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Fortunately we put my sister in a good facility but now they are asking me to take my sister to an important doctor appointment where they are evaluating her heart. I live over 8 hours away. (We have no other family in the area.) I can't go home right now because of my own doctor appointments which I can't cancel. The assisted living facility has aides who could take my sister but they will have to take off half a day, which they don't want to do for some reason. This is the first time this has come up. My sister will probably need heart surgery down the road and I will go home for that but I can't start running home to take her to the doctor. I should add that my car is old and I don't trust it on long trips. I also feel that the assisted living facility should be responsible for this, not me. I have other issues. My husband and I pay all my sisters bills with no help from my brother. I frankly resent this. My husband and I scrimped and saved for our retirement and have lived a very frugal life. My sister never saved a nickel for her retirement and it bothers me that we have to bail her out yet again. I have been helping to support her for over 40 years. One other problem - her medical bills are a nightmare to deal with. Many providers will only bill to Medicaid if you call them. In the past I unwittingly paid bills that I should not have. I have also gotten "scam" bills which were not owed. I am constantly having to call and at times fight with people to get these bills paid. Also my sister is still driving. I have tried to get her doctor or the assisted living facility to take her keys away - they won't do it. Meanwhile, she let her drivers license expire and lost her cell phone. I had to get on her to get her car inspected last year. I feel I am constantly putting out fires. I did try support groups and did not find them very helpful. thanks for listening. Lolli

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Why are you paying sister's bills? Have you tried to get her on Medicaid?
You need to save for your retirement.

Check into a Geriatric Care Manager to monitor sis as needed. Are you guardian or POA for sis? You can relinquish that to the state which will then step in to figure out sister's needs and care.

You need to take care of you.
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I looked after my parents from 700 miles away for the last 6 years. Finally got them in assisted living about 2 years ago, mom has passed away and dad is in memory care now.

It sounds odd to me that your facility can’t get your sis to a doctor appointment. Most places will do this for a reasonable fee. If not, you can hire any number of VISITING ANGELS type services to do this. It’s usually $20 an hour or so with a 3 hour minimum.

Ive had to make dozens of trips through the years dealing with everything imaginable. But I was fortunate to have just retired when all this started and my folks had the funds for a private pay facility.

I would also suggest questioning some of these medical appointments. Are they really necessary? My moms docs, and there were many, scheduled a ridiculous amount of appointments and follow ups. So poor mom would get hauled to the cardio office, sit around for a couple hours and be told she was fine, come back next month. Most docs don’t give the least thought to the hardships of getting elderly people to appointments.

Remember, you are in charge and will make the decisions. Sis may not like it but if you’re taking care of all her affairs it’s your call. Include her in discussions if she’s mentally able but in the end do what you have to do. My mom hated it when I became the parent but we had no choice.

I understand what you’re going through. There were many times when I started to wonder if I’d outlive my parents. They never cooperated on any issues. It was always done kicking and screaming. At one point I even considered walking away and turning them over the the state. But I’ve gotten through it and it’s settled down now.
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What kind of heart issue that requires surgery? Are you sure that you want to subject your sister with dementia to life-prolonging surgery? Will she be able to cope with recovery?
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Thank you so much for your answers. They all helped and gave me a lot to think about. My sister does need heart surgery. She has a damaged valve and is not getting enough oxygen to her brain which is contributing to her memory decline. She can hardly breath. She has a good surgeon and I know other people whose parents had this and they recovered very well. The assisted living facility does have a transport service called "Medicab". This a long appointment and the assisted living facility will have to send an aide with my sister which they don't want to do. I called the facility today and told them that they would have to take my sister to her appointment. That is why I put my sister there in the first place. Medicare and medicaid pay for most of my sister's bill. We pay her phone bill and medical co-pays and a few other bills. My sister lives on what is left after social security and ssi pay her room and board. I feel guilty for saying I resent paying my sister's bills but I wish she had made a plan for her retirement instead of letting us pick up the pieces. I do have DPA and I use it all the time. It was one of the first things I did. I did have my sister evaluated by various people early on and it was determined she should go into assisted living. In the state my sister lives in if you can walk and take care of your personal hygiene they won't put you in a nursing home. That is there decision not mine. It varies by state. As far as my sister driving, I am looking into different options. I am hoping we can get a note from her neurologist saying it is not safe for her to drive. Right now her car isn't working so she can't drive anyway. Thanks again! I am so glad I joined this group.! Lolli
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What are you and your husband going to do if either of you becomes disabled and in need of care? In other words, why are you putting paying your sister's bills ahead of your own financial security?
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Ask if there is a medical transport company that the AL uses that can take her to her appointments. When my husband was in rehab for mobility, the facility used a transport service twice for him for appointments. It was covered by insurance.

Have the DMV write a letter to the facility stating that she is no longer able to drive and they need to take her keys. If they don’t do it and something happens, it’s on them for going against direct orders.

Facility billing is a nightmare no matter which facility it is. We all deal with it. That’s why I used to have to set aside a half hour to examine my mom’s statements with a magnifying glass. Make sure you get a completely itemized statement from them.

Also, consider your sister may be ready to move on to more care. The more intensive the care she gets, the less responsibility you will have.
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With ur sisters heart condition, she is not safe to drive. Now no license, how about her registration. Who pays for insurance and gas. If that is you, I would get rid of the car. One less thing you need to worry about. Do u have friends in the area who can keep the car for you. Out of sight out of mind. As POA you could sell it but check with Medicaid first. If the car is in her name it means income if she sells.

No, the AL does not have the power to take her keys away. She is a resident and can make her own decisions. I don't understand why Drs. are so reluctant to take Dementia people off the roads. I think once there is a diagnosis they should be tested regularly.

I really don't understand why you have so much trouble with Drs. offices billing Medicaid if they except it. It should be automatic. Is ur sister on Medicare? It should be Medicare, and then balance is sent to the secondary insurance which is Medicaid. If straight Medicaid, then thats who they bill. I have never paid anything for my nephew. Between Medicare and Medicaid all his doctor bills are paid. That goes for dental and vision.
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Lolli56 May 2019
Thanks for your response. The medical companies I am dealing with don't bill to Medicare and Medicaid automatically. I have to constantly call them and remind them to bill. I have also gotten fake bills that I didn't owe, for example I got a bill from my sister's oxygen company that had already been paid by the assisted living facility. Most of the companies I deal with are okay but I am convinced some of them are dishonest - they "double dip". They bill Medicare and Medicaid and try to get money from me too. By the way I used to be an insurance biller and I also have an accounting background. When I have time I should turn some of these folks into the attorney general.
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