:confused: Hi Everyone and All,

I need any help that yall can give me. If I did not already tell you, my dads dr. had home health care start coming to his house. This is mainly to have him evaluated and to be helped also. There is a RN who is the patients manager and comes to see him 1 x week. There is also a physical therapist who comes 2 x week. And an occupational therapist who also comes 2 x week. They all stay less than an hour. Just depends on what comes up that particular day.

So, my mom did not like this too much in the beginning. The dr. just told us at my dads last appt., that he was going to be starting on that. They have had 1 session, of about 2 mo. And has now been started on his second session, for about a week or two. They evaluate him and report to the dr. and other people (who - I do not know!).

Anyway, the head lady, RN, called me (she and the other therapists call me a lot). She was nicely informing me that she and the other therapists and possibly the dr. (not sure), want to send a social worker to my parents house in a week or 2. Of course I will not talk to the social worker til next week, and then we will set up an appointment at my parents home. The social worker, me, my mom and my dad. Possibly my sister can come in to town also. I sure would like the support. And possibly our parents might respect her ideas more as she is older and not around as much.

This is what I need help on: What does a social worker do? Who does she work for? (like who pays her?) How much power does she have (as in where and if my parents are made to go to another place to live - like an assisted living and/or alzheimers place). Just in general everthing yall know about social workers. I have generally heard good things about them, so I expect them to help me and my dad (and my mom too, whether she knows it or not).

The home health people believe that my mom can no longer take good care of my dad in their home. She is trying and really wants to keep living there, but there house is very old, about 50 yrs. The door ways are too small for a wheelchair and there is a very long hall. So I know that is part of the meeting. Plus they know that my mom has early dementia and uncontrolled diabetes. Thus, she sometimes does not act "right" to and with the workers. And of course all the other people in the world. We put up with her because we love her. We just ignore her weird sayings or I tell her she needs to take some hormones!!! :>

Also, Is there the possibility of "someone or some group of people" making my dad move into a good alzheimers care place? By their findings and a couple of meetings and the family doctor also? I would love for that to happen, buy now that there is a slight chance that it might, I feel weird... My mom just leaves too much to chance, with my father and his needs and sometimes leaves him alone for up to 3 - 4 hours. I think she just freaks out and leaves (but tells him or the health person). She knows that I would come and give her a break, if she would just ask!

One more thing(?)! :> I was just thinking of writing the dr. a letter or talking to him on the phone, to ask that he have my dad made incompetent. Only trouble with that, is that then my mom would have his POA. And my sis and I are not sure that my moms dr. would give him her POA, which would then go to me. I think?????????

So I shall wait and see what happens next week. Keep my finger crossed, that my dad can go to a very good alzheimers place and that my parents will not have too much of a heart attack - or hate us forever.

Plus, there is also the thought of my mom living in that house by herself??? I hope that if and when this happens, that she will go looking for an assisted living place for herself????? I just do not know what, if any thing will happen?

Take care and thanks for listening.

Love, Wannabe

Dear Wannabe,

Sorry you are feeling so upset about this.

When the RN called you should have asked her who the social worker works for. What organization sends the nurse, physical therapist etc? That will be the same organization that wants an evaluation from the social worker.

They are usually women, so I'll say 'she.' She will make a family visit and evaluate the situation. How does she see the family functioning. Does it look to her as if the patient is being cared for well. Does she suggest a nursing home or an assisted living type of situation. SWs do not have any power to force anyone to do anything. They only make suggestions, recommendations. The agency she works for will relay her suggestions to you, and you the family will decide what to do.

A doctor cannot declare a person incompetent. That is a job for the courts of the state you live in. He can testify at that court hearing but the final decision goes to a judge.

We never had to have my Mom ruled incompetent, she just got sick, went into the nursing home, etc. My brother had POA before she was obviously incapable although she really didn't know for sure what she was signing.

I think you can probably trust the judgment of the social worker - they have a lot of experience helping famiies in distress and solving problems.

Good luck.

Love,

Martha

Hi Martha,

Thanks for replying. I appreciate the info and the advice. For some reason I thought that I had heard or read that a dr. could write a letter or a form, declaring a patient incompetent. Then it would probably have to go to a lawyer or somewhere like that?!

I guess when the Social Worker calls me Tues or Wed., I can ask my questions then. I am afraid that my dad will "put on a show" for the social worker. He can for a few hours. My mom cannot, she just gets more upset.

Yeah, we have talked with some social workers in the hospital, when my MIL was sick. They are a great help and can direct you/me and possibly get things done faster than a regular person could.

Thanks for the help Martha. If there are any other helpful people out there, just speak right up!!! :>

Love, Wannabe

I think Martha said it all so eloquently.:)

I just want to add though that the health care workers and social workers are looking at the whole picture. That means they're also looking at your mom. It's possible that they'll reccomend some type of services or assisted living for her too if they see that she's not capable living alone.

I think it's great that these people are involved because when a decision or reccomendation is made, it won't fall on your shoulders. They'll be the fall guys and maybe your parents won't be upset with you at all.

And your mom might be a bit better with taking her meds and such if the stress of taking care of your dad is off of her shoulders. Things don't always go the way we think they will and sometimes that's good. Remember how I got a few weeks ago when I thought my dad was coming back home? I was so frazzled I was literally shaking at the thought.

You might want to write down your questions for the social worker ahead of time. I know it helps me because I get so caught up in trying to remember important questions that I tend to forget the "not very important but want to know" ones.

Love, Barb

We have a similar team working with SIL and us and they are great. Having said that, they have been ‘on the case’ for nine months now and SIL is still in her home – she has a lot more help which has taken a lot of the burden off us – but essentially the situation is the same in terms of worry and risk.

I have learned a few things that might help:

Yes, find out who the social worker works for – in our case she is working for an agency contracted by the health authority. So there is a case worker at the health authority who is the overall coordinator and that is the person we can escalate things to.

Find out what the overall goal of this help is (that may sound stupid – but it wasn’t immediately obvious to us – like you, we were hoping that they would see just how dire the situation was becoming and recommend assisted living). Turns out the overall goal is to keep SIL at home for as long as possible :eek: – that is part of their policy – both for financial and social reasons. What this means is that they tend to look at smaller things that can improve the situation, but they aren’t inclined to take a big step back and look at the overall picture.

Build up good relationships with the team (you are already doing this). Otherwise things can happen that you are not aware of/not having input into.

Find out what exactly the assessments are that they are doing. We got terribly excited at one point when we were told an assessment was being carried out – but it turned out to be only a safety assessment from the occupational therapist. That’s great of course, but all the handrails and non-slip mats in the world aren’t going to address the big problems – kind of like moving the deckchairs around on the Titanic. By letting the case worker know what our broader concerns are, we have had much higher level assessments carried out.

When you know they are carrying out the right kind of assessments, make sure that you and your sis get separate input (there are things you need to say that you cannot say in front of your mother), and ask to be there when they are talking to your parents (SIL can present a very convincing front, all of it fictitious, and, unless we know what is being portrayed, we aren’t able to correct any misleading impressions).

The team only gets to see your parents in hour-long bites, so they can miss the bigger-picture things (although they and your doctor do seem to be on to things). So yes, document those bigger things that you worry about so they won’t be missed – medication, nutrition, food hygiene, personal hygiene, medical conditions, finances, lack of supervision, would your mother be capable of recognizing a situation that requires medical (or other) attention and does/can she ask for help where appropriate?

Hope some of this helps

love Georgie

Hi Barb and Georgie,

Thanks for all yalls help, too. It just seems to be snowballing. Or, I have a great imagination and much ability to worry and stress!

That is a very good idea about writing down questions and things that I have noticed. Both good and bad. And I am afraid that if my dad got into a alzheimers home, my mom would try to stay in that big ole house by herself. She would probably burn it down by mistake.

The most perfect thing would be if both of my parents could get into the same, 3 level care housing! There are at least 3 that I have seen myself. Boy are they money hungry! :> Very nice ones tho.

That is also a good idea of finding out the health ladies "mission" is. I do not think that they would want my dad to stay there, unless there was a caregiver there everyday for at least 16 hours a day! And with the addition of many things done to their home to make it safer for an ad person.

My mom would not be wanting to take her meds more under any circumstances! I dont think. Unless she changes her ways of thinking!!!

I do talk to my dads RN, Case Manager a couple days a week and some of the other pts and ots. So, I just hope the Social Worker is as nice as them. I think that my mom must have said and done some really weird or not nice things to the health workers last week. I have learned a little from sis from when she talked with my mom and from my mom. Plus, now my mom wants a form signed to say that the health people can only come 3 days a week total - for all 3 of them!!! She told me that she does not like them telling her and dad what to do.

My sis and I said that my mom might do what she always says she might do. Take my dad and run away. From the drs., nurses, medicines and who ever else she is mad at that moment!!! I do have her licence plates written down. I had better check on Tues, as they do change plates some years.

When you said could my mom know when to do what she should in an emergency or whatever! Whooooo Boy!!! Of the partial list you wrote, at least 5 would need to be addressed about her to the social worker. One time my dad said he could not breathe and she tried to put a straw down his throat, to help him breathe!!! Luckily she could not find one and he breathed.

Sorry, if I go on and on. I am going to have to go out and do something fun tomorrow, just to have 1 day or not thinking of this disaster... I feel like a sneak and a liar towards my parents. And I feel sick to my stomach and nervous and think of all the work ahead, no matter which way this issue goes!!!

Thanks for listening and keep the ideas coming. I will make my "scratch list" soon and talk to my daughters (for ideas and so they will know). And I am going to lightly clean my house, so in case I do not get to for a couple of weeks.

Bye for now and thanks.

Love, Wannabe

Good grief - I think telling the straw story should be enough by itself!!! And she is still driving?????????? Add that to the list.

I would say you have a more than an airtight case that your parents would both be much safer in the kind of facility you are thinking of, your father is in extreme danger, and your mother is a danger to him and to herself.

And don't for heaven's sake feel like a snitch for saying any of this - neither of your parents are able to help themselves - you as their daughter can. The situation I'm in it's not my call, I just try to work with whatever I can - the rest of the family are quite happy to sit back and NOT say or accept what the situation and dangers actually are.

All I'm saying is, don't hold back talking to the social worker about how bad things really are - this is your chance to get an objective, professional opinion as to what the right thing to do is. Don't get sidelined by temporary 'fixes' - things are as bad as they need to be. And it won't be something you need to feel guilty about because it is an informed and balanced (and right) outcome.

Good on you for having a day's break - very wise.

My thoughts are with you
love, georgie

Just a ps on this in case I seem insensitive to your feelings. I have appreciated always that I can deal with this ghastly disease in SIL much easier than everyone else here because I have a little bit of distance emotianally. When it is your parent or spouse it is a whole other deal.

love Georgie

Hi Georgie,

Thanks for the advice and picker upper!!! :> I just need to tell it to my mind, my stomach and my nerves!!!

I am going to go and look at some more care places in their area - about 45 - 60 min. from my house. And I will start on my social workers list. Then I go for my regular visit to my parents on Tues. I do hope that the social worker calls on Tuesday or at least Wed. The waiting to see what will happen is driving me crazy...

Back to my breathe, breathe, breathe~!

Love, Wannabe

Dear dear Wannabe, take time to do something fun you've wanted to do for a while but haven't had the chance. Enjoy yourself and don't worry about anything in that time for yourself.

Have a grat time on your "time out" day.

AND NO HOUSECLEANING!!! ;)

Love, Barb

If there is a Home Health agency involved, then the social worker works for that agency. Medicare or other insurance pays for the social worker just as it pays for the therapists.
The reason the social worker has been ordered is the health care team is seeing problems that need to be addressed. From what you've written, there is a safety issue regarding your dad and your mothers ability to provide adequate care. A social worker is totally appropriate in this situation.
If your family is unable to assist/provide your parents care, then it is in everyone's best interest to find a facility that can . It is a good idea for you to present to the social worker your concerns and request if he/she can locate an affordable facility that can take both your mom and dad. It is the social workers job to determine your parents financial situation when picking out a suitable facility.

Hi Mari,

Thanks for all the info on social workers and the health care agency.

My dads case manager/RN, is the one that told me that the social worker was going to talk to me and then to all 3 or 4 of us. Do you have any idea of what happens when someone (like my mother) does not let them in her house??? My mom is getting tired of all these strangers coming everyday to their home. I am afraid that she might not let one of them in tomorrow. The physical therapist, I think.

That makes sense that the medicare or government pays for these helpers. It is paid at 100 %.

Does that mean that I have to dig up all the amounts to let her know how much money the have? Or can she/he just go by their 2005 tax forms???

Thanks again for you help.

Love, Wannabe

Dear Wannabe, in Minn. where my folks live, the financial data wasn't needed for the SW and the early evaulations. The new issue we have found now is that gov. is checking back 5 years on financial data to see if your parents had large amounts of money and made "gifts" to children to lower their estate so that the government would pick up the cost of the care.

The SWs are wise folks and will be able to check the care of both of your parents. The evaluation of your father will encompass if his needs are being met, by whom and what their physical status is. It might precipitate an eval being set up for your mom also if she is exhibiting signs.

My father is in the independant living end of the facility that both he and mom are in. He would like to have mom living with him,but she requires a watchful eye and he needs only help with his meds. No agency will allow them to live together (heck, they've only been married 63 years) because of the rise that my mother presents being unsupervised...so that is an issue when your folks get to the need to move stage. If they are different ends of the care spectrem......

go have a good time and take a big breath.....

Hi I bake,

My mom is at the point - at times - that she would not want to be in the same area as my dad. She sad then she would be careing for him there too!!! I am talking about at an assisted living, alzheimers care home.

The social worker took it slow and easy the first day. Just her, me, my mom and my dad. She did not rush them, just sort of informed them about what was available (just a tiny bit) to help them. We all got to talk and ask questions and I just gave her a couple of copies of the VA and the long term care. She said she will research that and then we can meet again...

She comes as many as 1 time and as many as 12 times. Just how ever much they need or it requires.

She will probably come back next week and then another week after that, when my sister will be in town and ask and talk. I always bring her up to date on the phone, and she calls my parents about 5 x week.

Thanks forr you info.

Love, Wannabe

Wannabe, one thing you might want to check into. In our home state, the waiting list for the VA home is 9-12 months for folks with AZ. For those who just need "other" type of care. If there is a waiting list, you may want to get them on now...

wishing us all good health and good luck.....

Hi Ibake,

Thanks for the info. I have a day off tomorrow (Fri) and am going to look at a few more assist. living/alz. homes in my parents area. I can ask about the waiting list, while I am there.

Is there any way to check out a very good home caregiver for my father and mother? Like the 3 x week, 1/2 day???? My mother is worried about $ and the stealing and snooping issues.

Nite, Nite.

Love, Wannabe

Hi Ibake,

Thanks for the info. I have a day off tomorrow (Fri) and am going to look at a few more assist. living/alz. homes in my parents area. I can ask about the waiting list, while I am there.

Is there any way to check out a very good home caregiver for my father and mother? Like the 3 x week, 1/2 day???? My mother is worried about $ and the stealing and snooping issues.

Nite, Nite.

Love, Wannabe


My Mom was terrified of the same things - stealing, snooping. We hired the HHA through a bonded agency. If anything would be stolen, they would be responsible. However nothing ever disappeared that Mom did not throw out herself! Of course my Mom didn't have much worth stealing. As all of you know, her life savings later went to NH care - so it was silly to worry about a few nice items. But for Mom, having a stranger in the house was far more traumatic than going to a nursing home.

In the NH things do disappear - but Mom doesn't have anything valuable. I send her 'play jewelry' such as you can get in the Dollar Store. She loves it, and if it 'wanders off', there is more where that came from.

AD is a disease of losses. First your loved one loses their memory. Then they lose their sense of morals and customs - walking around naked, not caring if they smell bad - and in the end you lose yur loved one because the real person is gone, only a shell of the one you love so much is left. For the victim, they lose their car and license, they lose their right to decide for themselves, they lose the respect of their friends and families, they lose everything. The objects in the house they worry so much about are insignificant compared to all the other major losses.

I feel as if I lost my Mom a few years ago, even though she is still alive, and I am still flying to NY regularly to see her .... what is left of her.

Love,

Martha