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Use it when needed without explanation.
Failure to plan on anyones part does not constitute an emergency for you.
How much does the long-term care insurance cover, and for how long? If you can't figure it out from the paperwork, call the company and pretend to be your parent so you can ask.
Most policies cover a certain percentage of care each month, up to a certain total amount--which usually works out to be about 3 years. If the bill the parent pays for long-term care insurance is higher, then the coverage would last longer, maybe 4 or 5 years.
But so many people who purchase these policies assume that their long-term care bills will be 100% covered for the rest of their lives. Even if the parent signed up before cognitive decline, they probably did not fully understand the policy details. They dealt with a smooth salesperson who was well-trained in creating a trusting relationship, and specifically trained to dodge every practical question. Then your parent was presented with a 50-page policy in tiny print, and told where to sign.
It can be frustrating dealing with the disease. There is no rhyme or reason to the things they do, say or remember! Patience is essential!
2. Don't call it a nursing home. Assisted living, senior apts, rehab, new apartment are all better terms. Take the loved one on a tour of a modern facility. In their mind, they remember old, dreary, stinky facilities of the past.
I am the spouse of my FIL's primary caregiver, who also is his dad's POA both medical and financial. Lessons I've learned:
1. Do NOT accept responsibility for caregiving for anyone without have the authority to do so. That means getting durable power of attorney for both financial and medical sorted out before a crisis happens.
2. Except under special circumstances, the primary caregiver should be the one who is granted durable power of attorney for both financial and medical. Special circumstances include where one child is a CPA and another is an RN or MD and it makes sense to split the work. But both names should be alternates named on the other POA. When splitting POA, both POAs must also have a good relationship.
3. Healthy boundaries are not optional, and must be established at the beginning of the caregiving journey and not as an afterthought because caregiving may last a very long time. Healthy boundaries also extend to well-meaning or nosy family members, friends and neighbors.
4. Spouses are partners in caregiving. What affects the caregiver also affects the caregiver's spouse.
5. Caregiving may or may not be hands on. No one can provide care 24/7. Managing care is also caregiving, and also is a lot of work. Both types of caregivers are at risk for burnout.
6. Do what you can with love. When the love is gone, it's time to find someone else to do the work. Caregivers are at risk for compassion fatigue.
7. Take a vacation or staycation.
8. Set aside time for yourself every day.
9. You do not need to explain yourself - not even to your parents - just because you were asked for an explanation.
10. Having POA medical and/or financial means that you keep the person's medical and/or financial information private.
11. Doctors take advantage of Medicare. As medical POA, do not be afraid to advocate for your loved one. Does your loved one really need to be seen in the doctor's office every 6 weeks? Probably not.
12. Banks often do not accept financial POAs and require their own paperwork, which can only be completed when the loved one is still in his/her right mind with no signs of dementia.
13. When signing anything as POA, always sign "As attorney in fact for [name]".
As already has been said, caregiving must work for everyone involved.
Can you elaborate on the issues making this necessary?"
What my brothers and I found over the 7 years that we were managing mom's care is that the MINUTE she got admitted to a hospital or care center, someone was planning for her discharge.
We found that it behooved us to find out who that person was and be part of the planning so that we weren't caught off-guard. Hospitals tell you "your parent is being discharged tomorrow; where are they going?". Rehabs say "Medicare will no longer pay as your parent has plateaued; are they going home?".
YOU need to know that these folks expect you to have a plan in place. Have a list of local rehabs/LTC facilities that you've visited and which ones you find acceptable. Make sure that they will accept Medicaid after a year or two of private pay.
And know as well that you CAN'T set up Home Health Care until the patient is AT HOME. So the first 48-96 hours after discharge are either family taking full care or hiring 24/7 aides privately.
These are all things that I so wished I known before my mom started to decline.
In that same vein, as your LO approaches the end, sometimes doctors look to do procedures to extend life at cost of quality. Ask about the benefits vs the cost - and I don't mean monetary costs. Sometimes, a peaceful pain-free death is not the worst option on the table. Some doctors, however, have a hard time reconciling that fact.
Can you elaborate on the issues making this necessary?
To a new poster....please never consider doing anything that would jeopardize your future or your family's future. You can help without giving up your life. Often a poster is conned into giving up their life because the elder refuses to make even one change in theirs.
Don't fool yourself into thinking you can solve all their problems but just doing.....
You can't..especially the problems that they purposely made.
If you choose to help do not get mad at others for not helping too. You made your choice, they made theirs. Neither of you are wrong. Or so often we see you did realize you chose wrong and now want everyone else to suffer along with you.
Cannot stress boundaries enough. Make 'em and enforce 'em.
Siblings took full advantage that Parents were always my responsibility. They went to Lawyer Mom already had dementia. I am not POA or Health Proxy, if you think something is wrong it is. Greed makes a big difference, make sure you have rights in writing, no one will help you later.
Stick to the facts and a lot of times the solution becomes obvious.
My mom did ask me to promise her years ago that I would never put her in a nursing home - she wanted to live in her own house until she died. I never did "promise" her that. When I had to place her, I moved her into an IL/AL facility and now she is in a new IL/AL facility in the memory care wing. I found a place that didn't look anything like a NH. Being that my mom is 95, I think she remembers visiting a couple of her high school classmates who lived in a NH in a very small town in Western Nebraska and I think it always haunted her thinking that is what they all are and look like. So many places have come a long way from that image - thankfully. She likes her new place even though it is quite a bit smaller than the previous one because of the cost plus the fact she really doesn't need a bigger one anymore since she declined this year.
Thank you for this thread! It is so very interesting, and I think will be very helpful to new posters.
There are some retired professionals in various helping professions, and some currently working caregivers who post here. They too are greatly appreciated for their time.
However, no one is licensed to practice law with a poster here, or use their R.N. license, social work, therapy license, CNA, or give actual medical advice as a doctor specific to a patient.
The advice is for informational purposes only. I think those past and present caregivers who have been, or are presently in the trenches, giving care, who have experienced caregiving can give some of the best answers, whether licensed in their field or not.
A new poster can choose the advice they want to follow, and leave the rest.
This is going to be one of the very best threads in a long time, imo.
Keep your appointments for physicals, health screening, dentist, eye doctor etc.
It's tempting, to blow off your own appointments when you feel like all you do is sit in one doctor's waiting room after another, but your health is paramount. You can't take care of someone else if you're sick yourself!
If you think that your parent is "just" getting old and crotchety, anxious, more stubborn...get them a comprehensive cognitive assessment to find out exactly what you are dealing with. For us, it was a life saver.
Would bringing a meal once a week or cleaning the kitchen be more helpful.
Tell people what you need. I know that I never want to just jump in for fear of causing offence but I am more than willing to do whatever they need, I just need to be told. I can't imagine that I am the only one that feels that way. So be specific and when someone asks to help, take it.
The ones that you sign in a hospital or doctor's office have a 12 month expiration period. Having one that never expires is soooooooo much easier.