cross posted from health- Dad needs homecare right?

[Anonymous]

I think he does. I don't really know what I am talking about though.

Backround- Dad is late 70's and has Parkinsons. It's progressing...a lot... he walks very undsteadily but a little better with his cane or rollator. Has a powerchair that he .does.not.use. (I am so frustrated over that).

Lives with Mom, mid 70's, has bad knees and shoulders and celiac disease (and its attendant digestive/inflamation issues) but drives and is somewhat active. She takes care of him. I live a few minutes away and see them nearly daily, but I do work full time and commute 2 hrs a day.

Mom does so much. Too much. She hasn't felt well over the last several days and I took her to the er the other day. She wasn't feeling well today, Dad proceeded to slip/fall getting out of bed (I have put padded floor tiles down so he seems ok) and she could not help and apparently hours went by (!!!) before she told me-at which point I immediately left work, drove the hour there and called 911. They got him up. I called her dr to get her intoday because otherwise we will probably go to the er again at some point and they got her in Thursday...

Long and short of it is, I think we need someone to help Dad, maybe make sure his meds are ok and help with getting going. Is that a thing that can be prescribed by the Dr? What do I ask the Dr to do? I am going to mom's appt on Thu and have her add me to the hippa stuff. They have the same dr and I need to lay it out for the Dr-my mom minimizes this stuff and as you see above, won't even call 911. I"m going to have to take the lead on this. They have Medicare and Humana, if that helps. Any advice on what to do/ask for?

[Anonymous]

Yes, he does. Do you think your parents would be OK with people coming into their home? I know my parents would have the hardest time with this (they're not there yet). My MIL, on the other hand, who is Vietnamese, has always had staff to help her. For her it's the norm. As her Parkinson's has progressed, she's just adjusted what her staff has had to do, and we added a PT who visits at her home and and now a nurse who comes regularly to check the stomach pump that delivers her medication. My parents are very private and would HATE to the same set-up! But at one point, they're going to need something...

My MIL's staff are Vietnamese maids she hired by word of mouth, who at first, just came to clean, then came to cook, then grocery shop, and now do everything in the house, including massaging her when she's in pain, doling out her meds, and helping with light toileting, dressing, getting her in and out of bed, etc. They don't belong to any agency, but most of their previous or current clients were Vietnamese seniors as well. I've heard that home aides with agencies cannot touch medication and have restrictions on what help they can give.

[Anonymous]

Your dad's doctor doesn't need to prescribe home health care, and it is unlikely to be covered by insurance or by Medicare (but you can check and see.)

Usually insurance or medicare will cover brief periods of home health care for after surgery or an accident or illness requiring hospitalization, etc, but only if skilled nursing care or P/T is needed.

Your dad doesn't need skilled nursing, he just needs a home health aide to be there to help him if he needs it and to do he things your mom would do for him.

This is usually private pay and costs around $20-$25 an hour.

(Since you live nearby the easiest and cheapest thing for you to do would be to handle all his medications yourself because home health aides can't touch those without special certification. I bought 4 identical weekly packs with space for morning and evening pills, and fill a 4 week supply all at one time. It takes me about 15 minutes and as I do it I can quickly see which medications need to be refilled.)

[Anonymous]

Op here-Mom has been in the ER 15 hrs waiting for room. I'm hoping Dad doesn't fall before I get back to their house. It's all hitting the fan

[Anonymous]

Anonymous wrote:Op here-Mom has been in the ER 15 hrs waiting for room. I'm hoping Dad doesn't fall before I get back to their house. It's all hitting the fan

Sorry, OP. I know how hard this is. Hang in there!

[Anonymous]

OP - I think if you could get in touch with an agency to have someone come and do a general assessment of your parents and see what might be needed in terms of services that you could then prioritize the most important given based upon their financial situation, too. One thing to check is for any grab bars around the toilet and in the shower which might be installed. Also consider getting a hand-held shower head for your dad to use seated bench or shower chair. Are the toilets at a raised position which is easier to use? Your mom might even find this a safer alternative. Parkinsons is progressive so there seems to be a need for personal care support for your dad at times. However, likely there is a need for someone who might help out with laundry, general home tasks or even food shopping for your mom. Or if she is up to doing errands and food shopping being there so your mom could do these tasks and/or just get out herself.

This is the time for you to find out what your parents' coverage is in terms of long-term care insurance and or general finances so that you could again prioritize the care needed and perhaps look for options on how to find a caregiver. However, once someone needs to be lifted in falling, there is always the aspect of liability. Using an agency, they have the experience to help you figure out when coverage is most important etc. Also, both mom and dad should get a medic alert bracelet so that any fall could be handled right away. Also perhaps at least become familiar with assisted living options to know the cost and if they have a waiting list. If your parents could afford a tiered community, getting some information on them soon might be important if this was a realistic option if both experience health decline.

[Anonymous]

Op here-still in the ER but case management just saw us and I told her what is going on. She is getting me referrals for possibly hiring someone temporarily while she is in the hospital to help him, and to get help for her upon discharge and a home health assessment for him.

Oddly this hospitalization might be the catalyst to get a better situation at home for them!

[Anonymous]

OP - I would also look at what services in your area might help out your parents. Is there Meals on Wheels that might bring their main meal a couple of days a week? Is there a senior adult day program that has transportation that your dad might benefit from going out to a couple of days a week where he would be supervised and still give your mom a break? If you have siblings this is also a time to be in touch to be sure all understand what is going on so that it does not fall just on your shoulders. You also need to figure out what you can and can't do.

[Anonymous]

OP here, sitting at my parents table while Dad showers and I'll take us to the hospital to sit with Mom...some things we've done over the years is,
-grab rails in the bathrooms
-tub removed and low step in shower put in, has bench
-higher toilets
-ramps at exterior doors (we live in Fl so there is only one shallow step out, which is typical here thankfully)
-bed assist rail and padded mats on Dad's side of bed.

His pill box is filled until Sunday, I might have to bring it to the hospital for her to fill it then LOL I don't know what goes where. Soon as I get back there today I will hopefully have the agencies info to call to try to get someone to start ASAP while she's inpatient. I do have a brother, he unfortunately is out of the country on a much-delayed long business trip. When he gets back he's coming down (lives up north) but can't until then. We've been talking every few hours so he's looped in. My 18 yo dd has been amazing! she stayed all night last night and came over this am before I came back from the hosp to get my dad ready.

I already told my work I need FMLA monday at the least.

They are not interested in assisted living. They made clear to brother and I that they want to stay in this place. I'm divorced and willing to move in if that would be helpful, but we'll have this conversation later after this crisis.

[Anonymous]

OP here-on the good news front, Mom may be released later today, she's informed the entire ICU staff and the dietary dept that she wants to go home right now LOL. She's only in icu still because the hospital is so short staffed they decided to leave her there!

I did call the homecare places and no one could assist anytime soon. They are all short staffed and can't fill the hours they already have. My 18 yo dd is going to act as a home aide and my folks will pay her (Mom came up with that idea and actually it works well for us since dd wanted to pick up work before school starts). I will go over right after work. Mom at least will be home to watch Dad, if he did fall she can call 911.

Still going to have the homecare eval for Dad, as he needs care permanentely-even if we have to wait for available hours, it 's putting the ball in motion.

Hopefully Mom is back to normal by next month when I hope to take a much needed 3 day vacation it's MUCH needed now lol