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ADL's {activities of daily living}, House Bound, Not Broke financially quite yet
Internal Administrator
Posted: Tuesday, January 17, 2012 5:40 PM
Joined: 1/14/2015
Posts: 40463


Originally posted by: DLMifm

ADL's {activities of daily living}, House Bound, Not Broke financially quite yet

How does your LO flunk an ADL.

Toileting: how many times do they miss the toilet and get poop all over the floor? Once a day, once a week, maybe almost never? How do the agencies determine needs help with toileting?

Dressing: how many times .... does forgetting to put on depends (i.e.) underpants constitute needs assistance with dressing?

Unable to leave house on their own, constitute failing a ADL?

Needs help with toileting, does being unable replace a colostomy apparatus on their own constitute requiring help with toileting and failing an ADL? BTW this is not considered a nursing task/duty.

Unable to be left alone in home, memory issues, safety issues etc. Does this fall into an ADL?

I am faced with planing to be able to live for several more years on very little SS. At the moment our/my income is above the level to receive most aide such as mass health. It would be very unwise for us to spend down resources now. If I met the poverty levels to get such aid they tell me there would be more in-home assistance available. I am already drawing don to pay fixed expenses.

DW's Alzheimer's specialist MD tells me not to leave her home alone. We do get limited shifts per week from HI. But I find myself more and more house bound unless DW manages to get dressed and is willing to accompany me in the car for shopping etc. This is becoming a big issue with a lot of push back and argument.

No neighbors or family available to come over and cover.

How do people manage?

Basically I am venting during a difficult day and hoping for new ideas.

Had a six AM problem with a full bag of feces being dumped on the bathroom floor and a very upset wife not knowing what to do.

Dammnn I am tired. Out of bread, out of supplies for meals since DW was going shopping with me yesterday and backed out, didn't get dressed and won't leave sofa today.

DLM
Anonymous
Posted: Tuesday, January 17, 2012 5:40 PM
Originally posted by: biccoastal

So sorry. Your distress is palpable. I hope you will get some respite soon.

I wonder why you mention activities of daily living; it sounds like you think someone has underestimated your wife's level of impairment or your need for help. Are you seeking disability status or applying for aid? The ADL analysis is always subjective, so it helps alot to describe the challenges with specificity and detail, as you have here. Try to keep a journal if you can about what happens each day so you can refer to it later. (Saying she has toileting problems is one thing; describing the spilled bag incident another.)

When I practiced in the disability law field, the difference between good and bad results for the challenged person was often the level of persistence in describing the problem. You need to continue to describe what isn't working and what the consequences are. If you aren't getting the help you need, maybe you need to repeat your need with more detail or maybe you need to address it to a different person or agency. But be persistent. You need help and soon. Hang in there. Keep asking.
Anonymous
Posted: Tuesday, January 17, 2012 5:40 PM
Originally posted by: Cheryle Gardiner

Dave, when I became housebound because Jim refused to ride in the car with me (he was waiting until he could drive again), I relied only on waiting until his son could come over so I could go grocery shopping. When he had his meltdown and I took him to ER for observation, and was able to have him admitted to a Memory Care Home, I was able to regain my life. Fortunately (in a way) Jim is a disabled veteran and we have VA benefits. I say "in a way," because if not for the disability, we probably wouldn't need them for VaD care.

I would strongly recommend what I've heard from others here on the board: get yourself to an Elder Care attorney, one that is licensed and has experience in the ins and outs of protecting your finances while still being able to provide care for your wife. I know from reading on this board that there are ways.

Schedule the appointment for the next time you have a home health aide scheduled.

In the meantime, beg help from a neighbor to make a food shopping trip for you, or check with your local grocery stores to see if any of them has home delivery. I know Safeway has it out here, and as I recall, the first delivery is free.

Good luck and let us know what's going on.
Anonymous
Posted: Tuesday, January 17, 2012 5:40 PM
Originally posted by: Cathy J. M.

It's true that ADL status affects the amount of Medicaid-funded in-home help available to people who qualify financially.

I have no doubt that if you did arrange your finances in order to qualify for help, your wife's ADL status would pass any screening.

So it's the finances that are the sticking point, right?

Have you consulted an eldercare attorney? And of course, your state's agency for aging?

I believe Mass. pays $1500/month to family members who care for their eligible loved ones at home. But I see your point about safeguarding your own ability to survive later on.

I kind of gave up worrying about that since we got into a complete crunch and just had to have the Medicaid-funded in-home care. But if I had gotten good legal help a lot earlier, I'd be in a better long term position. Hope a good Mass. eldercare lawyer can help!
Anonymous
Posted: Tuesday, January 17, 2012 5:40 PM
Originally posted by: Starling

What you need to do is Google the Blessing Scale. It is a scale about which personal activities the patient can do, and which they can only do partly and which they can't do at all.

It is used by nursing homes to figure out which patients need what. And you can use it too.
Anonymous
Posted: Tuesday, January 17, 2012 5:40 PM
Originally posted by: DLMifm

<posted by Cathy J. M.:>Have you consulted an eldercare attorney?

<DLM> Ooooh yes. Long time ago. Just after DW was diagnosed and before AD became an issue for consent. Attorney Mary Kathleen Nealon is past president of BayPath (AAA) which serves more than 1,150 home care clients in 14 MetroWest communities

<posted by Cathy J. M.:>I have no doubt that if you did arrange your finances in order to qualify for help, your wife's ADL status would pass any screening.

<posted by Cathy J. M.:>So it's the finances that are the sticking point, right?

<DLM> Sooo True. So close to criteria but so far... Just barely above so many max limits.

<posted by Cathy J. M.:>your state's agency for aging?
<DLM> Definitely. BayPath is the AAA for my area. My aged parents (long deceased) lived near here many years ago. We never thought of ourselves as caregivers back then. They received meals on wheels and I did the facilitating through BayPath. lost contact for awhile.

<DLM> In 1996 my elder sister {89+}came to live with us. She received services from Baypath. Got her to move around 2009 to an apartment. She is thriving and I just wish I can do as well.
The congregate living apartment is managed by Baypath.
The manager of the apartments is also her BayPath case manager.

<DLM> They know our name well at BP <g>
Sister is a client
my DW is a client
I am a caregiver client.
They now manage federal programs as well as state stuff.

<DLM> The issue of ADL's relates to DW receiving more services from BayPath without our being qualified for medicaid (aka Mass Health)

<posted by Cathy J. M.:>I believe Mass. pays $1500/month to family members who care for their eligible loved ones at home.
<DLM> The have financial criteria.

<posted by Cathy J. M.:>But I see your point about safeguarding your own ability to survive later on. I kind of gave up worrying about that since we got into a complete crunch and just had to have the Medicaid-funded in-home care. But if I had gotten good legal help a lot earlier, I'd be in a better long term position.

<DLM>
I think I now have a start. Each year with my new annual income I get closer to qualifying for more help. I am constantly asking to see what is new and new programs.

<DLM> I was discussing services with BayPath. which is why I asked:
<DLM> Toileting: how many times do they miss the toilet and get poop all over the floor? Once a day, once a week, maybe almost never? How do the agencies determine needs help with toileting?

<DLM> Dressing:
is something that doesn't fit a carer schedule

<DLM> Unable to leave house on their own, constitute failing a ADL?
This a very general question. MediCare has some allowances for visiting nurse services if the person is deemed house bound.

<DLM> Needs help with toileting, does being unable replace a colostomy apparatus on their own constitute requiring help with toileting and failing an ADL? BTW this is not considered a nursing task/duty.

<DLM> It is one of those grey areas and Baypath didn't have an answer. One can not reliably predict when aid is needed.

<DLM> Unable to be left alone in home, memory issues, safety issues etc. Does this fall into an ADL?
<DLM> Apparently this is not considered a ADL I get to go out on the five days when they provide a home aid for a shift.

<DLM> None of above have reached or constitute a crisis.

<DLM> I can if really pushed use a delivery service of weekly food shopping.

<DLM> I have an application for subsidized housing when the sky falls.
--

Thank you for the considered response

Dave ifm
--
Anonymous
Posted: Tuesday, January 17, 2012 5:40 PM
Originally posted by: Cathy J. M.

Subsidized housing is my Plan B for the future too. Hope there will still be some available then!
Anonymous
Posted: Tuesday, January 17, 2012 5:40 PM
Originally posted by: lana3941@yahoo.com

I don't know what a "meltdown" is. would you please explain that to me? Lana


Smile....it could always be worse
 
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