Second Guessing

I think I’m reasonably intelligent and not typically prone to second guessing myself. But all this stuff with my mom and dad has me wondering more often whether I’m making the right decisions.

Power of Attorney

First it was their POAs (Power of Attorney). I’d never heard of one written that required a doctor’s affidavit before it could go into effect. I’ve read the documents a hundred times and I couldn’t see it any other way. Yet I thought people were questioning why it was so difficult. You see, I don’t believe most POAs are written this strictly. My brother-in-law finally read it and agreed with me.

So why don’t I trust myself? Is it the stress of the situation? Is it because I can’t imagine why anyone would write a POA this way? Did my parents not trust us enough to write it allowing us to represent them regardless of their state of mind?

By the way, we’re in the process of having my dad’s rewritten and a document drawn up where my dad declines to be my mom’s POA. This will make so many things much easier.

The other more recent issue is their insurance. A little background first.

Another hospital stay

As I’ve written, my mom has been in several facilities since her February 1 fall. Many of our choices have been driven by her insurance. They have Part C Medicare with Aetna (used to be Coventry). Aetna has been a pain in the butt.

Anyway, my mom recently was back in the hospital. She’d been in an assisted living memory care facility and close to my dad. One Saturday night, they called and said she had a temp over 100, diarhhea, and wasn’t acting normally. So, they wanted to send her to the hospital. Fine. How many times have you called and it’s been nothing?

Once there and after running a few tests, they determined her cardiac enzymes were high, indicating a potential heart issue. Her heart has always been fine. Of course, they wanted to admit her and she ended up on the cardiac floor. Despite the “no visitors” restriction right now, they did allow my sister or me to be with her. She simply can’t make decisions about her care.

By Monday, we were hearing she couldn’t go back to memory care because she required more care than they could handle. We assumed that meant she was permanently out, but we learned later that they simply meant she needed to go to skilled care first. Ok, how many times have we tried that?

My sister and I agreed that skilled care was not the answer, but neither was memory care. So, we told them goodbye and started looking for another place for her to go.

Insurance conundrum

The place we wanted for her does not take Aetna insurance. We kept saying, we don’t want skilled care; we want long term care. Why does insurance matter because it’s private pay anyway? Evidently, everyone starts in skilled care, just so they can do an assessment. And that’s covered through insurance.

Everyone kept saying, just change her insurance. Here was the next time I was second guessing myself. What am I missing? You can’t just up and change your insurance whenever you want, can you? Isn’t that why they have enrollment periods?

I did a little research on my own and discovered something called SEP (special enrollment period). It indicated if she was in or going to a long term care institution, she could qualify and change her insurance. I thought we were on our way!!

I finally called Medicare to learn more. And of course, there’s a catch. You must already reside in the institution. I was told they will call to confirm, so you can’t fudge on this. So, we were in a Catch-22. We can’t change her insurance through the SEP until she’s living there and she can’t live there until her insurance is changed.

I was right again. We can’t just switch her insurance because we want to, unless it’s during the annual enrollment period. Why do people act like it’s the easiest thing in the world? Why do they make me start second guessing myself?

And I was feeling lots of pressure. We had a time crunch and I do not like making important decisions when I feel pressured.

Back to SunnyView

My mom is now back at SunnyView, for the third time. They take Aetna, but surprise, surprise, Aetna denied the skilled care claim. My sister and I were right again. Skilled care is not making a bit of difference for her.

We know they’ll take good care of her at SunnyView and she seems to thrive there. They love her and are always thrilled to see her come back. As my sister says, I guess she was meant to be there.

We’ve tried assisted living and assisted living memory care, all in our attempt to keep my mom and dad together. I could certainly be second guessing what we’ve done as it’s been very disruptive, with so many ups and downs. But it’s all been with the best of intentions. We now have to face the fact that my mom simply needs a higher level of care. So, let’s hope we can get her settled in.

Next steps

Our plans are to get the POA situation in order, meet with someone from SHIIP (Senior Health Insurance Information Program), and then pick another form of insurance for them during the fall enrollment period. Possibly even Original Medicare.

Did you know it can take Medicare 50 days once they’ve received a POA for it to be a part of your record? Yikes!!

We may also look at other facilities that have both assisted living and long term care, continuing to try to keep my parents together. We will likely have to get on a waiting list. But for now, they’re safe. Maybe not where they want to be, but doing OK.

I could also be second guessing what we did by putting my dad in assisted living. But again, it was not to isolate him but to allow him to be with my mom.

Do you second guess yourself a lot? This has been an unsettling experience for me. I usually feel pretty confident that I understand things and know what I’m doing.

I guess I need to get used to the fact that we’re dealing with a lot of complicated things but I also feel we’re sometimes dealing with people who don’t know as much as they think they do!!