Question:
My Dad is 82 and plans to get married. From a financial stand point what need to be done. I am concerned about social security for his future spouse, and her health insurance. His future spouse receives health care from her deceased husbands employer and she is receiving his social security benefit which was higher than hers. The other question is if one of the two gets sick and need more care is there a way to keep the finances of the other from being drained. Thanks, Kevin
Kevin.Carolan@Xerox.com
Karen's Answer:
Dear Kevin,
Thank you for your question. One way to find out about the social security issue is to go to www.socialsecurity for the information. Financial issues can be tricky. These issues need to be addressed by a lawyer who specializes in medicaid and financial planning for the future. He or she will be able to answer your questions. I recommend Lisa Powers, 100 Allens Creek Rd., 14618, 244-2170. Carolyn Reardon at the Law Offices of Richard Kroll,2425 Clover Rd, 14618, 271-4470 is also very good. Oftentimes it's better and cheaper to pay a good lawyer who is experienced in these matters than to try to do it on your own.
Karen Witkowicz (585) 671-9702
Question:
Hi Karen, my parents live in Fairport and are 84 and 87. My father is not in great health and is needing some help as my elderly mother is not able to care for him as well as she could. He is on medicare however I have to attend to this matter and wonder where to start with getting an attendant to come in and bathe him and also someone who can help with house care and if need be to do other chores associated with my fathers care. Please contact me as soon as you can, thankyou for your precious time concering these matters. I should add my father is a diabetic and has to inject insulin 3-4 times a day, he lives in a split level home and has to go up and down the stairs...as italian as both of them are I want to help them, thankyou again
raymondlegnini@hotmail.com
Karen's Answer:
Thank you for your question. I am sorry I could not get back to you sooner. I recommend home support services. I highly recommend Comfort Keepers. I personally know the owner, Amy Hay. This agency supplies non-medical services,
to those folks who need extra help at home. These services include chores, housekeeping and in-home meal preparation as well as medicine reminders. Prices are set by the hour and usually are around $20 per hour range. Amy's number is 585-249-0100 and her web address is www.comfortkeepers.com For bathing and personal care, a home health agency is appropriate because they do "hands -on" care.(bathing, dressing,etc) I would try Traditions in Caring (585-241-9580)www.traditionsincaringcom; CareGivers (585-458-2150www.caregivershomecare.com and Lifetime Care Home Care (585-214-1000)www.lifetimecare.org Prices depend on what services are provided. I hope this helps.
Karen
Question:
My mom is 72 years old and is on disability for mental illness. She receives SSI and Social Security and is on medicare and medicaid. Her Mental Illness has become increasingly worse over the past seven years and my brother and I had to obtain co-conservatorship of her and her estate in order to help take care of her. She has been in and out of four mental health and medical facilities in the last eight weeks. We have decided to place her in a nursing home and she is upset because she says that the nursing home or medicaid will take her home to pay for the nursing home. She is hoping she will get better and be able to return home and she is worried they will take her home and never have a chance to go back home. Do you know what the rules are concerning this issue?
blueyedcnd@yahoo.com
Karen's Answer:
Thank you for your question. A home is a valuable asset to the medicaid office. You will need to sell the home and use the assets to pay for her nursing home care. The best thing to do is to check with the business office of the home you are considering and ask the staff how medicaid handles these situations. Most homes have staff members that deal with medicaid issues.
Question:
Upstate N.Y. My father is in a nursing home, he like every resident wants to go home, he lies to the social workers and says he just wants to go to the house to get a few things and will come back, to me he says: get the house ready cause im coming home to live but don't say anything, i had meetings with administration, clergy and social workers and tried to get them to understand the situation. They in return don't believe me and are enabeling him, tells him he can sign himself out and take a cab and go visit the home anytime he wants. He is 88 years old, in failing health, not incompetant but to allow him to go to his home would be helping him die. He said to me he would rather die at home than live there, The nursing home is taking the legal side of the issue and i'am taking the moral side. HELP, i'm running out of time and ideas.
chrply@yahoo.com
Karen's Answer:
Thank you for your question. This is an extremely difficult situation. Legally speaking, because he has not been judged incompetent by the courts, he has the right to go and do whatever he wants. However, if he goes home, who will care for him? What about the expense of home care? If his needs are not met, he will become more infirm, be hospitalized and end up back in the nursing home. If this is the truth of the matter, talk to him in this way. You and he might want to talk to his doctor about this. Hopefully, the doctor could explain the consequences of going home and being by himself. Also, has he actually tried to pack his things and leave the nursing home on his own? He may want to go home, but not actually start packing his things to leave. He may accept his living change over time.
Karen
Question:
When completing a PRI for a potential discharge to a NYS nursing home, is there a seperate compnent that should be completed for mental illness or mental retardation? If so, where are they processed?Are patients that have either of these components followed in any way once admitted to a nursing home?
mldred.salama@ynhh.org
Karen's Answer:
Thank you for your question. A PRI for nursing home admittance must be completed by a nurse who has been trained to do it. It is quite complicated. NYS law requires a PRI be done for anyone who may need a nursing home. No one can get in without it. There are many nurses qualified to do this. You could call Visiting Nurse Service or any home care agency to find one. They come to the home. There is a fee to do the PRI. It varies from around $80 to $95 to get one done. Be sure to ask about the price when you call. A PRI is not an assurance of getting into a home. There is a scoring aspect to it and the person may be deemed not incapacitated enough to need one. There is no separate component for mental illness,mental retardation or memory loss. These conditions can be noted on the PRI and the nurse can write her own description of these conditions and they are taken into account by the nursing homes. Copies of the PRIs are sent to various nursing homes for admittance consideration. If you have other questions, please call me at 671-9702. Thank you. Karen Witkowicz
Question:
Karen My mom is 81 and has dementia/Alzheimer. Early stages. She lives alone however my sister and I are doors away. my uncle next door. She is never alone more than a couple of hours. We prepare all her meals and put her to bed every night. She also has chronic back pain due to arthritis. My question to you is she is now unable to always get off her sofa with out assistance. where do i go to get a affordable lift chair? Of course she has very little money. The family is already helping with her bills and her insurance covers only $200. She does have medicare. Thank you, Nancy
Resunedirect704@yahoo.com
Karen's Answer:
Dear Nancy,
Thank you for your question. One of the best places I can recommend for a lift chair is Westside Medical Chairs. I have had good experiences with this company and the people who work there are very compassionate. The address is 509 Spencerport Rd,14606. It's in a strip mall plaza and the first thing you see is a CVS store. The phone number is (585) 227-8750. One of the owners is Ron. Tell him that I reommended him to you. If you have other quetions, please do not hesitate to email again. I will do my best to help you.
Karen Witkowicz
Question:
My 92 year old Grandmother refuses to leave her home, but we are worried about her sleeping alone. We have gotten a quote of $150 per sleepover visit, which we certainly can't afford. Any suggestion would be welcome. Thanks much -
jacqueline.young.perrins@jpmorgan.com
Karen's Answer:
Thank you for your question. This is a difficult situation that has been handled in different ways. The first and most important concern is safety. Is the house two-story or an apartment? Does she have some memory loss or physical conditions that would impede her getting around? Many older persons get up several times per night.
Sometimes adaptive equipment can be used. Maybe a portable toilet in her room would help if she needs to use the bathroom. These are sold in many medical equipment stores. If not, nightlights can be used in her room, in the hallway and bathroom. A walker or cane could be used as well as glowing textured tape on the wall so she could see and feel along. A picture of the toilet on the bathroom could help.
As you note, paying someone to stay with her is very expensive. Are there any friends or family members who would volunteer to stay with her one night a week? Are there any church members or members of organizations you or she used to belong to who could help out as well? Is there a next door neighbor who is interested in helping out? Maybe through the grapevine, you could find a person who does this privately and works for herself, not an agency and would charge less. (maybe someone you already know) If you go this route, the person needs to be checked out thoroughly and write back to me to find out what needs to be done in this respect.
Finally, if none of the above is feasible, you need to consider a move to a safer place. It's hard to know without knowing her finances what type of residential living she can afford. However, the options are independent living (probably not wise), assisted living complex or facility (there are many of these that offer a whole range of services) or nursing home. Talking to her about moving is crucial. You could say something like "I know you don't want to move. Nobody does, but should you have to move because of medical conditions, what kind of place would you like to live in? What are the three most important requirements you would have? What things would you like to take with you? Keep talking to her gently about these things several times per week, but be persistent even if she gets upset. Let it go for a few days and try again.
This is very complicated and involves many things. If you would like me to assist you, I would be happy to do it. Send me an email and we could get together to discuss this situation and what can be done.
Question:
Dear Karen, I believe i've spoken to you in the past, and just have two questions: My mom is in Aaron manor nursing home.She is 88 and has advanced alzheimers. (mentally, about 3-4 years old.) she broke her hip last summer, and is now in a wheelchair, (bad rehab!). before the hip, she had problems with ankle/feet edema, but now it's terrible, all the way up her legs, to the hip area. we've tried and tried to ask if they'll increase her lasix, walk her more,etc. Last weekend I went to visit her and she was crying, because her knees hurt so bad. They said they had given her tylenol and bengay, but it obviously wasn't helping. Sunday wasn't much better. Today, my sister called the nurse manager, who is NOT very helpful or caring, and he said he'd look into it. To me, this answer is not very acceptable. I am a nurse, and i would call the Dr. and get a better pain med. for her, and then call the family back. We had a meeting with this man about two months ago, and he told us he'd set up an aptm't. with the PA, (we've never even met her doctor!) . We're still waiting. My mom is in a lot of pain, and they just don't care. we don't know who to call. the other question: We just completed the whole process of getting mom on medicaid. Would it be impossible to have her moved, now that that's in place? We'd really like to look at the Fairport Baptist Home. Is this a realistic dream? thank you soo much for any help you can provide. I've never felt so helpless in my life! Sincerely, Linda Snyder
crab.legs2@yahoo.com
Karen's Answer:
Dear Linda,
I'm so sorry the situation has continued in this abusive manner. If she has been accepted for medicaid (which means an acceptance letter in hand), or, if the County medicaid worker can assure you and the social worker that she is eligible now, but it's just a matter of time for the paperwork to get through, it is possible to move her. Most nursing homes do not accept "Medicaid Pending" residents. In an extreme situation she might get in. When she definitely has the medicaid, she can be moved to a different place more easily. The Fairport Baptist Home is a possibility. I would call them immediately to check into it. Talk to the director of admissions and explain the situation. Tell her of the medical danger. Go in person if you can.
If you have not yet met with the Nursing Director of Aaron Manor, make an appointment right away to see her in your mother's room so she can see for herself what mom's condition is. If this doesn't work either email or write me back and I may be able to help.
You could also call her doctor or PA yourself, if you can find out their names, and tell them about the lack of care and concern. Demand immediate assistance. If all else fails, pack her up and take her to the emergency room yourself. Don't let anyone stop you. You are getting the medical care your mother needs. Your mother has a right to leave if she so chooses. (both for a medical exam and to go to another home). Even with her Alzheimer's, she may be able to give consent if you say you want to take her there to relieve some of her suffering. The Health Care Proxy can give consent and sometimes the POA can as well.
It's also time to call the NYS Nursing Home Complaint Hotline at 1-888-201-4563. If you would like to hire me to help, I would be happy to step in. Either way, please email or write back. I care.
Question:
What's a PRI and why does my mother need one to get in a nursing home?
Karen's Answer:
A PRI stands for Patient Review Instrument. This is a standard state form used to assess whether a person is medically eligible to live in a nursing home, which is considered the highest level of care. This form must be completed by a nursed trained in using this tool.
PRI's are not covered by most health insurance programs. However, if the person needing assessment is currently hospitalized, a hospital staff nurse would do one as part of hospital care. Home health organizations have nurses that specialize in this type of assessment. There are also nurses that work for private agencies that can do this. The general cost in the Rochester area ranges from $75 - $90. It is good for 3 months. If a suitable nursing home is not found within this time period, another PRI must be done.
Question:
We are starting to look at nursing homes for my father. I am trying to assess the relative merits of the facilities we have visited. What a bewildering process! Any suggestions?
Karen's Answer:
Assessing nursing homes for a loved one is difficult, especially if you have not been exposed to doing this kind of thing. I have produced a booklet called "Nursing Home Checklists" for consumers in this situation. It is a rating system that lets you compare 3 nursing homes at a time, has space for you to make notes and makes you aware of what questions to ask. I will gladly send you one free of charge. Please go to the contact part of my home page and type in your address and your email address. You will receive one in at least one week. Thank you for your question.
Question:
My 85 year old mother is starting to lose her memory. She can't remember where the bathroom is in the house. She goes outside and can't remember how to get back in the house. She keeps asking me the same questions over and over. What should I do?
Karen's Answer:
First you need to make an appointment with your mother's physician. You need to accompany her and make the doctor aware of her memory problems. Oftentimes, the doctor will refer her to a clinic for testing to determine what is causing her memory loss. There may be a physical condition or a neurological condition. After you know what medical conditions exist, you need to make yourself aware of resources in the community that can help you. Often memory clinics are associated with major hospitals and your mother would be seen on an outpatient basis. Most insurance companies (in New York state) will cover this evaluation. The Alzheimer's Association in your area would be a good resource if there is a possibility that she has Alzheimer's Disease or another memory related dementia.This would be a good way to get started on getting your mother the care she needs.
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