I will say…I’m sure I’m not the only one who wishes the health insurance industry was a bit more “standardized” from state to state. And especially when we are trying to help our elderly parents navigate this. There are so many variables. It can be difficult to navigate.
A number of us have dealt with or are dealing with moving parents to a different state…and yes, with MA Plans this can be a challenge.
As @deb922 noted, there are a lot of different “rules” and that was just for the states she listed.
Sorry, this will be long. TLDR … Actually, it went very well. It turns out that when someone is on hospice, there is a particular chain of command. If a patient on hospice falls, AL notifies hospice, whose responsibility it is to come evaluate the patient & notify the family. MIL fell in early evening, and AL notified hospice. AL contacted hospice immediately, and they said give her pain meds and they’d be out the next day. They came the next day & thought she had a break. They came out the day after that with a mobile xray machine & verified a break. At that point they finally contacted SIL to tell her what happened. Huge problem.
AL said that they should have handled her care during that interim between the fall & the trip to ER better. Staff didn’t want to hurt her, because she was in so much pain. But they should have had a way to involve management to come up with a care plan. Yesterday, they implemented a new structure that addresses some of the concerns we had. We feel comfortable enough to have her go back, but we will be monitoring what happens (cameras).
MIL has actually made really good progress, from looking like death Monday to being awake and aware today in a way we haven’t seen in a long time. Her attitude today is amazing. We are just waiting for the care coordinator to get her a rehab bed & insurance clearance, and she’ll be discharged to (hopefully) rehab.
The hospice is out. BIL is a pain, but he’s really good at following up on things. Hospice had to release her when she went into the hospital, and they kept dragging their feet. They were already on the s*** list because they were overmedicating her (SIL had to make them stop & MIL improved). Then the fact that they waited after the fall was unforgivable. As luck would have it, we met a manager from another hospice after the meeting, and he was great - if he does even 75% of what he says, it will be a huge improvement. So we’ll try them once she returns to the AL.
We actually have hope that there is a light at the end of the tunnel (and not a bright, white one).
Crashing back down to earth today, after a fabulous yesterday. MIL is back to how she was Monday, and she refused to do any PT. They got her to sit on the side of the bed, but she yelled and screamed. We walked in during PT, and MIL was very clearly back to being out of it. We’ve been here an hour & she has not acknowledged us yet. She just got some pain meds, and maybe she will be able to chat later. We’ve seen her like this far too often lately, though, and we suspect that yesterday may have been an anomaly. We’ll see what tomorrow brings.
Popping in here from another thread to remind folks that if parents have meals on wheels, you can name contacts to call if meal not picked up. (And heck, I should check on that for my Dad and his wife.). Good to include a neighbor on the list. And arrange a lockbox if possible (I gave one to Dad last year - will check on it when I visit next week.)
My example (non-parent): A few years ago I encouraged an elderly friend from church to arrange Meals on Wheels. She has no children and no local family, so she made me the emergency contact. I live on the other side of town and don’t have a key (by design… she was not a friend before Covid - I just worried about her). Unfortunately she sometimes left meals when she did not feel like going down the 8 steps to front stoop. And she’d not answer the phone when Meals and Wheels (and I) called to check on her. So a few times I went over to see she was ok. Once I had to get to her backyard (not easy) and bang on patio door to her bedroom door - oh, she yelled at me for that. And she rejected my idea for free lockbox service (installed by local firemen). Last year she really did have an emergency - long story, but by then a neighbor had the key and was able to get an ambulance called.
Dad struggles even with his non-smart tracfone (and his wife avoids anything computerish). But… I did set him up with an ipad with LTE connection - possibly it could run the new simplified app.
We have caught Uber & Lyft from time to time. It’s very helpful in other cities, especially to/form airport. So far we are still happy driving otherwise.
My folks always had us chauffeur then once they had to give up driving.
I’m retired and would be happy to chauffer parents if I lived near them. But from 2000 miles away, Uber assistance is the best I could offer (if they agree to the idea).
Since we all live on same island of our folks and everyone was willing to pitch in, it wasn’t too onerous on any one person and we were able to make things work for them and us. Some of us did more and others less, depending on availability and other obligations but we were fortunate that there were 7 of us to share the duties.
My friend did gogograndparent for a while until her mom was unable to know where she was going to be picked up and then they knew she could no longer use the service. It’s much tougher when folks have levels of dementia.
Remember the Chase Bank debacle?? It was June 14 when the helpful employee told me the account would be closed on June 16. Well, my dad’s bookkeeper mailed a large check for taxes to the IRS on May 30. The IRS deposited the check on June 11. On JUNE 17, Chase literally stamped “Endorsement Erased” on the back of the check and sent it to the IRS. So now Dad owes $148 in interest and penalties. !&@ ! (The bookkeeper is livid, rightfully so, and wants me to call the helpful employee. Ugh, I know she’s right on principle, but it wouldn’t take me long to bill $148 at work. I really don’t want to spend hours on this.)
We’ve been on quite the roller coaster with MIL. Every day we were there was different, and while some were good, some were very bad. We left Sunday, and she was moved to subacute rehab Monday. She apparently was in good spirits Monday, but she didn’t participate in PT Tuesday or Wednesday. She must have done the bare minimum yesterday, because they’re letting her stay. Her behavior has been very erratic, and they said that she was beyond horrible to everyone on Wednesday (for example, she asked my SIL if she is still married to her “useless” H while he was in the room).
I wish that H and I could be there, because second hand information is not particularly reliable. My SIL stopped thinking for herself somewhere along the line, and H can’t talk to her without her H being involved in the conversation. Her H’s views about things are skewed … for example, he’s convinced that she will be far more self sufficient after rehab than is possible. It’s frustrating, but we just have to deal with it. Right now, everything is a wait & see, but we really just get to wait & sometimes hear. It’s making a difficult situation harder for H.
I am so very sorry that MIL, as well as all of. you, are suffering. I suspect she is probably in a lot of pain when she moves and she’s not feeling settled in the subacute rehab facility. Is hospice providing any advice to make her more comfortable? You and H must feel so frustrated due to the distance and lack of substantive conversation with local sib. Hugs to you and your H.
Yes, her behavior seems to be correlated to her pain (something we experienced with my mom). Hospice is not currently involved, because she had to be released from hospice while in the hospital and in rehab. We will be engaging a new hospice when she returns to assisted living (the new hospice really impressed us with their commitment to the patient). She stayed in the hospital a long time before rehab because they wanted her pain controlled before sending her to rehab. Unfortunately, pain management outside of hospice is patient-dictated - she has to say that she is in pain. While she was in the hospital, we made sure that she was medicated long enough before PT that she was as comfortable as possible. I don’t know if that is happening in rehab. Even if it is, the pain still may be too much for her (you can only medicate so much if you want them awake to participate in PT).
As we watch this unfold, our thoughts about our own “end times” are a source of conversation. But the truth is, there’s only so much we can control.
This frustrates me, I understand why, but more often than not, elderly persons will not always say they are in pain and ask for pain medication. My FIL never asked for anything because of his personality and his upbringing (Scandinavian descent). He just suffered through his pains and discomforts at his AL and rehab after his fall. When my H called him, the only response was “I’m good. All is fine. No, I don’t need anything.” I knew he wasn’t but H never pushed for more info because FIL was never going to say how he really felt. It’s so tragic that he had to suffer when he deserved more for himself.
MIL didn’t get her hip replacement surgery until the pain kept her from being able to sleep at night. Once she had that done she then had the other hip done. FIL had his hips done after she had hers done. Another fear MIL had was that she would not wake up from anesthesia.
MIL lived to 92 and FIL lived to 92.
Things worked out. My dad died of cancer at age 64 (1995) and my mother died of dementia at age 77 (2010).
My Son-in-law’s parents will be moving to IL/assisted living apartment near their older son’s family. About 6 hours from where DD1/SIL/family live.
We are healthy and may be moving to DD1/SIL/family location in 2026. Our other daughter is single and lives in a 3rd state. We drive to visit her (and she drives to visit us) but it will be airline flights once we move to where DD1 lives. Major cities with direct flight between DD1’s city and DD2’s city.
It’s hard to live in a healthcare world that functions based on reasonable expectations of outcomes – you know, they expect XYZ to happen after XYZ therapies/drugs/tests. With so many elderly, there’s no way to know, no way to have expectations. My son was very ill as a child, and we called this Corner Theory. You expect to see the whole way, or part way, down a “street” of illness or therapy, but sometimes there’s a corner and you just can’t see around it. Is there a truck? A bear? An ice cream truck and safety? Just no way to predict and it feels awful. It’s a horrible cliche, but it really is one day at a time. Pain management makes it worse, imho, because you can’t tell if the absence of pain meds is the problem, or too much pain intervention is the problem.
At hospice, my father’s entire personality would wax and wane through his loveable self to this impossible monster. Like, we were a little scared of him, tbh. You are all, no doubt, doing the very best you can to make good decisions and minimize the bad ones, and I think that’s really all we can aspire to in such difficult circumstances for any family.
