Crazy Caregiver's First Blog
By CathySikorski on October 02, 2012
My caregiving life,unbeknownst to me, began very long ago. There have been numerous charges who have come and gone...but currently my stable includes, my 96 year-old mother-in-law, my dear brother-in-law with MS and a host of other health issues, my darling friend who had a terrible fall three years ago that caused her brain damage and changed her life forever, and recently my 84 years young Mom who fell and broke her arm in her vacation cabin in Canada the day we took our daughter back to college for the fall semester(my Mom must've thought the word 'fall' applied to her, since I now had an opening for additonal caregiving).
But over the 20 years or so that I've been helping friends and family, I have never been more exasperated by anything than navigating the health care system. This is just today's tale. Since Marie, my mother-in-law is in assisted living, she occasionally requires medical care. Urgent medical care, if they can't figure out why she is crying out in pain, can't ambulate, or seems weirdly incoherent even for her. And since they are merely aides, they do not have the requisite medical knowledge to decide if she needs medical attention, STAT, or is just having an 'off' day. So, to their credit, these wonderful caregivers attend to Marie's needs very carefully every day. But when she appears to be in true medical distress, they call an ambulance to take her to the hospital. Usually, by then she is beyond communicating to them what her real issue is. And, invariably, her two sons, or I am not easily found or can get there quickly. AND, my mother-in-law is 96 AND she doesn't drive and in fact, she has never driven, not that I would WANT her to drive herself to the hospital under these or any circumstances.
Thank goodness, on the occasion in question, after we all spent 7 or 8 hours in the emergency room, they sent her home without a real diagnosis except undetermined pain.
Now the fun part. Medicare won't pay for the ambulance. I have no idea why. When I asked the Medicare representative, she had no idea either. "Sometimes,"she said nicely,"it just doesn't make sense to you or me." Really, ya think? So I copy all the paperwork, appeal the denial, and two months later am told that the AMBULANCE has to appeal, not me. And when I call the AMBULANCE, they say, "O no, we can't appeal that you have to call Medicare". And I say, "Okay, but I am not paying your $797 ambulance bill either."
Medicare has no idea why I got that letter or what I am supposed to do. So she tells me to start over with a new appeal and see what happens. And guess what? I am an Elder Lawyer, I know what I am supposed to do and do it all in a detailed manner, and I STILL can't get anyone to do this right. So, even though my mother-in -law is obviously a pro bono client, I have spent a lot more than $797 in my time trying to find out: WHY A 96 YEAR OLD LADY CAN'T GET A RIDE TO THE HOSPITAL FROM AN ASSISTED LIVING FACILITY IF SHE IS IN ACUTE DISTRESS? As soon as I find out, I will let you AND THE LADY AT MEDICARE, know the answer.