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Old 03-13-2011, 10:39 AM   #1
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Need Help: Father & Stepmom (Long text)

Hello,

My name is John and I'm in way over my head. I'm starting the process of caregiving and am looking for any advice or experiences.

My dad and stepmom live in Florida. I am in Chicago. Two years ago my stepmom had a stroke. She suffers from Aphasia and cannot communicate well at all. I would say she is 90% up there in the head. She is fairly independent with basic day to day tasks, but my dad was her primary caregiver. He was a 74 year old guy in good health.

A little over a month ago, my father had a sub-arachnoid hemorrhage. I flew out that night being told we would be pulling the plug that morning. However, my dad survived the ordeal. Long story short, he spent a month in ICU, they put a shunt in his head and he's been discharged to rehab. He's been there for a little over a week now.

Physically, he's doing great. Mentally, not so good. Personality-wise, he's there 100%. He still jokes the same, has the same mannerisms and for the most part is himself. However, He has little to no short term memory. He still remembers the past and who my stepmom and I are. He is unaware of where and what happened to him. He tells stories about the past or creates stories about things he's obviously not doing now. He is unaware of what's happening and has a short attention span.

He is also high-risk at the rehab facility. He has fell twice without supervision as he just thinks he can walk. He can't remember that he needs rehab. He can also get belligerent given that he doesn't understand what's happening. They may have to move him to a different place. Ultimately, because of his mental condition, he may have to be watched 24/7.

Meanwhile, my stepmom is burning through what little money they have saved away. Her neice helped her setup cab service from/to the house to the rehab center. I recently found out they have barely 13k in their bank accounts and have about 25+ thousand in credit card debt, which they are making minimum payments on. They have GREAT pensions, but after paying basic bills, credit cards and mortgage payments, they are lucky if they clear $600 a month for other necessities.

I feel, based on all this, that they can't go back to life like they had before. My stepmom will not be able to look after my dad and vice-versa. They don't have enough money for assisted home care and my dad needs full attention, possibly nursing home care.

Being that my dad can't make his own decisions and my stepmom is challenged, (though I'm not entirely sure if she can manage this situation at all) I feel like I need to start the ball rolling to get them into assisted living or nursing home care. I guess paid through Medicade since because they can't pay for it privately.

During his ICU stay, I got the power to make his medical decisions. My stepmom's doctor went on record to the hospital that she could not be making decisions for my dad due to her disability. Unbeknownst to me, this gave me the Power of Attorney, based on my dad's paperwork. (first to her, then to me). I have already used it to get a summary of their bank account info.

At this point, I want to move my father and stepmom from FL to Chicago, into an assisted living facility. My stepmom had no friends and only the niece. Meanwhile, I can visit them several times a week and check up on the facility. However, I have no clue where to start. Also, I don't know how I can do this as my stepmom doesn't know she doesn't have my dad's POA and she may fight me on this. (she is not thinking rationally at this point) If she is incapable of being her own POA, then it goes to her niece. Her niece doesn't want to be in this situation (she expressed this several times) and I'm not sure if she has even her aunt's best intentions in mind.

The first thing I'm doing right now is that I'm going to talk to several Elder Law attorneys who work with Estate law. I need to figure out how to manage their finances, sell the house, apply for Medicade and get them moved up to Chicago. I don't know how this will work considering I only have POA for my dad.

I'll stop this long message here! Does anyone have any practical advice on who I can or should be doing? I'm in my early 30s and have no experience with this. I really feel lost and unsure how to proceed.

Thanks,
John

Last edited by JohnInChicago; 03-13-2011 at 10:41 AM. Reason: too add details

 
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Old 03-13-2011, 03:55 PM   #2
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Re: Need Help: Father & Stepmom (Long text)

John,

The slow way is to apply for guardianship over your Dad.

It is easier to get IL state POA for properties as well as IL state health directive from you Dad. My husband is the IL state POA for property and the health directive for his Dad who has late Alzheimer's. If your Dad still prefers your help, he can sign for you on the POA. check with the lawyer to see if this will work. I believe the state POA can work on finances and taxes nationwide. My FIL is now in the East Coast and my husband can use the health directive anywhere to represent his Dad. In medicare A/B plan, you can also tell them you are the POA or representative.

Your stepMom is a little tricky. It seems you may need to be her POA as well. But check to see if her niece or relative can help. Looks like you may have to be... My friend's stepMom has her own kids so they don't worry about the stepMom.

Guardianship allows you to have total power over your Dad. There are also professional guardian available so you could try that for her.

Good luck,
NC

Last edited by ninamarc; 03-13-2011 at 03:57 PM.

 
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Old 07-04-2011, 09:36 PM   #3
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Re: Need Help: Father & Stepmom (Long text)

Quote:
Originally Posted by JohnInChicago View Post
Hello,

My name is John and I'm in way over my head. I'm starting the process of caregiving and am looking for any advice or experiences.

My dad and stepmom live in Florida. I am in Chicago. Two years ago my stepmom had a stroke. She suffers from Aphasia and cannot communicate well at all. I would say she is 90% up there in the head. She is fairly independent with basic day to day tasks, but my dad was her primary caregiver. He was a 74 year old guy in good health.

A little over a month ago, my father had a sub-arachnoid hemorrhage. I flew out that night being told we would be pulling the plug that morning. However, my dad survived the ordeal. Long story short, he spent a month in ICU, they put a shunt in his head and he's been discharged to rehab. He's been there for a little over a week now.

Physically, he's doing great. Mentally, not so good. Personality-wise, he's there 100%. He still jokes the same, has the same mannerisms and for the most part is himself. However, He has little to no short term memory. He still remembers the past and who my stepmom and I are. He is unaware of where and what happened to him. He tells stories about the past or creates stories about things he's obviously not doing now. He is unaware of what's happening and has a short attention span.

He is also high-risk at the rehab facility. He has fell twice without supervision as he just thinks he can walk. He can't remember that he needs rehab. He can also get belligerent given that he doesn't understand what's happening. They may have to move him to a different place. Ultimately, because of his mental condition, he may have to be watched 24/7.

Meanwhile, my stepmom is burning through what little money they have saved away. Her neice helped her setup cab service from/to the house to the rehab center. I recently found out they have barely 13k in their bank accounts and have about 25+ thousand in credit card debt, which they are making minimum payments on. They have GREAT pensions, but after paying basic bills, credit cards and mortgage payments, they are lucky if they clear $600 a month for other necessities.

I feel, based on all this, that they can't go back to life like they had before. My stepmom will not be able to look after my dad and vice-versa. They don't have enough money for assisted home care and my dad needs full attention, possibly nursing home care.

Being that my dad can't make his own decisions and my stepmom is challenged, (though I'm not entirely sure if she can manage this situation at all) I feel like I need to start the ball rolling to get them into assisted living or nursing home care. I guess paid through Medicade since because they can't pay for it privately.

During his ICU stay, I got the power to make his medical decisions. My stepmom's doctor went on record to the hospital that she could not be making decisions for my dad due to her disability. Unbeknownst to me, this gave me the Power of Attorney, based on my dad's paperwork. (first to her, then to me). I have already used it to get a summary of their bank account info.

At this point, I want to move my father and stepmom from FL to Chicago, into an assisted living facility. My stepmom had no friends and only the niece. Meanwhile, I can visit them several times a week and check up on the facility. However, I have no clue where to start. Also, I don't know how I can do this as my stepmom doesn't know she doesn't have my dad's POA and she may fight me on this. (she is not thinking rationally at this point) If she is incapable of being her own POA, then it goes to her niece. Her niece doesn't want to be in this situation (she expressed this several times) and I'm not sure if she has even her aunt's best intentions in mind.

The first thing I'm doing right now is that I'm going to talk to several Elder Law attorneys who work with Estate law. I need to figure out how to manage their finances, sell the house, apply for Medicade and get them moved up to Chicago. I don't know how this will work considering I only have POA for my dad.

I'll stop this long message here! Does anyone have any practical advice on who I can or should be doing? I'm in my early 30s and have no experience with this. I really feel lost and unsure how to proceed.

Thanks,
John
I am a Certified Nurses Aide and a Certified Home Health in California for 20 years and work for a home health and hospice agency full-time. Medicare will pay for a nursing home for your dad since he was in the hospital and is in a rehab now but for only 90 days. Talk to his doctor on how this can be arranged, he has to write an order for it first. You need to talk to a social worker and a case manager at the rehab he is in now to help make arrangements to get transportation from the rehab to the nursing home he is going to once they have found a bed available in a nursing home. Medicaid won't start paying for a nursing home until they have completely run out of money except for $2,000 in a savings account. Try to find a residential care facility that has license that will take someone who can't walk,will possibly could have some dementia, and who may need hospice care in the the future. This waiver comes from the state licensing board and this will ensure that your dad and step mom won't have to move again when they decline in health continually towards the end of their life. The residential care facilities cost less than a nursing home, are usually a home that have maybe 6-8 people living there so they get more attention from the staff. They will most likely be able to share a room together where as the nursing home probably won't allow it. You will have to find this out first before you place them in a facility. Ask what the patient and caregiver ratio is, Are the caregivers certified in first aid , CPR,and the hemlich manuever and is there a caregiver in the facility 24 hours a day 7 days a week that is first aid,CPR and hemlich manuever ? How are medications given ? Are they an RN,LPN/LVN or Med Tech? Med Tech's aren't always licensed by the state. What kind of agency provides advocacy for patient and their families independent of the facility ? In Santa Clara County,California where I work and live it's called the Ombudsman Program run by Catholic Charities. The name and phone number of this agency should be placed where anyone can see it in the facility. Make an appointment the first time to get a tour and information you may need and then make an un annouced visit maybe one or two times before you make a final decision as to whether this will be a good fit for your dad and step mom as you will be able to see what kind of care the patients receive every day without the staff knowing head of time that you're coming. I hope this helps you find the best place for your dad and step mom to live in until the end of their life.

 
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