I wrote about the many tools that have been helpful in caring for my father in October 2019, when his mobility was still possible but greatly challenged. A year later, things had changed. He fell and broke his hip in the fall, and he has not regained his ability to walk. Caring for him in this new chapter has brought some additional tools into my parents’ home, so it feels as if an update is in order. I am reminded by friends of the importance of sharing what we are learning about keeping our old people safe and well. May this be of benefit.
One of the challenges for eldercare in the United States is understanding Medicare and secondary insurance options and limitations. To bring Pop home from rehab before Thanksgiving, I had to acquire a hospital bed, a hoyer lift, and an adjustable bedside table (among other things). Medicare would cover a bed with electric adjustable head and foot, but you would have to manually crank the bed height (a burden when trying to protect the back of the caregiver). You can get a fully electric bed with a monthly fee. And if your loved one has a larger frame (6 ft. tall and 200 lbs), and a larger bed is needed, the monthly charge is significantly more.
Since my father is prone to bedsores and pressure wounds, I asked for a pneumatic air mattress for prevention. It turns out that Medicare will cover that… but only if your loved one already has multiple wounds that won’t heal. They care not to prevent them, apparently. Rather than leasing one from the hospital supply company, I found a mattress overlay that electronically moves air through pockets.
(Forgive the link, I have yet to learn the professional technique for such things.)
Medicare covers a hoyer lift for your loved ones who are unable to stand, walk, or transfer. That lift is completely manual… but they do not offer a fully electric option, even with a monthly fee. Since I am in my 50s and hope not to require eldercare before my parents are gone, it was absolutely necessary to have a fully electric version. This amazing tool allows me to get my father out of bed everyday and into his recliner, then back to bed at the end of the day. This gives him some level of normalcy, and I am grateful for this blessing. I found this lift through the same catalog that provided his recliner lift chair. It can be folded up for transport, but I doubt we’ll use that feature. I’m amazed by its maneuverability through tight spaces. We found the u-sling or the divided leg sling to work best for us. I was grateful to have gotten lessons from the staff at rehab…. but Dad and I also spent a morning watching videos on YouTube. It all takes practice, so be patient with yourself.
From the same catalog, I ordered a table for the hospital bed, so that we can do breakfast in bed when necessary. He may stay in bed longer on the days the bath-aid comes, and she is able to use it for her needs, as well.
We have a Costco membership, so that is where I get gloves and wipes, and doggy pee pads, which protect the mattress, and sometimes the tile floor where the aim-challenged dogs might tinkle now and then.
Since Pop can’t get to the bathroom any longer, I went searching for a urinal solution for someone with dexterity issues, that can serve for multiple uses overnight, when necessary. I found a cool device that I would have loved to have that time we slept on the steps of the Supreme Court when we were in our mid 20s. There were no open public restrooms in DC back then, and we had to go to the car to pee in a cup and then dump it out. (Yes, that actually is the craziest thing I’ve ever done.)
Other challenges are related to acquiring the care my father needs without being able to take him anywhere, since he can’t stand or transfer into the car. One exciting discovery was shared by his Physical Therapist. I was thrilled with the care he was receiving while Medicare covered home care for a few months after his homecoming, but longed for someone to care for his feet and toenails. They set up a Podiatrist to come to the house, which is when I learned Medicare covers these visits even when one is not receiving home care. Glory! Glory! We are in Central Florida, and had a great visit with Dr. Rivera from WoundMD. Pop’s feet have never looked so good. They can be reached at 407.720.4253.
UPDATED: Meeting with the Primary Care Physician and the Neurologist (for his epilepsy meds) can be done virtually, thank goodness, but the Dentist is a different story. When Pop complained about tooth pain and I started to panic about how to find a dentist that wouldn’t require transferring Pop out of a wheelchair (not to mention hiring transport to get him there), Mom hopped on line and found a mobile dentist. Imagine that! I think this is another Florida based business, but I’ve not had the time to research it. These magickal beings are from Tooth Fairy Mobile Dental Service. They provide comprehensive onsite dental care. You can find them at XXXXXXXXXXXXXXXX. The dentist and his hygenist came on Friday, and took x-rays and discussed a plan of care, which we’ll receive in writing Monday. I am removing my recommendation for this service, which has been a horrible disappointment. I now feel that they are designed to take advantage of elders who are in need of care.
The next big task was finding a new bath-aid, when Medicare stopped covering home health. This is something they do intermittently… ‘we see you need help, but if you aren’t making progress, we will stop providing that help’. I confirmed with his secondary insurance that they would cover a home health aid for bed baths, since he cannot stand to enter the walk-in tub, but when they referred me to the next step, I was denied further assistance. After several hours of telling my story to several people, I cried and gave up. I decided to let go of the need to have that assurance, just so I could get my poor guy a bath. I called several home health services, and found a few that had a 3 or 4 hour minimum of care for each visit. Since I am the full-time caregiver for my father, that felt wasteful of a fixed income for two retired social workers, so…. I kept looking until I found someone who offered a simple rate for bath assistance. A dear friend recommended the Visiting Nurses Association, and I learned they had a name change in our part of Florida. Now, Mediri Private Care, a partner of Orlando Health, we have found our lovely new bath aid for the foreseeable future. Again, in Central Florida, their number is 407.644.2433.
The biggest obstacle of the year, of course, has been how to protect my father from potential exposure to Covid-19, and how to get him vaccinated. Gratefully, my lifelong friend is on top of what is happening in community care, and she immediately alerted me to Florida’s program to vaccinate homebound residents. A week ago Saturday, we celebrated the delivery of the Johnson & Johnson (one and done) vaccine to Pop, at home. If you are in Florida and have someone who needs to be vaccinated for whom getting in line somewhere would be a challenge… here’s what to do: Send an Email to… HomeboundVaccine@em.myflorida.com to put in your request. They will reply with a link and a form to complete online. The 311 form allowed me to alert the Fire Department of my father’s inability to get out of the house on his own in an emergency, and in the comment section at the bottom of the form, I noted that we would like him to receive the vaccine at home as soon as possible. Our request was fulfilled within a week. They also are provided with one extra vaccine per household, in case someone else is in need. Since my mother and I had already been vaccinated, I was thrilled they were able to vaccinate an elderly neighbor of ours with the allotted extra dose.
For the last year, my greatest stress in caregiving has been that while handling all of the errands and grocery shopping for my parents, I would be responsible for killing my father by bringing home a virus I couldn’t see. I cried several times the day the CDC delivered his vaccine…. tears of joy and relief for him and for me.
When I list out my daily activities in eldercare for friends, that this is quite a lot is often affirmed. While I acknowledge that it certainly is quite a lot, I also understand that we are blessed to have access to the tools we need to make keeping Pop at home possible and somewhat simple.
Thank you in advance, dear Universe, for delivering all we need to keep our people safe and well with grace and ease, and may we be blessings to others, as our lives have been so blessed these many years.
Thank you for walking this path with me. Know that you are held gently in the light of love. Always. And… If there is anything you’ve learned about eldercare that is helpful, I’d love to hear about it!