Things I've learned in the last week

Monday, January 14, 2013
For context: The main issue that I've been struggling with over the last weeks is the fact that my Hot Mom has been ill. She's been having increasingly serious problems with her back over the last several months due to osteoarthritis and several bulging disks, and the last few weeks have brought matters to a head. 

Health insurance makes Mos Eisley look like a Garden Club

My Hot Mom is a Medicare patient with a supplemental policy through her former employer. This state of affairs leads to an endless morass of regulations. In fact, the regulations have regulations. And the bureaucracy is enough to make someone consider assisted suicide rather than try to get the type of help seniors need on a regular basis.

The main reason that my Mother's health issues have taken so long to diagnose and treat is that everyone is afraid of, and in thrall to, the regulations surrounding Medicare and supplemental insurance. The MRI that she had done IN NOVEMBER (after having to wait until it was cleared with guess who, the insurance companies) clearly shows the root cause of her excruciating pain, and yet it took months to get that data to the right person who, after taking one look, said, "Oh, yes, this is very straight-forward, and a surgical solution is really the only thing that will relieve the symptoms. How does tomorrow look for you?" Meanwhile, while everyone was fucking around with the insurance companies, my mother was suffering increasingly debilitating pain to the point that the simple act of standing was bringing her to tears.

Crap on a cracker, how is this okay?

Village of the Damned

Prior to taking my Mother to the Emergency Room on Saturday and forcing the issue, we thought that she was going to need residential care as a stop-gap measure until she could be seen and evaluated by a surgeon and pain management specialist. So I did some research and made some visits.

On the plus side, I found a facility that was clean, bright, cheerful, well-maintained and staffed, and appeared to be making real efforts to make their residents comfortable. Of course they had over 100 people on the waiting list.

On the minus side, I found a facility that reminded me of nothing so much as a 1940's era flophouse. Dirty, ill-lit, poorly maintained, loud, cramped and the entire facility smelled strongly of urine. And I have news for the horribly matter-of-fact woman who gave me my "tour:" All Nursing Homes are not dirty, ill-lit, poorly maintained, loud, cramped and smell strongly of urine. They just aren't. The fact of the matter is that you, Madame, work in a shithole and I wouldn't consider kenneling my dog there. So you can just fuck right off with your rationalizations. Just walking through that place literally brought me to tears. I can't imagine being forced to make a decision like that for my Hot Mom, but I know families are required to do so, each and every day, for financial and other reasons. What a horrible, depressing state of affairs, and I'm endlessly relieved that our own situation did not put me or my Hot Mom in such an untenable position. 

Resurrecting my Inner SNCO

If I've learned nothing else over the last several months, it's that when it comes to health care issues, I need to channel Senior Chief Murphy early and often. I can't help but feel that if I'd been more aggressive in advocating for my Mother's care, I could have saved her needless suffering. But now I know, and the next time this sort of thing comes up for her or anyone else who lives in my heart, I will not hesitate to resurrect my Inner SNCO. Don't mess with the Senior Chief, and ESPECIALLY don't mess with anyone I care about. I will cut you.

Bad events don't have to lead to bad experiences

Once we took my mother to the ER on Saturday, the staff at the Longmont United Hospital swung into action, and let me tell you something - if you have to be hospitalized, you could do much worse than LUH. The staff has been nothing but friendly, gracious, compassionate, and Johnny-on-the-Spot in terms of showing some urgency as it related to my Mom's pain management and surgical consultations. In terms of measurable, meaningful results, we got more done in 16 hours at LUH than we had in the previous 60 days of outpatient care. So thank you, LUH staff, for restoring some of my faith in America's health care system. You guys rock, from the ER doc who agreed to admit her so she could have a neurosurgical consult immediately instead of waiting two weeks, to the surprisingly erudite and charming food service attendant who brought her lunch. Her surgery will be performed at LUH this morning, and I have no reason to think the standard of care will be anything less than exemplary.

Good friends are that pearl of great price

Both my Hot Mom and I are blessed and double-blessed by a cadre of caring, generous friends who have really stepped up in our hour of need, in addition to the support of our family. Friends really are the "family you choose," and I'm so very grateful not only for the support of my own amigos, but of hers, as well. Taking care of each other is a foundational element of our humanity, and I'm secure in the knowledge that my foundation - and my Mother's - is strong.

12 comments:

Random Michelle K said...

Couple things about nursing homes: they generally have two "sides": a rehab area and a long term care area. The long term care areas typically have waiting lists while the rehab sides often have openings. If you can get her doctor to admit her for rehab, you can typically have more options.

If you and your mom have not already done so, talk to the social worker at the hospital. They are adept and dealing with Medicare and can usually smooth the path for you.

Additionally, push to get your mom admitted for rehab when she is released. A good facility will have OTs & PTs who can help her not just with her recovery from the surgery, but also in learning new ways to do everyday tasks when your mobility is limited. (This sounds dumb, but they'll go over things like sitting down in and standing up from a chair, which sounds stupid, but can be very helpful in reducing future injury.)

But mostly, find the social worker at the hospital--if they don't find you--and let them help you through.

Anne C. said...

And getting your mom started on good PT habits and other better ways to do things (as Michelle notes) now when she's feeling more accepting of help will be much easier than down the line when she slips back into long-held habits of doing things by herself for herself. (Sorry, Judy, you know I'm right.)

Jennifer said...

I'm so sorry to hear about the frustrating road you've been down -- there's been posts on FB but I didn't want to message you amidst the chaos to find out exactly what was going on -- but I am so glad to hear that you've graduated past the insurance companies and now have a team working toward ensuring your mother's pain-free future. Sending you much love and support from SoMD! *HUG*

Steve Buchheit said...

It truly sucks having to go through that. Did the same with my Mom… and she used to work at the hospital.

With the friendliness of the hospital, while I'm sure they really are that way, part of that might also be the new Medicare regulations that will base payment on the experience of the patients (low patient scores including outcomes = lower reimbursements, higher scores = higher reimbursements). But, yeah, in general insurance beyond anything more that getting a prescription filled (and sometimes even then) is a pain in the rear.

And what Michelle said. Getting an uncle into managed care with medicaid and medicare went a lot smoother after talking with the facility social worker.

And I hope your Mom feels better real soon. Living in pain is no way to live.

Janiece said...

Michelle, we're already on it. I've learned a tremendous amount about Medicare and long term care in the last weeks. I just ran out of time to discuss it here...

Random Michelle K said...

Of, if she has not already done so (I am assuming she has) make sure she's designated her Medical Power of Attorney. That will help in dealing with Medicare.

I will say that the individuals we spoke to over the years from Medicare were always very polite and helpeful and nice. It's just that the whole thing is so damned confusing.

Random Michelle K said...

One other thing, while I have the floor. ;)

Everyone, regardless of your age and health status, should have a living will and advanced directive filled out.

These vary by state, but doctors in WV have started prompting at every office visit, which is AWESOME. (I think they also have medical staff who are notarized, so they can be completed on site.)

If you and your loved one reside in two different states, you may want to look into filling out the different forms for each state (frex, VA would not take the WV forms).

The point is that you don't want to wait until you have a health problem before these things come up. Additionally, WV (and hopefully other states), have an online database for these forms, so they can be accessed by any doctor.)

Janiece said...

Michelle, all of those things are already taken care of.

Random Michelle K said...

I figured you were on the ball, but since you have a large viewing audience, I figured it would be good to mention it for other people. :)

The Mechanicky Gal said...

Janiece, remember SMOKEY EVENING EYES.
Just a reminder!
My love to you all.

Janiece said...

MG, WE ARE SO ON THE SMOKY EVENING EYES.

Janiece said...

Finally back at Mom's place after getting my Hot Mom settled in for the night after her back surgery. While the site of the surgery is painful, the excrutiating pain of the last weeks and months is on the run, and the Doctor expects her to make a full recovery. She'll probably be up to having some visitors tomorrow afternoon, but her surgeon wants her to start physical therapy immediately, so she may be in and out of her room.

Thanks to everyone who sent their well-wishes and offered to help. And a very special THANK YOU to my Sister-from-Another-Mister Stacey, who came to sit with me during the procedure and recovery so I wouldn't be alone. Thank you, my sister.