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Old 11-27-2011, 06:16 PM   #41
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I think his attitude and participating in physical therapy is the key. My grandmother didn't do her physical therapy exercises and paid the price. She ended up with a walker, bad posture and withered away. Such a shame as she was very healthy and independent up to that point.

I wish you the best.
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Old 11-27-2011, 08:19 PM   #42
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I spent the afternoon with him today. He's improving, but it's slow. He's doing more things for himself, but he's still in the wheelchair most of the time. He's progressing at the physical therapy. My sister saw him using the walker in the hall. He's been in rehab a little over 2 weeks and I expect he'll be there at least another 2 weeks. His biggest worry is that they will want to discharge him and he won't feel like he's ready. If that happens plan A is to have him go home with a Home Health Aide that my sister has all lined up. Plan B would be that he could stay in rehab and pay for it himself at $392/day. I don't think that includes the cost of therapy. My sister has a progress meeting with his case manager on Wednesday so we will see how he's progressing. So far it looks like it's planned that he stay through 12/10 which will be 4 weeks in rehab.

My sister also got an application packet for an assisted living facility that he's familiar with. He's open to the idea and we should apply soon as there is always a waiting list. He'd like to go home when he's ready but he knows he may need to make a change in the future. If your application is accepted and you are not ready you can defer for up to two years.

His attitude is very good. Three men on his rehab wing have been discharged and he noticed that all the newly admitted residents are women. Knowing him, he'll be handing out his Hershey's Kisses to them soon.

I've been enjoying taking care of his financial affairs. He never sat me down when I was a kid and said, "this is how to do this" but I seem to have been genetically imprinted. I'm so impressed by how clear his records and files are and it's so much like how I run my own financial life that it's all easy for me. He is comfortable in letting it go for now and he's grateful that I'm willing and able to do it.

Thanks for all the good wishes!
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Old 11-27-2011, 09:54 PM   #43
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These are all good things Sue. I am glad it is going so well for all of you.

Ha
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Old 11-27-2011, 11:48 PM   #44
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If that happens plan A is to have him go home with a Home Health Aide that my sister has all lined up. Plan B would be that he could stay in rehab and pay for it himself at $392/day. I don't think that includes the cost of therapy. My sister has a progress meeting with his case manager on Wednesday so we will see how he's progressing. So far it looks like it's planned that he stay through 12/10 which will be 4 weeks in rehab.
My sister also got an application packet for an assisted living facility that he's familiar with. He's open to the idea and we should apply soon as there is always a waiting list.
Thanks for all the good wishes!
I'm reading "A Bittersweet Season" by Jane Gross. The downsides of the book are that the events occurred in 1999-2003, back during the "dark ages" of geriatric care. Ms. Gross is also (hopefully) exaggerating her ignorance and her drama-queen behavior. It gets tiresome. You want to tell her to stop the dysfunctional family hysterics and get to the problem-solving.

Having said that, the book is packed with practical advice for geriatric medical treatment and care considerations. It's a good roadmap.

If there's one positive aspect about all of her emotional trauma, it's that it'll make you feel good about your father's progress!

J.D. Roth also has a great guest post about a woman who probated her father's estate:
Reader Story: What My Father’s Death Taught Me About Estate Planning

Now that you've managed the finances for a bit, you can look ahead and see what preps (if any) need to be tweaked. You have a valuable opportunity for a conversation with your father that many adult children never get to bring up.
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Old 11-28-2011, 11:11 AM   #45
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Broken hip treatment for the elderly is a familiar dance for me. The key to staying in the care facility with rehab is continuing progress and cooperation with the PTs. It is painful and a lot of work, praise his every effort. Emphasize to the staff that he lives alone, avoid telling them that assisted living is an option because they will set a higher ADL standard for discharge.

Even if you think he will be able to live at home (with or without help) put him on the waiting list. If his name comes up and he is doing OK you can tell them to pass over him at the moment. In almost all cases he will maintain his position on the list.
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Old 11-30-2011, 01:59 PM   #46
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Wow I am so sorry about your loss as well as your father in the pain that hes in.. I just wanted to say is if you have ever considered purchasing a medical alert system so that if he is ever alone especially in the condition that hes in that he will be safe at all times? A medical alert system is basically an alarm that can be worn as either a pendant or a wristlet so that if God for bid your father has a fall and no one is around to help him that he can just press the button and the ambulance are on there way to help him. My mother has a med alert and it has saved her life more than once. Its really a life saver and might be extremely beneficial for your father.
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Old 12-06-2011, 09:01 PM   #47
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Another update -

We thought he'd be scheduled for discharge on 12/10 but so far they haven't told us so he may be able to stay longer. He's improved a lot and uses a walker well although he says it's hard work and it tires him out. He has learned to transfer from the bed to the walker and to the wheelchair with someone nearby. He says he's not ready to leave, he likes the support and having his meals taken care of.

When his facility says that Medicare will no longer cover his stay he would like to stay another week or two and pay for it himself. He's worried about going home and falling. The plan right now is for him to stay until Jan 2 and when he goes home he will have the home health aide that took care of my BIL's parents for 12 hrs a day for at least the 1st week and then less time if he can handle it. We will also make sure that he has a LifeLine device. The home health aide came to see him today and he remembered her. They talked about all the things she can do with him, including taking him out. He's looking forward to being home if he can have help.

I'm much more optimistic about his outcome. His attitude is good and his physical progress is encouraging. Sometimes he seems like the same old Dad, just injured. Other times he has become very elderly and detached. He always liked paying his bills and watching over his accounts. Since I have taken over to help him he says that I can just do it all for him, he doesn't want to deal with it again. I don't mind, I'm just surprised that he's given up on it, I thought he'd want control again as soon as he could.

Going through his very neatly labeled files I found years of spreadsheets, not the Excel digital kind, the old ledger paper and pencil kind of spreadsheets. He had years of these to record his expenses and his investments, including 2010 when he was 84 years old! I didn't check his math but they looked reasonable to me.

Sometimes I think this may all turn out ok, he'll get to go home and get his life back. Things will be different but he's like me, he finds joy in everyday little things. On the surface he wants to improve physically and live his life again. And then, the practical guy that he is, he says things like, "This would all be so much simpler if I could just be with Mom again." I always tell him that I understand, but life doesn't work that way and you just need to do your best and enjoy what you've got while you are still here.

Sigh...

Nords, thank you for the link to the Roth blog. Very good stuff and I also enjoyed the comments.
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Old 12-06-2011, 09:17 PM   #48
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I'm much more optimistic about his outcome.
A lot of good vibes in those seven words.
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Old 12-06-2011, 11:28 PM   #49
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Other times he has become very elderly and detached. He always liked paying his bills and watching over his accounts. Since I have taken over to help him he says that I can just do it all for him, he doesn't want to deal with it again. I don't mind, I'm just surprised that he's given up on it, I thought he'd want control again as soon as he could.
Nords, thank you for the link to the Roth blog. Very good stuff and I also enjoyed the comments.
Glad it's helping!

My father was extremely independent-minded until the care facility showed him that he no longer had to do chores. Then he immediately relaxed and started enjoying the benefits of letting them cook, do laundry, and clean his room.

Maybe your dad is just having a "Why the heck was I working so hard?!?" epiphany.

If you're struggling with the care facility's discharge coordinator, or if good home aides aren't just dropping into your lap, then a geriatric care provider can help navigate the maze of benefits and referrals. Many of the better discharge coords and home health aides would rather work through a care manager anyway, especially if that means they can talk directly to the manager and no longer have to spend all their time educating us ignorant adult children. We felt that we got huge value for every penny we spent.
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Update - He's home
Old 01-12-2012, 08:51 PM   #50
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Update - He's home

Dad was discharged from the nursing home today and is home with the home health aide. My sister bought groceries and made a dinner for them but he insisted that he wanted a pepperoni pizza so they called for a delivery. My sister was disappointed but I'm glad to see my Dad having some spunk.

He had a Lifeline service installed this afternoon. The home health aide will be there 8am-8pm. She will get him to bed before she leaves. He's worried about having to get up during the night and being alone but he has a urinal container if he needs it. He does very well with his walker, he's just concerned about having to get out of bed alone.

While he was in rehab we had his apartment cleaned including a carpet cleaning service so it all looked great when he came home. I even took videos of where all his stuff was before the carpet cleaners moved things so we could get everything back the way it was before he broke his hip.

He's very appreciative of all that my sister and I have done for him. She handled logistics since she lives nearby and I handled all his finances, including details associated with Mom's death in October. I made a trip into downtown Cleveland (I hate going downtown!) to the County Administration Building and presented the death certificate and had their survivorship deed changed to sole ownership. Then I added Transfer On Death to my sister and I. Dad had signed all the papers with a notary at the nursing home. I also did the same process with his bank accounts, changing them from joint accounts with Mom to single accounts with me as POA and my sister and I as Payable on Death. We also changed the beneficiary on his IRA from Mom to my sister and I. This changed his future RMD to a smaller amount, I'm assuming that's because it's calculated on him being 85 and my sister and I being 56 and 59. He knew exactly what I was talking about when I explained it to him and he understood the advantage of a smaller RMD. An estate attorney had recommended these steps to avoid probate and they were all easy enough to take care of outside of having to deal with downtown Cleveland.

On one of my trips to see him I brought home his computer. It was full of viruses and spyware, had only 128K of RAM and hadn't been properly updated for years. A couple of his automatic Microsoft updates had not installed completely. I think he didn't let the downloads finish. Anyway, it seriously needed to be updated. I upgraded the RAM to 1GB and reinstalled Windows. Now it's quick and easy to start and I hope he uses it. I've been paying all of his bills online so I bookmarked all the sites I used, printed out his logins and passwords and I'm hoping he'll want to use the computer again.

I've also been monitoring his insurance claims. His Anthem Advantage insurance plan has been wonderful. Everything has been paid at 100% except for his $225/day co-pay for the 4 days in the hospital and an outpatient x-ray at his surgeons office. He will have a $128/day co-pay after the 20th day in the rehab. I think it was well worth it.

This is the first time I've had any dealings with Medicare. I'm astounded by how little actually gets paid to the provider. The allowed amounts are much smaller than on our own health insurance plan. I looked at these claims and wonder how hospitals and doctors can make any money if they have Medicare patients. But that's a whole 'nother issue, probably for the Political Forum....

I've also researched some old claims of my Mom's from 2010. She had some outstanding bills from outpatient treatments and I found some errors and had them resubmitted.

It's been a long ordeal. He left home for an errand on Nov. 7th and everything changed. He still needs help with many things and I think he will never be back to where he was. But we are hopeful that he will have a good quality of life with some compromises. We are lucky that his mind is still sharp. He's still himself - practical, logical, optimistic with a sense of humor. He hates having to depend on other people, especially for the personal stuff but he's willing to accept that he does need the help for now.

Thanks for all the support and advice. It really did help to hear from others who have been through this.
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Old 01-12-2012, 09:04 PM   #51
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Sue , Glad your Dad is doing so good .My Mom lived alone for many years with a life link button and a wonderful home health aide . I hope your Dad does as well . Of course soon the lonely widows will be dropping off casseroles .
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I thought I was done with updates, but no.....
Old 01-13-2012, 11:09 AM   #52
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I thought I was done with updates, but no.....

Our phone rang this morning at 5:30 am. Dad had fallen and he pressed his Lifeline button. My sister (3 miles from Dad) was first on the list but she did not answer her phone. I'm next on the list, but 30 miles away and I don't have a key! I gave my set of keys to the home health aide and my sister said she'd make a copy for us and give it to us on Sunday when we all get together with Dad.

I tried to call my sister, her cell, her husband and no one answered. Lifeline said they'd call Dad's local Fire and EMS. They told me if they couldn't get in they would have to knock down the door. They also told me they were speaking to Dad and he was ok, just couldn't get up. He had stood next to the bed to pee in the urinal and lost his balance when he tried to get back in bed. He did just fine 2 other times last night but on the third time he dropped the urinal (it didn't open!) and maybe he reached for it or something.

My DH immediately put clothes on and was ready to get in the car. We had a snowstorm last night so it would have taken him at least 45 minutes and without a key it didn't make sense for him to leave.

Lifeline told me that I could call Dad and he could hear me on the speakerphone so that's what I did. Of course, he didn't have his hearing aides in so we were both shouting, but I was reassured when I could hear that he wasn't hurt, just stuck. I asked him if he was lying down and if he could reach a blanket and he said he was on the floor with his head against a shelf, but that he was ok. I stayed on the speakerphone until EMS got inside and I talked to a paramedic who said they got him back in bed and would check him out. He didn't want to go to a hospital. I asked them to leave a phone in bed with him and have him call me after they left. He banged up his arm and bled a little on his white carpet and bumped his nose.

EMS didn't have to knock down the door, there is a 24 hour guard at the apartment building gate and the guard keeps a master key for occasions like this. I bet the guards know the EMS crew pretty well by now as there are many seniors in his building.

OY VAY!! He'd been home less than 24 hours and we've already had a crisis! Thank goodness he had the Lifeline, well worth whatever it costs. I'm impressed with the service and the technology. Being able to call from home and have him hear me helped us both feel better.

After EMS had left Dad called me and I knew he was ok. He said he would just stay in bed until his aide came.

Lifeline called me to follow up after the incident was over. I thanked them profusely and I told them we would all talk about how to plan better for the next call.

But DAMN, this did not go as planned. I didn't hear from my sister until a few hours later when she got up and checked her messages. She had her ringer off on her upstairs phone and she couldn't hear the downstairs phone. She had always kept the ringer off upstairs because her husband's kids all live out of town and would call at odd hours. Her cell phone was in the charger in the kitchen. She feels just terrible and kept apologizing.

Obviously we need to do better with this. My sister must be able to hear her phone. I must have set of keys. Neither of us knew that the 24 hour guard has a master key.

My sister's DH had a suggestion that we will look into. Dad needs to tell his doctor about how often he urgently needs to get up during the night and see if he can get a prescription to help with that. He'd be a lot safer if he didn't need to get up so often.

I need a nap. And a little alcohol later seems justified.
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Old 01-13-2012, 11:35 AM   #53
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Thank goodness it did not end badly. Don't be hard on yourself or your sister - many things don't go as planned. With some real life experience now you can improve your plan and be better prepared the next time. Getting him to seek some medical help is a good next step - not having to get up at night seems like smart prevention and improved quality of life for him.
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Old 01-13-2012, 12:56 PM   #54
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Hi Sue,

Is your dad able to afford some physio to build up the strength in his arms and legs?

My mom fell after coming home from 2 months in hospital. She didn't have Lifeline then, and wound up spending over 12 hours on the cold kitchen floor in the dead of winter. We got her the LifeLine the next day, but she also started doing strength training exercises. It helped a lot. She was able to get herself up from some of her falls and used LifeLine for others.

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Old 01-13-2012, 04:06 PM   #55
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O
My sister's DH had a suggestion that we will look into. Dad needs to tell his doctor about how often he urgently needs to get up during the night and see if he can get a prescription to help with that. He'd be a lot safer if he didn't need to get up so often.
My mom uses a generic bladder control pill and it is indeed a miracle drug. She never has to get up during the night which has enabled me to sleep in my own house at night. Otherwise I would have to stay there to help her up during the night. BTW, don't let his doc prescribe Vesicare(as my mom's doc did) as it is high as a cats back. Plenty of good generic ones that are cheap.

Sorry for your troubles.
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Old 01-13-2012, 04:52 PM   #56
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Sue, your posts about your parents for the last few months are so well written and helpful. Very matter of fact, but laying out all the work involved from the health care to the legal issues to the bank stuff and the estate.

Fortunately the trial emergency run last night did not result in any major injuries--your father is probably embarrassed to have caused so much trouble, from the way you've described him, and I hope it will be smooth sailing from now on.
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