My brother's birthday is coming up. It's November 1. I think this birthday will be a lot better than last years. Last year, my brother was at the old nursing home and I don't think they did much for him on the day. My husband and I took him out for dinner, but we didn't spend too much time with him, because we had so much driving to do back and forth.
This year, my husband is out of town. I think he is supposed to get back in time, but you never know. I plan on taking my brother out for dinner. There is a very nice restaurant that he used to like going to, in a big shopping center, near his new nursing home. I don't like the restaurant very much. It's Italian, with very big portions, and I eat too much when I go. But I don't care. I am so happy that he is doing better, it's improved by attitude about taking care of him.
By coincidence, he will start a new HMO on his birthday, which means the nurse practitioner can start seeing him, which I have concluded is a good thing. I don't think the nursing staff is capable about detecting changes in his congestive heart failure, but the nurse practitioner works on his floor. I think it will be much easier to contact her when I think something might be going wrong.
Meanwhile, the new nursing home has just asked me to fill out a very long form for the State of Illinois so they will pay for his nursing care. They want me to go back for five years and dig out bank records, tax forms, etc. I am going to ask our case manager to help out and find out if we really have to do this form.
Sunday, October 28, 2012
Sunday, October 21, 2012
putting on weight
Yesterday, I took my brother out to breakfast. He was a little agitated. There were two reasons: he saw a dentist and he had difficulty arranging for the newspaper to be delivered to him.
My brother hasn't seen a dentist in about 3-4 years. It was at the bottom of my list of things to get done for him, and the old nursing home had been monkeying around with the request for almost a year. This new nursing home only took two weeks. They have a visiting dentist, apparently with x-ray capabilities in the home. My brother had been complaining about a chipped tooth (he has had several) so I wasn't surprised when he told me he was going to need a crown. He teeth are pretty discolored, so the first thing they had to do was take x-rays, and he's scheduled to get his teeth cleaned. I warned him it may take several appointments to get the teeth thoroughly cleaned because it had been so long. My husband is concerned that the nursing home dentist is going to take advantage and rack up a bunch of bills. He suggested that we take him to our dentist, or at least to another one, to get a second opinion. I should also mention that is not clear if Medicaid is going to pay for dental treatment or not. I am assuming not. However, our parents left us some money for his care, and this seems like a very good thing to be spending money on. Also, anything that is going to save me or my husband personal time is well worth it. So I am going to call the nursing home on Monday and tell them to go through with it.
The second item he was concerned about was that there was some kind of hassle getting the Tribune delivered to his door. Apparently he worked it out. I think this is wonderful because he is so much more taking an interest in the outside world. He prefers the Sun-Times because it is in tabloid form and easier for him to physically use. I didn't tell him, but I plan to get him a subscription to the Sun-Times for his birthday.
When I took him out, I noticed that I had difficulty zipping his jacket. He mentioned to me that he had put on 5 lbs. I suspect by next weekend I am going to have to assert myself and make sure that a doctor gives him a higher dosage of lasex for a while. It always amazes me how I notice way before anyone else when his congestive heart failure is acting up.
My brother hasn't seen a dentist in about 3-4 years. It was at the bottom of my list of things to get done for him, and the old nursing home had been monkeying around with the request for almost a year. This new nursing home only took two weeks. They have a visiting dentist, apparently with x-ray capabilities in the home. My brother had been complaining about a chipped tooth (he has had several) so I wasn't surprised when he told me he was going to need a crown. He teeth are pretty discolored, so the first thing they had to do was take x-rays, and he's scheduled to get his teeth cleaned. I warned him it may take several appointments to get the teeth thoroughly cleaned because it had been so long. My husband is concerned that the nursing home dentist is going to take advantage and rack up a bunch of bills. He suggested that we take him to our dentist, or at least to another one, to get a second opinion. I should also mention that is not clear if Medicaid is going to pay for dental treatment or not. I am assuming not. However, our parents left us some money for his care, and this seems like a very good thing to be spending money on. Also, anything that is going to save me or my husband personal time is well worth it. So I am going to call the nursing home on Monday and tell them to go through with it.
The second item he was concerned about was that there was some kind of hassle getting the Tribune delivered to his door. Apparently he worked it out. I think this is wonderful because he is so much more taking an interest in the outside world. He prefers the Sun-Times because it is in tabloid form and easier for him to physically use. I didn't tell him, but I plan to get him a subscription to the Sun-Times for his birthday.
When I took him out, I noticed that I had difficulty zipping his jacket. He mentioned to me that he had put on 5 lbs. I suspect by next weekend I am going to have to assert myself and make sure that a doctor gives him a higher dosage of lasex for a while. It always amazes me how I notice way before anyone else when his congestive heart failure is acting up.
Saturday, October 13, 2012
a new man
My brother is so much more talkative. He is like a new man. I was thinking today about all the effort I made to keep him alive when he was in medical crises. Now I am very glad I did. At the time I wondered if it made sense to use a lot of modern medical intervention, that maybe I should let him "die" as nature intended. But then I figured everyone else gets a chance to live longer with modern medicine, why shouldn't he get the same breaks. When he first started living in a nursing home, both my husband and I felt that he wouldn't live more than a year. This was somewhat based on what his doctors were telling us. Even after the first year at the old nursing home, his health seemed precarious, he had several bouts of congestive heart failure and pneumonia, and he "acted old", fairly listless, and very tired.
But if you saw him today after the move to the new nursing home, you wouldn't be thinking that anymore. He wasn't hoarse today. He seemed like he was getting out of breath a bit, but he was quite chipper and pretty talkative (by his standards). We talked about the Presidential debates, I read to him out of the paper about Jesse Jackson Jr's woes, and when we got back from breakfast, I helped him"paint" (he dripped fabric paint) on a white muslin square for the quilt that I making for my daughters. (All our family members are contributing a square.) He told me how he had gone to the guitar concert at the nursing home before.
Yesterday, I got a call from the social worker, who was sitting with my brother, to ask if we wanted him to join an HMO where a nurse practitioner who practices on his floor would handle his medical issues. The presentation was pretty confusing. Right now, if the nurses think he is getting sick, they are supposed to call a doctor and get orders. On the other hand, they are telling me that the doctors only come into the nursing home and see patients every 3 months. This ticks me off pretty much. Why should they get paid by medicaid to go see patients for 5 minutes every 3 months, and not be expected to come to the nursing home if their patients are sick? I supposed their reimbursements from public aid make it not lucrative. What a sick medical care system we have. The short of it is that I asked the social worker to send me the paperwork so I could read about what we are signing up for. Then I think about the fact that I am pretty well educated, my husband is in the medical care policy business, and we are pretty well informed, compared to most families. What about the people who aren't?
Meanwhile, my brother wasn't hoarse, but he did seem out of breath, so I am going to keep an eye on him. I am going out of town for the week for work, but I think he probably would not get that bad that quickly, if he is going into a decline. I am going to ask my husband to go visit him while I am gone.
That's another good thing about the move. Now that he is closer, my husband is going to visit him, mostly on his own, without me, which gives my brother more support. Very good!
But if you saw him today after the move to the new nursing home, you wouldn't be thinking that anymore. He wasn't hoarse today. He seemed like he was getting out of breath a bit, but he was quite chipper and pretty talkative (by his standards). We talked about the Presidential debates, I read to him out of the paper about Jesse Jackson Jr's woes, and when we got back from breakfast, I helped him"paint" (he dripped fabric paint) on a white muslin square for the quilt that I making for my daughters. (All our family members are contributing a square.) He told me how he had gone to the guitar concert at the nursing home before.
Yesterday, I got a call from the social worker, who was sitting with my brother, to ask if we wanted him to join an HMO where a nurse practitioner who practices on his floor would handle his medical issues. The presentation was pretty confusing. Right now, if the nurses think he is getting sick, they are supposed to call a doctor and get orders. On the other hand, they are telling me that the doctors only come into the nursing home and see patients every 3 months. This ticks me off pretty much. Why should they get paid by medicaid to go see patients for 5 minutes every 3 months, and not be expected to come to the nursing home if their patients are sick? I supposed their reimbursements from public aid make it not lucrative. What a sick medical care system we have. The short of it is that I asked the social worker to send me the paperwork so I could read about what we are signing up for. Then I think about the fact that I am pretty well educated, my husband is in the medical care policy business, and we are pretty well informed, compared to most families. What about the people who aren't?
Meanwhile, my brother wasn't hoarse, but he did seem out of breath, so I am going to keep an eye on him. I am going out of town for the week for work, but I think he probably would not get that bad that quickly, if he is going into a decline. I am going to ask my husband to go visit him while I am gone.
That's another good thing about the move. Now that he is closer, my husband is going to visit him, mostly on his own, without me, which gives my brother more support. Very good!
Wednesday, October 10, 2012
hoarse again
It's Wednesday night, and I'm already back from visiting my brother. In fact, I noticed when I left that it was at about the same time that I was just arriving at the old nursing home. My life is so much better.
My brother was in a good mood, but I noticed that he was hoarse. When we were sitting outside, he mentioned that his pants were getting tight. I casually asked when did that start, and he said about two weeks ago. So I went to the front desk and asked to talk to his nurse on the 7th floor. I told her I thought his congestive heart failure may be acting up again and asked her to check that out and also to look at his lungs. I will call tomorrow to follow up.
It is perplexing to me why I am the first person to notice these symptoms and that the nursing staff doesn't notice. And my husband went to visit my brother earlier in the day and didn't notice either. It makes me feel like I can never leave town for very long, my brother's life would be in danger.
On a better note, it sounds like the nursing home listened to my brother when he first moved in and re-registered him to vote. Now I just have to figure out if we have to get him an absentee ballot or what. They also have a notary public in the building, which makes life a lot easier for financial dealings.
My brother was in a good mood, but I noticed that he was hoarse. When we were sitting outside, he mentioned that his pants were getting tight. I casually asked when did that start, and he said about two weeks ago. So I went to the front desk and asked to talk to his nurse on the 7th floor. I told her I thought his congestive heart failure may be acting up again and asked her to check that out and also to look at his lungs. I will call tomorrow to follow up.
It is perplexing to me why I am the first person to notice these symptoms and that the nursing staff doesn't notice. And my husband went to visit my brother earlier in the day and didn't notice either. It makes me feel like I can never leave town for very long, my brother's life would be in danger.
On a better note, it sounds like the nursing home listened to my brother when he first moved in and re-registered him to vote. Now I just have to figure out if we have to get him an absentee ballot or what. They also have a notary public in the building, which makes life a lot easier for financial dealings.
Sunday, October 7, 2012
a good day
Today, a Sunday. I took my brother out for breakfast. Now we go to a local International House of Pancakes. It's not nearly as personalized as the family restaurant we used to go to, but my brother doesn't seem to mind. It was a little cold outside, so he probably is not going to be able to sit outside for very long. However, he has been sitting outside a lot, you can tell because the top of his head is quite tan.
He says he has two male friends that he sits outside with. I think this is great. I am really pleased that the nursing home managers let him roam wherever he wants to go within the building, it gives him much more independence. I asked him if he had gone to play poker, he told me no because it was all women. I encouraged him to go and told him the ladies would probably like the presence of a man and he seemed to perk up about that idea.
Today was also a good health day, he didn't need assistance in getting up from his seating position at any time.
This placed has a visiting dentist every other week and also a monthly audiologist visit, so I think my life is about to get much easier in regards to that too. My brother really needs to see a dentist, I let it go because it seemed like there were so many other issues to deal with first. Then about three months ago I signed him up for "dentist insurance" at the old nursing home. Medicaid/Medicare was supposed to pick up for the cost, and the nursing home kept on forgetting to sign him up for a dental visit so he never had one. Hopefully, this nursing home is much more together and he will actually see a dentist within the month. I don't mind paying for it, he just needs to get it done.
His hearing aid went bad last week. Thankfully, my husband was able to bring it in and it was fixed on the spot for $30. Apparently I had let the insurance I have on the hearing aid go (I never got a bill to renew it), so I was glad it didn't cost much. I have been thinking for a long time to get him another hearing aid because he breaks his at least once a year, and then he has to go without an aid for a while, which is really hard on him. The only drawback is that these hearing aids cost at least $2000, and I am not happy with the audiologist my parents had been using for him. Now I think I will contact the nursing home audiologist, and if problems ever develop, it can be taken care of within the nursing home structure.
I used to think that my brother only had one or more two years of life left before his heart failed, but now he is doing so much better I am rethinking what the likely scenarios are.
He says he has two male friends that he sits outside with. I think this is great. I am really pleased that the nursing home managers let him roam wherever he wants to go within the building, it gives him much more independence. I asked him if he had gone to play poker, he told me no because it was all women. I encouraged him to go and told him the ladies would probably like the presence of a man and he seemed to perk up about that idea.
Today was also a good health day, he didn't need assistance in getting up from his seating position at any time.
This placed has a visiting dentist every other week and also a monthly audiologist visit, so I think my life is about to get much easier in regards to that too. My brother really needs to see a dentist, I let it go because it seemed like there were so many other issues to deal with first. Then about three months ago I signed him up for "dentist insurance" at the old nursing home. Medicaid/Medicare was supposed to pick up for the cost, and the nursing home kept on forgetting to sign him up for a dental visit so he never had one. Hopefully, this nursing home is much more together and he will actually see a dentist within the month. I don't mind paying for it, he just needs to get it done.
His hearing aid went bad last week. Thankfully, my husband was able to bring it in and it was fixed on the spot for $30. Apparently I had let the insurance I have on the hearing aid go (I never got a bill to renew it), so I was glad it didn't cost much. I have been thinking for a long time to get him another hearing aid because he breaks his at least once a year, and then he has to go without an aid for a while, which is really hard on him. The only drawback is that these hearing aids cost at least $2000, and I am not happy with the audiologist my parents had been using for him. Now I think I will contact the nursing home audiologist, and if problems ever develop, it can be taken care of within the nursing home structure.
I used to think that my brother only had one or more two years of life left before his heart failed, but now he is doing so much better I am rethinking what the likely scenarios are.
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