I think I’m reasonably intelligent and not typically prone to second guessing myself. But all this stuff with my mom and dad has me wondering more often whether I’m making the right decisions.
Power of Attorney
First it was their POAs (Power of Attorney). I’d never heard of one written that required a doctor’s affidavit before it could go into effect. I’ve read the documents a hundred times and I couldn’t see it any other way. Yet I thought people were questioning why it was so difficult. You see, I don’t believe most POAs are written this strictly. My brother-in-law finally read it and agreed with me.
So why don’t I trust myself? Is it the stress of the situation? Is it because I can’t imagine why anyone would write a POA this way? Did my parents not trust us enough to write it allowing us to represent them regardless of their state of mind?
By the way, we’re in the process of having my dad’s rewritten and a document drawn up where my dad declines to be my mom’s POA. This will make so many things much easier.
The other more recent issue is their insurance. A little background first.
Another hospital stay
As I’ve written, my mom has been in several facilities since her February 1 fall. Many of our choices have been driven by her insurance. They have Part C Medicare with Aetna (used to be Coventry). Aetna has been a pain in the butt.
Anyway, my mom recently was back in the hospital. She’d been in an assisted living memory care facility and close to my dad. One Saturday night, they called and said she had a temp over 100, diarhhea, and wasn’t acting normally. So, they wanted to send her to the hospital. Fine. How many times have you called and it’s been nothing?
Once there and after running a few tests, they determined her cardiac enzymes were high, indicating a potential heart issue. Her heart has always been fine. Of course, they wanted to admit her and she ended up on the cardiac floor. Despite the “no visitors” restriction right now, they did allow my sister or me to be with her. She simply can’t make decisions about her care.
By Monday, we were hearing she couldn’t go back to memory care because she required more care than they could handle. We assumed that meant she was permanently out, but we learned later that they simply meant she needed to go to skilled care first. Ok, how many times have we tried that?
My sister and I agreed that skilled care was not the answer, but neither was memory care. So, we told them goodbye and started looking for another place for her to go.
Insurance conundrum
The place we wanted for her does not take Aetna insurance. We kept saying, we don’t want skilled care; we want long term care. Why does insurance matter because it’s private pay anyway? Evidently, everyone starts in skilled care, just so they can do an assessment. And that’s covered through insurance.
Everyone kept saying, just change her insurance. Here was the next time I was second guessing myself. What am I missing? You can’t just up and change your insurance whenever you want, can you? Isn’t that why they have enrollment periods?
I did a little research on my own and discovered something called SEP (special enrollment period). It indicated if she was in or going to a long term care institution, she could qualify and change her insurance. I thought we were on our way!!
I finally called Medicare to learn more. And of course, there’s a catch. You must already reside in the institution. I was told they will call to confirm, so you can’t fudge on this. So, we were in a Catch-22. We can’t change her insurance through the SEP until she’s living there and she can’t live there until her insurance is changed.
I was right again. We can’t just switch her insurance because we want to, unless it’s during the annual enrollment period. Why do people act like it’s the easiest thing in the world? Why do they make me start second guessing myself?
And I was feeling lots of pressure. We had a time crunch and I do not like making important decisions when I feel pressured.
Back to SunnyView
My mom is now back at SunnyView, for the third time. They take Aetna, but surprise, surprise, Aetna denied the skilled care claim. My sister and I were right again. Skilled care is not making a bit of difference for her.
We know they’ll take good care of her at SunnyView and she seems to thrive there. They love her and are always thrilled to see her come back. As my sister says, I guess she was meant to be there.
We’ve tried assisted living and assisted living memory care, all in our attempt to keep my mom and dad together. I could certainly be second guessing what we’ve done as it’s been very disruptive, with so many ups and downs. But it’s all been with the best of intentions. We now have to face the fact that my mom simply needs a higher level of care. So, let’s hope we can get her settled in.
Next steps
Our plans are to get the POA situation in order, meet with someone from SHIIP (Senior Health Insurance Information Program), and then pick another form of insurance for them during the fall enrollment period. Possibly even Original Medicare.
Did you know it can take Medicare 50 days once they’ve received a POA for it to be a part of your record? Yikes!!
We may also look at other facilities that have both assisted living and long term care, continuing to try to keep my parents together. We will likely have to get on a waiting list. But for now, they’re safe. Maybe not where they want to be, but doing OK.
I could also be second guessing what we did by putting my dad in assisted living. But again, it was not to isolate him but to allow him to be with my mom.
Do you second guess yourself a lot? This has been an unsettling experience for me. I usually feel pretty confident that I understand things and know what I’m doing.
I guess I need to get used to the fact that we’re dealing with a lot of complicated things but I also feel we’re sometimes dealing with people who don’t know as much as they think they do!!
Oh Linda, I can relate. What you are going through is so challenging. You want to do the right thing by your parents, but you’re not sure what that is…and everyone has advice…some of it useful, some not so much. We had to find care for my mother quite suddenly last November, and now we are going through it with my mother-in-law. We had her in independent living with aides to help her. She fell and broke her hip…so it was off to the hospital, followed by a rehab/skilled nursing center and now an assisted living center. COVID-19 adds another layer to the complexities. I wish you and your parents all the best.
Thanks Christie. I’m learning more and more about others having the same struggles. I guess it’s all a part of the process and we have to accept it and learn as we go.
Oh my, I’m so sorry you’re having to deal with all of this. They surely don’t make it easy. I had to jump through all those hoops years ago with my mother. Sadly my Dad was already gone, but sounds like that would have been even more difficult. I hope you’re able to get it all worked out.
My mother did have a POA, but no doctor’s approval – of course that was quite a number of years ago.
Grace & Peace,Iris
http://www.IrisOriginalsRamblings.com
Slowly but surely we’re chipping away at things. I think we’ll get there but it won’t be easy or quick. Thanks Iris.
Having had my SIL (an adult with mental challenges) as a responsibility for many years, there have been times I’ve called and merely said I was her on the phone. I know it’s completely wrong, but I still do it. I do understand why there are many checks in the system. A friend of mine is a senior-care lawyer and constantly dealing with families who have taken advantage of their elderly relatives. When money is involved, many folks values seem to disappear.
Good luck working through the issues… and yes, trust your gut more! Stop second guessing… you make the best decisions with the information you have at the time. More information later does not mean you made the wrong decision at the time; you just know more now.
I would love to do that but I’m afraid they’d ask me a question I can’t answer!! When my dad was staying with us, they would sometimes accept his approval.
Every time I relax a little bit, something happens. Now my dad’s assisted living facility has been hit with COVID. What a mess!!
Ugh, health insurance woes. My parents both had an Advantage plan for their Medicare coverage, and the restrictions of it drove me up the wall. I know Original Medicare isn’t a walk in the park either (my wife’s mother had her own dramas with it), but I think comparatively there is less finger-pointing. So sorry for your troubles.
Yes, the federal employee health coverage (FEHB) coordinates well with Medicare, or so my former colleagues who are on both tell me. I’m definitely keeping my FEHB later. I just pray the system is still around at that point!
Hang in there…
Thanks Marty. I was told Original Medicare requires fewer approvals which has been our biggest issue with Aetna. I know nothing will be perfect.
Thanks SO much for saying FEHB coordinates well with Medicare. I wanted to believe what I was told about that.
be a little wary of Tim’s USPS insurance plus Medicare Mivkie kept her Mayo insurance and because of kidney failure was automatically put on Medicare since kidney failure is an automatic disability we never found anything in writing and were never told that after 36 months of kidney failure and dialysis Medicare automatically becomes primary so once or twice a year for the last 7 years she was alive I had to spend 3-4 days on the phone with both insurance because the system kept putting her Mayo Insurance as primary. Good luck don’t worry too much everything will work out for you and your mom, second guessing is natural just don’t stress over it.
Thanks Mike. It’s always good to hear about other’s experiences. You think you have a plan and then life throws you a curveball.
Be careful when you get on Medicare and think your husband’s health insurance will cover whatever Medicare does not. I was told by HR not to have employee private insurance along with Medicare as they will both claim that the other is responsible. Look at that carefully with a trusted professional. I understand your frustration with health insurance rules and conflicts.I appreciate your care for your parents.
Thanks Jean. My husband works for USPS so he has federal government insurance. We were told that it works hand in hand with Medicare, but I know we need to make sure we completely understand everything and how it works. It seems no insurance is without its hassles.
We’ve just dealt with POA with my mom in the past year. Initially, we had the POA that required 2 doctors to declare her capacity. Until that was in effect, we did not have the authority to act on her behalf. Mom had moved to a care facility and needed to change her mailing address. That was a complicated process and prompted us to seek the other POA requiring another trip to the lawyer with mom to authorize that. I often reflect on this period in my life and ask myself why acting on my mom’s behalf is so much harder than acting on my children’s behalf when they were dependents? good on you for the good work you’re doing with your parents.
Thanks Mona. I guess we’re not the only ones trying to deal with this type of POA. I’ll feel so much better when we get it all worked out. Some places are easier to work with than others and will allow me to represent my mother. I know exactly what you mean about changing a mailing address. There are still some that need to be changed but we can’t, as neither my sister nor I can do it, and my dad requires so much hand holding which is impossible when we can’t physically be with him. We had a bad storm yesterday and there’s some damage to their house. I’m struggling to get my dad to make the phone calls to deal with it. Oh well. One day at a time.
I think second-guessing is expected in a situation like this. You are making decisions on behalf of your parents. How can you know all there is to know about aged care and health insurance. And, don’t get me started on bureaucracy and incompetence. Sounds like you are doing your best with a difficult situation. Blessings.
Thanks Suzanne. Since I will be 65 in about 8 months, I guess this is good information for me to have anyway. However, my situation is different as the insurance we have through my husband’s job will cover what Medicare does not.
Oh, the bureaucracy. I understand about privacy and security, but to change an address? I’ve been beyond frustrated some days.
I’m sorry you are going through all of this. My friends who live in countries with universal healthcare think we are absolutely nuts. I have to agree. Just as a side note, I seem to remember having to get a doctor to declare my father incapable of making his own decisions before my brother, the POA, could take over. Unfortunately, there are too many kids (not in your case, obviously, nor in ours) who can’t be trusted so it’s a good piece of security.
I’m sure there are families that need that extra security. I would never think about taking advantage of my parents. I give my dad a monthly accounting of what’s been spent as I believe in total transparency. I’m blaming this on the attorney because I know my parents have always trusted both my sister and me. And they probably had no idea how this would play out. Thanks Janis.
I second guessed myself once this year. Still haunting me
Only once? That’s pretty good!!
I’m usually decisive