Please register to participate in our discussions with 2 million other members - it's free and quick! Some forums can only be seen by registered members. After you create your account, you'll be able to customize options and access all our 15,000 new posts/day with fewer ads.
She went to the neurologist about two weeks ago and they did a complete workup, I believe. The doctor said everything looked good in her brain activity and everything was "connecting" like it was supposed to. The only area which wasn't right was a section that showed she had had a stroke and perhaps a second mini one earlier. Now she is wearing a heart monitor for a few weeks to figure out if there was something with her heart that caused the stroke.
Once all of the testing is done, and some time has gone by we will have a better understanding of her health and capabilities. Right now we're taking this as a wake-up call to figure out her 'next step' in life and where she'll live and how she'll pay for it, whether it's next week or next year. Thanks for your comments on the medical information. It helps.
Is she receiving physical, speech, and occupational therapy? Speech therapy in particular could help assess her communication (including reading and writing), actual speech - not just the ability to form words but to create sentences, select the right word, and understand what others say and mean - and swallowing, which is often affected by stroke. The occupational therapist could assist in recovering the ability to handle routine activities of daily living, and of course the physical therapist would help her make the most of remaining, unaffected abilities, and hasten the return of abilities which were affected, but not eliminated, by the stroke.
While the doctors will look at the physical evidence of the stroke, the therapists will examine how it has affected her functioning and offer assistance in making the most of her abilities and finding alternate ways to accomplish tasks. They may well get to know her as an individual far better than do her doctors, as they will take into account her life, former strengths, background, intrinsic intelligence, personality, wishes, interests, and so on - not just the brain damage done by the stroke. Therapists are usually the ones who can spot the more subtle damage and its effects, and who can address it.
Her doctor should have recommended these therapies and started the wheels in motion for her to receive them, but if that hasn't happened, I'd strongly urge you to do whatever is necessary to at least have her evaluated for all three forms of therapy and get whatever is available to her in place. She might qualify for in-home therapy, since she can't drive, or out-patient therapy might be arranged, if transportation issues can be dealt with.
She may not be able to remain in her home, but meanwhile, there are probably simple things ( a rubber mat in the tub to avoid slipping, simple devices for removing lids, large-handled utensils, and so on) which the OT can recommend to make it safer and easier for her to live there until a decision is reached about her future.
Medicare generally will pay for the original assessment and pay for therapies as long as the patient is making progress, something which is assessed by the therapists. Unfortunately for this policy, stroke patients generally make progress, then plateau for a while before new progress can be seen. It's as if the brain needs time to adjust to each level of progress, and takes time off in between sessions. So it's important to advocate strongly for ongoing therapies during this process - the 18 months to two years referred to elsewhere in this thread - to help retain whatever progress has already been made.
Family members, friends, and caregivers can also assist with some of the therapies - think of it as "homework" - but they cannot and should not be expected to do all of the therapies themselves.
I'd also encourage you to get in touch with the National Stroke Foundation and the National Heart Association, both of which can send you very helpful free materials. There may be a support group for stroke survivors and their family members in your area, and there's a lot of information - most of it sound - online.
Meanwhile, is someone staying with her, especially over night and in the morning to assist her with breakfast, bathing, and dressing? If she is unable to read and write, there are very likely considerable safety issues. Does she prepare her own meals? Can she read labels? Does she confuse similarly packaged different foods? How about cleaning supplies, many of which are toxic?
Meals on Wheels might be very helpful at present, and might help allay fears about her nutrition and ability to prepare meals safely.
Yes, by all means, let's have the taxpayers pay for her care rather than utilizing her own assets.
BTW, the "look-back" period is five years, not three.
Agreed! However, the OP said she was living on SS alone and had already been paying for her own care. The assumption (perhaps incorrect) is that she probably didn't have many assets and could feel free to use them for her own care over the next FIVE years (without worrying too much about outliving them), at which point she would qualify for Medicare/Medicaid. If she qualified for that type of assistance at age 85-90, one could hardly accuse her of 'milking the system.'
To your point, I similarly have little empathy for the deadbeats out there who 'milk the system' for most of their adult lifetimes ... while others pay the tab.
Location: Chapel Hill, NC, formerly NoVA and Phila
9,781 posts, read 15,804,357 times
Reputation: 10894
Quote:
Originally Posted by jghorton
Agreed! However, the OP said she was living on SS alone and had already been paying for her own care. The assumption (perhaps incorrect) is that she probably didn't have many assets and could feel free to use them for her own care over the next FIVE years (without worrying too much about outliving them), at which point she would qualify for Medicare/Medicaid. If she qualified for that type of assistance at age 85-90, one could hardly accuse her of 'milking the system.'
To your point, I similarly have little empathy for the deadbeats out there who 'milk the system' for most of their adult lifetimes ... while others pay the tab.
I probably slightly misspoke. She primarily relies on social security. My husband said she has a small IRA, and she has an annuity. Then she has some money invested in some mutual funds and CDs. After speaking to her yesterday, I believe she has about $200K or so in all. But her memory isn't great right now, so it's possible she's forgetting about an account. Selling her house and car she may get about another $100K. SS is about $1500 per month, I believe.
If I add up her assets and divide by 10 (assuming she lives for 10 more years) then add in her SS, it appears she will have about $4K per month. The apartment is a minimum of $2K with no meals or about $2500 per month with one meal per day and twice per month housekeeping. Utilities and transportation to shopping and other places are included. Her LTC policy is about $400 per month, and her medicare is $225 per month. It will be tight but I think doable. What may not be doable is if she needs assisted living but not quite LTC, because the assisted living is more expensive. But I think we'll cross that bridge when we come to it.
For now we're not doing anything until we know her full prognosis from the cardiologist and till we are more certain of her finances.
Location: Chapel Hill, NC, formerly NoVA and Phila
9,781 posts, read 15,804,357 times
Reputation: 10894
Quote:
Originally Posted by CraigCreek
Is she receiving physical, speech, and occupational therapy? Speech therapy in particular could help assess her communication (including reading and writing), actual speech - not just the ability to form words but to create sentences, select the right word, and understand what others say and mean - and swallowing, which is often affected by stroke. The occupational therapist could assist in recovering the ability to handle routine activities of daily living, and of course the physical therapist would help her make the most of remaining, unaffected abilities, and hasten the return of abilities which were affected, but not eliminated, by the stroke.
While the doctors will look at the physical evidence of the stroke, the therapists will examine how it has affected her functioning and offer assistance in making the most of her abilities and finding alternate ways to accomplish tasks. They may well get to know her as an individual far better than do her doctors, as they will take into account her life, former strengths, background, intrinsic intelligence, personality, wishes, interests, and so on - not just the brain damage done by the stroke. Therapists are usually the ones who can spot the more subtle damage and its effects, and who can address it.
Her doctor should have recommended these therapies and started the wheels in motion for her to receive them, but if that hasn't happened, I'd strongly urge you to do whatever is necessary to at least have her evaluated for all three forms of therapy and get whatever is available to her in place. She might qualify for in-home therapy, since she can't drive, or out-patient therapy might be arranged, if transportation issues can be dealt with.
She may not be able to remain in her home, but meanwhile, there are probably simple things ( a rubber mat in the tub to avoid slipping, simple devices for removing lids, large-handled utensils, and so on) which the OT can recommend to make it safer and easier for her to live there until a decision is reached about her future.
Medicare generally will pay for the original assessment and pay for therapies as long as the patient is making progress, something which is assessed by the therapists. Unfortunately for this policy, stroke patients generally make progress, then plateau for a while before new progress can be seen. It's as if the brain needs time to adjust to each level of progress, and takes time off in between sessions. So it's important to advocate strongly for ongoing therapies during this process - the 18 months to two years referred to elsewhere in this thread - to help retain whatever progress has already been made.
Family members, friends, and caregivers can also assist with some of the therapies - think of it as "homework" - but they cannot and should not be expected to do all of the therapies themselves.
I'd also encourage you to get in touch with the National Stroke Foundation and the National Heart Association, both of which can send you very helpful free materials. There may be a support group for stroke survivors and their family members in your area, and there's a lot of information - most of it sound - online.
Meanwhile, is someone staying with her, especially over night and in the morning to assist her with breakfast, bathing, and dressing? If she is unable to read and write, there are very likely considerable safety issues. Does she prepare her own meals? Can she read labels? Does she confuse similarly packaged different foods? How about cleaning supplies, many of which are toxic?
Meals on Wheels might be very helpful at present, and might help allay fears about her nutrition and ability to prepare meals safely.
Best wishes to you and your family.
Thanks so much for all of your advice! It makes a lot of sense. It is my husband's mom, so I've been letting him handle everything (he has medical power of attorney, so he talks to the doctors, for example) but now I realize that I am the reader and researcher of the family, and I don't think he has been as proactive as he probably should be.
Good idea to contact therapists. I do believe she needs to be evaluated. I haven't been impressed with the speed (or lack thereof) of her medical care so far. When she is seen, it has been fine. But they were very slow to see her. Every step seems to take so long. We called her general practitioner after we suspected a stroke. He evaluated her and agreed it was likely a stroke. Then he called "the best" neurologist. Well, they scheduled her appointment for A MONTH later! I was livid! It took several phone calls and FINALLY, we got her seen by one of his associates a few days later. It was like they didn't think her case was urgent or something. Now that she has seen the neurologist, he suspects it's related to her heart and she went to the cardiologist and she's hooked up to a heart monitor as we speak.
I just asked my husband about it and apparently, after the cardiologist gives their review. they said the next step is to look into therapies. Thanks for the recommendation for the National Stroke Foundation. I hadn't even thought of that. I will look up their website now.
Regarding her capabilities, the funny thing is, she writes perfectly fine. In fact she has beautiful handwriting. She just sent my daughter a birthday card and it looks like calligraphy - that's how she has always written. So her writing is fine. It's just her reading. She can read very slowly but she gets frustrated after about a sentence or two. It's a big struggle for her. Her speech is perfectly fine, too. It seems her memory and her reading are the only affected areas. She gets dressed fine, too.
My husband has been checking on her every few days in person and he sets up her pills in her weekly case, because she did miss taking a few. And she has a friend who checks in on her too. For the most part she seems pretty lucid - she is just forgetful sometimes so we have to keep on top of her.
Aah, the joy of getting older! Thanks again for all of your great advice.
Location: Chapel Hill, NC, formerly NoVA and Phila
9,781 posts, read 15,804,357 times
Reputation: 10894
Quote:
Originally Posted by runswithscissors
She was REALLY lucky with that stroke. My mom ended up paralyzed on a feeding tube in a nightmare situation in a SNF and wasted away a year before dying. WITH OVER $1 MILLION IN ASSETS that her LAWYER refused to release for her to die at home, in cahoots with the SNF claiming it just wasn't "in her best interests".
I am sorry to hear that. Yes, my MIL sounds like she didn't get too much damage, relatively speaking. She was in very good health prior to the stroke and volunteered, ran around, drove, etc. So it has still been a big setback for her, but it could have been much, much worse.
By the time one reaches 85, it's a little late to 'start' planning to outlive one's assets. One thing she could change, however, is to spend or give-away her available assets to the point where Medicaid/Medicare will pay her facility living expenses. There is a 3-year 'window' for that, but, if her health prognosis is such that you expect her to potentially live another 10-years, it could be well worthwhile.
That is now five (5) years, not three (3), I believe. What is available through Medicaid is not always comparable to a private pay. I am not sure how that applies with assisted living, not a nursing home. And why not use her assets to see that she is cared for ? That is what it should have been for, not to pass along to the children.
michgc, you are doing all the right things. I have been through this 3 times and it never gets any easier. In all three cases, the individuals had worked very hard all their lives but there were not many resources for them to fall back on. And, much family help was not too readily available. We did the best we could.
I agree with research, research, research. Then you are equipped to make better decisions.
We are going through those questions right now for ourselves. My wife and I have separate pensions plus social security plus IRAs and the question we had is what to do to ensure the money does not run out too soon. The IRAs are subject to market variation, which we want to avoid. The instrument for that is an annuity. That is what I suggest you check out for your MIL Her assets(you mentioned the mortgage is paid off, so there is property, yes?) could be converted to an annuity. There are many forms which could provide a certain amount of income for a guaranteed period or for her life, depending on how she wants it set up.
"Most of my money I spent on fast women and slow horses; the rest I just wasted"
Please register to post and access all features of our very popular forum. It is free and quick. Over $68,000 in prizes has already been given out to active posters on our forum. Additional giveaways are planned.
Detailed information about all U.S. cities, counties, and zip codes on our site: City-data.com.
Please register to participate in our discussions with 2 million other members - it's free and quick! Some forums can only be seen by registered members. After you create your account, you'll be able to customize options and access all our 15,000 new posts/day with fewer ads.
