I've posted before about in-law care-giving. Aged mother in law, lives in same town.
We are at the tail end of a visit from sister in law from several states away. Sister in law has been here for 3 weeks caring for her mother. A much welcome respite.
It had been discussed, prior to her arrival here on the scene, she would be talking it over with her mother, to try and get her mom to come up to her home, for a stay of maybe a few months.
This, in my opinion, is absolutely essential, as I am expecting twin grand-children, due in about 1 month (if they don't come sooner, as is the case a lot of times with multiples pregnancies). The expectant mother also lives locally here, and has a 4 year old daughter. I will be on that front, helping .. as much as is needed. And not on the front with mother in law and care-giving, and have made that as obvious and apparent as I know how to make it. It would be great if mother in law would agree to go to her daughter's home (several states away) for a period of a few months .. and allow me the latitude to put my energies where I want them to be, on my daughter who will have had a c-section .. and my grand-daughter (4 years old) and new twin babies.
Nothing doing. Mother in law has dug in her heels, and will not hear of it, going to stay with her daughter for any period of time.
What are her reasons?
In mother in law's defense ... her daughter ... I don't even know how to describe it. I will say that when her daughter comes here to visit, she all but breathes for her mother and if she could find a way to do that, she'd do that too. She is the most nervous nelly, never sit down - ever ... worry wart, do everything, all the time .. person that I've ever encountered.
A great example, as I was taking her to the airport yesterday for her departure, . I reached into the fridge to grab myself a bottled water and shut the fridge and turned to walk away, as I've done for all of my 50 plus years living on this earth .. and she said to me, "Oh make sure that fridge shut". WTH???? Like I don't know how to shut a fridge? That's just a small, very small slice of what she is ... how she is.
She is so very hyper-vigilant, seeing to every minute details down to it's finest most minuscule point, fine tooth comb, questioning every point along the way, "should we do thus and so, but maybe if we do thus and so, then such and such will happen, maybe we should do it thus and so .. but then so and so might happen, maybe we shouldn't do thus and so, but do "x" "y" and "z" instead, but if we don't do it that way then ..........", on and on and on and on it goes. And usually in hyper warp speed, as to every single friggin thing.
If her mother moans .. "what's wrong mother?, why did you moan, are you alright?".
Mother: "Yes, I'm fine, I was just sighing out loud".
Sister: "Why did you sigh? Are you hurting, are you sure you're alright, why are you sighing what's the matter?"
Mother: "For God's sake __________________, I was just sighing, .. calm down, I'm fine".
Sister: "Are you sure, .. because if something is wrong you need to tell me".
Mother: "Everything is fine, I'm fine".
Sister: "Are you sure, we did a lot yesterday, did we do too much, maybe we shouldn't of gone to two doctors in one day .. was that too much for you, are you too tired now, maybe we need to move those other doctor appointments so we won't have two in one day, is that too much for you, for one day .. is that why you were sighing .. what's wrong, are you sure you're alright".
Hopefully that kinda gives a little bit of a snapshot of what goes on when sister is in the ring directing things.
So in mother in law's defense.. I do get it, why she wouldn't be chomping at the bit to go to her daughter's home.
BUT ....
The only experience she has with her daughter, in the last years as mother in law has aged and been unable to go anywhere much, has been the daughter coming here, periodically, for periods of about 3 weeks at a stretch. When her daughter comes here, she moves heaven and earth for her mother and then some, and doesn't sit down, doesn't stop .. the WHOLE ENTIRE TIME.
Is there a possibility maybe (as I said to mother in law, when she expressed that isn't happening - talking to me - her going to her daughters .. ever) .. could it be possible that maybe if you would go to where she lives .. she'd be more busy managing her own life in that setting than your's and she would get out of your backside .. and not be as hyper-drive-vigilant as you experience in her, when she's here, could that be possible.
The daughter is retired, lives several states away. Does come here, generally, every few months .. and stays for a period of about 3 weeks at a stretch. I wish I could make a list of everything the daughter did when here this last time, but it would take up the whole character allotment:
Just as a side note on that .. someone we encountered in all this . not sure who it was .. advice was as follows on obligating one's self to the care expenses going forward .. and dollars to contribute.
"be careful doing that, circumstances change . in people's lives . if you should fall short, one of you . because of your own employment or health . or whatever the reason . that leaves the other party then responsible for the whole bill .. and that may be too much of a hardship for the other person to bear .. financially .. it's better .. if you will .. if you want to spend money . .spend money to better her life in the form of taking her to lunch, take her to the hair salon .. take her to a movie if she's able . bring her special treats .. that kinda thing goes farther".
I thought that was some pretty sound advice.
Maybe if it was a matter there are 6 offspring and the shared expense is $200 each, each month . so somebody's circumstances change and now the other 5 have to pick up that one person's $200 contribution each month . it's not that much . it's do-able. But .. with only two . to come up with whatever the shortfall might be .. it's something to weigh heavily . as to whether to do so . and how much. Sound advice.
There are only a few it seems that do take Medicaid . and the price is affordable . and the geography is workable .. etc etc.
I'm sure if we were willing to travel 45 mins or so . maybe that would broaden the search field of viable sites . but we really don't wanna have to do that . since we're the ones that will be called upon ..
But anyway ... I think it's a mistake to look in the fancy pants site . as a viable option ..
MIL doesn't get dressed. SIL counters . maybe she'll rise to the occasion and do it . if she knows the alternative is a SNF .. Maybe she's right .. I don't think so . but maybe.
But the alternative, at least thus far, .. is the family owned site . .where the folks residing there, mostly out of it . and slumpers . and SIL's assertion there . .that'll cause her to be completely depressed . it's enough of a change with all this . her whole world up ended with all this . then stick her with people who are hopelessly gone . as to slumping and not communicative .. she'd fall into despair and give up.
My response to that . . "she's not gonna live forever SIL .. and at some point she will indeed give up . absent some massive stroke or heart attack .. she's going to . at some point pass on .. that's a given ..
SIL: "But I don't want her somewhere that the despair sends her there sooner than it has to".
Done .. not my decision . I've said what I have to say on it . and I don't think fancy pants is the site for her.. but . it's not my choice to make, all I can do is weigh in with some other thoughts . .and I've done that.
Iincluding today's visit by SIL. Even tho MIL pouting ... exclaimed she didn't ever want to see Poochy again.. it hurts too much.
SIL took Poochy anyway today. Probably his 3rd or 4th visit there.
If she doesn't want to be up and ready by 8 she should be able to skip breakfast and have her first meal be lunch which will give her plenty of time to dress.
But not help with dressing .. (they said they will . in the event some one is injured or ill .. and recovering) but as the "norm" . no. They don't help with dressing.
And yes, I confirmed today myself .. emailed the director at Fancy Pants . and asked .. does the resident have to present for all 3 meals, every day .. can the resident opt for . if they'd prefer .. staying in their room to enjoy a bowl of cereal .. and some fruit .. from their little mini fridge.
Answer was yes . they have a few residents that opt for that .. and that's fine.
Asked also is there a window of time as to the dining room and being present and accounted for . or does one have to ring in at a designated time as present.
Answer was:
Breakfast is served from 8 to 9, dining room closes at 9
Lunch is served from 12 to 1, dining room closes at 1
Supper is served from 5 to 6, dining room closes at 6
So . yes there is a small window that one can get there . and be seen and present on site .. for meals. Small window, but yes.
Or - does sil just think she pulls the car up with mil and her stuff in it and hails a bellboy?
I’ll bet money Fancy Pants Facility has a PROCESS which includes someone going to assess MIL as well as asking to see the progress notes from the rehab AND getting a copy of any and all recent medical records.
Has anyone mentioned that little hitch?
SIL seems to be chasing unicorns again. I wouldn't hesitate to call M to set her straight.
Lunch is served from 12 to 1, dining room closes at 1
Supper is served from 5 to 6, dining room closes at 6
Wonder if MIL can be dressed and timely enough to be at the dining room for any of these meals on her own? What happens if she don't show up? Does she not eat at all, unless she has something cold in her small fridge? Do they at least prompt them as to meal-time?
That AL sure seems odd to me, too, as I also thought dressing assist and timely help to meals was part of AL's. Not IL's, but AL's - thus "assisted".
Yep. They said as much.
They"d be reviewing that once she is in her short stay at LTC and Medicaid approved.
And no Fancy Pants does not accept Medicaid Pending at all. MIL won't land there until Medicaid approved (if they find her suitable).
Glad I was along for the tour. They mentioned they'd be doing that. But I asked some valid questions based precisely on what's seen in MIL.
SIL even said "we might've scared them from taking her .. not sure they're used to folks that can be as needy as her".
Yup well.. they need to know the reality .... not the minimized flying monkeys story.
Iinterestingly enough (bear in mind Medicaid Betty has not yet met MIL ... she only knows of what she's heard from M and me and SIL ... said she would indeed at some point in this be reviewing her medical records.. but as of yet I don't think even that has happened as to Medicaid Betty and how clear her vision is as to MIL just from what she's been told)
She does not recommend ...really hesitant to give opinions on most any place .... can't..in her line of work, show any real favoritism.
Here was her response at our sit down with her when we mentioned we'd like to tour Fancy Pants site.
Betty, shaking her head no: no no I really don't think that will be a good fit for her based on what you all say about her .... not gunna be a good fit really ... I can't just come out and tell you no .. it's your choice of course always ... go look at it .. go talk to them. I'll just say this much .. if she needs help, for instance getting in and out of her Depends .. she won't find it there. They aren't going to help with that".
Talked to her again this afternoon ..mentioned (at least) my misgivings .. having gone there.
Her response; yea its shiney and polished there .. really pretty good if what you need is an apartment .. nice private room apartments ... but what you saw there, what you said... seeing most up and on their walkers ... it really is a setting for folks that don't need much help. I liken it to .. if I pay someone to take my dog for a walk .. they don't do it .. I ask why and they tell me the dog never barked. That's not what I paid you for. Why would you pay for AL and then not get it ..
But yet SIL wants us to visit their step up unit there .. they do have one. Need more care ... they have that in what's known as their Care Center... basically LTC.
They don't take Medicaid Pending in any of their care levels though.
But Anyway ..SIL eyeing this AL with yes the worry .. Will her mom be able to rise to the requirements ... an awareness there in SIL .. it's an unknown. But SIL mentioning .. we need to go see their LTC ... if she can't do AL there ...maybe she goes to their arm of LTC.
Mentioned this to Betty tonight. Her answer: theyre not going to take her unless she's self pay .. I'm here to tell ya.
Me: really? We asked and they said not as long as she's Medicaid Pending.. but Medicaid approved... yes ... if we have beds available.
Betty: I don't want to call anyone untruthful but I've seen it ... they won't take you unless you're self pay .. seen it happen ...
Me: wonder why they'd tell me they would.
Betty: I really can't answer that .. I don't know ..but I can tell you I've seen it ...
So. Not sure what's up there with that discrepancy. And yes I imparted this info to SIL who responded "we need to go see the LTC and talk to their folks.. see what they say".
She isn't going to be "happy" no matter where she is. It could be the Hilton, but it's not "home". Home is somewhere in her past long ago, when she was younger and could realistically care for herself. That ship has sailed. I agree, someone needs to get M in on a conference call to help her (SIL) show MIL some tough love.
I know it's up to them ultimately but M ....!!!.... you are seemingly the only one that brings the coffee your mom can wake up and smell.
Reel her in ... this is not gunna work and here's why.
SIL has resumed seeing everything through the prism of MIL’s irrational likes and dislikes.
This is bad.
Dorker, DH knows he needs to get double-tough, right???
No .. get tough no.
M is the only hope.
Mom moved there from an apartment complex registered (not licensed) by the state in a category called Independent Living With Services. The services were daily lunches for one hour, I think, and M-F suppers for an hour. There were activities on offer, including exercise classes. The rent was quite affordable for her two-bedroom, and the meal plan was reasonable as well. One could hire out via for doctor-ordered in-home health aid (such as for Mom's post-fall wound care) or P.T. and the like. Medicare and supplements cover such costs. These services were arranged independently from the apartment management itself. You could hire out for housecleaning, and for laundry - arrange it through the complex or hire it on your own.
The management could deem a resident unable to live independently if need be. Frankly, the Fancy Pants place sounds like this sort of place, but for an AL high price. Mom's current AL situation has nothing like such restricted meal hours. The staff does collect people gently if that is needed for getting to the dining room. A hungry resident who misses regular mealtime can ask the available staff for food as well. In-room meals are allowed in special cases.
A friend in AZ has her mother in Assisted Living and assistance dressing, bathing and so forth is part of the deal there as well.
I have no idea about the Medicaid situation at either of these two places.
I am just really surprised to learn of the view that AL is not LTC.
As for the fancy pants AL not helping the residents get dressed for the day or helping change a wet depends: those activities are giant, time-sucking black holes which require hiring additional staff. That's why some facilities up charge for dressing, toileting & feeding.
Mom's AL finally let residents come to breakfast in pjs, robe & slippers with socks. They could be in the common area after breakfast for a short time before having to get dressed for the day.
The right place will be found the first time around if SIL & H are clear & realistic about MIL's actual abilities at the time of admission.
Hoping she can some how muster inner reserves & rise to the challenge of expected behavior seems like a recipe for failure.
Maybe, like Medicaid Betty says, all the talk about Fancy Pants Place being a Medicaid accepting facility is just blowing smoke. How can it be that MIL would even qualify for that LITTLE help?
As EmilySue pointed out, how on earth can that one-hour dining window three times a day possibly be enough for MIL? She can't stay on track, and it takes her a very long time to get dressed. This is absurd for SIL to even be considering this place. Let's hope that Fancy Pants Place says they won't meet MIL's needs (and if she's going to be on Medicaid, there is a good chance of that, regardless of her physical capabilities, I suspect).
Is it known for sure yet that MIL's supplemental insurance policy will NOT pay the copay for additional days of Medicare-approved rehab beyond 20 days?
At first this angered me, that *I* was the one who was doing everything and did not have POA. But now? Works for me! There is a stipulation in the POA document that the POA cannot be paid (or pay themselves? Not sure...); they can only be reimbursed for expenses they incur. SO if I WERE a POA, I might not be able to be paid for my time. (Maybe the POA would allow for a caregiving contract for the POA -- not sure -- but we would never be going that route with my pay as my mother will never be Medicaid-eligible, so as long as the "gift" to me from the trust for my caregiving isn't over $15K/year there is no need for any further recordkeeping for the IRS.)
I am the boots on the ground, but my brother (only one is doing any POA work, as the other one doesn't want to do it and will only do so if something happens to the first brother) is doing plenty regarding financial stuff for my mother. The trust had to be retitled, bank accounts retitled as to trustees, communications with the LTC insurance company, my mother's supplemental insurance company, her prescription drug plan, etc.
I wish there were a way HE could be compensated, also, but the POA document seems to prohibit it. WE are the only ones doing the work; the other two do basically nothing. The retired brother hasn't been down here in nearly four months.
I presented my "bill" to my brothers for all of the back-pay recently. No one protested -- they all know now what I've had to do here. I've saved us all at least a year of our inheritance paying for an AL, probably more like two years (my mother's LTC insurance will NOT pay for AL).
SO this is my long-winded way of saying that NOT being POA could be a way for H keeping himself from being mired in MILwork in FL. I don't know. Just something to think about.
Betty answered we are meeting with the atty .. who can fast-track .. somewhat .. the Medicaid Pending status . as well as get agreement .. he works with these places .. as to getting placement as Medicaid Pending status for her short-stay at LTC ..
Also so he can create a QIT .. (qualified income trust) . otherwise .. that only reserve she has at this point, $20k .. has to be spent down to liquid asset of $2k or less . before she can even apply for Medicaid Pending.
As to why it's done this way .. I don't really know/understand the inner workings of why this is the path it has to go. But indeed it is .. she has to be discharged from her current setting .. and go short-stay at a Long Term Care facility .. as Medicaid Pending .. and she'll wait it out there ... as to approval on Medicaid .. and once that's seen to .. 30/60/90 days ... she'll then be Medicaid approved and can then direct towards AL.
That's how it's done.
One can bring their loved one home if they care to do so .. but the above is a way to fast-track it. Bring them home . the waiting list can be a year or more ..
I honestly don't think there's any need to be hunting for an AL at this time- except to keep you all away from rehab. Looking at the LTC makes more sense. Planning what to take for her room from the house makes sense. But spinning wheels about a place that will surely reject MIL- no time for that!
Me: "M .. you seem to be the only one that can grab ahold of your mom's floating balloon and bring it back down to earth and ground it, .. ".
M: "oh no .. yea .. I think that's why mom wanted me to stay there and help . .she knows that she has a tendency to go too far afield .. and she wanted me to stay there to help keep her grounded. What's going on"
Me then explaining the whole Fancy Pants site .. and what I see as the very real probability that here granny won't be able to hang with the rigors and expectations there .. and that .. SIL in her assertion .. "We have to at least let her try .." .. is pie in the sky wishful thinking . and only stalling .. she will be ejected ultimately and to the very setting that MIL .. vehemently states "now don't' yall stick me in some place with people who don't know chit from chitola .. don't do that to me (land of the slumpers) .. and so SIL in her .. "we at least have to let her try . if she can do it .. great .. if not . then her fate was in her hands .. not us directing her to a place of the slumpers .. it was her that landed her there, in her inability to do it .. we have to at least try"
how is it that such a pie in the sky . balloon floats off .. ungrounded .. raised such a realist . how did that happen
M: Poor Dorker, you are in such a tough spot with all this . you've done so much through the years . and you know this thing front and back as to granny's capabilities or lack there of . but you really have no say so in it all.. you are in such a tough spot with all this. Yes I agree with you ... granny . she doesn't manage time . one has to stay behind her prompting her . not sure why mom thinks she can do that .. and I know that granny hasn't dressed herself ... not routinely . in a couple of years .. opting to stay in pj's all day .. no . that really doesn't sound like the right fit for granny there. I'm going to call mom tomorrow .. thank you for sharing this with me, I've really been kinda out of the loop since I left there on Sunday .. and so not really up to date on the goings on .. I think mom maybe needs to think really hard about setting granny up for failure .. that will result in her landing among the slumpers in the end anyway .. I'm going to talk to her tomorrow and try to see if I can't get her to maybe take a closer look at it".
Me: "M . just so ya know . before she left here to go with your mom for six months .. she was pj's all day every day .. unless she had a doc appt. ... in which case one would have to arrive . about 1 1/2 hours ahead of time to keep her on task and prompted to keep moving .. time management ... and .. dressing for her .. is an all consuming tiresome venture that .. renders her in the end, .. spent ... this was my observation . and she's certainly not gotten better in her tenure in your mom's care in IL .. she's only gotten worse . .as she will be going forward . for the most part, . she's almost 90 yo . she's not gonna suddenly wake up .. with time management skills in tact .. and the abilities and stamina to dress daily .. But . ya know.. church lady would come to visit her . like once a week . and .. she never dressed .. even knowing church lady was coming .. church lady offered countless times to take her to lunch . if she'd like to dress for the day upon the next upcoming visit . and said when it would be .. but granny always declined .. same with us .. when we'd offer to go get her . to take her out to dinner, or lunch . she always declined .. opting to stay home .. dressing just too hard . too grueling a process.
But suddenly your mom is thinking this is all gonna miraculously fall into place .. since granny will be told . if you can't do this . .then the next stop is slumperville. I don't see it happening.
M thanked me .. for bringing her up to speed and said she'd take some time today . to get ahold of her mom and maybe try to reel her in some
So, two things, the attorney’s fees will be eat some of the $20k... they may want to think hard about having the atty set up the qualified income trust, depending on what MIL makes in pension, SSI, etc. Attorney’s fees, moving costs, etc may be enough to spend down if you add in a non-revocable burial trust which is usually exempt under Medicaid.
My mom’s funeral was close to $6k and there was no casket and it was NOT fancy. You guys could be looking at double that depending on what MIL has stated in her wishes for burial. Not sure if you have mentioned whether she has done any pre-planning, but I thought I would throw it out there as many people aren’t aware of that. Any funeral home can set that up for you... the attorney does not have to do that.
Again, there may be more of a reason for the qualified to be set up, but just in case, that $20k may not all be available for AL anyway. DH needs to play major hardball on the POA before anything. DPOA for finances for sure... then he can just go ahead and do many of these things on his own, because it is immediately active and doesn’t have to wait for her to be declared.
They need to stop discussing so much with her. I know this sounds awful. Please know I would never advocate such a thing for anyone, EXCEPT in light of the cognitive issues. She can barely make a grocery list. All of this stuff coming at her hard and fast is causing her to entrench. My in-laws did the same thing. Almost verbatim.
My DH and I had to finally realize that we were not doing them any favors by talking about everything with them. But, as is so common, we were doing what we had ALWAYS done with them. We were very close so we would naturally discuss lots of details. In the case of DH and SIL, they are used to “proving” themselves to her. They are over-explaining, if I had to guess. This will make things harder for them, but it will also make things harder for the scared part of her.
You may also see her start to fixate on pieces of this. It is almost like their brains can’t handle any of the actual processing to make a real decision and move the process along, so they ruminate. It sounds like MIL is starting to do that. Using the same language over and over that they know will strike a chord is also one of those “fight/flight” strategies.
And DH needs to compartmentalize. He can be sad when this is all said and done. Stick it in a box and deal with it later. I would bet once she is placed, after the first couple of manipulative phone calls, he will be over it, lol.
As I told SIL yesterday . her now on the train of thought . "let's go look at the LTC setting of the fancy pants place . if mom can't make it in the fancy pants site . they'll be referring her to a higher level of care .. they have that . in their LTC .. their SNF .. let's go look at it .. "
Me reminding her .. "remember, I don't know why the discrepancy here, but Betty Medicaid says they aren't gonna take her into their LTC .. that they only accept self pay there".
SIL: "Yea but they told us they do . they accept Medicaid . why would they tell us they do .. but Betty says they won't . that's weird .. we need to go there, take a look at it, talk to them".
Me: "I don't know why .. Betty didn't seem to be able to answer that either, but said it's been her experience .. referring people there, . they don't get accepted unless self pay . seen it happen . so .. I don't know .. looking at their arm of LTC/SNF there .. I just don't know".
SIL: "We really should go look at it .. in case MIL gets directed out of Fancy Pants . at least get a feel for what it looks like, talk to them about referral there, should she be ejected out of AL .. what are you doing tomorrow ..
Me: SIL you need to focus .. dial down on right now .. we can look at that LTC later . .that's not imminent . .what is the issue at present are two things .. and 1 of those is the referral for what would be her short-stay in LTC . that needs to get done . find out who/where that comes from and get on it . and 2 .. we need to find out if we can buy a few more days there at her present site .. via her supplemental coverage .. if there's any way to do that, . so that the Medicare Pending ball is rolling .. as we go to short-stay and Pending status .. those are the next two things that need immediate attention . not a visit to a possible LTC .. after she possibly fails at AL.
MIL and her husband . .eons back . paid for a cremation package . .and so that is the "plan" .. and the documents to prove it.
As to discussion with her .. she'd raised her hackles yesterday with SIL .. "you guys are leaving me out of of the loop here, you're out there going about finding a place for me and I have no idea what you're looking at . and what that's all about .. I need to know what's going on".
SIL: "Mother I have told you as much as I know, we're all trying to find out way here too, .. uncharted waters ... ".
SIL then went into reminding her that she'd apprised her of fancy pants and our walk-thru there .. "I did tell you .. ".
SIL feels that she can approach her mom . and has done so .. "Mom Fancy Pants place . they have some expectations as to what you will be required to do there .. You're going to have to get dressed daily .. can't wear pj's there and stay in your room all day .. that's not gonna be allowed ... you have to get dressed every day and you have to make your way to the dining room .. at least some of the meals . .each and every day .. do you think you can do that".
MIL: "Will they let me use my walker?".
SIL: "Of course".
MIL: "Well I will do my bests to do what I'm told to do .. I don't want to give anyone any trouble .. I'll do my best .. just don't stick me in some place with people that don't know chit from chitola . don't do that to me".
SIL: "Well the good thing about fancy pants site . there are people up and about on their walkers . and dressed for the day and conversing with one another .. and so .. that part is good".
MIL: "Just don't stick me somewhere with people that don't know chit from chitola . don't do that to me".
SIL telling me .. (on the sly) .. she knows she will have to go to LTC .as Medicaid Pending ... I haven't told her a lot about the fact she will be with just that population in that setting . and for 30/60/90 days whatever .. I think that would send her over the edge .. gotta give this stuff to her in small bites it's too much for her to process it all.
Also, my experience with fancy pants ALs here... often they do have a couple of Medicaid beds, BUT 1) sometimes, you need to prove ability to pay for 2 years before you are eligible for one of those beds. 2) SIL probably doesn’t realize that they likely have a medical director... who has a relationship with a hospital or other office... who has access to some of those beds for emergencies (like people who are booted from rehab and can’t go home, lol)... his/her patients get precedence in those cases. 3) Fancy pants facilities can be choosy. It isn’t a matter of you apply and you are in. They assess, check with primary care, etc to determine if someone is a “fit” for their community. They will not tell you this at the front end typically. It isn’t sketchy, they are just doing their own form of due diligence. But your average Joe has no idea the inner workings of that industry. By the time they do, they have wasted a great deal of time on someplace that wasn’t a realistic option anyway.
My FIL used to sit on the BOARD of one here, had everything in place, had paid much in deposits and had contributed practically a wing of that place and they STILL wouldn’t take him. They said they were memory care, but after consulting his Dr, said no. We had never thought that would be an issue, there was no backup plan and they did not make this decision until after we had done all of the forms, planning conferences. Such a colossal waste of time when we were already worn down to nubs caring for both of them. I was scrambling all over the place to find another option because by that time, we were desperate. It was awful.
And the SWs have a TON of inside knowledge. If Betty Medicaid seems reasonable and relatively knowledgeable (I.e, she doesn’t strike you as a nutball), SIL needs to LISTEN to her. Carefully. There are some things Betty can’t come out right and tell you guys, but she sounds like she is trying to do right by you and giving you hints and tipping you off to pitfalls. SIL is only hearing her mother’s oh-so-upset voice in her head. She is so driven by her guilt, so is DH. I wish for them that they could let that go... they have no idea how freeing it is. Someone else on this board often says guilt should be reserved for what you are doing wrong, or something like that. There is no malintent here.
Anyway, she needs to shut that out and open herself up to Betty. (I realize that I am preaching to the choir and you know this... this thread has just sucked me in over the last 2 years apparently and now I can’t shut up :D)
There are lots of components to the politics of those facilities... I had no idea and found out so much more than I ever wanted to know the hard way.
She is feeling out out of control, but cannot handle being in control. It sucks. Truly. But at this point, it is what it is. SIL can just keep repeating what she said today and the rest of you keep doing what you are doing. Last minute, bring her to wherever SW and Dr and rehab have recommended and say, no beds at the other place, this is your temporary digs until something opens up.
Jeez, that woman is just jerking chains all over. I have sympathy for the situation, but the narc piece is definitely at play here.
But as I explained to SIL .... "Betty says they won't take her in their arm of LTC . unless she's self pay ... ".
Sil then countering, .. "But we asked them .. they said they do . why would they tell us they do if they don't .. why would Betty say that .. ".
Me: "I don't know . Betty didn't seem to have a real reason .. not one that she maybe is willing to divulge anyway .. but .. what do we know .. maybe the set aside Medicaid beds they have there . and they are only a few . .for all we know . are kinda set aside of the residents that have been self-pay and now switching to Medicaid . having spent down their assets .. I really don't know .. ".
You're right .. SIL and DH both . just hear the sad pleas of their mom . and not the realities of the setting. So right about that.
SIL having shared with me . in the past few days .. a convo between she and church lady .. church lady imparting to her, 'ya know.. you need to have a life outside of all this . and your husband needs you, you need to be caring for him".
HOORAY CHURCH LADY ...
Sadly .. for whatever "his" makeup ... DH seems so sad .. that it all has to go this way .. and more to the point guilt laden .. that he can't step up to the plate and swing for the fences in it all .. in the sense that he "says" .. his words .. "If I wasn't working . if I was retired .. I'd go stay out there and take care of her, so it wouldn't have to go this way".
Me, the ever patient .. bite my cheek raw on the inside . not to say the wrong thing and blow up .. "Now dear that was the approach your sister had too . .and she IS retired . and she was willing .. so she said . for a long time .. to do the c'giving .. to keep from this path ... she can't do it.. what makes you think you're any different . .that you'd somehow be able to stand up to the rigors of it all".
DH: "Well SIL . in her case, . she's her own worst enemy . doing far too much . .not letting MIL do for herself what she can and should do . and working herself to a nub .. I wouldn't be like that".
ME: "Well . I am more of the ilk you describe .. and I had to exit the scene .. I couldn't do it either .. and I wasn't housing her and doing her every breath for her .. and I couldn't keep doing it .. it's been tried".
DH: This is all just so sad ..
((as I said, his overwhelming emotion .. is sadness .. but sprinkle in some guilt . that he can't be the one to step into that all consuming role - the one he hasn't had to do .. and take this on, f/t .. and prevent his mom this dreadful path we're now on))
And YES YES YES . it makes me want to throw things and get flat out ugly .. "DH she has been on this train of decline for how long now . .but orphaned church kids and church deterioration and hunting were far more priority than was your mom's train sailling off the tracks time and again .. what makes you think that suddenly now . if you could be retired . you'd be willing to give up your entire existence to attend to this .. That's what SIL tried and she can't do it. Just stop it .. .just knock it off .. you had ample opportunity to get more engaged and chose not to .. when it wasn't this path .. and you consistently chose not to . opting to do other more meaningful things to you and your world .. .it hasn't gotten better, and it won't . it's gotten worse .. and it will get worse and worse . .she's almost damn 90 years old .. and for you to now sit and pine away that you just wish you could step into that role. Just stop it .. I've tried it . to a lesser degree than SIL . who housed her . and breathed every breath for her .. SIL has tried it .. and she too can't do it. Just stop it.
It was almost .. I was ready for it .. "now what you need to do here is let me come home to my house . and we will ALL go and look at these places, I mean . afterall .. I'm the one that has to reside there, . now that's what we need to do here".
I was ready for it . and for that hook to be baited and set and yanked in ..
But it wasn't said by her. It didn't go that far.
If it had, .. I'd of probably baled out of it all ...
MIL is not able . though she'd sell you that she would like to be a part/parcel of it all .. she isn't able to get dressed .. get in the car .. go to site A .. walk around . talk .. ask intelligible questions . relevant questions .. process what is said to her .. assimilate it in her mind and follow up questions to answers given .. and then back into the car and now to site B . and same thing.
SHE IS NOT ABLE TO DO THAT!
I think she would sell it that she needs to be just that role in this ..
And .. it's questionable whether SIL's balloon would float that as a notion .. I don't know that SIL would rule it out, as I would .. summarily shut that down.
If the Medicaid pending LTC could be for 30, 60 or even 90 days, then perhaps the facility visits should be to those places. And of course there is a good possibility that the short stay LTC facility could become her permanent home. Right? Or are there LTC facility beds that are only for people while they are Medicaid pending?