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He's the same person he was yesterday, last week, last month, last year.
Bingo. This is just the brief period of pseudo-sanity before he plunges into utter irrationality again. I'm not convinced it's worth "striking" at this point. Just more of the roller coaster frustration when he undoes it all in a week.
Bingo. This is just the brief period of pseudo-sanity before he plunges into utter irrationality again. I'm not convinced it's worth "striking" at this point. Just more of the roller coaster frustration when he undoes it all in a week.
All true except the frustration part. I am not frustrated. Options are clear. There are three paths. Everything is clear in MY mind and I have no stake in which he chooses or when or anything. There is some I am leaving out regarding the house that was huge, huge help to me whether he changes his mind or not, I know the way.
This is where my brother foils himself sometimes in his quest to keep people on edge. He's a talker. If I can marshal my patience to get on the phone or in person with him, he will reveal things I need to know. But only in this phase of the manipulative cycle. I forget the name now, but he's wooing me back in. There is a short window. Where he will be sweet as pie.
And my sister is the bad cop now. That has always been my role. Playing good cop is interesting! We never had a good cop on the same side. Good cops have never been cops. They have been enablers.
If I closed the window with my summary, so be it. That keeps me on this side of my boundary. And I got what I needed.
I can't believe I'm talking about this like a game, but it is a game.
Has no one met with a caseworker or an elder care attorney to figure out exactly what his options are for care?
There's all this what will Medicaid do or not do -- but it sounds like no one will contact anyone at the state of Texas to found out definitively what his options are. (i.e., "what Germaine said" pertains to the state of Wisconsin, which may be different than Texas).
Has no one met with a caseworker or an elder care attorney to figure out exactly what his options are for care?
There's all this what will Medicaid do or not do -- but it sounds like no one will contact anyone at the state of Texas to found out definitively what his options are. (i.e., "what Germaine said" pertains to the state of Wisconsin, which may be different than Texas).
It all seems like supposition and what ifs.
My sister knows all this. Of course I am going to confirm or deny with her whether Texas is the same on that point. I was just saying that is something that came to mind when he said Medicaid can't put him in his wheelchair to use his Van to go exercise.
I understand it's confusing for a sister to come out of nowhere. She was informally adopted by my father and stepmother and as adults, we've not been around each other. She and my brother were not even around each other as teens, because he was so much older and gone from home.
So she never had any responsibility in his life or his care. It was by pure chance that her home health care agency was sent when the rest of us had finally convinced him to GET home health care.
So that is what I was saying upthread. All this wondering and trying to get information second-hand is over. No more hair-pulling with ifs and butts. (buts?)
I said maybe Medicaid home health will do that (hint, hint) and he said they can't or won't. From what germaine said, if someone can leave the house to do that they are not homebound and therefore cannot get home health care?
I don't know what the rules are in your state or in your brother's specific situation. But, yes, they can be very strict on the definition of "housebound".
I know that the time, a number of years ago, that my husband had been in a medically induced coma (technically a medically induced state of unconsciousness) for over a week and then continued in regular intensive care for a while and was released from the hospital with a walker and told that he should not drive for at least a month and he did not qualify for home health care or home physical therapy or home occupational therapy through Medicare because he was not housebound. I kept saying that I had a fulltime job, with no paid sick days, so I could not drive him to out-patient therapy and was simply told "He is not housebound so he does not qualify for services in the home, YOU have to figure out how to get him to out-patient therapy, three times per week, for the next six weeks".
How are you not housebound, just getting out of a coma in intensive, intensive care, needing a walker (he could barely stand or walk, even with a walker when he was released from the hospital) and being forbidden from driving?
Last fall, when Hubby was temporarily home with me, I mentioned to a therapist that he had to ride in the car with me to go through Walgreen's drive through to pick up HIS prescriptions (as he could not be left home alone), I was informed that if anyone saw us and reported it he could be dropped from Home Therapy, through both Medicare and Medicaid, because he was not housebound anymore.
So, yes, the rules regarding housebound can be very strict. But, since your brother is not married, and lives alone, the rules may be different in his situation.
Last edited by germaine2626; 09-27-2018 at 02:45 PM..
I don't know what the rules are in your state or in your brother's specific situation. But, yes, they can be very strict on the definition of "housebound".
I know that the time, a number of years ago, that my husband had been in a medically induced coma (technically a medically induced state of consciousness) for over a week and continued in intensive care for a while and was released from the hospital with a walker and told that he should not drive for at least a month he did not qualify for home health care or home physical therapy or home occupational therapy through Medicare because he was not housebound. I kept saying that I had a fulltime job, with no paid sick days, so I could not drive him to out-patient therapy and was simply told "He is not housebound so he does not qualify for services in the home, YOU have to figure out how to get him to out-patient therapy, three times per week, for the next six weeks".
How are you not housebound, just getting out of a coma in intensive,intensive care, needing a walker (he could barely stand or walk, even with a walker when he was released from the hospital) and being forbidden from driving?
Last fall, when Hubby was temporarily home with me, I mentioned to a therapist that he had to ride in the car with me to go through Walgreen's drive through to pick up HIS prescriptions (as he could not be left home alone), I was informed that if anyone saw us and reported it he could be dropped from Home Therapy, through both Medicare and Medicaid, because he was not housebound anymore.
That terrible story was in my head. I never get over all that you went through and how many crazy little things would prevent you from getting what was needed - ugh! You are such a strong person and so caring. You're always here for others though you are surely still grieving the loss of your husband.
My sister will know or find out, but it only seems logical that if he can drive in a Van to go to 'PT', and if being home bound and needing home PT to qualify for the other stuff, they would take it all away if goes places in the Van.
It's kind of strange because he needs some home health to get into the Van. He can't dress himself or get himself into the chair that goes with the Van. I'm not sure any agency is ever going to even think that is safe, though. It's probably a moot point, but that is not brain damaging to pin down.
I keep coming back to 'none of these details really matter because he wouldn't even really go and keep his leg strength up', and if I understood my sister correctly, it's not even possible to only work on that and expect it to do anything.
He has to work core and he won't. But I could be wrong. I know nothing about any of that. I am just always skeptical of anything he says. He's always his own program director and I have more faith in the peeps that tried to get him to do core first. I feel like they must want that for a reason.
It was a rare day that I could say that to him and not get a screaming response. He calmly explained his perspective that his core is shot, he will never get it back and doesn't even need it for the limited amount that he wants to do.
A bitchy part of me says (in my head) you don't want to do anything that is hard. You want the bare minimum to transfer to stay at home and other people to do stuff no one can do. Maybe if he worked core he could get in the Van himself. IDK.
I don't know what the rules are in your state or in your brother's specific situation. But, yes, they can be very strict on the definition of "housebound".
I know that the time, a number of years ago, that my husband had been in a medically induced coma (technically a medically induced state of unconsciousness) for over a week and then continued in regular intensive care for a while and was released from the hospital with a walker and told that he should not drive for at least a month and he did not qualify for home health care or home physical therapy or home occupational therapy through Medicare because he was not housebound. I kept saying that I had a fulltime job, with no paid sick days, so I could not drive him to out-patient therapy and was simply told "He is not housebound so he does not qualify for services in the home, YOU have to figure out how to get him to out-patient therapy, three times per week, for the next six weeks".
How are you not housebound, just getting out of a coma in intensive, intensive care, needing a walker (he could barely stand or walk, even with a walker when he was released from the hospital) and being forbidden from driving?
Last fall, when Hubby was temporarily home with me, I mentioned to a therapist that he had to ride in the car with me to go through Walgreen's drive through to pick up HIS prescriptions (as he could not be left home alone), I was informed that if anyone saw us and reported it he could be dropped from Home Therapy, through both Medicare and Medicaid, because he was not housebound anymore.
So, yes, the rules regarding housebound can be very strict. But, since your brother is not married, and lives alone, the rules may be different in his situation.
To the part you edited in, this last sentence my pc won't let me bold, that is probably true. They probably wanted to foist onto you whatever they could, even with you explaining you couldn't.
I know. I had a feeling I was being 'sucked in'. to the nurse: 'Tell my sister I have MS and and I can't walk and I need to be checked on often'. I chose to focus on the good last night, but the convo wasn't all good. *I* did good during the parts that are hard for me. I took notes, processed everything he said combined with what my sister has said, and sent him a summary.
Because his plan was all about staying home. Which I am not going to argue with per se, I just pointed out the giant hole in that plan.
He will not work his core. He says he doesn't need it. All he needs are his legs to transfer. This particular nursing home won't make him work on his core like the last place. They will do what he wants, just get his legs strong again. And then IF someone would just dress him and get him into the electric wheelchair with a belt, off he can go to the place where he can work on his legs.
I refrained from pointing out that when he could get in his Van he never went to 'work out'.
He wants me to find a grant to expand the bathroom, which I ignored because that won't solve the problem if he can't transfer.
I said maybe Medicaid home health will do that (hint, hint) and he said they can't or won't. From what germaine said, if someone can leave the house to do that they are not homebound and therefore cannot get home health care?
IDK for sure but just going off what HE said, that they can't, as he put it, I said on a message well why can't this woman in the spare room do that? If she can't, and Medicaid can't, no one can. You can't keep your strength, the effects of this nursing home therapy wear off, and you are back at square one. You either submit to Medicaid home health, Medicaid nursing home, or Medicaid assisted living, where someone would help you dress, you'd have more freedom than in a nursing home, and remove the 'albatross' of the expenses of the house (he had put it that way a while back).
The response this morning was 'You make a compelling case'.
You say here strike while irons are hot - oh, they are never hot! There is no striking. A fantasy was spun and dispelled.
If you meant the special needs trust, again, nope. I totally get why you would think that, but I fell for that a few times. Just last month I feel for it and tried to put wheels in motion and strike while irons and that was all for nothing. This will all change.
While it's good that he understands the process. Spend down or be strategic and put his assets in a trust. And some other things related to the house that he didn't seem to 'get' before, that doesn't mean there will be MOVEMENT.
Another thing that was GOOD was that he let me ask questions. I was able to clarify 'You want Medicaid on a temp basis. To pay for this nursing home visit if MediCARE won't. 'Yes'.
This 'plan' is all based around needing this place to get his legs strong so he can return home, not to stay in there on Medicaid, and not to even keep Medicaid going via home care. Hence my response to him above.
But there is nothing to do. He will come up with something else. It's for me to 'go away' again because I did all I can do besides update my sister on the exact type of PT he is willing to do and I got the names of the machines he is after and some other detail that is of use.
I AM hopeful that it's real he's backing off Dad, so for him I am not bogging him down. My update to him was brother is happy as a clam at the hospital getting lots of attention and will soon move to his favorite nursing home, he is A-OK, and that woman did bring him what he wanted from the house (Dad normally does).
Think about what I wrote above: He would really put his assets into an irrevocable trust for temp nursing home payment? Pfft. No way. Then when he went home as planned, he wouldn't have complete control of that money. Whoever administers it can't spend it on just anything. Maybe because 'he's a lawyer' (he did used to be one) he knows a way around that too, but I didn't even go there. To ME progress was made for ME in terms of knowledge. HE is back at square one.
*I* am calm! *I* feel better about everything because a huge part of angst and worry is the unknown and there don't seem to be many unknowns anymore.
If no one can do anything, then no one can. You have established your boundaries, stick to them and let the chips fall where they may.
Has no one met with a caseworker or an elder care attorney to figure out exactly what his options are for care?
There's all this what will Medicaid do or not do -- but it sounds like no one will contact anyone at the state of Texas to found out definitively what his options are. (i.e., "what Germaine said" pertains to the state of Wisconsin, which may be different than Texas).
It all seems like supposition and what ifs.
Quote:
Originally Posted by jencam
My sister knows all this. Of course I am going to confirm or deny with her whether Texas is the same on that point. I was just saying that is something that came to mind when he said Medicaid can't put him in his wheelchair to use his Van to go exercise.
But you have indicated that you don't know for sure what Texas Medicaid covers (in general) or what services they will offer him (specifically.) And I guess per the above response your sister is from out of state?
Someone really needs to get on the phone with the state.
And the "madness" started with your mother who enabled your brother to the point that he needs constant attention.
But you have indicated that you don't know for sure what Texas Medicaid covers (in general) or what services they will offer him (specifically.) And I guess per the above response your sister is from out of state?
Someone really needs to get on the phone with the state.
And the "madness" started with your mother who enabled your brother to the point that he needs constant attention.
My sister works for a home health agency in Texas. Her home health agency was sent to provide him home health. Her office is minutes from his house. She did his assessment and coordinates his care.
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