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The fight for health care is personal, part 1

July 20, 2009

There are over 47 million Americans without any health insurance. None.They don’t qualify for state aid because they either make too much money or the state/s aren’t taking any more enrollees. Before you get your panties in a wad over the “making too much money” part, some are managing to pay premiums on children who have a chronic illness, or the “too much money” means they are above the poverty level according to government standards. For some, they simply can’t afford the premiums. Correct me if I’m wrong, but didn’t the Republican overhaul of bankruptcy disallow filing due to high medical expenses?

When it became all to apparent that my mom, at 84, could no longer live independently, I brought her to live with me. I had always promised her that there would be no nursing home for her, and it was a promise that I intended to keep. Two years earlier, an RV had run a red light and slammed into their car, killing her husband almost instantly, and severely injuring her with a fractured pelvis, 8 broken ribs, dislocated shoulder, abrasions, and more. Determined not to remain in a wheelchair, she learned to walk all over again. She lost that ability due to illness prior to moving in with me. Once here, she needed a walker and a wheelchair to get around.

Her medicine ran over $1,000 a month. When the Medicare prescription drug revision/ modification was passed, it dropped the cost to several hundred a month. Her previous physician strongly suggested that she get involved with other seniors, so we enrolled her in an adult day care that she attended 3-5 days a week; that was around $2,000 a month.

Medicare would not cover a home health aide coming out to assist with baths, dressing, etc., so we took care of it on our own. The local hospital had a program where physical therapists would come to the home, but she was placed on a waiting list because they were short staffed. After having gone through their hoops to make sure she’d benefit from the PT, no one was available. Insurance would not cover having a private one come out, so we were at the mercy of attempting to do it ourselves.

Respite services were expensive…at least I considered it expensive at $15 – $20 an hour depending upon the physical limitations of the client. There were 3 days that we used their services: 1 was for a wedding, 2 were for day trips out of town. Neither Medicare nor her supplemental policy paid for that – otherwise we would have used it once every week or two. She loved visiting with others, and honestly we needed the decompress time.

When she developed an irregular heartbeat in the Spring, I drove her to what was alledgedly a fine  hospital 5 minutes away. It was the last time she was in my home. She was admitted to the hospital, where 1 week later she suffered a stroke because no one in their physical therapy department could be bothered to come up an sit her up – even though her doctor had instructed them to. When she missed a meal because no one would feed her (she had extremely limited use of her arms due a late onset of Parkinsons), I made sure that I was at the hospital to feed her every meal. A nurse couldn’t be bothered to put down her magazine and come see about her IV going off for 15 – 20 minutes.

Medicare said after x number of days (I believe 30), that she had to be dismissed. So they moved her to a rehab facility about 15 miles away. Her care was good, but she wasn’t making adequate progress according to Medicare, so she had to be moved to a nursing home that would provide at least some rehab. It, too, was a nice place, but again, after a certain number of days, because she wasn’t meeting the Medicare requirements of progress, she was being discharged.

I felt like I was in a nightmare. Before she’d gotten sick, she was able to help somewhat in getting up, but now, there was nothing. The stroke that she’d suffered in the first hospital had taken the last bit of strength that she could muster. It was then that I broke down. I didn’t know where to turn to protect and help my mom. Her Medicare wasn’t going to, nor was her supplement. What do you do, where do you turn? She’d worked so  hard all her life. The irony – she was a nurse.

The one person who’d believed in me always, and doors were closing. She was in her 80’s and so her life wasn’t valuable evidently.

A supervisor from the nursing home helped us. There are private residential homes that provide care, 24/7.  But guess what? Medicare and her Blue Cross supplemental did not cover. It was $2,000 a month just for her to live there. Any extra services would be added. We found one, a good one, that was 5 minutes away. Within 2 months, she’d been hospitalized twice as her poor little body weakened. It’s what the body does when it’s ready to let go – it gradually shuts down.

When the doctors said that she was dying, Medicare covered her Hospice. Mighty big of them, as they offered no encouragement to her recovery. Their encouragement was for her to die.

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