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My mom is 65 and doesn’t want Medicare and has no faith in her doctors care and has had two strokes. She has office of private management government care health insurance with Kaiser permnate and they are not the best healthcare provider in the world sadly. She is currently trying to do physical therapy and is too tired to practice and is suffering from swelling muscles and depression and frustration which she ends up screaming at me over the littlest things. I live at home with her and dad who has also suffered a stroke and heart attack. My question how do I convince her that if she doesn’t seek treatment for health problems because the stroke that she will be able to move on from physical therapy to occupational therapy? My only thought is if she doesn’t get what she needs from in home therapy then I’m thinking of trying to get her living assistance at home which she doesn’t want because of pride or Covid or feeling embarrassed when the fact is I can’t do it all. No matter how much I do her needs can’t be met by me alone. My dad can’t help he just watches tv all day and not really being helpful to talk about it and is having a hard time himself by not showering just washing up. I know many here say that I just should just leave them and go my own way but I’m currently trying to get myself together through visiting a back doctor for my injuries I got a few years ago in 2016. So my options as a caregiver is very limited and any advice from those who are or have been going through the same things life throws at us would be helpful cause some days like today I just need a break. I help her with taking a shower and meals and even balancing the bills and sometimes my dads stuff. Should I just wait til she gets sicker then get power of attorney and then sign her up for Medicare and then ask a doctor for living assistance? Cause some days I want just be able to take care of me only. Get a job after healing from my injury almost fully and get back to living cause right now I’m just in limbo. Feeling like my life is put on pause the only good thing I can think of is my school debt got canceled due to fraud as Biden administration shutdown the collections. But after that my life has been just sitting at home watching my mom suffer and get at me constantly. I try to in courage her and show her that a positive change can happen but she refuses to see it. This could cause more health issues for us both so any good advice would be very helpful and sorry for venting so long. Thank you and she also has memory problems as well. I know I’m wrong and should never shout at her but she won’t let me help her because of her loss of independence and won’t seek console support for it and I’d be willing to go there with her.

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Cutlass, please call Kaiser with mom. They almost certainly REQUIRE her to enroll in Medicare Part A ( I belive is is automatic, and free).

She needs to find out from Kaiser if she is required to sign up for Part B (and yes, there will be a substantial LIFELONG penalty if she doesn't do this timely) so call today.

Is she still working? To my knowledge the only legitimate reason to delay signing up for Part B is if you can show credible, comparable employer insurance.

Medicare for Dummies is a wonderful source of information.

https://healthy.kaiserpermanente.org/shop-plans/ready-for-medicare

Also, there are folks at www.bogleheads.org who understand the intersection of Federal Employee Health Insurance and Medicare. Asking questions there will get you terrific information.
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" I live at home with her and dad who has also suffered a stroke and heart attack."

As long as you are there to take care of their every need, nothing will change.
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Cutlass101 Mar 2023
So you saying I should leave I wish I could but this takes time and I must get myself together before I can just pack up and leave but I respect your answer thanks
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Sounds like the strokes have caused dementia in your mom, especially that she refuses Medicare which is of benefit to her.

My DH and I have had Kaiser Permanente for 20+ years now and with their Medicare plan, absolutely every medical issue a senior may have is covered in a "one stop shopping" sort of environment.

My dh was sent to the Mayo Clinic for a liver transplant and paid for hotel accommodations as well as the 2 surgeries involved.

I was dxed with stage 4 metastatic cancer and set up IMMEDIATELY with immunotherapy treatments by Kaiser. Which was crucial bc I'd been given 2 months to live at that time.

Get mom tested for dementia with a SLUMS or MoCA test if she's agreeable. Then insist she sign up for Medicare immediately (hopefully with Kaiser) or you'll have no other choice but to stop helping her because she is hellbent on killing herself thru neglect and due to pride.

Both of your parents would be best served in Assisted Living and selling their home to finance it, if necessary.

If they refuse all of your help, then you have no other choice but to leave them be and wait for The Phone Call they're in the hospital. Mom won't be released to live independently anymore and then she's forced into managed care against her will. Her choice.

Best of luck to you
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Cutlass101 Mar 2023
Thank you for sharing your experiences and thank god you survived cancer and your significant other had that liver transplant. It’s good to see Kaiser work for you cause I haven’t seen those kinda results not that I’m looking forward to seeing my parents get sicker and need those kinda treatments but every little bit helps and their treatments for stroke management was lacking except in my dads case. He was able to spend time in a rehab center and get his needs met precovid. Mostly in my area they are short on doctors and when my mom or dad go to see the doctors they are a bit to relaxed when it comes to the health of their patients with only a 20 min time limit it’s hard but I wish and pray that my mom have a doctor that would take the extra step to give my mom a health care team. Far as a dementia test she may not agree to that due to various reasons of fear and pride and more arguments. My thoughts are she just wants to take risk and wing it and pay for later with more bad health. Which in turn brings more stress to me. I wish she could understand this more clearly more than anything else so I’m take your advice and step back a bit and let things play out. Living assistance has always crossed my mind. My father has Medicare part A and b but feels he may not need assistance but I beg to differ he doesn’t take showers like he used to and doesn’t eat a lot foods but is on heavy medication that makes him go to the bathroom a lot. So it’s a tough one and yes I’ll be making that phone call i dred most cause I live with them everyday. Maybe when it comes down to that she will finally see that she understand her needs god willing while in the hospital and it can be met hopefully not against her will but if so be it. Thank you lealonnie and I’ll try update you throughout the situation.
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As long as you are living in your parents' home, you will be expected to help them in whatever ways they need or want, and those needs will increase dramatically as time goes on. If this is an arrangement you have made in return for free room and board, you may need to re-think your living situation before your parents will stop relying on you. Why should they hire outside help if they can het you to help for free?
Health insurance is not going to pay for day-to-day help whether the insurance is Medicare or Kaiser or any other company.
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It doesn’t seem like either of you are benefiting from this situation.

I understand your desire to help your mom but she isn’t cooperating with your suggestions in order for her to see improvement.

What has your mom’s doctor said about her condition?

So, I would back off for now. Focus on your own needs to get your life back on track.

Wishing you and your family all the best.
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Cutlass101 Mar 2023
Thank you need and yes it’s not a great situation we had her first doctor who had retired wanted her to take a ct scan to see why she has the swelling she didn’t want to do. The second doctor was a young and didn’t speak English well but tried to give her a water pill for the swelling and didn’t give much medical diagnosis except that her kidney function was low and was told by a kidney specialist that she would need another blood test to see what’s going on. She got mad at the doctor and me and refused to follow through and they took her off blood pressure water pill. So she went for a third doctor and this one gave her a water pill and advised her to see if she would take another blood test to see why the swelling is happening and she won’t really ask to many questions for her condition and the doctors under this health care plan don’t seem to want be the to caring but just at the limit for 20 minutes so they don’t want set her up with a damn team or anything unless she saids give it to me and damn shame so yes I’m gonna take your advice and step back. When she goes into the hospital I’m have to step up and help with dad to try something different instead just let her out the hospital after short treatment and then I’m stuck with everything. So at this point I’ll do a little but I’m still going to the back doctor and getting what I need so that I can try and be at my best when the shit hits the fan sadly to say and thanks for your advice need sometimes gotta hear it from someone else!
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If a person qualifies for Medicare and misses the enrollment period, there may be a penalty for signing up later.

Maybe your Mom will listen to a professional advising her. Like a Geriatric
Care Manager.

Apologies, I have no further details.
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Cutlass101 Mar 2023
Thanks send for message and I will have to look into this for her at some point. I don’t know if Kaiser has such a thing or I’ll try a google search for more details and yes she is aware of penalties but feels that she will be paying double for health care and Medicare when in fact me and dad tried to get her to see that you gotta have back up plan when things go south it’s been tough but I think dementia is causing this so I have to see what else can be done as time goes on.
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i would suggest that you talk to Kaiser as a start. Ask to talk to a financial counselor. Since they have your Moms birthdate, they know the situation with Medicare. Because your Mom is not yet 66, she is not eligible for full social security benefits, however, she could be eligible for partial benefits or spousal benefits. However, to talk to Kaiser, you will need to get the HIPAA form signed allowing you access to her medical records. They have a good portal that will allow you to see the results of past tests and visits. It is quite likely that you are not getting the full picture of your Mom’s health.

Recovery after stroke is very hard. Your parents might qualify for 24 hour care and Medicaid. Again, Kaiser could guide you in this area.

My brother had 5 strokes which were considered mild. He was no longer allowed to drive and could not be left alone. 2 years later, he was diagnosed with pancreatic cancer. His wife filled out financial aid forms with Kaiser, and also POA and medical POA. He died about 2 months later and Kaiser’s financial aid took care of the entire bill. He did not have to eliminate any assets to get the financial aid. He had 3 rentals which paid his mortgage, and a wife who worked clerical jobs when he got the strokes.

PT is hard work, depending upon what part of the brain the stroke damaged. However, it is possible that there is more going on. Did your Mom tire easily before the stroke?

Tell your Mom that you want to be a partner in her health. However to be a partner, she needs to sign the HIPAA allowing you to be her extra eyes and ears in her health care. Then be her health advocate.

i suspect she doesn’t like her primary care physician at Kaiser. Work with the care counselor (again you would need HIPAA signed) to see if it can be changed.

Get a good understanding of her medical situation. Then try to be a little goofy while you are giving her care. It may make her more receptive to your suggestions…..get access to her medical records.
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Cutlass, you have a lot on your plate, but perhaps prioritize the tasks: 1) First, get medical help that you need, but also please see a Counselor/Therapist who can brainstorm these many issues with you. The counselor does not need to be someone who is an expert with stroke survivors care. The counselor is for YOU.
2) Find a part-time job or work as a volunteer, if no "paying job" can be found. This will build up your self-esteem and give you more 'backbone' in dealing with difficult Mom 3) Kaiser Permanente surely must want your mother to be on Medicare or at least on the "Kaiser-managed Medicare". Your mother is totally misunderstanding Medicare, thinking it will be in ADDITION to what she's already paying. Your Mom must immediately get enrolled in Medicare Part A or face life time monetary penalities. Talk with Kaiser about someone who can explain the wisdom of Kaiser-managed Medicare (part B). Please share with Kaiser on the phone that your mother has suffered 'Cognitive Impairment" with her strokes and that you need Kaiser's help in getting her enrolled in their version of Medicare. This list (and there are more things, I know, to address) should help you make a start. Getting out of the house to a part-time job is vital for you.
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NO ONE can do it all. Figure out what you can manage: tell your parents what that is, and hire help for the rest. There is no other way. You have to take care of YOU to be of any help to anyone!
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1) you need to pay your bills and your student loans after things get back to normal with the gov't You are not obligated to pay for them. You will also be in quite a bind being unemployed and if one of them passes or ends up in a NH on Medicaid, your combined income will deminish. It sounds like both have diminished capacity to make important decisions. There is no way to convince a stroke person or one with dementia to reasonably think.

2) POA if she allows will not allow you to put her on Medicare or Tri Care. She needs to do it. Only other answer is guardianship which is expensive. Unless one of them is hospitalized and becomes an unsafe discharge, you have to wait and claim unsafe discharge and tell them she cannot afford private care. The hospital can become the next go to probate where she will be assigned a guardian and will then be elegable for Medicaid.
3) Walk away and let the chips fall where they land, which will most likely be another hospitalization. If they become on their own, then you can say that there will be an unsafe discharge. Imagine how your life would be becoming independent again and just having nice visits with the parents when they are tucked away in facility care.
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