Hey there!  Congrats in advance on the new grandbaby!  How exciting for your family! 

In my experience, some insurances cover respite care and others don't.  You'll need to call your mom's to see if they have this type of benefit. 

I know that probably wasn't the advice you were looking for, but I'm hopeful for you that it'll all work out.

Thanks , Missy. She has Medicare and another  that I will call. I am so worn out sometimes it seems like it's only God and me...Sheryl

Dear Momwacko,

My name is Aaron Mulvey.  I am a Nursing Home Administrator and have a great deal of experience with respite care, especially for short-term trips like the one you are currently longing for (Congratulations by the way on grandchild #2).

OK.  You need to do a few things pretty quickly.  March is sneaking up on us!

#1 Decide if you were happy / satisfied with the nursing home care you received during your mother's previous stay.  If you were then you can start there.  If not, then we have more work to do looking at other facilities.

#2 Evaluate what type of physical and medical shape your mother is in?  Does she confuse her medications?  Does she forget to take her medications?  Is she diabetic?  Has she been weak (note this key word - GENERALIZED WEAKNESS)?  Has she experienced any falls?  When was the last infection she suffered?  Does she have difficulty standing from a chair or rising from the bedside?  Are her mobility habits poor when doing activities of daily living (bathing, changing clothes, cooking, cleaning, etc...).  Answer all of these questions and add any of your own concerns to the list.

#3 Know your options:

• If you will remember back to the previous stay in your nursing home, the doctor was required to give a "physicians order" to be admitted, and  I'm sure that there was an admission agreement that you had to sign.  These steps are common and most individuals like yourself are familliar with them.  The part of the process that the public is not widely educated on is what steps are taken prior to the physician writing the order for admission.  Here is where you must pay attention.  As you have stated in your earlier post, your mother is enrolled in Medicare.  This is good.  This is also where your list of physical and medical issues comes into play.  Make sure that you have this list completed and it is comprehensive.  Make an appointment with your mothers primary care physician.  Attend the appointment with your mother.  Inform the physician of your situation.  Explain your need for respite care and why.  Doctors understand caregiver stress and the need for respite care, so you should be well received.  If your mother is skitish about your intentions it may be necessary to speak with the physician privately.  Again, doctors are experienced with these situations and you need to know that this type action is normal.  You should use your "tools" and "key words" while speaking to the physician so that you can exhaust your best options first.  Explain your concerns.  For example you might elaborate on a situation that involves two or more risk factors that have led to a recent incident.  EX: Mom took the wrong medicine at the wrong time and since she is getting weaker and has trouble standing from the bed she fell and sustained a laceration, etc.  In these type situations it is possible for the physician to suggest a brief acute stay at the hospital for evaluation of her issues, families often request these hospital evaluations be done.  Now here is the key.  Medicare is an entitlement program.  We spend our lives working and paying taxes into the program so that when we retire and reach elligible age, we are allowed to partake in it's benefits.  A medicare paid nursing home stay would be possible if your mother stays in the hospital for 3 midnights.  Three midnights is the key!  Once the three midnight requirement is met, your mother would be elligible for a skilled nursing home admission.  At which point the physicians recomendations would be followed.  Whether it be for Physical Therapy, Occupational Therapy, or for Speech Therapy, assistance with ADL's (Activities of Daily Living), or for monitoring medication administration.  Any way you look at this option both you and your mother have a great chance at benefiting.  You get some respite and your mother gets stronger and more able to care for herself in the future.  I see this option used freequently, and remember that the physician is your partner.  Respite for care givers is highly recomended on a regular basis.  Caregiver burnout can even turn dangerous for some at times.  Respite is good.
• Now lets say that your mom is in great physical and medical condition, and I hope she is.  This would be a good time to explore your state's medicaid program.  You will need to have a well rounded knowledge of your mother's financial situation for this.  Each state governs it's own medicaid program, and thus each state has different acceptance requirements.  In my state you need only have less than $2000.00 in liquid assets, and have a qualifying need for nursing home care (Again the needs are relatively minor EX: diabetic, confused and needs assistance with medication administration, or weakness with a need for therapy).  If you meet the requirements then you will most likely be accepted into the program.  Contact your state medicaid office to explore the minimum requirements for acceptance.  I have a link on my website for each state's medicaid office and their contact information.  www.nursinghomehelpcenter.com [nursinghomehelpcenter.com]
• If neither of the above options pan out, then you need to call your secondary insurance provider and inquire as to what type of benefits she is entitled to under her plan.  Without knowing any other information on her plan I can't help you too much on this one.
• Last resort: Private pay.  I hope for your sake it does'nt come down to this as care of any type on a private pay basis is extremely costly.

#4 Evaluate and decide what is the best course of action for you and for your mother.

#5 Execute your plan.

I hope this helps.

Aaron P Mulvey, N.F.A. - www.nursinghomehelpcenter.com [nursinghomehelpcenter.com]

Dear Momwacko, I am a 58 yr old female who has been taking care of a almost 94 yr old female for 5 yrs. I must admit I was VERY impressed by Aarons response! However, the lady I care for is NOT related to me, she has no living family. But I love her dearly. I do not know what your or your mothers financial situation is but if you know someone you can trust REALLY trust who she is compatible with then I would think of hiring them for the period you are needing off! Personally, I hate agencys but that is just me! I also think the idea of having your Mom put in the hospital for 3 MIDNIGHTS then moved to a in house rehab is a GREAT idea. You may or may not be able to sit down and explain to your Mom what is going on. Remember when you leave her that they are experienced , and she WILL be ok. This will give you some pece of mind so you can actually ENJOY your trip with your new grandbaby!

I wish people could form some sort of "group" so lets say thre was 5 who are caregiviers and ofcourse it would depend on the level of care their loved one needs but maybe 1 could take in another for 1 week and then you could re-pay the favor!

I hope your mother realizes what a sacrafice you are making each and every day for her. God Bless you. A agency will cost you a arm and a leg you should be able to hire someone for say $10-12 hr a agency will charge you $17-22. And altho they are bonded----beware. If you ever want to e-mail plz feel free to do so--sometimes just talking helps! cccarter2005@att.net

I realize now that I am probley way to late! Sorry!