Sunday, September 06, 2009

YoYo (Woo Woo): Old Ladies in Nursing Homes

The Florida nursing home commissars called in E.'s sister Esther, who is their mom's caregiver, to say that mom is "dying" and that they are "bringing in hospice." Now we have to figure out from a distance what that means. There is dying precipitously and there's dying gradually, and at 98.5 with assorted systems visibly degrading, obviously we know mom is "in process," as it were.

It's our understanding that going into hospice simply means death is anticipated within six months, so in one sense we have learned nothing new. I retract that. It confirms our conviction that mom will never return to equilibrium, that state in which we knew she had recurrent problems but there was a solution for each of them, a "reset," as it were.

The practical concern here is determining when E. goes back to Florida and how often. She was just there for a week. She is planning to go back in November when Esther goes to Texas for the birth of a grandchild, but if mom is *dying* dying -- the big Double D -- of course she'll go back earlier. But we don't know, and Esther is in a kind of denial about the whole thing, an attitude both brave and virtuous since she's caregiving like crazy, but not useful in terms of clarity and post-mortem planning.

Well, as one of my deans likes to say: There you go.

Meanwhile, my mom back there in Tennessee in *her* nursing home, my mom who is pretty much a sad vegetable, had a sudden burst of manic energy that stunned her caregivers. My sister caught the tail end of it. To the happy Baptist nursing home came some Gospel singers, and there my mother (91.5) was pumping her fist, going "woo woo" and saying "you are awesome."

Where this came from no one knows, only that very quickly it went away.

A friend wonders how we can afford all this. With my mom, it's velvet. We managed to enroll her in CalPers nursing home insurance eight years ago and paid out about $25,000 in monthly premiums -- my older sis and I split the costs while my younger sister sponged away all my mom's money. Isn't that a nice symmetry? A little more than two years we "stole" my mom from my younger sister -- long ugly story -- and put mom in the Happy Baptist and started collecting from CalPers. Mom was not eligible for Medicaid because of the way my younger sister had dissipated mom's nest egg. When it came to selfishness, my younger sis doubled down.

Ah well. Thank you, CalPers.

Meanwhile, we failed to get E.'s mom into the CalPers program, and now she is on Medicaid because our heroic efforts to keep her in her home dissipated her nest egg. (And we didn't skim a nickel. More fool us.)

Here's a hint: If your aging parent has a little too much monthly income to qualify for Medicaid even though having no savings, there's something called a qualified income trust that solves the problem. And if you get a reverse mortgage on Aged P's house, that money is not considered as regular income and thus is outside the rules of the qualified income trust.

Okay, writing about this is depressing. But, reduced to its essence, I'm saying that both of our moms are what passes for all right, at least in the kingdom of the ancient where death is the dawn and all is in shadow. Or, less smarmily, it ain't pretty, but it's not unbearable.
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