sister end of life

[Bigdawg]

59 yr old sister is in the hospital. 40+yr smoker and alcoholic. 10% kidney function. Liver just as bad. My nephew(36) and niece(33) are there with her. They want a decision on dialysis now. She wants to wait until I arrive on Thursday. No insurance, no job. Has paid for house (basically falling down) and a paid for car worth maybe 5k. I don't have the funds to finance the mutiple hundreds of thousands of dollars that would be needed for transplants, dialysis and ongoing care. I live 1300 miles away. They next few days/weeks will be interesting. Thoughts?, Ideas?, things I should think about?

 

[easysurfer]

Sorry to hear about the stressful situation.

Anyone in family have a POA or Medical POA for your sister?

This helps if someone designated as such. Otherwise, there could be a tug of war of emotions between family members as to what to do.

 

[flyingaway]

Is there something called ACA or Medicaid?

 

[EastWest Gal]

It's not on you to pay for it. Medicaid will cover. Talk to the hospital financial folks. They help her get enrolled in ACA or Medicaid, if they haven't already. Ultimately it's up to her. Your job is to be a sounding board for her, not a savior. The only thing you should be paying for is your own transportation and place to stay while you visit. If she needs to spend down assets to qualify for Medicaid so be it. That's what it's there for-a safety net.

 

[disneysteve]

Very sorry for what you're going through.


I second the question about Medicaid. If she has no income and no insurance, she probably qualifies. You didn't mention a spouse though. What has she been living on with no job? Where does her income come from?


From what you've said, it doesn't sound like she'd be a transplant candidate, so that's probably not a concern. But dialysis certainly is, and that could extend both the quantity and quality of her life significantly, and Medicaid should cover all of that.

 

[Scratchy]

If she has renal failure she can immediately qualify for medicare parts A and B, or sign up for an Advantage plan. That's provided she has worked enough that she would normally qualify for social security later on, or is the spouse of someone who did.

Medicare would give her the best options. If not, medicaid or ACA plan would be options.

 

[Bigdawg]

Sorry to hear about the stressful situation.

Anyone in family have a POA or Medical POA for your sister?

This helps if someone designated as such. Otherwise, there could be a tug of war of emotions between family members as to what to do.

Thank you

No POA and no will. I will assist my nephew and niece making decisions. So far we seem to be on the same page.

 

[Bigdawg]

It's not on you to pay for it. Medicaid will cover. Talk to the hospital financial folks. They help her get enrolled in ACA or Medicaid, if they haven't already. Ultimately it's up to her. Your job is to be a sounding board for her, not a savior. The only thing you should be paying for is your own transportation and place to stay while you visit. If she needs to spend down assets to qualify for Medicaid so be it. That's what it's there for-a safety net.

Thanks. This is what I thought. I plan on talking to the hospital folks when I arrive on scene. SO basically has no assets. Car worth a few K and house worth maybe 20-30 k is somebody wants to pay for a falling down house. No 401k or bank assets.

 

[Bigdawg]

If she has renal failure she can immediately qualify for medicare parts A and B, or sign up for an Advantage plan. That's provided she has worked enough that she would normally qualify for social security later on, or is the spouse of someone who did.

Medicare would give her the best options. If not, medicaid or ACA plan would be options.

No spouse. She has worked enough and qualifies for SS. She has been living from job to job. I am guessing she hasn't worked in 6 months or so. Unemployment probably. Doesn't do much and owes nothing on the house. RE taxes very small in AR. Probably lives on less than $200/month is my guess.

 

[street]

WOW! That is a rough decision to make and wish you the best, in how things turn out.

 

[Bigdawg]

WOW! That is a rough decision to make and wish you the best, in how things turn out.

Thanks Street. I have read many stories on here (to include your story) on peoples struggles with health issues regarding family members. I am capable of dealing with this. Doesn't mean I want to. I am blessed with a fantastic spouse, adult children and supporting friends. My stash will support ME as I deal with this issue. If my sister could somehow survive this ordeal (dialysis, kidney and liver transplant, etc...) it would literally cost millions of dollars. Doubt her body nor the medical community/system would support that. I won't say to my sister "you did this to yourself with 40 plus years of drinking and smoking". Though I want to. Maybe I can at least be of comfort to her as this journey comes to and end. I see no positive outcome. Is it wrong for me to hope it ends quickly? If there was hope for a promising future for her I am all for being there and helping make that future possible. I just don't see it.

 

[athena53]

I'm sorry you're going through this- it's pretty much what happened to my Ex at the end of his life for the same reason. DS, our only child, was 24 at the time. All of us- DS, his pastor (a close personal friend), my Ex's sister and DH and I- agreed to let him go with palliative care. At some point it becomes clear that no matter what they do to fix the current issues, they won't have any quality of life left.


I wish you peace. Please keep us posted.

 

[Dtail]

Wish you all the best with your decisions. No reason to feel that any monies should come from you.

 

[Bigdawg]

Athena, Dtail- Thanks. I have housing options local where she lives. Also can probably officiate volleyball and baseball there to augment my costs a bit. I have a small network of family/friends in that area. My 89 yr old mother is there local and I help her (and her boyfriend) when needed. They are both declining also. Full plate. I can do this. No offense to the non believers out there but me and the big man upstairs have an agreement. He doesn't give me anything I can't handle and he equips me with the tools/ability to deal with the things he puts on my plate.

 

[Dash man]

Athena, Dtail- Thanks. I have housing options local where she lives. Also can probably officiate volleyball and baseball there to augment my costs a bit. I have a small network of family/friends in that area. My 89 yr old mother is there local and I help her (and her boyfriend) when needed. They are both declining also. Full plate. I can do this. No offense to the non believers out there but me and the big man upstairs have an agreement. He doesn't give me anything I can't handle and he equips me with the tools/ability to deal with the things he puts on my plate.

Prayers for you BigDawg!

 

[easysurfer]

Thank you

No POA and no will. I will assist my nephew and niece making decisions. So far we seem to be on the same page.

Glad to hear that so far you are on the same page.

I've gone through times with family members and friends where there's friction as one person may want to do whatever is necessary to not let the person go or at least wait until family members and show up when another family member might say, let the person go peacefully as soon as possible. That's just health decision part.

In those times, I remember, eventually there came a point where the family pretty much agreed it was time to let go. Even for those who had the view of whatever is necessary.

 

[Aerides]

...I won't say to my sister "you did this to yourself with 40 plus years of drinking and smoking". Though I want to. Maybe I can at least be of comfort to her as this journey comes to and end. I see no positive outcome. Is it wrong for me to hope it ends quickly?...

I think your feelings are normal. It is possible she is now filled with regret and clinging to hope, but most likely just wants the comfort of her brother now, so it's great that you can be generous to be there for that.

You can call the hospital administrators now to start looking at medicaid, etc., in case she has implied to them you're the source of financials, to get that moving. Chances are something is already in motion since she's been admitted beyond the ER anyway.

 

[easysurfer]

Wish you all the best with your decisions. No reason to feel that any monies should come from you.

+1.

I'm health care POA and financial POA for a sister who is in a nursing home.

Your sister and other family members may have said that you are the one good with money, so kind of delegate that part to you.

As long as your sister is of sound mind, should get the POA documents done. The hospital should have a form ready, I'd think. Main thing is when the hospital wants paperwork signed either have her sign or someone sign correctly as her by POA. This way, protects you in case the hospital says you gave your signature to agree to pay.

 

[MichaelB]

Thanks Street. I have read many stories on here (to include your story) on peoples struggles with health issues regarding family members. I am capable of dealing with this. Doesn't mean I want to. I am blessed with a fantastic spouse, adult children and supporting friends. My stash will support ME as I deal with this issue. If my sister could somehow survive this ordeal (dialysis, kidney and liver transplant, etc...) it would literally cost millions of dollars. Doubt her body nor the medical community/system would support that. I won't say to my sister "you did this to yourself with 40 plus years of drinking and smoking". Though I want to. Maybe I can at least be of comfort to her as this journey comes to and end. I see no positive outcome. Is it wrong for me to hope it ends quickly? If there was hope for a promising future for her I am all for being there and helping make that future possible. I just don't see it.

Bigdawg, it’s not wrong and I think you have a helpful attitude. You are neither responsible not liable for the choices others make, even when they are close, and you’re also not responsible for the outcomes. IMO your most important contribution now can be emotional support for your sister and her family, along with some neutral, clear minded help navigating the healthcare resources available to her.

When I was up to my eyebrows with family health issues I took a workshop for caregivers and it helped immensely, mostly in remaining balanced and healthy while others were failing. It’s far more effective to lend a hand to others when you are emotionally, physically and financially strong.

 

[Scratchy]

No spouse. She has worked enough and qualifies for SS. She has been living from job to job. I am guessing she hasn't worked in 6 months or so. Unemployment probably. Doesn't do much and owes nothing on the house. RE taxes very small in AR. Probably lives on less than $200/month is my guess.

She will likely qualify for both medicare and Medicaid, which is very broad access to health care providers and little to no out of pocket expense.

 

[ExFlyBoy5]

As mentioned, she will qualify for MediCARE since it sound like she is in renal failure. Also, very possible that she would qualify for SS disability which opens the door to other modes of assistance.

I feel for you BigDawg and salute you for being such a rock for your family. There will be a special place for you upstairs when your time here is done.

 

[Bamaman]

My wife and I have counseled a number of people with serious health issues and incapable of work. We've always been appalled at those that could be on social security disability but never went to the doctor regularly and had a paper trail required to use their benefits. There's no substitution for someone taking care of their own healthcare.

To get on Medicare, you've got to have 40 quarters working and paying into the system. That essentially means 10 years of gainful employment. After Social Security Disability deems someone disabled, Medicare starts 2 years from the starting date of disability. Young adults and those chronically unemployed in bad health end up on Medicaid, but they find it very difficult to find quality healthcare with doctors often not accepting it.

When it comes to end stage renal failure, most likely the person will go on hemodialysis. Nephrologists may try to talk patients into going on peritonial dialysis, but it takes a strong, young person to handle flushing themselves out with a tractor trailer load of liquids monthly.

My father, uncle and first cousin were all on hemodialysis for about 4 years. That's about the average time people last before throwing a clot to the brain, heart or lungs. All spent 3 hours three days a week hooked to the machine, and it was essentially a living hell. We don't wish it off on anyone.

Best thing you can do for your sister is help her get all her legal ducks in a row--including a will and healthcare power of attorney. You could also assist in getting paperwork filled out and filed for Social Security Disability. It may be of some assistance. So often, those in such bad shape cannot handle such details on their own.

If her liver is in such bad shape, it doesn't sound like she has a good prognosis. We're so sorry.

 

[Bigdawg]

My wife and I have counseled a number of people with serious health issues and incapable of work. We've always been appalled at those that could be on social security disability but never went to the doctor regularly and had a paper trail required to use their benefits. There's no substitution for someone taking care of their own healthcare.

To get on Medicare, you've got to have 40 quarters working and paying into the system. That essentially means 10 years of gainful employment. After Social Security Disability deems someone disabled, Medicare starts 2 years from the starting date of disability. Young adults and those chronically unemployed in bad health end up on Medicaid, but they find it very difficult to find quality healthcare with doctors often not accepting it.

When it comes to end stage renal failure, most likely the person will go on hemodialysis. Nephrologists may try to talk patients into going on peritonial dialysis, but it takes a strong, young person to handle flushing themselves out with a tractor trailer load of liquids monthly.

Best thing you can do for your sister is help her get all her legal ducks in a row--including a will and healthcare power of attorney. You could also assist in getting paperwork filled out and filed for Social Security Disability. It may be of some assistance. So often, those in such bad shape cannot handle such details on their own.

If her liver is in such bad shape, it doesn't sound like she has a good prognosis. We're so sorry.

Thank you. Just landed in a city near by. Will be heading over there in the morning. I am taking notes. Thanks for all the suggestions and support.

 

[daylatedollarshort]

Best wishes to you in coping with a difficult situation. I agree with others you don't need to feel financially responsible at all. I'm sure any help you can provide sorting out Medicaid and Medicare type issues will be appreciated.

 

[Montecfo]

BigDawg,

Saddened for your sister and family. You will no doubt be an amazing resource and part of her support system.

Praying for best possible outcome and strength and comfort for all.