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About 8 months ago my 87 yr old grandma suffered a broken femur due to a fall. After surgery she was put in a rehab center for 6 months. We were told to make some type of arrangements before the 6 months passed. She had such limited mobility and no further improvement in therapy so they said she could not stay longer. They said she either needed to be put in a nursing home or go home with 24 hour care. Grandma said no way to the nursing home and i dont blame her. Since gramdma still has somewhat decent amount in savings, medicare would not cover any kind of 24/7 services. My family and i had decision to make. We looked at prices of caregivers and there would be no way she could afford them. Shed maybe make it 6 months and then be forced to give her house up to a nursing home. She doesnt want that. I decided to step up. I am 30 with no children or other major responsibilities. So she gets released little over 2 months ago. Comes home and i move in to her house so i am there 24/7. Grandma is hard to get along with and can be mean but i still want to do everything i can. She needs help toileting, washing, changing, meals prepared and brought to her. Medicare covered for home visits twice a week physical therapy,occupational therapy and a nurse for 9 weeks so far. The physical therapist would give grandma "homework". She wanted her to get up and walk several times a day. Which is fine but she needs me to assist with a gait belt. Everytime i urged my grandma to walk she would get angry with me and say "ill do it later!" I was only able to get her to do it about twice a day after plenty of arguing. I told this to the physical therapist and she was mad. My grandma then blamed me saying when she wants to walk, i am downstairs. I do stay downstairs in downtime only because her television is so loud. And asking to turn it down is a whole other argument! I tell her if she wants or needs anything while im downstairs she can call my phone and she DOES. She calls if she wants me to put a blanket on her, if she wants lights turned up or down, if she needs to pee, anything and everything she's asked. But never ever has she called and said she needed help with walking therapy and when i suggested it she declined with anger. So she tells this girl that shes alone and i stay downstairs and wont help. I did admit that i do go down there for peace becsuse of the blaring tv and to catch up on some lost sleep since grandma doesnt go to bed til 11 pm and wakes at 4am for bathroom, insulin, and even wants breakfast at that time! So some nights are really hard if im not able to fall right asleep. Which a lot of times im not. Im up with anxiety and worry from this situation. The PT tells my grandma that if i am away from her and cant help her walk and cant do what she needs, then maybe she should get a new 24 hour caregiver! I said how? And do you have any phone #s of these agencies then? She said she will have the home nurse give me info. So the following week the home nurse confronts me asking if im quitting and why do i want the #s. I said "no i was just frustrated and a bit offended that the PT would give such an opinion when she is only in the house with grandma 30 mins at most" i told the nurse how i try to catch up on some sleep and that whenever grandma needs me she can call me. I said i am feeling sick from lack of sleep and if i get sick who will care for her?The nurse tells me "ha! No one gets sleep nowadays! Youre not even that old. You cant be very sickly. You seem more concerned with your wants/needs than hers. A true caregiver would be sitting next to her the entire day!" I told her ive tried that but the tv is too loud that it hurts. And im only downstairs til about 9 am then after that im in the next room from her. And also that grandma eats by my preparing and bringing food right to her about 4 times before i even think of eating once in the day! This nurse says she wants her care extended another 6-9 weeks eventhough all other therapy has not been extended. And on top of this criticism i thought before this incident that this nurse had been rather lazy and her visits were turning into gossip and tea time. But never would i have said or accused her of that! She gets up to leave and says "ill go ahead and extend my service. Ill see you beginning of next week. Oh honey! I hope you dont think youre being judged!" I totally know i am. So just wondering should i let anyone from her agency know of this? Or would that open up new doors of accusation? It is going to be reall uncomfortable now to see her knowing she thinks this of me.

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Abbey, is your mother okay with the difficulties for you in taking care of your grandmother? It seems like you are doing all the work, and it's all to save Grandma's house being taken by Medicaid? Are YOU going to inherit that house?

You are 30 years old, and should be working at your own career, living life as a young person should. Why is everyone okay with your being the 24/7 caregiver? How long is this expected to continue for you?
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I agree with CTTN55. Unless you are being paid, and paying into Soc Sec, you are losing serious ground towards your future. Do you have workman's comp insurance? Your grandmother can add that to her homeowners policy. What if you get hurt caring for her and are unable to work a regular job later on?

Get a written caregivers agreement and get paid and when the money is gone, sell the house and let Medicaid and provide 24/7 care.

You say that Grandma doesn't want to sell the house and go into a nursing home but at the first opportunity she has, she throws you under the bus. I could not stay loyal to that. If Grandma wants you to give up your life and care for her, she needs to appreciate what you are doing.
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You can try requesting a different nurse without making any accusations. Is this an aide, RN or LPN? What are they supposed to do for grandma? Maybe you could ask them to walk her when they come. Do they actually do anything for grandma like bathing, changing bed etc. Next time they come have a list of things you would like "help" with.
If you call the agency and request a new nurse ask them what the nurse is specifically expected to do.
If some one suggests a new caregiver ask them sweetly to arrange that and some one to pay for the services. How are you managing to live by the way if you can't go to work?
It is so frustrating when you get uncalled for accusations.
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Abbey there are a lot of really unprofessional people out there. We had a couple doozies who of course had zero experience with caregiving. A few I'm guessing did not even have much contact with the elderly. I agree with Veronica, just request a different nurse. You don't need to give them a reason; if they push you, you can just say your grandma requested someone else or you can just reply, "I'd rather not say."

Re: the therapist, if she thinks most of her patients are doing half of what she asks them, she is out of her mind. She is working with a tired, stubborn population and she should assume that what they do during her visits is all the physical therapy they get. (Not that you shouldn't keep pushing your grandma -- that is great. But your grandma is a "free agent" and neither you nor the therapist can make her do anything.)
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So if she goes ahead and unilaterally extends her services for another 6-9 weeks, who gets the bill for that? I betting it's not Medicare, it would be up to you and grandma to private pay.
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You are the one who is dealing with the nurse and if you feel like she is a problem, it is not a big deal to make that request. If you are having a hard time with this woman, other people probably have too. From your description, she is at the very least unprofessional and possibly unethical. She sounds like she is offering little or no assistance to your grandma. The longer she is in your house, the more you are going to worry about her. It sucks but when you are caregiving, there are going to be times where you just have to put your foot down with people. It is hard to do but just think about next week when you don't have to see her. Anyhow it sounds like you have the perfect out with the primary dr not ordering the additional weeks of help.
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Don't be afraid to ask for a new nurse. But I would make a mention of unprofessional behavior and possibly unethical behavior. You should explain what went down but keep it short and sweet. Talk to a lawyer that deals with elder laws to know what your rights under law are. She most likely does need to be in a nursing home though.
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Abbey, I can see why you want to care for your grandma at home. Placing a loved one in a facility presents its own set of challenges. If it gets to that point, your family will make that decision. From what you have written about your grandma here, it does not sound like her behavior is out of the ordinary for a person in their late 80s with dementia, especially if their baseline personality was "feisty" to begin with. It sounds like the issue is what you asked about: the screwball home help that rehab sent. (If your grandma needs to be hospitalized again you can request a different rehab facility. That one sounded bad.)

It might be worth it to think about what Mom2mom said just to protect you and your grandma in case she does need to apply for Medicaid for long term care. There are books on caregiving that might have advice on on that. But many families are in the same boat: loved one has "too much" for social services but not enough for around the clock care. We did similar to what you are doing; there is no way my grandparents could have afforded to pay us.

It sounds like you and your mom are taking really good care of your grandma. If you need a little more in the short term, sometimes the county will offer a few hours a week of visiting aides who can help bathe, feed, or do light housekeeping for your grandma. The income limits are not as stringent as for Medicaid; it is through the county's Dept. of Aging. Your grandma may qualify (even with live-in help.)
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"My mom actually does help. Alot. She takes over for two days so i can have two days off. "

But your mother is still accepting that you are the free 24/7 caregiver, which just isn't fair to you AT ALL. It's as your mother is more concerned that HER mother's wish to not be in a facility takes precedence over you, her own daughter.
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This isn't about the nurse but about paying for care. I suggest you go talk to an elder care attorney. Even if you don't want to hire one, you'll get a lot of good information.

It's quite possible that you can get her care paid for through a government program. You mentioned medicare but it's medicaid that pays for long term care, not medicare. As for her having too many assets to qualify for medicaid, there are a variety of ways to spend down those assets until you meet the medicaid requirements. So go talk to a lawyer. It may cost a few hundred dollars, but it can save your grandmother 10's-100's of thousands depending on how long she needs long term care.
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