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.
It's nice you decided to assist your parents. Was this a short-ish term plan? Or a long term plan? Either way, it seems it is time for a NEW plan.
Would you consider talking through the issues with a therapist or councillor? Someone to listen & bounce ideas off? Support for setting new goals - to reconnect to your own life plans?
If she's had two strokes, hasn't someone at her doctor's office advised her, asked the above questions, and outlined her options for care? Isn't she under a doctor's care now?
Once she gets sicker, how is she going to grant POA to anyone? That may be impossible already.
There are a lot of things going seriously wrong here, and you need an advocate. There must be a council on aging where you live, so call them first. Then try other places if necessary. (An Alzheimer's support group, a stroke survivors' group, AA if alcohol or drugs are a problem.) Don't give up until you get help.
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
Mom really has no say when it comes to Medicare. If not taken at 65, there will be some big penalties when she finally does. If she is already collecting SS, Medicaid A&B are automatic. The card just comes. If not collecting her SS, then Medicare needs to be applied for. I would call ur local Social Security office and ask what you can do to get her signed up. That with two strokes you don't think she is competent to make an informed decision. When the card comes, you hold on to it, don't show her. Be aware though, because of Part B, her SS, if receiving it, will be less. If not receiving SS, then she will be billed monthly. She maybe forced to get Medicare at 65. You need to call Kaiser. My husbands BC/BS is Union. When we turned 65, they changed our coverage to a supplemental. With supplementals, they only pay what Medicare doesn't. So Mom may end up with no insurance at all.
If your Mom is suffering from a Dementia, you can't reason with her. I agree, call your Office of Aging saying, I cannot physically care for her anymore. Let them evaluate the situation. Really, its no longer what Mom wants, its what she needs. If Dementia is involved she has no idea of what she needs.
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.
Maybe your Mom will listen to a professional advising her. Like a Geriatric
Care Manager.
Apologies, I have no further details.
As long as you are there to take care of their every need, nothing will change.
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.
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.
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.
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.
"My Agent shall have full power and authority to do anything as fully and effectively as I could do myself, including the power to make health care decisions and give informed consent to my health care, refuse and withdraw consent to my health care, employ and discharge my health care providers, apply for and consent to my admission to a medical, nursing, residential or other similar facility that is not a mental health treatment facility, serve as my personal representative for all purposes under the HEALTH INSURANCE PORTABILITY and ACCOUNTABILITY ACT (HIPPA) of 1996 as amended, and to visit me at any hospital or other medical facility where I reside or receive treatment".
Just from reading the thread, your Mom sounds competent enough to sign a Durable Power of Attorney. I know every case is different but my Mom just signed one for me, she is 89 and was diagnosed with unspecified dementia in 2018. The notary read it to her and asked if she understood her rights, told her she could revoke it if ever necessary and asked her to sign her name.
Let APS decide what professional care your parents need and figure out how to get it paid for..............free yourself so that you can deal with your future. Please seek out a CODA meeting (Codependents Anonymous) to help you with separation anxiety.
Mindfulness Meditation can offer you calm and serenity.
Tell your mom and dad that you need others to come in and help because you can not do it alone anymore. Let them know the amount of time that will need to be covered by other "helpers". Let them know that you will help to set up appointments for interviews and be there for the interview process. Then, ask family, friends, members of your faith community, home health agencies, sitters... to get involved.
If you can not get enough help, it might be time to talk to your parents' doctor(s) about assisted living facilities versus skilled nursing facilities and what their health insurance will pay for.
Health insurance is not going to pay for day-to-day help whether the insurance is Medicare or Kaiser or any other company.
Of course she's frustrated and angry. We probably all would be if what we were doing independently last week is now a dependence on others.
As for her not following up with exercise, it appears that reminding her or telling her to do it doesn't work. Have a conversation that is calm and just question how she wants to move forward. Allowing herself to get weaker or not handling a medical problem MAY mean that she could become immobile and a good chance she won't have a say so in where she lives or who handles the care. Ask open ended questions so that perhaps she will participate in the conversation: If you could no longer get around the house and I couldn't physically move you around, what do you think we would do to care for you?
I'm not sure what kind of assisted living at home you're talking about. Check the Kaiser insurance she has - my guess is it's a Medicare Advantage plan with Kaiser. It should have very similar benefits as Medicare and probably a little more (kind of like Medicare plus). There is a good chance Kaiser policy covers some in home health care just like Medicare - weekly nurse, physical and occupational therapy, some drs available to do house calls like podiatrist.
If she flat refuses to see a doctor, it's not really going to matter if she has Kaiser or Medicare.
Try your best not to panic.
Transition to only one or two (or as few as possible) changes at a time. If you are overwhelmed, your parents are feeling worse… keep that in perspective.
Your dad’s TV habits may be a way for him to hide from his problems. Watch them both for signs of depression, which will exacerbate the stress. When depression does strike it takes a month for antidepressants to become effective, so you will suffer more if you have a stretch of time in denial.
Get a little help if possible to assist in the jobs you find the most difficult. (For me it was showering). Getting an infrastructure in place is always a good idea in case of emergency.
I’m sorry for your pain. Understand that you are grieving these changes but never forget that these will be “the good old days” of the future. Appreciate every moment and try to find the positives.
Federal Employees pay into Medicare so she is likely to be eligible for free Part A. Part B would still cost her. Have you actually checked to see if she is eligible for Social Security? Under the old PERS Federal retirement system she wouldn't have paid into SS. However back in the 80s a new retirement program called FERS, Federal Employees Retirement System, came into effect and new employees and some others transferred into the new program. In FERS, people were and are paying into Social Security. At mom's age she might have had FERS and be eligible for some SS benefits. You might check that out if you otherwise just assumed she was not eligible because of working for the federal government.
Services include home care and meals.
https://www.medicare.gov/sign-up-change-plans/different-types-of-medicare-health-plans/pace
Program of All-Inclusive Care for the Elderly (PACE) is a Medicare and Medicaid
program that helps people meet their health care needs in the community instead of going to a nursing home or other care facility.
With PACE, you have a team of health care professionals working with you and your family to make sure you get the coordinated care you need. Usually they care for a small number of people, so they really get to know you.
When you enroll in PACE, you may be required to use a PACE-preferred doctor.