The Paralyzing Fears When Facing Important Decisions for Care – Part One

By Janice Martin, Owner of Senior Liaison of Central Florida

When the need for assisted living becomes a crisis, the situation can become overwhelming and affect the ability to do anything. I refer to it as paralysis and I’ve identified four types that will hinder progress at the expense of your loved one. This month, I’ll address two types and two family’s experiences.

FINANCIAL PARALYSIS
Assisted living is very expensive. Although the care fees can be covered through the Medicaid Waiver for those who qualify, many communities do not accept it and it does not pay for the room cost. A private studio apartment can cost around $4,000 which must be paid for by the family. This is simply not possible for many people.

A family needing help for their wife/mother reached out to me. She has advanced dementia, frequently wanders, and it’s difficult for her husband to convince her to return. She no longer recognizes him and becomes angry when he tries to provide care. He is not able to leave her alone and relies on his family to bring him groceries and other necessities. I reached out to a memory care community where he’d visited several times. They told me he is in denial of how advanced his wife is. I disagree. This family has no money, no savings, and no way to pay for even a fraction of what the community charges. They fully recognize the extent of her diagnosis, but they are paralyzed to do anything because of their financial situation. They were so overwhelmed that they didn’t know where to begin, what is available, or where to turn. So, they did nothing.

Another roadblock is her husband is not her power of attorney and without it he couldn’t apply for Medicaid. As a result of her dementia, she is unable to understand what she would be signing and she doesn’t recognize her family, so power of attorney is no longer possible. Again, they avoided this critical issue due to cost. The only option is guardianship – which is more expensive than obtaining power of attorney.

Her care needs are such that a nursing home is appropriate, and Medicaid can cover the cost. The challenge is that she requires a locked area where she can’t leave on her own, a long-term bed, and the facility to accept her as Medicaid pending. Trying to find a place that fit all three criteria was exceedingly difficult – but not impossible nor readily available. Until then, they must continue to live in crisis.

The immediate solution was to enlist the help of Hospice, for which she is qualified. In addition to care at home and later the nursing home, they provide emotional support and social services at no cost through Medicare. Hospice recognizes that her husband is able to make decisions for her as next of kin and will help him to apply for Medicaid. By requesting “spousal diversion as an impoverished spouse,” some of his wife’s social security could be diverted for his own living expenses.

ANALYSIS PARALYSIS
Families often try to determine every possible scenario that could happen and overlook the immediate need. The What-Ifs take over. What if she has to go to a nursing home? What if she runs out of money? Should they move her to where they are, or move in with her to provide care?

I was contacted by a family who live out of state. Their mother and father lived in an assisted living here in Florida and the father recently had a debilitating stroke. Mom and dad have long term care insurance to pay for the community, but their daughters felt dad needed more care. They were rotating travel so one of them was with them constantly. They were exhausted and consumed with questions and over-analyzing every scenario. Should they move them to another assisted living? Should they pay for additional outside help? Should they wait until dad passes and then move mom closer to them? Should they move them both now? How do they arrange medical transportation to another state?

I located a smaller assisted living to provide a higher level of care and increased attention. However, the long term care policy would only pay for a community with more than 10 people and this one had six.

More analysis ensued… Were they willing to pay from mom and dad’s savings to get him the level of care he needed? What if they moved them both to stay together, or should they move dad and keep mom where she is?

They were paralyzed because there were too many unknowns and unable to focus on the immediate need. They were also overwhelmed with grief knowing that dad would pass soon and felt the need to simply DO something – anything – so they could feel they were in control of the situation. But they weren’t, and sadly creating more chaos. When I was able to help them focus on the most important issues, they were able to make decisions. Sometimes, when you take a breath to think clearly, the answer will present itself.

When any situation becomes overwhelming, I encourage you to reach out to someone who can provide practical information. Professionals such as Senior Liaison of Central Florida have many resources to connect you to the help you need. Next month, I will present two additional situations – Information Paralysis and Guilt Paralysis. Stay tuned!

Janice Martin is an author, educator, and specialist on senior living options and the owner of Senior Liaison of Central Florida Inc. She has written “The Complete Guide to Assisted Living: Everything You Need to Know Before, During, and After a Move.” This award winning and #1 best seller is available on Amazon.com in paperback and eBook. For more information, call 352-477-1866 or email SeniorLiaisonCFL@gmail.com

Senior Liaison of Central Florida

352-477-1866 | seniorliaisoncfl.com
seniorliaisoncfl@gmail.com