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   -=> Quoting Maurice Kinal to Nancy Backus on 09-27-05  17:37 <=-   
      
    NB> Seems strange... I've been out of the loop for almost 2 months.  Life   
    NB> got crazy here... still isn't totally resolved... Loooonnnngggg    
    NB> story!   
      
    MK> I got time.  I was wondering where you disappeared to.   
       
   I had a family wedding to go to August 12, followed by a week of camping   
   with my extended family.  When I returned, I was only home 2 days before   
   the woman for whom I am POA and health care proxy got sick with a UTI   
   and pneumonia, and had to be admitted to the hospital.  So I spent over   
   a week mostly at the hospital with her, pulling down 15-hour shifts most   
   days, I think it was 8 in a row... all I did at home was go there to   
   sleep a couple of hours.  She is about my age, but has CP (cerebral   
   palsy) and COPD (chronic obstructive pulmonary disease), and a bunch of   
   other stuff that's in comparison rather minor.  The CP makes it   
   difficult for many to understand her (among other things), the COPD   
   makes her very susceptible to pneumonia.  Over the years, I've developed   
   a relationship with her doctors as well, so when she's in the hospital,   
   sleeping around the clock, or hooked up to breathing treatments, I can   
   discuss her medical issues intelligently, and ask the right questions.    
   Oh, and keep my eyes open for all the stuff that falls through the   
   cracks with medical personnel not familiar with her panoply of meds,   
   etc, and watch for the anomalies that might indicate that something is   
   wrong.  And once she starts getting better, one of my functions is   
   keeping her there long enough to be sure* she's medically ready (as   
   opposed to her just wanting to be) to go home.  And the other major one   
   is to facilitate all the tests, people and paperwork needed to get her   
   to discharge.  And actually, involved as all this sounds, this was only   
   the small part of my crazy absence.  We went home on Aug 31, so I could   
   have been back to about normal...  exhausted, but pretty much normal.   
      
   Trouble this time was, in order to get her home, the home health agency   
   that supplies her 24/7 health aides and her weekly nurse who checks her   
   vitals and fills her mediset and the occasional therapist, decided, in   
   their "wisdom", that she needed the regular assist of 2 people, not just   
   the one she regularly has.  And of course, the insurance (even if it   
   hadn't been Medicare/Medicaid, the gov't programs) won't pay for two   
   people.  Granted that she is overweight, and, due to the CP, a bit   
   floppy.  But, it really does NOT require the assist of 2 unless she is   
   practically unconscious, or one of the 2 isn't exactly competent.  Even   
   in the hospital, without her full strength back, she was able to do   
   enough of the assisting to move herself around in bed and such that I   
   was able to assist her by myself, and I am only allowed to lift or pull   
   15 pounds, 25 max in a pinch and very carefully.  Plus, of course, I   
   couldn't brace myself properly, given that my right ankle is still   
   healing from the break last February.  Yet I was able to do what needed   
   to be done, without endangering myself or her.  And the other piece of   
   this, is that it was one, maybe two, of their aides that had NOT been   
   taking proper care of her, which is what landed her in the hospital in   
   the first place.  So to me it sure looks like a good case of CYA on   
   their part.  Also, they've been making intimations on certain levels   
   (not the aides themselves that actually do the hands-on care, mind you)   
   that she'd be much "safer" in a nursing home instead of her own   
   apartment.  She, on the other hand, is adamantly opposed to the very   
   idea of a skilled care facility, and in fact, wouldn't (and couldn't)   
   get the hands-on care she needs to have, one on one, if she were to be   
   in such a place.  Her doctors, and as you may guess, I as well, quite   
   agree with her on her non-suitability for such a place, at least for   
   now, and probably right along...  She'd have to have no brain at all   
   left, basically...  And what's wrong with her certainly isn't in her   
   intellect at all.   
      
   Anyway, they presented me with their "solution" to this... I would just   
   have to sign a contract with them to provide (either by my own person or   
   a schedule of qualified persons) a second person in the house, at all   
   times, in order for them to be willing to reopen the case and resume her   
   services with them.  I'm sure that they expected me to back down at that   
   point, as it was obviously an impossible venture (to say nothing of   
   being a rather trumped up premise).  Instead, I signed my life away, in   
   order to get her home, where we could start working on other solutions.   
      
   It also sounded, at the time they first were proposing this, that this   
   was only if she wasn't cleared by the hospital to be safe with the   
   assist of one.  So over the weekend, as the doctors and other personel   
   at the hospital talked things over with us, we went along with doing   
   discharge planning that expected her to clear the hurdles.  In fact,   
   when the hospital's Physical Therapist checked her out, she was sure   
   that she was safe with no more than one assist.  And a night nurse, who   
   used to work as a home health aide, witnessed my ability as a   
   "half-assist" to do the job, and wrote up a long comment to that in the   
   record.  And the doctors also were convinced by their tests and such   
   that she was good to go with no more than one.  Nevertheless, the agency   
   already had decided that assist of 2 was necessary, and wouldn't even   
   listen to the facts.  Instead, they pumped some of the Patient Service   
   Techs, whose guidelines tell them never to try to move a patient by   
   themselves, and who never let the patient assist, and got from them the   
   "truth" that of course she needed the assist of at least 2, maybe more.   
      
   Sorry, I guess I'm still* (now what, over 2 months later) a bit steamed   
   over the railroading here...  :(   
      
   But yes, I actually signed it, and they still refuse to release me from   
   it, even though in actual practice it is PATENTLY evident that it is   
   nothing but bull.  It's been useful in some instances to oversee what   
   the aides have been doing (and/or having my presence encourage them to   
   do their jobs properly), and it was useful when I broke in a new aide   
   for overnights.  And I won't deny that I can be useful in taking care of   
   her.  But necessary?  Not at all.     
      
   How is it working out?  The one aide most likely responsible for the   
   hospital visit didn't come back, the aide I wondered about I had to stay   
   with for her whole shifts, but the others, including the new one that I   
   helped to train OTJ, all covered for me, sent me home to sleep or   
   whatever, have some semblance of a life, etc.  And even those who think   
   I need to be there still expect me to get her meds from the pharmacy,   
   and don't quibble if I should happen to go home for a short bit to   
   change clothes or shower, or am out to do her grocery shopping.  I still   
   have to be there for when anyone from nursing or therapy is scheduled to   
   be there or is expected to call me there, as it is their part of the   
   agency that actually manipulated this situation into happening.  And I   
   usually would have tried to be there for most of that, even before the   
   stupid contract.  I also always try to be there for when her doctors   
   come for home visits, and anything else where decisions need to be made.    
   I am, after all, her health care proxy and her POA (for everything).  It   
   appears that the aide side of the agency (supervision included) thinks   
   that it is just really ridiculous for me to be stuck there.  Fortunately   
   as it turns out, since this past week I came down with a bad case of   
   (probably) strep throat, and haven't dared bring my sickness over to her   
   house, even if I had been up to it (which I wasn't at all for the first   
      
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