Saturday, July 22, 2017

No Cardboard Box under a Bridge for me!



Don’t leap to conclusions on what I’m about to tell you but I had an appointment with a person whose business card says he’s “a specialist in home care and assisted living placements.” I met him in March on a bus tour of independent and assisted living facilities and I was impressed with him enough to want to take advantage of a free service where he can estimate how long your money and assets will last in places like. I’m nowhere near wanting or needing to move into a facility but I wanted to get some footwork done for someday maybe. And don’t we all worry about whether or not we’ll end up in a fleabag Medicaid dumping ground or worse yet, get loaded up in a shopping cart and set loose at the top of a hill. Bye bye, there’s cardboard condo community down there under the bridge that you can afford.
 
He said I have enough assets to qualify to get me into most continuing care places---the kind where you start out in independent living and as needed they move you up in care levels plus they won’t kick you out if your money runs out. Not that he’s recommending that for me (far from it) but he said---and this is the important part---qualifying for those kinds of places is an great indicator that a person has enough assets to private-pay at nice/r places, with lower monthly fees for the rest of your life. (Continuing care places cost more up front in exchange for that life care guarantee and no one gets anything back if you die long before using up all your own money.) Of course, no one knows how long any of us will live but it’s the same principle as buying extended warranties---the companies selling them are betting you won’t need to use them i.e. continuing care facilities have developed extensive mathematical formulas and they are gambling you’ll die before it starts costing them money. And they are factoring into their calculations a two year stretch at the highest cost level at the end. I didn’t tell him this but the dark side of me wonders if when your money runs low if that's when you have a "tragic accident” like my sister-in-law did, chocking on a pill because no one was around who was certified to do the Heimlich in a timely manner?

The guy was here for nearly two hours and by the time he left I felt so much better---no eating cat kibble to save money for me! If there’s anything he doesn’t know about the various facilities around town, it isn’t worth knowing. For example, he asked if a religious affiliation was important to me and I said, “Quite the opposite” and I told him I didn’t like one of the places we toured on the bus trip because it felt “too churchy.” He replied that it’s common in this town for places to boast that they do prayers, devotions and Bible readings daily with their meals. “Not a good fit of me!” I said emphatically. And he named some places in my target area that don’t let religion bleed all over their mission statements. We covered the dog-friendly places, the view out the unit window, the ideal location for family support, the food and activities, etc., etc. Three pages of questions and answers and it will all be on file for my nieces when/if they need it. He’d take me and/or them on a tour of his top three recommendations when the time comes, or even next week if I wanted. I’m not ready for that. I hope I’m never ready but we all know our health can change in a heartbeat so when ‘hope’ fails it helps to have a plan. 

Change of topic to something else I’ve never done before: I had my first e-visit with my doctor’s office. I got diagnosed online for ‘acute cystitis’ otherwise known as a UTI to the ladies out there. I filled out the questionnaire at 9:00 Monday and by 11:00 I had the promise of an antibiotic called in to the pharmacy and orders left for a urine test. By Wednesday morning the lab order still had not shown up on my patient portal and I thought, well, maybe e-visits don’t do it the same way as office calls, so I went to the lab. No order was on file and I had to wait for them to call the doctor’s office. Finally, I got to pee in a specimen bottle.

I made three trips to the same medical building that day. One of those trips was for a mammogram and we all know how much fun that can be. I was getting pulled, stretched and pressed at the exact same time a lab technician two rooms down was leaving a message on my home phone that I’d failed at giving an adequate urine sample and I needed to come back and do another. Great! I’ve been peeing a million times a day and the one time it counted, I did a wham-bam-thank-you-ma’am quickie that only satisfied one of us. The bummer part is the e-visit doctor told me not to start the antibiotics until after I’d taken the urine test so I had to spend over 48 hours lusting after the promised relief sitting in a medicine bottle on the kitchen counter-top. ©

45 comments:

  1. Excellent homework done re possible future care - and all free consultation! I'm surprised at his thoroughness. The few times I've availed of free advice, it's been perfunctory (to draw your in further - no thanks! I don't like that dishonest approach). Or, offering a service that with in-built (not advertised, or touched upon by consultant) charges, would cost me a little more money. In the latter instance, they were very friendly, 'please do have a coffee'! etc. I got a bit suspicious about the overly-glossy brochures, and although they pushed me (after the gratis coffee) to just sign here, I'm thankful I said 'I'd think over it'. From talking to others, later found out that they were to-be-avoided. It was a lucky escape. Although it seems bothersome, it pays to talk to others (though I hate talking financials with colleagues).

    Sympathise with the medical condition, and tantalising to have the miracle-bottle so close, yet so far! ~ Libby

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    1. I didn't sign anything and knew going into it that I wouldn't be asked to do that and he knew I was just looking for information for the future.People doing the same job he does do a lot of advertising on TV and I wouldn't trust them, but he works through the hospitals as a private contractor and has had this same kind of appointment with many people down at the senior hall.

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  2. Azo Standard is a good temporary fix and it's over the counter. It's a numbing agent .
    What causes this in older women? Not enough water?

    I dread the thought of having to leave my home. I wonder the cost comparisons of having in home health care to assisted living, even if you needed it daily for most of the time. Did you discuss that any? And I'm alone too ( a widow and no children).

    And a nursing home is even worse! That's why I favor not only assisted suicide for terminal illness (which should include Alzheimers, but even if you feel you've had a good life and are just ready to go as you can see your health getting worse. I would "rest" easier knowing I had that option.

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    1. I drink a LOT Of water and I don't think UTI are only common in older women, younger women just don't talk about them as much. Lots of causes, sex being one of them. LOL I've never tried AZO but I did look at it.

      He ran through the numbers of home health care compared to assisted living and it wasn't cost effective if you need a lot of hours in day. (Do the math at $15 an hour times 24 hours times 30 days times 365 days.) And I know from my sister-in-law's experiences in that area that the turn over of help those services is god-awful so you're constantly having strangers in your house. If you just need a few services like help with showers, it can work for a while.

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    2. Ha! Sex is no longer an issue being a 70 yr. old widow with no desire to have another man in my life and thankfully, the old urges aren't as strong as when I was young😜

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  3. Good information for you. That must ease your mind. It's so unpleasant to think about "that" time of life. Kudos to you for taking care of business.

    Forty-eight hours is a long time to be uncomfortable. I don't even want to write it here because you know... it will happen... but I've only had one UTI in my life. Knock on wood.

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    1. It does easy my mind and also helps me know I'm doing the right thing to stay here instead buying a condo at this point in my life.

      I had the UTI a week before I decided it wasn't going to go away on it's own so it was longer than the 48 hours of watching that bottle. LONG week.

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  4. Don't envy you the long wait you endured. Hope you are all better now.
    Good idea to check into assisted living. I have visited several family and friends in one and feel I could adjust quite nicely in one. But I am an easy mold. Read Effie Leland Wilder's book Out to Pasture. She published the book at 85 from an assisted living home and wrote 4 more till she passed at 97. She made it sound almost fun.

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    1. I am better now. Thanks for asking. Only one more pill to go and the antibiotic will have done it's job. And I felt better after the very first of six pills.

      I've got to get that book! She sounds like the role model for the way I'd want to spend my time in assisted living.

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  5. It's a good thing to check out all of your options and to do your homework now, you are very smart by looking into the facilities that you may one day use, it's better to know what is available than to be thrown into a situation you know nothing about.

    As for the other stuff I'll just say, "you ladies carry on and you are all doing well" because this is out of my wheelhouse so to say ha ha.

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    1. I saw a cartoon on someone's blog recently where they where they were doing a prostrate exam in a mammogram machine so you guys would understand what it feels like. LOL Just be glad it's out of your wheelhouse. LOL

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    2. Oh Lordy I can just imagine...wait I really don't want to imagine a prostate exam in a mammogram machine LOL.

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  6. Great post. Funny, informative, real life stuff. "religion bleed all over their mission statement"....great writing! It sounds like you got some great info from that consultant and nothing better than to be reassured that worst case fears can be set aside.

    I haven't had an e-visit yet, but I do use the online resource my clinic offers for getting lab results, sending messages to my doc, making and cancelling appointments, etc. I like it. I went to a talk on how older people can stay longer in their own homes and a lot of it centered on the ability to use online resources -- order groceries, food, Uber rides, handyman repairs, etc....including doc visits. I just hope I can continue to navigate the internet for all these things. So far, so good! But I do get overwhelmed by the whole hacking/privacy thing and as hard as a try to be safe, there seems to be no truly 100% non-hackable wall. Thanks, Russia. LOL

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    1. We finally got grocery deliveries in my town. Haven't used it yet but I would if needed. And it's on my to-do list to get a ride in an Uber car just to try it out. I suggested to the senior hall director to put a class on about how to do grocery orders online and set up an Uber account. I hope she does it this winter!

      I have noticed a great deal of interest in my blog from the "Russian Federation" when I mention Trump or Russia in a post. Kind of creepy because I seriously doubt some senior citizen over there is interested in my life. (If I am wrong, please introduce yourself in a comment?) They really to monitor our internet!

      I'd use the e-visit again. But there are only about 10-12 conditions they will treat that way and they say they have the right to refuse and ask you to come in.

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    2. Yikes! We are being monitored?!? As you know, I've written a lot about my dislike of the current president.

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    3. Go to your stats and then click on audience you'll see the countries that come to visit. Be sure to select a time frame at the top first. When ever I mention Trump and Russia I get a big inflect.

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    4. No Russia for me. I think you have a bigger blog presence. Mine is so teeny tiny. Pakistan seems to like me though. LOL

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    5. I get Pakistan, too, and lots of Canadians, people from Great Britain and Australia. You probably don't blog often enough for the word crawlers to pick you up.

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  7. Boy this was informative. I bought long term care insurance at age 47 because I feared having to live in a horrible place as my grandmother did. It was $6,000 a month and it was sub standard to me and honestly anyone. I hope this long term care along with finding someone as you did will be helpful for me in the near future.
    As for the AZO someone mentioned - remember my post about this - your urine will turn orange, do not be alarmed. It does not share that tid bit of info on the box anywhere. I hope as I type this you are feeling some relief Jean

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    1. In my state and probably in most, these placement people get paid by the facilities and by law each place pays the same 'finder's fee' so there is no bias in their recommendations. With your long term insurance I'll bet you'd do okay. But it was worth the peace of mind for me to talk to the guy.

      The UTI is much better---all symptoms are gone---but the prescription sure seems to have effected all my joints. They are stiff and hurt and I didn't want to mix drugs so I haven't taken anything for it. That changes tonight!

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    2. AzoGantrisin used to be a sulfa drug for urinary-tract infections and it contained a mild pain killer to be used for the first couple of days after the infection was discovered. Then you would take the additional sulfa pills without any painkiller for the following ten to twelve days to kill the organisms that caused the infection. I liked the regimen; it was painless and killed the bacteria. Unfortunately many people did not complete the entire regimen and so the bacteria became immune to the medication. What is being sold now I believe is just the pain killer to carry you over until you can get medical help. The old sulfa pills were huge and difficult for some to swallow, thus becoming known as "horse pills.'" This is from my college class in Pharmacology.

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    3. Glad I didn't have to take 'horse sized pills." I was given six antibiotics, two a day for three days and all the symptoms are gone. With any infection, you can't stop the treatment early or, like you said, it starts all over again.

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  8. When I'm living in my cardboard box under the bridge, can I come and visit?

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    1. Can you believe we even talked about how some seniors give up their homes to go live on a cruise ship because it's cheater than assisted living. Not sure if that's a joke that's been going around or it's actually true. But I thought that would be ideal for you.

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    2. It is true! I have a friend who knows someone who's doing it! The problem is, you need to have money to do that, too. I still haven't figured out that whole money thing.

      However: I do have this for you. I can't find the post, and I'm not even sure if it was here or on another blog, but there was a discussion of vacuums and roombas and such. When I read this, I just laughed.

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    3. Roombas that can map your house and sell the data? That's funny. No wonder some people are getting so paranoid! If they didn't cost so much and I didn't have a dog I'd get one. I read reviews from pet owns some of the things that happen with that pairing is laugh-out-loud funny.

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  9. My research indicated only about 20 percent of people need and use long term care insurance and since it was unaffordable for me, I chose not to worry about it. Ironically, one of the few things I don't worry about.

    Glad the UTI is under control. I've had a few and they're not in any way tolerable.

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    1. By the time most people decide they should have it, it's unaffordable. What surprised me was he said it still shocks him how many people in my age bracket are still living with a lot of debt---not me---and haven't saved anything for a nest egg.

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    2. I read that too. They must be living in la-la land. I paid off everything as soon as I could after I was 50. I can't stand being in debt!

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    3. People think Medicaid and their Social Security will be enough but they don't fact in how nasty those places can be or they just don't care because they don't think they will ever need to go.

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  10. Oh, Jean, I hope you are feeling lots and lots better by now!

    I've used Doctor On Demand a few times to great success. I was without a primary care physician for a few reasons, and found myself with a nasty sinus infection at one point. I was treated with great compassion and professionalism, then prescribed medicines which were sent immediately to my neighborhood pharmacy. I still have the app on my phone, just in case, even though I now have a PCP.

    Lots of hospitals now offer the same service--for example, Cleveland Clinic--so it's a very successful model. And affordable, too.

    Keep drinking water! I carry it with me wherever I go.

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    1. I think the UTI is gone after three days of meds. Even though there was a hitch with the lab not getting the order I would do it again. It's new to them and to me. Never heard of Doctor on Demand, that sound's interesting! It's probably the wave of the future so we might as well not fight it.

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  11. I would love to be able to e-mail my docs office, instead of going in. As for those "nice" elder homes? I've been out checking the dumpster behind Lowe's to see how large their boxes the fridge's are shipped in. I think if it were sided in Contact paper, it might be rain-proof.

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    1. I got a chair delivered last year and the box it came in was so heavy and it was covered it plastic. I saved it to use as a paint booth for my outdoor furniture but it would be big enough to sleep in. LOL It sure wouldn't blow away.

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  12. Jean, Sorry to hear about your UTI -- no fun! It sounds as though you had a very helpful and productive visit with the assisted living specialist. I find that the more places I learn about or visit, the more it helps me to pin down my own needs and preferences. The tricky thing about the timing for all this is that for many facilities, especially the continuing care places, by the time you feel like you need them, you no longer meet their physical (as opposed to fiscal) requirements to get in. -Jean

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    1. That really is the tricky part, isn't it...timing. I've pretty much ruled out the continuing care places. I just don't trust them not to take advantage of seniors with no kids to help oversee them. One place even has a financial adviser with an office right in the building! See, ripe for a scam. Giving up privacy is a biggie, too, but those places that track you with monitors seem more private than the ones who send actual people to come check you out. I want five more years at home, I think.

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  13. Glad you were able to obtain the info you wanted re retirement facilities. Having provided rehab services in many in a large geographic swath here I have a good idea of the ones I would find desirable, but they can change over time as management, ins. and staff changes. I've attended some special events they hold to introduce people to their community -- often they address downsizing, offer refreshments or meals, entertainment. Can easily obtain assessment from them about financial specifics for their facility, care levels, etc. with no obligation.. They encourage attending many times if desired and recall meeting one resident who said she attended their events for 5 years before actually moving in. Important to mix with residents when possible.

    We each have to determine what sort of setting works best for us. The more desirable facilities here are those that offer all levels of care. A sizeable non refundable deposit can discourage some people from settling on one of the best which is affiliated with a Protestant religion. I can tell you that I've worked in that one extensively and several others with other religious affiliations. Religion was not foisted on residents. Some services were offered but there was no pressure for attendance. These communities also were superior in care compared to others. Retirement communities with all levels of care that don't require a nonrefundable deposit are desirable for some folks who want the option to be able to financially afford to be able to move -- so each of us has to decide what works best for us. Some religions are not as intrusive, pushy or oppressive and dictatorial as others -- more ecumenical and tolerant.

    Some better quality retirement communities don't accept patients on Medicaid in combination with Medicare (Medi-Medi) so a person needs private supplemental ins with Medicare. Finding quality communities accepting Medi-Medi can be challenging. Current health care plans being considered in D.C. if passed will seriously negatively impact Medicaid so quality of care would likely be adversely affected in the years ahead as people counting on that supplement are going to learn the hard way. It won't happen right away but all proposed plans so far have these cuts kicking in over time -- will be a too late rude awakening to many decent hard working people who don't seem to understand how their lives will be affected.

    Can make a difference if have regular visitors -- family, friends, paying attention to care a resident receiving, but not all have that. Also, older we get, more disabled, can be less desirable if have to move from Asst living to a different facility for skilled care. Need to know at what level of function they'll insist you must move to different level of care.

    UTIs real pain, especially as we're told to minimize antibiotic intake to curtail evolution of resistant forms of those bacteria. Glad yours better.

    We'll see how my plan to remain living in place in my house,works out. Have established I will have access to support for my needs. Problematic might be if extensive personal care needed or 24/7.

    Gave my kids Roombas years ago as got a deal. They liked them. One had a cat, thevother a small dog, and neither animal paid much attention to them after initial sniffing curiosity.





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    1. Places like that changing over time was the reason why I turned down the tour of the guys top three recommendation as five years from now they might be different. And you are right about any governments cut backs in Medicare or Medicaid coverage is going to impact these kinds of places.

      I read some reviews from pet owns that Roombas spread 'accident' all over the place and since Levi seems to have a sensitive stomach, I decided against getting one, but I love the idea of them.

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    2. An important thing to realize is that just because a person might finally decide they're ready to enter a facility doesn't mean they'll be accepted. They examine medical records/status really closely and consider what prognosis likely to be for various existing medical diagnoses. Recall being told a couple years ago by admissions people at one of those group meetings I attended, then spoke privately with someone afterward just for information, ""Don't wait until it's too late.". Yeah, you'd need to first survey the areas before starting Roobas, but accidents hasn't been a problem for my kids pets. They just did one room with each startup.

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    3. He said that same thing about them examining your medical records and maybe turning you down.

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  14. Meant to add, I'm continuing to get monthly bursts of Russian page visits -- think may be bots and may be transitioning some to U.S. sites. My question is why, what for? Gathering data for scams, hackers, I.D. theft, political or some other I can think of. Know of another blogger who's been receiving similar -- she blogs in Oregon.

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    1. I agree the Russian visits are probably bots and crawlers. I cringe when I see some bloggers give away so much personal information---not just their own but on their kids and grandkids---birthdays, anniversaries birth towns, etc.

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    2. And yet, we have been warned time and time again about the possibility...

      we don't want to believe that someone is always out to get us. It goes against our sense of security in this nation. When in fact we have no such basis for that belief. Just because I have done nothing to harm them doesn't mean that they will not try to harm me. I think we're all very naïve in that manner.

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    3. People looking for someone to scam don't care if their mark is a nice, deceit person.

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