I have a 79 year old tenant that I am concerned about. She has had a few situations that have set her back this year (e.g., 1. her dear sister died and she wasn't able to see her before she passed - took it VERY hard, 2. she had her debit card number stolen and about $400 worth of merchandise bought - they ordered products in her name and then stole them off her porch!, 3. she lost her phone - which made her miss her prescription delivery so she was without all of her medicines for a few weeks...she is on a LOT of prescriptions.
She has had a lot of trauma in her life and I would definitely call her a survivor. She is tough, but the trauma took its toll also.
When she gets stressed or anxious she develops diarrhea. Apparently, this stress reaction developed 30+ years ago and NO ONE HAS SUGGESTED SHE SEE A GASTRO DR.!
This last bout has really taken a toll on her mentally and emotionally - made her afraid to eat anything. So, she got weak and dehydrated leading to an elevated heart beat and a lot of anxiety as she felt she was never going to get over this. (Trip to ER for IV bags).
Her brother in NY is naturally concerned for her well-being BUT tends to yell and harangue her when he is finally able to get her on the phone - which stresses her out and - you guessed it, gives her diarrhea.
Her kidney doctor is VERY concerned for her and is trying to find some home health resources for her and this will be brought up with the primary doctor in an appointment this next week. (And another appointment that will do a mental health assessment a couple of weeks away...)
Do ANY health insurances cover home health aides? (I don't want to get my hopes up....)
Does a doctor have the authority to ORDER that she go into a nursing home?
I am trying to help her navigate all of this. I had some serious talks with her and told her is going to have to prove that she can take care of herself if she wants to stay in her apartment.... that not eating is NEVER the answer to a bout of diarrhea (BRAT diet), and that she needs to square up with her brother and set some boundaries so she is not allowing him (or his wife) to verbally abuse her.
Probably everyone will say she has to go to a home..... but I really think that will kill her...
Thanks in advance for your time and consideration.
Lainey
Medicaid (which she would have to apply and qualify for due to very low income) might cover some aides at home.
Have you and your tenent ever called your local Area Agency on Aging? That's where I would start in trying to see what services she would qualify for.
For starts, you want them to do a "needs assessment" and ask about "case management" services,
Thank you for your reply!!
Yes, I did call them and put her on the list for Meals on Wheels. Not sure how long before that starts and not really sure how much help it will be - She can be persnickety!
She has Medicare and another insurance.... Really hoping we can get some home health aid for her!!!
I will definitely ask about needs assessment and case management!!!!
Thank you so much
Has she tried any meditation programs? They can really help. And yes, she should see a gastro doc.
She should more or less go to no to nearly no contact with her brother as he provides no kindness or care. Hope the meal delivery may help even if she just eats a portion of it. Also some home health aid would be helpful.
It simply sounds as though living alone in the future may make her prey to circumstances that she might be protected from if living in a facility not to mention her existing physical ailments. I wish her well. I am sure she is fortunate to have you as a neighbor.
If she has original Medicare the doctor can order her home health care. This is a nurse once a week to take her vitals, help her manage all those prescriptions and basically keep a medical eye on her. If she needs help with bathing a cna can come a few times a week and help her bath and change her bed linens. A physical therapist can evaluate her to see if she needs a bit of help with her balance or strength training.
This care is covered by Part B with original medicare for anyone who has a difficult time leaving home and needs intermittent skilled nursing. Patients are generally already considered home bound when they qualify. Her doctor might be willing to order it to help her get things under control even if she isn’t typically homebound. Doesn’t mean that can’t leave home, just that it’s difficult.
It’s worth a try. If the doc will order, the RN who comes out to evaluate will know if she qualifies to continue seeing her. If you go to the doctor with her, stress that she lives alone.
It sounds like your tenant may have IBS, irritable bowel syndrome, which can be aggravated by stress. I’ve had that for many years and it can be dormant for a long time and then as you suggested, stressful events can trigger it. Many, many people have it. At my worst it is accompanied by nausea and vomiting, stomach cramps and diarrhea. Oddly another symptom is sometimes constipation. If it is unchecked and fluids not replaced, dehydration can cause a lot of problems.
Gastro doc suggested the low FODMOP diet, (Stanford Medical School version). You basically eliminate foods high in FODMOPs for a few weeks and then add them back one at a time to see which might be a trigger. It’s kind of a reset for the stomach and allows it to calm down. I noticed there were several foods I had to eliminate which are healthy foods. You don’t have to eliminate them forever unless of course they prove to be a problem. I was also told to take Benefiber daily.
There is a tablet that dissolves under the tongue that will stop the cramping almost immediatly. Hyoscyamine. It works like magic for me when I need it.
Even if she won’t eat the meals on wheels everyday, there will be someone checking on her which is a good thing.
About the home killing her. Home health can help a senior live at home a lot longer than they would be able to otherwise …in my experience.
However, they have to be willing to accept the help.
Diet and exercise are foundational. If she doesn’t want to be bothered, she will continue to decline at a faster rate and eventually the regular care from a nursing home might benefit her. Each person is different, their circumstances are diff, their support system is diff.
Do you intend to stay in her life as her caregiver? It is a huge responsibility. The IBS (if that is what she has) can’t be cured, it has to be managed. She may not have it for years, or at least that’s been my experience then it’s back and I have to manage it.
You mentioned kidney issues. Of course, dehydration is a biggy and you indicated she takes many medications. Probably her diet is awful. If she eats a lot of processed foods she won’t like the taste of healthier foods. That takes awhile to adjust to. She may not be willing. So it really depends on how willing she is to make changes that will keep her healthy at home. A housekeeper would be something else to encourage. Even if it’s only once a month it can really make a difference.
Unless she has funds to private pay for ALF then she would need to qualify physically and financially to go to a NH on Medicaid.
You could contact Area Agency on Aging to see if she qualifies for any additional services. They are affiliated with the Meals on Wheels group. You might ask about any resources for grieving they could refer you to.
Check her ADLs periodically so you notice big changes as they happen. You are kind to help her. Good luck.
As you have experienced, "talking" at her has gone nowhere. This is because she either has short-term memory impairment, hearing impairment and/or the beginnings of dementia.
Dementia starts slowly as shows up as "stubbornness". It robs people of their ability to use logic, reason and judgment. This is why "informing" her goes in one ear and out the other. It also robs them of their ability to have empathy for others. So, don't expect gratitude for what you're doing for her. Or understanding how hard you're working on her behalf, making sacrifices, etc.
My MIL is in LTC on Medicaid in a wonderful facility. Maybe you should take her to see a modern facility to see how nice they can be. She is currently being killed by her own self and decisions right in her own apartment. It can't get much worse than that.
It may also be a case where Adult Protective Services are moving in now to arrange for guardianship by the state. That would also likely mean placement in facility care for her own good at this point. If she wishes that not to happen, that being a court case, she will have representation, but if doctors examine her and judge her not safe and competent to now live alone their word will count for a lot with the court.
This ultimately--concerned and loving as you are--isn't your business. The details aren't shared with you and you cannot know what is happening. You will be notified by your friend or her family.
Clearly you are very kind and loving. But this happens to so many.
Praying for God's grace, guidance, direction and timing!
Thank you ALL again.
Lainey