Carol Bradley Bursack, CDSGF
Author, speaker, columnist and eldercare consultant
Over the span of two decades, author, columnist, consultant and speaker Carol Bradley Bursack cared for a neighbor and six elderly family members. Her experiences inspired her to pen "Minding Our Elders: Caregivers Share Their Personal Stories," a portable support group book for caregivers.
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Question
What is the purpose of the Assessment of Daily Living Skills?
Carol's answer is terrific. I just wanted to add that Medicare and LTC insurance also use those tests to see if people qualify for... Carol's answer is terrific. I just wanted to add that Medicare and LTC insurance also use those tests to see if people qualify for certain services. It's kind of an all purpose tool used throughout the industry to assess the needs of the individual.
Take care,
Carol see more
Take care,
Carol see more
Question
Where can I get comfort care reading material to give to support families with love ones on comfort care?
I agree that reading material that speaks to our unique struggles can be very comforting. It's kind of you to think of helping others... I agree that reading material that speaks to our unique struggles can be very comforting. It's kind of you to think of helping others in this way.
The Hospice Foundation ( http://www.hospicefoundation.org/ ) has good reading material to offer. Also, just by typing hospice and (separately) comfort care into the Amazon search engine (after selecting "books," you should come up with many selections. Even your local library should have some material. Some funeral homes have brochures with suggestions, as well. However, between hospice and Amazon, I think you'll find an abundance of good material.
Take care,
Carol see more
The Hospice Foundation ( http://www.hospicefoundation.org/ ) has good reading material to offer. Also, just by typing hospice and (separately) comfort care into the Amazon search engine (after selecting "books," you should come up with many selections. Even your local library should have some material. Some funeral homes have brochures with suggestions, as well. However, between hospice and Amazon, I think you'll find an abundance of good material.
Take care,
Carol see more
Question
Why does mom sleep all day some days, then no sleep at all on other days?
Most people, as they age, have some pain from arthritis or other issues. That is often enough to interrupt sleep. Some research suggests... Most people, as they age, have some pain from arthritis or other issues. That is often enough to interrupt sleep. Some research suggests that older people just have a harder time sleeping long periods regardless of other issues. You mom could be suffering from depression which can cause people to sleep too little or too much. Also, of course, dementia can interfere with sleep rhythms. I don't feel that this indicates end-of-life issues, but I do think a medical checkup may be in order.
Take care,
Carol see more
Take care,
Carol see more
Question
When caregivers live in "their world" is there a chance of their losing touch with the non-dementia universe?
I recall when my sons were young they had some marvelous pre-school/kindergarten teachers. These people did what they did very well.... I recall when my sons were young they had some marvelous pre-school/kindergarten teachers. These people did what they did very well. However, on occasion, as an adult away from the kids, I was afraid they'd give me a sticker for doing something well.
Of course, some personalities are drawn toward certain professions, so maybe these people would be top-of-the-world perky no matter what they did. It's hard to say. But I'm comparing them with caregivers because people can get so drawn into their daily world – and that includes caregivers – that they may have trouble switching gears in other situations.
When we are constantly surrounded with a certain type of person/activity it will affect us to some degree, but we need to reacquaint ourselves with the rest of the world fairly regularly to keep in touch with reality.
I think there is a true danger in getting so drawn into the dementia world by 24-hour caregiving that depression and fear become part of our lives. Agoraphobia may become a problem if the caregiver seldom leaves the house, because it may eventually become too “foreign” to leave the house at all. Before depression or fear of going outside happens, professional help should be sought.
It does seem to me that if someone living with their loved one who has dementia is starting to feel like they are struggling to hold on to their own personality, it's more than time for respite care in the form of in-home caregivers or assisted living. The caregiver needs to get out in the world beyond caregiving to stay in touch with reality.
This is one of the most interesting questions I've seen in awhile, though I was just asked the same thing last week (in person). So, none of you are alone. Share with each other. But please do everything you can to maintain some life outside of caregiving. It's essential to your mental health.
Take care,
Carol see more
Of course, some personalities are drawn toward certain professions, so maybe these people would be top-of-the-world perky no matter what they did. It's hard to say. But I'm comparing them with caregivers because people can get so drawn into their daily world – and that includes caregivers – that they may have trouble switching gears in other situations.
When we are constantly surrounded with a certain type of person/activity it will affect us to some degree, but we need to reacquaint ourselves with the rest of the world fairly regularly to keep in touch with reality.
I think there is a true danger in getting so drawn into the dementia world by 24-hour caregiving that depression and fear become part of our lives. Agoraphobia may become a problem if the caregiver seldom leaves the house, because it may eventually become too “foreign” to leave the house at all. Before depression or fear of going outside happens, professional help should be sought.
It does seem to me that if someone living with their loved one who has dementia is starting to feel like they are struggling to hold on to their own personality, it's more than time for respite care in the form of in-home caregivers or assisted living. The caregiver needs to get out in the world beyond caregiving to stay in touch with reality.
This is one of the most interesting questions I've seen in awhile, though I was just asked the same thing last week (in person). So, none of you are alone. Share with each other. But please do everything you can to maintain some life outside of caregiving. It's essential to your mental health.
Take care,
Carol see more
Question
How do I find part-time services for my dad?
Most in-home care agencies will work blocks of time. You just set up what you want. Look for an agency that is part of a well-known chain... Most in-home care agencies will work blocks of time. You just set up what you want. Look for an agency that is part of a well-known chain such as Home Instead or Comfort Keepers or a local agency that has a good reputation. Either way, ask for references. Your dad's needs shouldn't be hard to meet with an honest conversation with the agency or caregiver involved.
Good luck,
Carol see more
Good luck,
Carol see more
Question
Mom continues to wet the bed even with wearing depends. I believe she's just become dependent on using these ....
One reason most nursing homes hesitate to put incontinence protection on people is because they do become dependent on the pads. You could... One reason most nursing homes hesitate to put incontinence protection on people is because they do become dependent on the pads. You could try getting her up more often if you can physically do it. If she uses the toilet more often, she may not have so much stored urine at night. Also, cutting back on fluids close to bedtime may help.
Good luck,
Carol see more
Good luck,
Carol see more
Question
Can I pay off our home and not get caught up in the 5 year Medicaid time frame since it's our primary residenc...
Paid off or not, your home is an asset. However, if one of you needs Medicaid, they won't make you sell the home if the spouse still... Paid off or not, your home is an asset. However, if one of you needs Medicaid, they won't make you sell the home if the spouse still lives there. However, they will put a lien against it. I'll qualify this by saying that every state has variances on Medicaid laws, but this is the general way it's done.
Take care,
Carol see more
Take care,
Carol see more
Question
What qualifications are necessary to be compensated by LTC for services?
That depends on the insurance company. They may insist that the person be a Certified Nursing Assistant, but likely they won't. Check... That depends on the insurance company. They may insist that the person be a Certified Nursing Assistant, but likely they won't. Check with them. They may be delighted to pay someone not certified but they would pay less. Each policy is different.
Take care,
Carol see more
Take care,
Carol see more
Question
My father has Medicare and a supplement. In hospital, no POA, talk of a nursing home. How do I protect his ass...
You aren't likely going to be able to protect his assets. Medicaid is for people who can't pay. So, if he's in a nursing home... You aren't likely going to be able to protect his assets. Medicaid is for people who can't pay. So, if he's in a nursing home for a long time he will eventually "spend down" his assets and then likely qualify for Medicaid at that time.
Will your father wake up and be cognitively able to assign you as POA? If not, you may have to seek guardianship. That is slow and expensive. Considering your different states, I think I'd ask an elder law attorney for some advice.
Good luck,
Carol see more
Will your father wake up and be cognitively able to assign you as POA? If not, you may have to seek guardianship. That is slow and expensive. Considering your different states, I think I'd ask an elder law attorney for some advice.
Good luck,
Carol see more
Question
How can I get the state to give my father-in-law Medicaid?
The problem is that the house was in his name within the past five years so it's still considered an asset. They do that so people... The problem is that the house was in his name within the past five years so it's still considered an asset. They do that so people don't give away their property just before they need Medicaid.
Depending on where you live, it's possible that his son could still live there, but a lien would be put against the property value to pay off Medicaid. You may want to check with an elder law attorney.
Good luck,
Carol see more
Depending on where you live, it's possible that his son could still live there, but a lien would be put against the property value to pay off Medicaid. You may want to check with an elder law attorney.
Good luck,
Carol see more
Question
How do we make my mom eligible for Medicaid?
Most likely, you'll have to cash out the life insurance. I imagine the amount of cash value - if any- is very minor and would be spent... Most likely, you'll have to cash out the life insurance. I imagine the amount of cash value - if any- is very minor and would be spent down quickly. As you say, insurance policies are considered assets because the family would benefit from that money after the person's death.
That leaves you without the money to bury her after her death. You could talk with an elder law attorney to see if there's any way around this, since every state is a little different. Good luck,
Carol see more
That leaves you without the money to bury her after her death. You could talk with an elder law attorney to see if there's any way around this, since every state is a little different. Good luck,
Carol see more
Question
Mom's been sleeping in a recliner and can't sleep in bed due to back problems. She needs a hospital bed but a...
It's very hard to have age and illness take away one's ability to function normally. I think your mother is fighting the aging... It's very hard to have age and illness take away one's ability to function normally. I think your mother is fighting the aging process by denying that she needs these things. Understanding this may won't change your situation but it may help you cope with more compassion.
Try not to use words like "baby monitor". That may seem like no big deal to you, but just saying that they have new monitors for elders may make a difference. Perhaps if you said "adjustable bed" rather than hospital bed, it may help. You get the drift.
If your mom hasn't been tested for dementia, she maybe should be. Dementia can cause people to act out of character. However, she may just be fighting each and every step because she doesn't want to give in. It's horrible for you, but if you can find some things where she can make choices (such as she takes some meds), it may help.
Good luck. Your have your hands full.
Carol see more
Try not to use words like "baby monitor". That may seem like no big deal to you, but just saying that they have new monitors for elders may make a difference. Perhaps if you said "adjustable bed" rather than hospital bed, it may help. You get the drift.
If your mom hasn't been tested for dementia, she maybe should be. Dementia can cause people to act out of character. However, she may just be fighting each and every step because she doesn't want to give in. It's horrible for you, but if you can find some things where she can make choices (such as she takes some meds), it may help.
Good luck. Your have your hands full.
Carol see more
Question
Can I hire people to get my father who has Parkinsons up & down stairs?
I've always said, only half jokingly, that every community should have people available to help elders up off the floor when they fell... I've always said, only half jokingly, that every community should have people available to help elders up off the floor when they fell and didn't need medical attention but couldn't get up. Your situation is much the same. So many of us have faced this. With my mother, it was falls. I couldn't get her up on my own and had to call 9-1-1 (they got a little annoyed after awhile).
I do have a suggestion for you. Type your state name and "aging" or "aging services" into your browser. You should find your state's version of the National Family Caregiver Support Program. It may have a slightly different name in your state, but every state has a version. Follow the links to find a contact and ask about services in your community. These people know what you are trying to cope with, so they may be able to suggest something. Good luck,
Carol see more
I do have a suggestion for you. Type your state name and "aging" or "aging services" into your browser. You should find your state's version of the National Family Caregiver Support Program. It may have a slightly different name in your state, but every state has a version. Follow the links to find a contact and ask about services in your community. These people know what you are trying to cope with, so they may be able to suggest something. Good luck,
Carol see more
Question
Reported to Elder Abuse two times in a three month period. What are my rights?
That's horrible. You may need an elder law attorney to help you out. I'm assuming that this is for financial abuse. Jealousy can... That's horrible. You may need an elder law attorney to help you out. I'm assuming that this is for financial abuse. Jealousy can turn some people nasty.
If you are following prescribed reporting, you shouldn't have any trouble proving your innocence, but that doesn't take away the pain. It's up to you whether you want an attorney to pursue this. Good luck,
Carol see more
If you are following prescribed reporting, you shouldn't have any trouble proving your innocence, but that doesn't take away the pain. It's up to you whether you want an attorney to pursue this. Good luck,
Carol see more
Question
Hospice can't help unless someone has cancer or other "life-limiting" illness....What now?
Igloo, thanks for mentioning the scoring methods. So much is subjective - even with the scoring. But it's good to point out the medical... Igloo, thanks for mentioning the scoring methods. So much is subjective - even with the scoring. But it's good to point out the medical guidelines. We appreciate it. Carol see more
Question
Under Texas law: when Medicaid recipient dies, do proceeds from sale of house go to heirs or Medicaid?
Likely, they will require a sale (or equivalent money) for what they paid for her care. If a spouse still lives in the home, then a lean... Likely, they will require a sale (or equivalent money) for what they paid for her care.
If a spouse still lives in the home, then a lean is placed against it but the spouse is allowed to live there. However, if this home has been empty, it is an asset. I can't speak for Texas, but I expect this will be the case. If anyone is reading who lives in Texas, please chime in : )
I might add that no matter how much advice your read about Medicaid, it's best to check with your state. If you have major questions, an elder law attorney is a good resource.
Good luck,
Carol see more
If a spouse still lives in the home, then a lean is placed against it but the spouse is allowed to live there. However, if this home has been empty, it is an asset. I can't speak for Texas, but I expect this will be the case. If anyone is reading who lives in Texas, please chime in : )
I might add that no matter how much advice your read about Medicaid, it's best to check with your state. If you have major questions, an elder law attorney is a good resource.
Good luck,
Carol see more
Question
Hospice can't help unless someone has cancer or other "life-limiting" illness....What now?
I understand what you are dealing with. I've been in similar circumstances where quality of life continues to get worse but there is no... I understand what you are dealing with. I've been in similar circumstances where quality of life continues to get worse but there is no terminal disease. It's hard for you to watch, but there's not much you can do but continue to make sure the doctor does what he or she can to keep your mom pain free. It's frustrating, because doctors are limited with what they can prescribe unless a patient is terminal and on hospice.
Hospice care is covered by most insurance and Medicare, but the person must be deemed terminal with an approximation of six months or less to live. Of course, many people live longer than that on hospice care and some get better and go off. Your mother doesn't qualify because there's no terminal disease.
Keep tabs on your Mom and watch carefully. Also, keep in touch with the doctor. If your mom shows any signs of terminal disease then she would quality. Meanwhile, urge the doctor to go for quality of life management.
Take care,
Carol see more
Hospice care is covered by most insurance and Medicare, but the person must be deemed terminal with an approximation of six months or less to live. Of course, many people live longer than that on hospice care and some get better and go off. Your mother doesn't qualify because there's no terminal disease.
Keep tabs on your Mom and watch carefully. Also, keep in touch with the doctor. If your mom shows any signs of terminal disease then she would quality. Meanwhile, urge the doctor to go for quality of life management.
Take care,
Carol see more
Question
Hospice can't help unless someone has cancer or other "life-limiting" illness....What now?
I understand what you are dealing with. I've been in similar circumstances where quality of life continues to get worse but there is no... I understand what you are dealing with. I've been in similar circumstances where quality of life continues to get worse but there is no terminal disease. It's hard for you to watch, but there's not much you can do but continue to make sure the doctor does what he or she can to keep your mom pain free. It's frustrating, because doctors are limited with what they can prescribe unless a patient is terminal and on hospice.
Hospice care is covered by most insurance and Medicare, but the person must be deemed terminal with an approximation of six months or less to live. Of course, many people live longer than that on hospice care and some get better and go off. Your mother doesn't qualify because there's no terminal disease.
Keep tabs on your Mom and watch carefully. Also, keep in touch with the doctor. If your mom shows any signs of terminal disease then she would quality. Meanwhile, urge the doctor to go for quality of life management.
Take care,
Carol see more
Hospice care is covered by most insurance and Medicare, but the person must be deemed terminal with an approximation of six months or less to live. Of course, many people live longer than that on hospice care and some get better and go off. Your mother doesn't qualify because there's no terminal disease.
Keep tabs on your Mom and watch carefully. Also, keep in touch with the doctor. If your mom shows any signs of terminal disease then she would quality. Meanwhile, urge the doctor to go for quality of life management.
Take care,
Carol see more
Question
What is needed for a relative (Son) to talk directly to his Mother's doctor regarding her health?
A Power Of Attorney for health care (health directive) should be set up, but the quickest thing to do is ask your mother to sign the HIPAA... A Power Of Attorney for health care (health directive) should be set up, but the quickest thing to do is ask your mother to sign the HIPAA form the doctor's office offers allowing you to "help her with her health issues". If you're careful about how you phrase this to her and let her know that you just want to help, maybe she'll comply. Most people like to know someone is on their side in this complicated medical system. You can let her know that this will help with handling insurance issues, etc.
As far as mentioning your concerns in front of your mother, you could write the doctor a letter before her appointment telling him or her of your concerns. At least that would put the doctor on alert. But please do see if you can get the HIPAA form signed, or better yet the Power Of Attorney. We all should do that - something drastic can happen to any one of us. Good luck in convincing her.
Carol see more
As far as mentioning your concerns in front of your mother, you could write the doctor a letter before her appointment telling him or her of your concerns. At least that would put the doctor on alert. But please do see if you can get the HIPAA form signed, or better yet the Power Of Attorney. We all should do that - something drastic can happen to any one of us. Good luck in convincing her.
Carol see more
Does anyone know if there's an elder care caregiver advocacy group?
Good luck,
Carol see more