Memory

The thing that sucks about memory disorders is that you have to walk on eggshells around people with them 24/7.  It's exhausting for the loved ones (I know), and I would imagine it's even more exhausting for those going through it.  It's typical for memory loss sufferers to lash out in anger and frustration, often the opposite of their natural personality/temperment.  My husband's progression has gone so slowly that he's adjusted, with the help of medication and assisted living, so most days he's pretty stable -  but it's taken 5 years.  Unfortunately, I'm not able to apply all this knowledge and experience to anyone else.  Raj's mom, for example, was typical - very angry and depressed, even violent at times - leading up to her diagnosis; but we didn't know that was common behavior back then for someone suffering memory loss.  My grandparents, from what I remember, were atypical - cooperative, calm, trusting - as they aged and their memories worsened.

So how do you deal with memory loss in another?  What if they can't see their changes in behavior or don't recognize their symptoms of depression?  What if they truly believe everyone else is wrong, and their paranoia gets projected back out at the world?  How do you express concern or love?  How do you explain it to children?  I really don't know.  All I can do is turn to my faith, pray for patience and discernment.

I try to see things through their eyes, so when my memory fails, I won't put my loved ones through the "walking on eggshells" that seems so cruel.

  

Meh

Today, I was assigned a Patient Advocate from Allstate/Hewitt to work on the now year-long battle with Rush University Medical Center & United Healthcare.  After such a long time of fighting to have the claims for Raj's stay processed properly, I gave up and found other insurance - Medicare with various supplements for Raj, and a separate plan I found on the open market for the kids and myself.  Once our new coverage was in force, I called Hewitt to cancel the oxymoron medical coverage I was paying 3x more for.  My request was DENIED, and they explained that the only way to end the medical coverage is for non-payment of premium (even though they still haven't processed November 2010's benefit election to charge the correct amount for said premium)!  The benefits representative had a hard time communicating their "decision" and I stayed on the phone an extra hour to provide enough information for him to appeal on our behalf.

After similar experiences with Raj's Humana plan for June - December of 2011, I was assigned a Patient Advocate from Humana, and I'm keeping him very busy.

The issues are pretty much the same, regardless of Medicare vs non-Medicare coverage, PPO vs POS, prescriptions included or not:  They promise the world when you elect/buy the coverage, provide documentation to support this to "comply" with Healthcare Reform and other laws; and I suppose everything would be going well, if it were not for claims.  When I submit claims for covered expenses - prescription drugs, doctor visits, hospital services, durable medical equipment - both sides panic.  The billers don't even want to try, and the insurance company won't process anything to be paid, even if it DOES get submitted.  The folks answering the phones either hang up on me, or tell me the providers have no intention of honoring their contracts.  I've never seen anything like this BEFORE Healthcare Reform.

Example:
A line item for one of Raj's hospital stays (the first line, unfortunately) got submitted as "out of network" instead of "in network" so all subsequent line items and claims were processed incorrectly.  Endless calls, emails, and faxes resulted in backing out an invalid deductible (good) but they resubmitted it with ME as the patient (bad).

We've already lost several of Raj's doctors, due to issues they've experienced under Healthcare Reform, and we lost another one - his psychiatrist - last week.  Anyone know of a psychiatrist in the area that is accepting new patients?  How about one that is still in business?

Lookin' up

I'm in a much better place, now that disability has been reinstated, I've cashed out my VUL and replaced it with term life insurance (at a preferred rate!), and we have a REAL offer on the Wauconda land!  The BIL, Dave, came out of woodwork with demands for some legal proceedings, which I haven't heard any more about since the initial threats; But at least we know he's alive (as of 1/24/2012), and that's something!  I even fought off a cold (or whatever it was).  And today was supposed to be 60 degrees - the sun feels great!

Sometimes, it's hard

So I wake up early this morning to check on our disability EFT, which didn't happen yesterday.  I'm told they stopped paying the claim, since they didn't receive our doctor's forms.  This has happened before, which is another reason why we switched some of Raj's providers, but other times, the disability payments kept coming while the insurance company worked with the doctors on what they wanted; then we'd receive a letter warning that benefits could cease in a month, and I'd remind the doctors to submit their paperwork.  This time, no warning - they didn't even TELL us - but our income has disappeared.  The bills, however, still need to be paid.

Add to this several other irksome issues with health insurance, our dental cleanings being denied, the bank's website missing transactions, an empty refridgerator, and multiple dashboard indicators lit on my car, and I've had a truly rotten day.

Hopefully, I'll be able to get our income source reinstated; If not, I'll figure something out.  God always provides; But for tonight, I need some rest.

Medicare & other

Got Raj signed up for a different set of Medicare benefits for 2012.  Instead of Parts A & B with Humana Medicare Advantage in 2011, I'm going with Parts A, B, D and F.  So far, the prescription plan (D) got processed, we've received the Member ID & card, and they've even processed my POA so I can communicate with the Community CCRx on Raj's behalf.  With Humana, these processes took 3 months!  We'll see what happens when I try to fill the first prescription, which is waiting for me at Osco.

Hopefully, BCBS-IL will be a good choice for a High-Deductible Plan F.  Since the first set of expenses just go toward the deductible, parallel to base Medicare, I'm not worried that this coverage isn't in place immediately. 

High on the list of what's needed is a hospital bed for Raj.  With his knees so rigid, he literally crashes into the single bed we have there for him, and it can't handle the impact.  Because of the reflux, he should sleep with his head elevated anyway, and this bed will address that, as well.

The patient advocate assigned to help me with the backlog of 2011 Humana claims is working on the first one; We'll see if someone internal to that organization can make any progress!

Raj was home for Christmas-gift opening several days ago, and he was cooperative.  His coughing was almost constant, though, so he's not remembering what the speech therapist taught him.

I heard back from one of the two life insurance companies I applied with today.  I need the cash, so I'm planning to surrender my VUL and replace it with basic term insurance.  I haven't seen how my physical exam turned out, but I was surprised to be quoted at the "Standard" rate.  I have no chronic conditions or diagnoses, am experiencing pretty normal "female" stuff through a long peri-menopause, and take one prescription to manage those symptoms.  I keep up with regular massage and all shots/tests/labs/maintenance/dental/eye stuff, and take supplements for optimal health .  I haven't had a cold or flu in years, BP is great, and my only ER visits were 7/2009 (bad headache after cushioning one of Raj's falls with my whole body on a concrete floor) and 9/2011 (tripped while walking the dog & had sore wrist X-rayed).  Hopefully, the other insurance company will come through with a better rating.

Contact Made!

I finally heard back from the new psychiatrist at Raj's facility, and he's making the necessary med changes to (hopefully) avert mania.  Apparently, Dr. G reduced the main mood stabilizer due to his liver counts.  Raj had mixed up this information, and requested dropping one med while starting another.  Now I think we're on the right track with those meds and liver counts are OK at the moment.  Also, I followed up with his PCP on the new cholesterol med & reminded her to run labs on that.  I even had an initial conversation with Dr. G's billing rep, and was assigned a "Humana Cares" representative to help me with the backlog of claims that they keep denying!  Merry Christmas to me!

Mania?

Raj's mood has been stable for so long, I know I should be grateful.  But his new psychiatrist hasn't ever spoken to me directly, so when he asks the "kid" about the "candy store", the kid certainly isn't going to tip his hand.  For the past couple of weeks, Raj has been increasingly irritable and demanding.  I don't know how long it's been, but my only medical contact for his care at the assisted living facility (Nurse Judy) lost her job.  All I have for the on-site psychiatrist is an email address, so I sent him a message tonight regarding Raj's symptoms and clarifying various med changes.  I hope it's not too late to prevent a full-blown manic attack and/or hospitalization . . .

Maybe he's right.  I do the best I can as his caregiver and Power of Attorney, but he's saying (again) that I'm just not doing well enough.  He's miserable and wants out of that facility right now.  The grass is always greener (blah, blah).  We've gone through this more times than I can count; Each time, I wonder if I can endure yet another round.  I tell myself that there's no one else to take this responsibility, that he doesn't intend to lash out at the kids and me, that this phase of aggression/lying/complaining will eventually pass . . . but it takes a lot of energy and constant vigilance to erect and enforce the necessary boundaries to protect my sanity and safety.

Lord, help me to focus more on the good that is all around me, and less on everything else.