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
How do I confront my father with his reckless abandon of spending what he doesn't have?
This is as difficult as convincing someone to quit driving. I think kindness is necessary, but you also need to be firm. Does your dad have... This is as difficult as convincing someone to quit driving. I think kindness is necessary, but you also need to be firm. Does your dad have a good friend - someone outside of the family - who can help? Often, elders will listen to someone of their own generation before they'll list to their kids who just want to "control" them.
If that doesn't work, I guess just closing the accounts and letting the chips fall may be your only answer. Just understand what a blow to his self-esteem this is. You'll need to try to help him work through it.
Take care,
Carol see more
If that doesn't work, I guess just closing the accounts and letting the chips fall may be your only answer. Just understand what a blow to his self-esteem this is. You'll need to try to help him work through it.
Take care,
Carol see more
Question
My mother is in a nursing home in Ohio. How do we react to a transfer or discharge notice?
I'd go to the website www.ltcombudsman.org and type in the Zip code of the nursing home. This will get you to the ombudsman (your... I'd go to the website www.ltcombudsman.org and type in the Zip code of the nursing home. This will get you to the ombudsman (your advocate) for long-term care facility problems at that nursing home. The ombudsmen are well trained in how to handle these things and they are there for you. The information should also be available on your state website but this site is very convenient.
Good luck.
Carol see more
Good luck.
Carol see more
Question
Transferred house to kids, but now don't know how Medicare work for that?
I believe you are thinking of Medicaid, not Medicare. When your husband turns 65, he can qualify for Medicare which has nothing to do with... I believe you are thinking of Medicaid, not Medicare. When your husband turns 65, he can qualify for Medicare which has nothing to do with your finances. That is a way to get health insurance once a person turns 65.
By transferring the house to your kids, if neither your husband nor you needs nursing home care or other Medicaid services for five years from now, then it should not be a problem. The house would be theirs. That's what's called the five year "look back." Medicaid looks back into your finances to see if you've transferred assets to your family members just to qualify for Medicaid. If you did so five years or more before either of you needed Medicaid, then there shouldn't be a problem.
If your husband did go on Medicaid because he needed nursing home care that you couldn't pay for, they'd still let you live in the house. After you sold the house they would then likely take the money out of the assets.
I do wonder about this attorney you saw. He or she should know Medicaid law and be able to explain it all to you. If he can't, you should see an elder law attorney. Every state has a little different twist on Medicaid, and some are starting to try to recover money from adult children. Please see an expert to get this all laid out for you so you know just where you are with your financial planning.
Good luck,
Carol see more
By transferring the house to your kids, if neither your husband nor you needs nursing home care or other Medicaid services for five years from now, then it should not be a problem. The house would be theirs. That's what's called the five year "look back." Medicaid looks back into your finances to see if you've transferred assets to your family members just to qualify for Medicaid. If you did so five years or more before either of you needed Medicaid, then there shouldn't be a problem.
If your husband did go on Medicaid because he needed nursing home care that you couldn't pay for, they'd still let you live in the house. After you sold the house they would then likely take the money out of the assets.
I do wonder about this attorney you saw. He or she should know Medicaid law and be able to explain it all to you. If he can't, you should see an elder law attorney. Every state has a little different twist on Medicaid, and some are starting to try to recover money from adult children. Please see an expert to get this all laid out for you so you know just where you are with your financial planning.
Good luck,
Carol see more
Question
How do I keep mom's mind off wanting to move yet again?
Hi Denise, Beautifulsc gave you some terrific advice. I'd like to add that a large percentage of elders who break a hip don't live... Hi Denise,
Beautifulsc gave you some terrific advice. I'd like to add that a large percentage of elders who break a hip don't live more than a year afterward. I'm not saying this to make you feel afraid or sad, but to underscore the fact that she may be more vulnerable than she realizes. A move could be very hard on her.
In the end, unless she's cognitively unstable and you can prove it, she has a right to move. I hope your brother and his wife can gently let her know that as much as they'd love to have her nearby, a move for her at this time wouldn't be wise.
Distraction and keeping her busy may help keep her from insisting on moving. Also, simply putting things off could help. I'm sorry you have to cope with this after doing so much to help her, but it's what you are facing, so stay strong, don't argue but try to tell her the reasons it wouldn't be wise (if she's cognitively okay), or else keep distracting and redirecting her to other issues if she's cognitively impaired. This too will pass.
Take care,
Carol see more
Beautifulsc gave you some terrific advice. I'd like to add that a large percentage of elders who break a hip don't live more than a year afterward. I'm not saying this to make you feel afraid or sad, but to underscore the fact that she may be more vulnerable than she realizes. A move could be very hard on her.
In the end, unless she's cognitively unstable and you can prove it, she has a right to move. I hope your brother and his wife can gently let her know that as much as they'd love to have her nearby, a move for her at this time wouldn't be wise.
Distraction and keeping her busy may help keep her from insisting on moving. Also, simply putting things off could help. I'm sorry you have to cope with this after doing so much to help her, but it's what you are facing, so stay strong, don't argue but try to tell her the reasons it wouldn't be wise (if she's cognitively okay), or else keep distracting and redirecting her to other issues if she's cognitively impaired. This too will pass.
Take care,
Carol see more
Question
Why can't we have unisex handicapped bathrooms for the elderly?
I not only relate to this - I've written about it in my column and in forums and articles. Newer malls and other places have started... I not only relate to this - I've written about it in my column and in forums and articles. Newer malls and other places have started putting up unisex bathrooms, but many restaurants and, shamefully, clinics, don't have them. I used to take my dad for his medical appointments and as soon as we'd sit down to wait he'd need to use the bathroom. He couldn't go alone. I couldn't go in the men's room nor could I take him in the women's room. It was horribly frustrating.
Dad even wore a protective pad on those occasions, but when I'd tell him he could "just go" because he was wearing protection, he'd get angry. He wasn't going to "wet his pants." So, while wearing a brief can help (he'd eventually have no choice), it's not a humane and dignified answer to this problem.
I can't fix this for you, but I can tell you I do understand.
Take care,
Carol see more
Dad even wore a protective pad on those occasions, but when I'd tell him he could "just go" because he was wearing protection, he'd get angry. He wasn't going to "wet his pants." So, while wearing a brief can help (he'd eventually have no choice), it's not a humane and dignified answer to this problem.
I can't fix this for you, but I can tell you I do understand.
Take care,
Carol see more
Question
Should I consider taking care of my dads personal hygiene so he can come home?
If the only reason your dad is in a nursing home is because of hygiene, that is likely something you can learn to deal with. It seems... If the only reason your dad is in a nursing home is because of hygiene, that is likely something you can learn to deal with. It seems culturally "wrong" for a child - even and adult child - to become that physically intimate with a parent, particularly a parent of the opposite gender. But it's fine. You both would likely get over that discomfort quite quickly when you realize this is just a "clinical" procedure. The embarrassment should soon evaporate if you both just understand this for what it is - healthcare.
Be careful, however, that you are aware of the other things you are taking on. Will he still be able to get his physical therapy? Will you be able to handle his other physical needs because of size and weight (and your strength)? Are your personalities compatible?
Talk over any move you make with a social worker or someone who knows what services he can get at home before you make such a move. You don't want to take him home and regret it.
Take care,
Carol see more
Be careful, however, that you are aware of the other things you are taking on. Will he still be able to get his physical therapy? Will you be able to handle his other physical needs because of size and weight (and your strength)? Are your personalities compatible?
Talk over any move you make with a social worker or someone who knows what services he can get at home before you make such a move. You don't want to take him home and regret it.
Take care,
Carol see more
Question
Paying medical bills when you only have medicare. Are there options?
Great advice, Igloo! It's true that 60-80 percent of bankruptcies are because of medical bills (depending on the source of the... Great advice, Igloo! It's true that 60-80 percent of bankruptcies are because of medical bills (depending on the source of the statistics). Sandy, you dad may be one of those statistics. Whatever you do, don't "guarantee" to pay those bills. If your dad has assets and your formal appeals to Medicare don't work, try to negotiate for your father with the clinic/hospital. What's left, he'll have to pay. But you need to keep your finances separate.
Take care of yourself, too. This is awful stuff for our seniors to face, but it's not uncommon.
Carol see more
Take care of yourself, too. This is awful stuff for our seniors to face, but it's not uncommon.
Carol see more
Question
Paying medical bills when you only have medicare. Are there options?
Your question makes sense, but I'm wondering if he only has Medicare A, which has no premium for most people, or if he carries Medicare... Your question makes sense, but I'm wondering if he only has Medicare A, which has no premium for most people, or if he carries Medicare B plus even a supplemental policy. If he has a supplemental policy, you could check with the carrier to make sure that they are covering everything they should.
You can make an appeal to Medicare, but I can't guarantee that this will help. That's generally meant for services they don't cover but that you think they should. Try the site at www.medicare.gov. You'll also find a phone number there is you want to talk with someone.
Good luck,
Carol see more
You can make an appeal to Medicare, but I can't guarantee that this will help. That's generally meant for services they don't cover but that you think they should. Try the site at www.medicare.gov. You'll also find a phone number there is you want to talk with someone.
Good luck,
Carol see more
Question
When is it time to consider getting Power of Attorney for my spouse?
I'd say do it now. It's not likely this is going to get better. She is apparently an alcoholic in denial, plus there's a good... I'd say do it now. It's not likely this is going to get better. She is apparently an alcoholic in denial, plus there's a good chance that she may be suffering from a mental illness, as well.
It's not unusual for married couples to have POA for each other. You'd have a lot of rights as a spouse, but much depends on how you've set up your assets. I'd speak with an attorney, soon.
Good luck,
Carol see more
It's not unusual for married couples to have POA for each other. You'd have a lot of rights as a spouse, but much depends on how you've set up your assets. I'd speak with an attorney, soon.
Good luck,
Carol see more
Question
Should I be taking my husband to a Neurologist or a Geriatric doctor?
You may want to try a geriatrician simply because your husband feels the neurologist talks down to him. You'll likely need to see a... You may want to try a geriatrician simply because your husband feels the neurologist talks down to him. You'll likely need to see a neurologist for a final diagnosis, but the guidance of a geriatrician may be very helpful in all of his (and you) health decisions, so it's good to start such a relationship if you can. Since geriatricians specialize in aging, most have a good approach to these sensitive issues.
Don't expect miracles - your husband is in denial and wants to stay there. But a geriatrician will test for other possible causes of his cognitive issues, as well.
Good luck,
Carol see more
Don't expect miracles - your husband is in denial and wants to stay there. But a geriatrician will test for other possible causes of his cognitive issues, as well.
Good luck,
Carol see more
Question
How do I get my parents to a senior facility when they are in denial that they need help?
You have my sympathy. It's got to be so stressful to be drawn into this. I agree that calling social services may be the only way to... You have my sympathy. It's got to be so stressful to be drawn into this.
I agree that calling social services may be the only way to get something done. They have a right to live like this (unfortunately, in this case), but if a social worker can say they are unsafe and living there is unsanitary, there may be some way to force the issue. Otherwise, I'm very sorry to say, you may just have to wait for a very serious fall or other medical decision places on of them in a nursing home.
Please let us know if there are changes.
Carol see more
I agree that calling social services may be the only way to get something done. They have a right to live like this (unfortunately, in this case), but if a social worker can say they are unsafe and living there is unsanitary, there may be some way to force the issue. Otherwise, I'm very sorry to say, you may just have to wait for a very serious fall or other medical decision places on of them in a nursing home.
Please let us know if there are changes.
Carol see more
Question
I don’t want to be mom’s caregiver. Why do I feel this way?
You've gotten some great advice here. What you feel is natural. You've finally gotten to the stage of having an empty nest. You... You've gotten some great advice here. What you feel is natural. You've finally gotten to the stage of having an empty nest. You enjoy your independence. Your mom sounds like she is acting more needy than she really is, which doesn't bode well for the future.
Don't feel guilty. You'll need to help her make decisions as she ages, but she sounds like a prime candidate for assisted living. In such an environment, she'd have the social outlet she needs and wouldn't just depend on you for that part of her life.
As ifnorotic said, cargiving is "easy to get into but hard to get out of."
Also, it is true that becoming the caregiver changes your relationship forever. If she were in assisted living with friends and activities, you could still be her daughter without so much day to day caregiving - at least for now.
Take care of yourself,
Carol see more
Don't feel guilty. You'll need to help her make decisions as she ages, but she sounds like a prime candidate for assisted living. In such an environment, she'd have the social outlet she needs and wouldn't just depend on you for that part of her life.
As ifnorotic said, cargiving is "easy to get into but hard to get out of."
Also, it is true that becoming the caregiver changes your relationship forever. If she were in assisted living with friends and activities, you could still be her daughter without so much day to day caregiving - at least for now.
Take care of yourself,
Carol see more
Question
I am still only getting 2 hours a week free from my mother. I am in over my head. Is it wrong for me to want t...
You are not wrong or bad for the way you feel. This arrangement isn't working and won't likely improve. Start looking for assisted... You are not wrong or bad for the way you feel. This arrangement isn't working and won't likely improve. Start looking for assisted living if you can. Whatever money your mother has is meant for her care.
AL will eat her money up fast, so a lot depends on whether she will eventually qualify for Medicaid in your state. Find out what she needs to do to qualify and stay on top of that.
Unless your sister or someone else can relieve you for more time and you can separate your life from your mother a little, you really need to change this dynamic. Ask your sister to help you figure it out.
You can be a wonderful daughter with your mom in a different home and you having your own life. This situation isn't good for either of you in the long run.
Take care of yourself,
Carol see more
AL will eat her money up fast, so a lot depends on whether she will eventually qualify for Medicaid in your state. Find out what she needs to do to qualify and stay on top of that.
Unless your sister or someone else can relieve you for more time and you can separate your life from your mother a little, you really need to change this dynamic. Ask your sister to help you figure it out.
You can be a wonderful daughter with your mom in a different home and you having your own life. This situation isn't good for either of you in the long run.
Take care of yourself,
Carol see more
Question
Mom qualified for Medicaid in California and we're trying to get her into a nursing home, but the waiting list...
Igloo gave you excellent advice. We often have to choose a home that is more difficult to access but will work at least for a time. Then... Igloo gave you excellent advice. We often have to choose a home that is more difficult to access but will work at least for a time. Then you can place your mom's name on a list for one closer to you if you choose. I hear from people in more populated areas than my community and they often have to travel quite far. But even in my own community, we sometimes have to choose a home that isn't our first choice.
I will add that moving someone isn't easy, so you may decide to stay with the one father away if your mom is happy. It does seem like that's your only choice if she can't stay with you until there's an opening.
Good luck - we're with you in spirit,
Carol see more
I will add that moving someone isn't easy, so you may decide to stay with the one father away if your mom is happy. It does seem like that's your only choice if she can't stay with you until there's an opening.
Good luck - we're with you in spirit,
Carol see more
Question
When should you move an elderly parent from an assisted living facility to a 6 person board and care?
If she has dementia, a move could be hard on her because of the confusion, but if her mind seems pretty good, the board and care would... If she has dementia, a move could be hard on her because of the confusion, but if her mind seems pretty good, the board and care would likely have a better caregiver/care receiver ratio. What does she want to do?
In the end it's about the quality of each facility and the staff who run it. I'd meet the staff at the board and care and try to get a feel for how they all get along with each other and how happy the residents seem.
We often have to make difficult decisions for our loved ones. I'd say do your homework, talk to your mom about moving, and if all is good, then move. But if you feel any negativity as far as staff goes in the board and care house, I'd keep her in the AL.
Take care,
Carol see more
In the end it's about the quality of each facility and the staff who run it. I'd meet the staff at the board and care and try to get a feel for how they all get along with each other and how happy the residents seem.
We often have to make difficult decisions for our loved ones. I'd say do your homework, talk to your mom about moving, and if all is good, then move. But if you feel any negativity as far as staff goes in the board and care house, I'd keep her in the AL.
Take care,
Carol see more
Question
NC Medicaid denial of personal care services, do I need an elder care attorney?
Frankly, I would. It's a lot easier to do legal business when you have someone who knows details of the state law by your side. Be sure... Frankly, I would. It's a lot easier to do legal business when you have someone who knows details of the state law by your side. Be sure the person you hire is right up to date with this new law so he or she can prepare.
Good luck to you. Changes in law that catch people in the middle are rough on everyone involved.
Carol see more
Good luck to you. Changes in law that catch people in the middle are rough on everyone involved.
Carol see more
Question
My friend has started the dying process. How do I comfort him so he will stop trying to stand up?
Hi Shawn, Your faith will help you through this. My opinion is that since Don is dying, you and hospice are there to help him though the... Hi Shawn,
Your faith will help you through this. My opinion is that since Don is dying, you and hospice are there to help him though the process with as little pain and as much dignity as possible.
Hospice often asks the family about medications since sometimes there is a choice between making the dying person more sleepy and less responsive, or having him or her awake more, but suffer more pain. They aren't doing that to make things harder for you, but to let you be part of the process.
You will never forget Don's dying moments. The deaths I've attended have been very spiritual and the peace was profound.
You are a wonderful friend and neighbor. Blessings to you.
Carol see more
Your faith will help you through this. My opinion is that since Don is dying, you and hospice are there to help him though the process with as little pain and as much dignity as possible.
Hospice often asks the family about medications since sometimes there is a choice between making the dying person more sleepy and less responsive, or having him or her awake more, but suffer more pain. They aren't doing that to make things harder for you, but to let you be part of the process.
You will never forget Don's dying moments. The deaths I've attended have been very spiritual and the peace was profound.
You are a wonderful friend and neighbor. Blessings to you.
Carol see more
Question
Can a DPOA with health decisions sign a DNR?
I'm sorry that you have to go through this again. However, you write: "I do know she would never want to be on machines." I... I'm sorry that you have to go through this again. However, you write: "I do know she would never want to be on machines." I believe that is your answer. You are not signing these DNRs because you want her to die, you are following her wishes not to live artificially.
If you have POA for health care, then I believe that should certainly cover the legal part. As to why you have to sign again, likely readmission is the reason. They have a lot of rules they must follow and some seem nonsensical to us but there are reasons behind them (at least there are supposed to be). I think you can sign this DNR with no guilt knowing that you are doing what your mother wants.
Take care,
Carol see more
If you have POA for health care, then I believe that should certainly cover the legal part. As to why you have to sign again, likely readmission is the reason. They have a lot of rules they must follow and some seem nonsensical to us but there are reasons behind them (at least there are supposed to be). I think you can sign this DNR with no guilt knowing that you are doing what your mother wants.
Take care,
Carol see more
Question
My friend has started the dying process. How do I comfort him so he will stop trying to stand up?
Hi Irish Eyes, You sound wonderful and caring. I can see how scary this is. Have you asked the hospice nurse how to cope with this?... Hi Irish Eyes,
You sound wonderful and caring. I can see how scary this is. Have you asked the hospice nurse how to cope with this? Sometimes we caregivers are torn between helping our love one do what he or she wants all the while knowing that it's risky.
I will say that this stage isn't likely to last long. It's possible the hospice nurse can talk with the doctor about the hallucinations, since that could be caused (or made better) by a change in medication.
You need to ask yourself if you will feel guilty if he falls and gets hurt. Again, I'd talk with the hospice nurse and/or doctor and ask directly what is the best way to handle this.
Take care of yourself, too,
Carol see more
You sound wonderful and caring. I can see how scary this is. Have you asked the hospice nurse how to cope with this? Sometimes we caregivers are torn between helping our love one do what he or she wants all the while knowing that it's risky.
I will say that this stage isn't likely to last long. It's possible the hospice nurse can talk with the doctor about the hallucinations, since that could be caused (or made better) by a change in medication.
You need to ask yourself if you will feel guilty if he falls and gets hurt. Again, I'd talk with the hospice nurse and/or doctor and ask directly what is the best way to handle this.
Take care of yourself, too,
Carol see more
When I take time out to be with friends, my mom seems a little resentful. How do I handle the guilt?
If you have senior companions in your community (look up RSVP in your phone book), they may have someone who could visit with your mom some days. There may be someone from your church who visits elderly people alone, as well.
But you absolutely have the right - and likely need - to have a day for yourself. Your mom gets lonely, which is understandable, but you have to take care of yourself, as well.
Carol see more