Caretaking 102 - The Aftermath

MANY years ago, when I had the high school's "behind the wheel" driver ed, the instructor spent lots more time on pulling into parking spots, rather than the  dreaded parallel parking that would be on the exam.  Made sense to get good at what one would do more often. 

My best friend was the one to take me out for practice drives - he made sure to take me to an empty parking lot after a big rain to practice getting out of skids.  Turns out I needed that skill the day after graduation, when I said goodbye to him and his family moving away and then driving off to my summer job very early.  Major skid on some S curves, but I pulled out just as my reflexes had been trained to do.

Thank you all for the encouragement.  I have been promised (threatened???) that I will be repeating that trip again next lesson.  

Congrats on your latest achievement, such great progress!

Son was very somber yesterday during dinner.  He claimed he was very tired, which may have been the case.  He didn't bring up the subject of his father, so neither did I. 

Holidays are difficult ...   

Trigger of the day:  Being told at the bank this morning that I needed to open an estate account in order to deposit a check of $14.96 made out to Bernie's estate. Hunting for and finding the death certificate, short certificate, letter of testamentary, and EIN; all of which I provided the bank with back in January. (I was told they only keep the documents at the branch for three months and have no way of verifying that the documents were provided to them previously!) Making an appointment to open the account; going back this afternoon with all the documentation and being told I didn't need to open the account at all because the amount was so small. What was most upsetting was believing everything was in place and having to go through it all over again. I still don't know if/when such an account will prove necessary.

joan_crystal said:

Trigger of the day:  Being told at the bank this morning that I needed to open an estate account in order to deposit a check of $14.96 made out to Bernie's estate. Hunting for and finding the death certificate, short certificate, letter of testamentary, and EIN; all of which I provided the bank with back in January. (I was told they only keep the documents at the branch for three months and have no way of verifying that the documents were provided previously!) Making an appointment to open the account, going back this afternoon with all the documentation and being told I didn't need to open the account at all because the amount was so small. What was mot upsetting was believing everything was in place and having to go through it all over again. I still don't know if/when such an account will prove necessary.

As executor, I'm pretty sure that you should have been able to endorse the check over to your personal account (or any other account for that matter.)  That might have required proof that you were, in fact, the executor, but not any need to open a new account.

Not according to the bank manager.  She did make an exception in my case and deposited the check in my account.  She was not there this morning when the bank policy was invoked.

joan_crystal said:

Not according to the bank manager.  She did make an exception in my case and deposited the check in my account.  She was not there this morning when the bank policy was invoked.

That's ridiculous!  

Agreed!

It is horrible when red tape blindsides you.   

You might want to open that estate account anyway, when you are feeling calm and prepared, so this can't happen again. When Mom died and my brother was executor, he needed the estate account to unravel everything my parents had in place. And it could be good to have it in place, just in case. 

The bank manager was dead set against doing it for a check of less that $15 when I didn't know what other checks, if any, might be written to the estate.  I was told that I would incur fees unless I had a minimum daily balance of $1,500 in the estate account.  Bank has all the information and approvals needed should an estate account prove necessary/desirable at any point in the future. The bank has promised to let me deposit small checks to my account going forward.

if I ever get some perspective on the past five weeks of frustration in regard to Heath care, I could recite how the beaureacratic quagmire in so many areas threatens our sanity!

joan_crystal said:

The bank manager was dead set against doing it for a check of less that $15 when I didn't know what other checks, if any, might be written to the estate.  I was told that I would incur fees unless I had a minimum daily balance of $1,500 in the estate account.  Bank has all the information and approvals needed should an estate account prove necessary/desirable at any point in the future. The bank has promised to let me deposit small checks to my account going forward.

Well, that makes sense. But what an ordeal they put you through for nothing...   

Drove for 90 minutes today with a brief stop in the middle of the trip.  Much was 35 and 40 mph narrow, winding road with no shoulder.  Fewer bikes and joggers mid road than last week.  Only car that passed me over the double yellow line was a Maplewood police car that had been tailgating me so closely on Valley Street that it looked like a black SUV behind me.  No siren or flashing lights to indicate otherwise.  Sometime next week, I get to repeat the trip.  Once I maintain a steady 35 mph on the 35 to 40 mph roadways, we get to up the level of difficulty.

Well done!  

Hooray for driving progress. I seem to have lost some ability to take on highways, 280, GSP, etc. and would like to regain. You seem to be doing so well with driving Joan.  New Jersey is not the easiest place to learn!

Trigger coming up: on a date soon in July, what would have been my husband's 88th birthday and the 6-month anniversary of his death fall on the same day. 

On good side, a visit from a cousin who is like a brother and his wife, almost a whole week, wonderful and balm to the spirit.

Best wishes to all of you!

Tomorrow will mark the six month anniversary of Bernie's death and I hadn't even noticed that approaching landmark until I read your post.  I haven't been focused on the calendar so much as on objects and events that are saturated with his memory. Even then, days which have had special meaning in the past have become easier to live through now that he was gone. Veterans Day, was extremely difficult knowing that he was lying in a hospital bed wanting to be at the ceremony yet unable to move.  Memorial Day was far easier, even though it involved a ceremony that he had helped plan and share for so many years and included the reading of his name as one of the now-fallen being remembered. 

joan_crystal said:

Tomorrow will mark the six month anniversary of Bernie's death and I hadn't even noticed that approaching landmark until I read your post.  I haven't been focused on the calendar so much as on objects and events that are saturated with his memory. Even then, days which have had special meaning in the past have become easier to live through now that he was gone. Veterans Day, was extremely difficult knowing that he was lying in a hospital bed wanting to be at the ceremony yet unable to move.  Memorial Day was far easier, even though it involved a ceremony that he had helped plan and share for so many years and included the reading of his name as one of the now-fallen being remembered. 

I think because the six months is on the exact day of his birthday, a day we always celebrated, even though celebrations in last year were really not the word for our lives.

 We had certain rituals and they are associated with certain times.

I am relieved that his final decline was not too prolonged and that I have friends coming the weekend after who often celebrated his birthday with us. And we will have a small memorial party. When I see photos of the last years, I can see what was happening with his health with clearerveyes.

For those going through illness and caregiving, I can only say get what you need before it is emergency--whether help, equipment, added doctors or therapists--better to be over prepared than always scrambling and overwhelmed. 

We do the best we can...

I find energy for daily life returning.

We Live on with fortitude, for ourselves and also for them.

Pre-planning is a wonderful goal eagerly to be sought. Denial and lack of sufficient foresight are the major obstacles to overcome.  Scrambling still seems to become the reality no matter how detailed the preparations. Too little time.  Too much stress.  Too little strength beyond facing immediate crises.  24 hours to select a rehab.  24 hours to hold a burial.  It is not just the illness we have to prepare ourselves for but the aftermath as well.  The preparation needs to be done before the illness takes hold.

I'm not sure you can ever be prepared enough. I mean, you can lay plans for logistics and finances and all the mechanisms involved, but the emotional upheaval and scrambling to meet deadlines will still happen. At least, that is what I found. And denial was so strong that I managed not to quite believe either of my parents were dying despite all the evidence to the contrary. It is a grueling process, losing someone.   

Right now we are in the middle of the medical tsunami following a rush to the ER with a life threatening condition. 

One harsh lesson learned too late: hospitals are under pressure to discharge patients to reduce Medicare costs.

 If you are discharged after 2 nights in the hospital, Medicare will not pay for rehab. Three nights, and the patient can go into rehab! However, the fact that one of the many papers signed by the patient's family includes a patient bill of rights which gives the patient the right to refuse discharge! No one felt obliged to tell me about our rights!

So, my husband was discharged unable to walk, on a catheter, back to a home without any necessary equipment! With me as sole caretaker!

I needed a day or two to consider rehabs to send him to, but I was given no time!

Seven weeks later, every day is a challenge!

joan_crystal said:

Trigger of the day:  Being told at the bank this morning that I needed to open an estate account in order to deposit a check of $14.96 made out to Bernie's estate. Hunting for and finding the death certificate, short certificate, letter of testamentary, and EIN; all of which I provided the bank with back in January. (I was told they only keep the documents at the branch for three months and have no way of verifying that the documents were provided to them previously!) Making an appointment to open the account; going back this afternoon with all the documentation and being told I didn't need to open the account at all because the amount was so small. What was most upsetting was believing everything was in place and having to go through it all over again. I still don't know if/when such an account will prove necessary.

My Uncle passed away in Pennsylvania.   He left me his car.  I wanted to sell it to my sister who lives in 

Vermont.  In Pennsylvania they have what they call Tag Offices which do much of the paper work and they also have DMV offices for the drivers test and other paper work  I was told I would need the Title to the car,  short form of the death certificate and photo ID.  I was hurrying to get to the auction of the

house about 30 minutes away

The Tag office would not accept my Passport as photo I D. I can and have gone to Albania and had that recognized.  They sent me to the nearest DMV office , a few minutes away.  Told me that I could have

a Pennsylvania photo I D taken there

After 40 minutes in line I was told that they could not give me a Pennsylvania photo ID since I was not a resident.  The nice lady there told me to simply give my sister all the paperwork and let her take the 

car to Vermont and register it there.  The Tag office would have required $70 from her to give her a more or less pass to drive the car out of State

She drove it to Vermont the next day and registered it subsequently without trouble

I'm so sorry. Medical care has become such a machine, and an unkind one at that.

author said:

joan_crystal said:

Trigger of the day:  Being told at the bank this morning that I needed to open an estate account in order to deposit a check of $14.96 made out to Bernie's estate. Hunting for and finding the death certificate, short certificate, letter of testamentary, and EIN; all of which I provided the bank with back in January. (I was told they only keep the documents at the branch for three months and have no way of verifying that the documents were provided to them previously!) Making an appointment to open the account; going back this afternoon with all the documentation and being told I didn't need to open the account at all because the amount was so small. What was most upsetting was believing everything was in place and having to go through it all over again. I still don't know if/when such an account will prove necessary.

My Uncle passed away in Pennsylvania.   He left me his car.  I wanted to sell it to my sister who lives in 

Vermont.  In Pennsylvania they have what they call Tag Offices which do much of the paper work and they also have DMV offices for the drivers test and other paper work  I was told I would need the Title to the car,  short form of the death certificate and photo ID.  I was hurrying to get to the auction of the


house about 30 minutes away

The Tag office would not accept my Passport as photo I D. I can and have gone to Albania and had that recognized.  They sent me to the nearest DMV office , a few minutes away.  Told me that I could have

a Pennsylvania photo I D taken there

After 40 minutes in line I was told that they could not give me a Pennsylvania photo ID since I was not a resident.  The nice lady there told me to simply give my sister all the paperwork and let her take the 

car to Vermont and register it there.  The Tag office would have required $70 from her to give her a more or less pass to drive the car out of State

She drove it to Vermont the next day and registered it subsequently without trouble

There is something about the necessity of having to re-do things, thinking you can do them easily. Today I talked to pension fund and need to get a Medallion signature for a small account. My bank of forty years gave me the run around and the bank where I opened an account Six months ago is being helpful, but it does take one back to have to go into the same papers again.

And DMV--how can a passport not be proper ID?

But the real terror lies in the early discharge from hospital, the isolation, scrambling of emergency. You have, MT, all the lifeline that good thoughts can provide.

It is now about to rain, fortifying the grass,  and we can hope, our hearts.

mtierney said:

Right now we are in the middle of the medical tsunami following a rush to the ER with a life threatening condition. 

One harsh lesson learned too late: hospitals are under pressure to discharge patients to reduce Medicare costs.

 If you are discharged after 2 nights in the hospital, Medicare will not pay for rehab. Three nights, and the patient can go into rehab! However, the fact that one of the many papers signed by the patient's family includes a patient bill of rights which gives the patient the right to refuse discharge! No one felt obliged to tell me about our rights!

So, my husband was discharged unable to walk, on a catheter, back to a home without any necessary equipment! With me as sole caretaker!

I needed a day or two to consider rehabs to send him to, but I was given no time!

Seven weeks later, every day is a challenge!

All the more reason to read the fine print!  I wonder how many patients or caregivers do this when faced with a life or death situation in which they have turned to the hospital for help.  It might be helpful for hospitals to include this information verbally upon admission but even then, I wonder how many persons in your situation would actually be able to focus on what was being said at that point.

Is your husband receiving any kind of home care? Visiting nurse?  Physical therapist? Case manager? If so, they can help arrange for needed equipment. If not, his doctor may be able to prescribe something.  We were able to get use of a hospital bed and a wheel chair through Bernie's insurance (Medicare).  We also got some needed medical supplies.  If lack of equipment is a continuing problem, it is worth a follow-up to see if you can get it now.  Typically, medicare rents the equipment for you and you return it when it is no longer needed.

Does his present condition merit a readmission?  I was forced to do this twice when Bernie was discharged from the hospital because his condition had deteriorated to the point where I could no longer care for him at home, even with assistance.  If this can be supported, if the hospital will agree to readmit him, you may be able to get your three consecutive days.

thanks for all suggestions-- gratefully received!

Another lesson on the new health care reality:

When a patient enters ER care , their status is "observation" or "obs". If the patient is "admitted" to a bed within the hospital, make sure to ask the status so you know it is changed to admitted. If that box still reads observation, Medicare will not pay for transfer to rehab!

I spoke with numerous hospital personnel over this ridiculous glitch and was  always told that health insurance coverage confusion is the issue.

We may find out that Medicare won't be picking up the costs for the many,many tests etc received while in the hospital  

The reference to 3 days in hospital to be eligible for 20 days of Medicare sponsored rehab comes with a few caveats.Its more like 72 legitimate hours in hospital supported by chart notes. A kindly doctor or hospitalist can't keep you another day just so you hit that number. Regarding rehab, there are markers that need to be met showing progress, to continue your stay at rehab. Once someone plateaus, or stops making progress,your time is up, although you can use the balance of days if you are readmitted to hospital within 90 days I think. The rules don't take into consideration any personal situations such as the burden placed on spouse or inappropriateness of home, but there are social workers or care managers that are suppose to set up aftercare plans and help with transition to home and equipment needed. We of a certain age need to educate ourselves to the realities of medical care in 2016.

mtierney said:

thanks for all suggestions-- gratefully received!

Another lesson on the new health care reality:

When a patient enters ER care , their status is "observation" or "obs". If the patient is "admitted" to a bed within the hospital, make sure to ask the status so you know it is changed to admitted. If that box still reads observation, Medicare will not pay for transfer to rehab!

I spoke with numerous hospital personnel over this ridiculous glitch and was  always told that health insurance coverage confusion is the issue.

We may find out that Medicare won't be picking up the costs for the many,many tests etc received while in the hospital "> 

Do you have secondary insurance that might pick up some of this?  If so, I would suggest contacting them ASAP so you will know what to expect.