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:
As an illustration: say you accompany your elderly relative from her car into the hotel for the big wedding reception, you grab at her and hover around her and panic at every painful step thinking "oh for God's sake we'll be here 'til Christmas." Gradually, you get used to the fact that very old, frail, ill people just do take forever to do anything, and that is fine.
YD thinks that MIL can't wash herself. Not like a normal person, not like she used to, not like YD herself would, no, she can't. But for the purposes of the assessment she may well be able to, especially if a well-meaning kind young person doesn't take over mid-task. It might take all morning. So what if it does? If it does take her all morning, then that is exactly what ought to be in the records. That would be an accurate assessment.
There is too strong a sense of urgency adding to the family's stress load. Rehab will handle the discharge. The proposed facility will handle the admission. Let Them. Float. Breathe.
And Dorker, agreeing with a doctor is much the quickest way to shut him up when he's lecturing you and you're tired of him. I should hold back on the fanfares until MIL is actually deriving any benefit from an antidepressant that she is actually taking as prescribed.
In the short-term, no harm no foul. Yes, you are at times the brain for 3 people. Nothing new there. That’s the essence of Dorker!
During this acute transition period (through lawyer & interim placement & residential placement), your Emotional Intelligence is a good model for SIL, DH and the other merry pranksters.
And...... without going overboard, create opportunities to spin your ‘presence’ to DH & SIL as:
“Wow! I’m learning so much that will help me navigate my mom’s/dad’s/stepparents’ decline.”
”I know this discovery period has been so rough for you two - and your immediately families. [Try not to point to yourself, Dorker!] When I need to explore care options for my kin, I won’t have to turn my household upside-down and cobble the info from Ground Zero like you two did. Hopefully, more peace in my home the 2nd & 3rd time around, right?!?”
“Listen, I know there’s not much to feel good about right now. But we’ve all gotten an amazing education this past year. And not just for my benefit.”
”DH, your fellow church officers will go through this. SIL, your friends and sibs-in-law will go through this.”
“Perhaps there IS a greater good in this sky-high stress and erosion of our spirits. Once we are out of the fire, we can be supportive of peers who are hurting in the same way.”
All the while, Dorker, mentally practice ways of vaporizing after lawyer & MIL’s interim placement. Rehearse it in the mirror like a high-school musical.
You’ve known all along what you intend to be once MIL has proper placement:
A family member who visits. A family member who bestows kindness on her own terms and her own schedule.
Make it happen, Dorker. 👍🏼
There's another AL not too far from here, .. accepts Medicaid .. Maybe we shouldn't rule it out ... we have ruled it out, maybe we shouldn't.
Recently in the news, .. a 94 yo woman raped there. WTH? Yes!
And .. son in law's g'dad spent a stint there, and was somehow allowed to dehydrate and hospitalized from there. SIGH SIGH SIGH
AL can be more honed in on as we go forward, not as pressing to sort that out at this moment and I keep drilling that .. let's focus o what's right in front of us . the atty meeting (they had a cancellation and so has been moved up from 3/15 .. to this coming Monday .. hooray). The OT ongoing . what are they doing specifically to work with her, .. ? I know at first they had her standing to fold pillow cases .. not sure what the h377 that was supposed to achieve .. and that went the way of dinosaurs ... that's been nixed .. so what are they doing . .get them on it, if they aren't helping her to dress herself . if they aren't .. why aren't they .. the transition to LTC .. all of those are going to be more pressing at this moment, AL can be determined as we move along in all this, I keep drilling.
As to answering .. does she change into her own PJ's. . She does indeed. She is showering . .also .. .her doing it .. with a spotter of sorts .. someone on standby should she become unstable. She is showering 3 x's weekly .. and in an ADA shower .. complete with a bench . she holds onto the grab bar, to stand up as needed to complete her shower .. on her own .. spotter on standby. She puts on her own pj's .. and takes them off.
Her struggles seem to be socks/shoes. And .. I don't quite have a peg on that issue .. I know she has slippers . one just slips foot into . she also has your fancy/flashy looking name-brand sneakers you see a younger runner might wear.
Not sure .. that's just me .. is she struggling to put on sneakers? Complete with lace-up .. and tying them . why? Why doesn't she have the ugly ole (I think I know the answer to that question . those are for old people .. velcro sneakers you generally see elderly wear).
She has to wear socks . her feet freeze all the time .. so not wearing socks, . .. not really appropriate ..
Her struggle is with her socks and shoes . and bending over. Her arthritic fingers and the struggle to get her fingers to work .. to get a shoe/sock on .. he fingers gnarled by arthritis .. fingers that don't bend . fine motor skill.
I know she has a long long shoe horn .. uses that .. somewhat . to get that foot into the shoe .. I know there is a DME that helps .. with socks .. one puts the sock on this apparatus . and then puts foot in it .. and pulls up . on the apparatus and it slides the sock into place. Why doesn't she have that? Has that been attempted? I don't know the answer to that question.
These are all things that it's MO . OT should be addressing . and why they aren't . I don't have a read on.
She also struggles with putting on and taking off a bra. SIL reports she has tried like 30 different bras with her .. as to trying to find one she can work with. Per SIL she's told her . . "just stop wearing a bra". I don't know the take on that one, whether MIL is willing to do so. I did send SIL a link .. bras for elderly women with arthritic hand issues. Fastens in the front . snaps .. and put on like a jacket .. SIL did say that would probably work for her, .. don't know if that's been perused ..
She does indeed though ..... at her 3 x's weekly shower .. change into her own pj's .. and her pj's . aren't your mumu type . they are . think flannel pajamas .. pants .. pull up . elastic waist .. and top . .buttons down the front.
So yea .. get her pull on track/running pants . she's not a runner . .of course .. but there's no rule that says she can't wear that .. and pullover tops . and some kinda velcro (those are for old people) sneakers .. and stop with the flashy . trendy .. colorful . runner
runner sneakers you see that younger folks run around in . not appropriate for her needs.
As to the question of what is Dorker going to do going forward as to team MIL. That's one I've also pondered.
I don't have a clear answer.
Each site we visit .. I am careful to ask . what do they do as to a physician . is there one on site . on call, how frequent do they visit?
That gets answered to my satisfaction ....
Generally there are two physicians on call . that visit the site every-other-week (PCP) .. and .. .the nurses are adept at calling with whatever issue .. say a UTI oncoming .. and getting a lab ordered . on site .. .(do they have a lab tech at these places or what, .. I dunno) .. but generally the answer has been ...most things you'd see a PCP for .. a stomach bug .. a fever, .. a UTI . that kinda thing .. they address on site . and if antibiotic needed it's delivered .. on site..
That satisfies my question as to that kinda issue.
What is left unanswered in my mind . going forward. I don't have a clear direction in my own mind about it ..
Cardiologist - seen periodically to rx Elliquis. That doc (all her docs) will likely change once she switches to Medicaid .. not at all sure that her present cardio takes Medicaid . I'd be not. But nonetheless .. she will need to be carted .. to cardio . periodically .. for them to "check her" and continue Elliquis rx. So who does that? These places all have transport . for a fee of course .. but if you need someone to accompany her .. and .. help her assimilate any info . that .. in family owned place . is handled by the owner who accompanies and assimilates info .. at fancy pants .. it's not .. you will need to accompany or provide a trusted source .. as to that issue.
She sees a Neuro .. for follow up and so forth as to her stroke risk . and rx'd Gabapentin . for her neuropathy in her feet. That will be a recurring need, to be carted to neuro doc. And .. say she gets there, . having been transported . and the doc is now asking her . "how's your neuropathy . better/worse?" Is she able to articulate that .. questionable would be my answer . I don't know, don't think so. But nonetheless .. she would need to be followed by neuro .. and visits there.
She sees an ortho routinely for steroid knee injections .. that one pretty routine .. she goes in . sits in the waiting room til called .. and then is generally seen by the PA there, and injections administered, . next appt scheduled for some 10/11 weeks forward . and on her way. Would she be able to hold onto .. and realize the importance of that little card that tells her the next appt and give that to the appropriate authority at any site where she lands .. and have them note .. "Ok we have to have Ms. ________ back at ortho for knee injection on such and such date". Questionable .. I don't think so.
Eye issues .. she sees a vision doc .. I think 1 x or 2 x's in a year . for vision changes. That may change once she's Medicaid .. I think Medicaid only allows one visit to eye doc . per year, not sure. But nonetheless . she is followed as to vision changes .. and then if there is need for change to eye glasses that's another stop along the way. She is followed by a different doc as to inserting plugs in her tear ducts .. and so that's another visit. She's followed by another doc to check on her histioplasmosis .. to make sure there isn't more damage . and result blindness .. .if it should change. Who is gonna cart her to these appts? The site . paid for transport .. any changes and/or issues .. will they be articulated by MIL appropriately ... ?? I don't think so.
She "was" seen . more frequently than she is presently . by a Podiatrist . some bunion thing on the sole of her foot that had to be whittled at periodically .. that hasn't .. somehow that has been off the radar . that bunion I guess having arrested as to being problematic in more recent times .. wasn't the
MIL may not be a slumper....yet. But she is definitely needs assistance with EVERYTHING.
Wasn't the case there for a long while . periodic visits to have that whittled away at. Doesn't seem to have been an issue in the last year or so .. don't know why. But should that flare again . who is gonna cart her there?
These are just a few .. I know in times in the past .. a doc may order an MRI or CT . or whatever .. should that be at issue . who is gonna cart her there? I know in times in the past, docs have ordered lab work .. who is gonna cart her off for that. Things I've seen to before I exited the whole damn confounded mess.
I don't have any clear answers to above.. how does that all get seen to .. send her on their paid for transport . fine and good . .but who is gonna assimilate info given . who is gonna articulate any new concerns and process/understand what is said to her as to the results. I don't know.
I'm betting the assumption is me .. and that would be a wrong conclusion for anyone to assume.
SIL's only answer to above has been: "Well in the past, I've always tried to time out those visits . so that I can be the one to see to all that when I'm here. She's right . when I exited that's what she did do . for too long . it was me . in the damn roads all the time seeing to all the above .. and then at other times, when she's sick or whatever. SIL's answer to the above: "I guess I can just try to time it out that I will return here and visit and see to those appts".
Hasn't been hammered out.
As to Xena's point . the bigger problem is gonna be the flare ups and ensuing mess . with UTI's and Diverticulitis . (chitapalooza). I get the sense that fancy pants .. is gonna expect her to have an awareness . and be preventative .. (Depends) .. and follow thru there .. and family owned "We're all family here" .. meets the need where it is . need a bed change . soiled your clothing . .okay we'll be with you in a moment.
Sad as it is . the reality of her circumstances are such that .. she probably is more suited for "We're all Family here" .. than she is Fancy Pants.
I know that is a bitter pill that SIL and DH are both grappling with presently . .trying to work that bitter pill down their throats.
While their mom is not a slumper . indeed she isn't .. and isn't one of those sitting around in a stupor not sure who/where she is .. that is indeed not her state of being. She also is not fully functional and able to sequence thought .. and "DO" what is expected of folks residing at Fancy Pants . she just is not. Maybe 10 years ago .. but that ship has sailed IMO.
I think SIL . she points to the 103 yo met at the Fancy Pants site . on her walker .. and moving about .. slowly . but moving about . alert/oriented . etc.
Getting SIL to realize . that 103 yo .. has the fortune .. that she somehow has gotten to 103 . alert/oriented and ambulatory .. great . wonderful . .that's splendid. But that's not your mom's case.
Getting SIL to recognize .. acknowledge .. wear it/own it, etc . that her mom . while yes she can tell you who she is . she can tell you where she is . and why . indeed she can. She also can't be expected .. not in any real sense . to sequence/plan, executive function type things . it just isn't there in her. It just isn't. To expect her to have any real clear thought .. to .. for instance, .. "gee ya know I told that doc the other day that my neuropathy seems worse . and they changed my rx . and now I'm feeling these weird symptoms . wonder if it's related .. I should probably mention that to my c'takers . maybe they need to call the doc on my behalf. Expecting more than she's capable of sequencing .. truly IMO.
To expect MIL to wear it/own it/live it . as to any awareness (seen this far too many times) .. "gee they had to come in here earlier today and clean up chitapalooza from h377 . I better be wearing Depends all the time here . it's not good. She fails to do so. Truly she does. If prompted/reminded .. yes .. but absent
That way, you can focus on just being MIL's friend and daughter in law, as you've wanted to do.
About the place that's had the rape incident, I would cross that one off the list. I couldn't in good conscience send a LO to a place that's had that kind of history. I wouldn't worry too much right now about the AL and as you said, just focus on working with the attorney, and with the rehab and Betty on making her LTC transition smooth, and just go from there.
But absent those repeated reminders/prompts . she defaults back to underpants. She just does ... it's a fact.
We will keep looking . not right now . it isn't pressing . .but we will keep looking if for no other reason . for perspective .. at AL's .. is there something out there that will take Medicaid assignment . something in between .. the land of the slumpers . and the fully functional Fancy Pants.
I hope MIL can get different shoes. My mother did not wear a bra after a fall last summer which left her bruised. I really don't think it made a difference. I think its wonderful news that MIL is showering herself and dressing. Those are huge steps forward considering the past. Maybe, possibly a new routine will bring her around even if it's only baby steps at a time.
I also agree with others that family slumper facility would be better. Even though she is showing progress she has physical limitations that FP place would not help with. Perhaps I am not thinking realistically but maybe she would feel less lonely and start to enjoy making progress.
So happy for you all in getting a sooner appointment with the lawyer. The proper one can make all the difference with dealing with Medicaid.
i think she should have to stay in IL with SIL as caregiver. M can keep them on track. MIL will have Poochie and her ironed pajamas.
My mother was in a non-profit assisted living facility. Once they accepted someone, they kept them until the end unless they had to have skilled nursing around the clock. It sounds like the small family oriented place you're looking at.
The ALF had a primary care physician, a visiting RN, and a podiatrist. They offered a transportation service but frankly it was useless: not flexible enough. We were responsible for specialist medical visits.
Our first step was to sit down with the PCP and figure out which "specialist" functions he could take over. Most of her specialist visits were just routine follow ups anyway, and the PCP could do that. Our next step --- and this was the hard one --- was to find a reliable woman with practical nursing experience and common sense (a CNA would also have been good) to take her to all other appointments, listen to the doctor, explain the results of the visit to us, follow up, schedule the next appointment, etc. We paid by the hour. If the small family style place will take on those tasks it's WELL WORTH IT to send her there. Until we found the right person to help my mother, I was taking her to some kind of specialist on the average of once every ten days.
Suitable clothes that are easy on and off: we bought a supply of fancy "track suits." Nice colors, rhinestones and embroidery etc. She felt pretty and got lots of compliments. Like so many elderly ladies, she liked SAS brand slip-on loafers. They're soft leather so they're comfortable.
Wasnt listened to, as you note.
Realtime, thanks. Good to note .. consult with PCP ... maybe some of all her specialist visits can be seen to ... I don't know.
Dont see a PCP willing to do histioplasmosis follow up and tear duct plugs .. but maybe ... or knee injections.
Forgot to add Dermo ..to burn off screen for skin cancers... sometimes found .. and needing tx. Add that to the list. A biproduct of growing up in FL and years and years in the sun before a lot was known about sunscreen and skin cancers.
Add that as another specialist seen every six months ... sometimes requirement for follow up visit to remove skin cancer
And .. no none have been of the dangerous malignant sort. Just unsightly .. and .. no she isn't of the Ilk to chalk it up to "yea its ugly but they say the chances of it turning into a malignancy .. pretty nil... so just leave it be ..not gunna do it ..keep having these skin cancers burned off ... just ... I don't care .. it's not gunna kill me ... and something needs to .. just I'll live with it"
Vanity would rule that out ...
Some might think this premature but if I had the appointment I would take:
1) Social Security statement that comes out each year
2) Original Reverse Mortgage documents and last received.
3)Last bank statement/statements on any accounts MIL has.
Of course you will need to provide more documentation but the Attorney can give you a truthful answer as to what it’s gonna take to make this happen.
Not to be a b!tch - but seriously?
Wearing a Depends to bed will
solve the bed wetting problem? Ummm - have you any experience with Depends?
The question of the ages: How is it you can put them in a Depends, WITH a inserted pad, lay them down on a pile of chux- and they STILL manage to get the sheets wet?
If you have the answer to that one, there are about 100 threads over in the “Questions” section that could really use this info.
And - as for a diarrhea blow-out? Forget about it! It might stay contained for about a minute but once the individual moves...ugggg!
And speaking of “Ugg” - like the segue?- there are tons of slip on style shoes, boots and slippers lined with either real or imitation sheepskin that just might eliminate the need for socks. Feet stay toasty warm.
So true. My MIL was legendary for blowouts. And leaks. Didn’t matter what we did. She still needed the Depends, etc., of course. But, that is another one of the many things that sneaks up on you with caregiving. Starts slow... then you turn around one day, and 80% of your waking time in spent cleaning up the aftermath of incontinence.
And it is physically demanding. It is the changing, and the laundry, and showering or cleaning them up, and redressing them, and cleaning carpets (because they trail it behind them trying to get to the bathroom via walker “in time”). I was so exhausted. A facility is so so much better equipped.
Your daughters may very well have good intentions to haul MIL to appointments (if DD even would; can't believe she will be willing to wrangle toddler twins to do that), but it will be passed off to you, because you are a soft touch with them.
And there could be SIL from afar, making appointments for the specialists for MIL. You've been so helpful recently (and I assume still be until the actual placement of MIL), that I expect SIL WILL assume that you will take on some of the carting MIL around duties.
It will be interesting to hear how the elder attorney meeting goes on Monday. Will you be going to it? Maybe that is a good idea, to make sure you don't get assigned duties in absentia! (And we'd like you to be our fly on the wall to report back to us.)
When it rains it pours. Have the twins this morning for DD to take fevered sick 5 yo to doc
Dx, type A Flu
Rrecommend keeping twins away, 48 hours. Guess that means I'm up.
ANd word this morning the 94 yo husband to MIL's sister passed..(live in VA)
Did MIL have a flu shot this year? When did she last have contact with 5 yo?
Might want to have SIL mention this to the DON.
So you're keeping the twins over the weekend, Dorker?
Having to keep the twins b/c older child is ill is one obvious reason YOU cannot be the go-to for MIL's myriad drs appts!!
If DH is feeling oh so sad--he can step up and take her..betcha the "sadness" over MIL's decline is quickly ended.
I would look at a lot of these drs visits--are they absolutely necessary or are they simply the result of too many drs weighing in on every single thing this woman complains of? I would cut off any unnecessary drs calls. Mother would see her orthopedic surgeon twice a year for no other reason than to see if there wasn't maybe a surgery she hadn't had yet. 2 years ago, trying to get him to do a 2nd hip replacement, he looked at her and said "I am firing you as a patient. I will not do any more surgery on you, no matter what. You are too old and too high risk for anything else to be done". She was FURIOUS.
Sounds like maybe a good PCP could handle most of MIL's issues. One and done kind of visit. She's still trying to turn back time.
My FIL was still have cancerous lesions burned off his scalp as soon as the week before he died. Does MIL still need aggressive TX for her skin and such? The knee injections are probably helpful, but really? at 89? At some point those just simply don't work. She's not running marathons, she barely moves.
The family's call. This is s good time to consolidate dr visits and utilize all the in house facilities that they NH offers. Otherwise, you still have the exact same problem you had before, who to tote MIL to dr visits? All you'll be doing is returning her to a NH which she is going to simply hate.
Hoping the lawyer sheds some light on the situation and is really helpful in moving this all forward.
There will ALWAYS be emergencies; but with good communication with the facility, they should be few and far between.
For "regular" appointments, once mom was in the NH, I always had an aide accompany her in the ambulette, I arrived separately by car. If I got stuck in traffic, etc, mom would have someone with her.
I NEVER transported mom is my car after the incident where she grabbed the steering wheel from my DH. It also just never seemed safe for untrained rookies like us to do transfers; aide had a gait belt and knew how to use it.
Per DD's pediatrician... all who have been near 5 yo .. stay away from MIL for 1 week.
That includes both me and DH. They were actually here last night for dinner when the 5 yo nose dived in like 5 mins .. from well to a sudden fever ... that quick
So DH and myself have been around 5 yo.
SIL has not ... not for a week or so.
Like the Eliquis - just left as is, along with the other heart meds, although the doctor watched for symptoms of changes there. (they also weighed her frequently for water weight.) I would think the gabapentin, as long as it worked, wouldn't need checking either. And if it's cortisone shots she gets for pain - that would be simple enough to arrange, I would think, when/if her pain came back?
And I would think the doc could check for concerning cancerous growths too. Hopefully it's time to simplify, and K.I.S.S. and SIL will realize that too. Doesn't seem like it would bother MIL much at all.
Gout
A lot of discussion on doctors visits today. Just wondering if the bunion pain may have been the gout all along? Bunion pain I always thought was aggravated by too tight shoes. Gout shows up in the same spot as where a bunion forms. Wondered if someone brought MIL her shrimp she loves before the thumb flared? Shell fish will tip Uric Acid into a flare plus all the sodium not good for her CHF. Since she had lost weight she may have been in ketosis. I only bring this up because we all like to bring treats to our loved ones when things aren’t going well for them. It’s important to understand gout so as not to aggravate it. A lot of otherwise healthy foods do aggravate gout.
Supplement
Some on this forum say be sure to keep the supplement (medigap) plan as it will allow her to see her doctors who don’t take Medicaid. It may be a state by state decision? The attorney should know. It comes out of her income and has to be paid to the insurance company. In other words she can’t keep the premium money. All her income ( except the pna-personal needs allowance) goes to her care but supposedly this is allowed as an exempt expense. Medicare/medicaid rules do change from year to year. Some may be grandfathered. Like the Plan F now has a deductible except for folks who already had it prior to 2019.
I wondered what one does while in Medicaid pending status for outside doctor visits? Most of the regulars here seem to have been self pay but perhaps someone has experience on this?
Dressing options
My mom at about 95 dispensed with the bra, wore soft cotton undershirts with fleece or velour zipper top and pull up bottoms. She slept in them and changed at her leisure. Her finger tips were numb so she couldn’t manage buttons any longer.
My aunt (92) prefers a button up shirt similar to a mans collared pj top. Mostly flannel in winter and poplin in summer. She wears a mans sleeveless T-shirt instead of a bra. (Started that when she retired in her 50s). She likes flannel lined jeans and wool socks for cold feet. They both dress/dressed themselves.