forever. Ad inifinitum. So they sent out letters to everyone they could come up with to whatever address they had to see if they could collect this lost money. And each and every letter has the alleged recipient’s name AND FULL SOCIAL SECURITY NUMBER.

In my sister’s case, the nice lady said that since her claim number on the letter had the letter “C” in it, it means she received money as a child and they want it back. And even though, admittedly, she probably never saw that money or even knew it was coming to her. She had to pay it back. And if she didn’t pay it back, as the letter sent to her address of 45 years ago clearly states, any income tax refund she may be entitled to in the future will be taken to absolve her of this debt.

Soooooooooooooo, not only are they generously giving out Social Security numbers to random strangers for the identity-theft taking, they will likely take your income tax return money and you won’t have a clue as to what the hell is going on.

REALLY????? FORTY-FIVE YEARS AGO I OWED YOU $195.89 AND YOU LOOKED SO HARD FOR ME THAT IT TOOK YOU THIS LONG TO FIND ME AND SPREAD MY SOCIAL SECURITY NUMBER TO THE WIND?!?!

Yay government!

Perhaps someone at Social Security should read the Forbes Article below!

YOU JUST GOTTA LAUGH……

Cathy Sikorski

A case for joint bank accounts

I may have sealed my own fate by allowing myself to be a lawyer and a caregiver. People really like that stuff. One way or another, they are going to find a use for me. My sister is now in the process of settling her aunt’s estate and she needs a lawyer who understands estates and the legal ramifications of former caregiving. She took care of this Aunt for many years. Both because she’s her Aunt and because the Aunt successfully alienated every single person in her life. My sister is now left with a miniscule estate to administer to pay back the state where her aunt had nursing home assistance and get all her other bills taken care of. Sounds easy, right? Nope, this Aunt left “everything” to my sister AND four other nieces and nephews in a foreign country. Swell. Thanks. Because NOW, rather than wrap this up easily, which a joint bank account would have accomplished, it will require a small mountain of paper work to satisfy the bank, and the state, that no one is getting anything except those who are owed. But Aunt pain-in-the- neck didn’t want a joint bank account, which of course, is absolutely her right. But oh the trouble that now creates.  And of course, corresponding with those in the foreign country that they are getting nothing and would they please acknowledge that so that we can all go on with our lives. Hmmmm.  Wonder how that will work out?

How to ask for help

I haven’t really mastered the fine art of asking for help, which is probably why so many people keep ASKING ME FOR HELP.  After a luscious week of time with my daughters both home from far away, and lots of time with visiting family over the 4th of July holiday, I was pleasantly exhausted and ready for the messy structure of my life. My 90  year old Aunt came to stay with us while all the family was here, and my sainted 84 year-old mother kept Aunt J at her house until I had more room. During that time Aunt J developed an indeterminate pain to go along with the continuing pain from her shingles that I discovered on her last visit three months ago. Ultimately, my Mom determined that a walker was in order, and it seems to have done the trick to keep Aunt J upright, balanced, and less whiney(also wine seems to help). We did a mani-pedi day for all the ladies as a treat, and now I pay the price. This morning, as I try to get back to work, laundry, phone calls, grocery shopping, appointment-making, etc., Aunt J comes downstairs with a finger the size of a sausage. WHAT??? The only thing we can think of is that she got nicked at the salon and has an infection. She was treating it herself, apparently, with Band-Aids and Neosporin. So off to the clinic we go, the walker, the Aunt, and the sausage finger. The very sweet doctor(who happened to be the shingles doctor as well) lances her finger, squeezes out all “the badness” as Aunt J calls it, and puts on a Band-Aid and Neosporin and gives us a prescription for antibiotics. But wait my cell phone is ringing and the number is eerily familiar……

“Hello?”

“Cathy?”

“Yes?”

“This is your brother-in-law’s caregiver. We are pretty sure he has a urinary tract infection”,

Yup…. you just gotta laugh.

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…..

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.