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Hi All,


Regulars might recognize me from quite awhile ago. I was in here regularly for 3 years when my father was ill. Everyone here was a tremendous help during a difficult time and our whole family was so appreciative of all the wonderful advice with various problems as they arose. Sadly, in 2008 dad went to join Mom, who'd passed a few years earlier, and though I meant to stay active here, life intervened.


Well, I'm back, as I'm seeking everyone's wisdom once again. A few years back my sister-in-law had to have a leg amputated caused by diabetes complications and other issues. Within a couple of months of that amputation it was decided by her Doctors that her other leg must also be removed to save her life. It's been at least two years now, and she and my brother have had a hard time of it.


They live in another state with no family (never had children). My best friend from childhood goes over twice a week and helps my SIL bath, and straitens up the house. She also helps out whenever something comes up where she's needed. She's a saint, and I love her to death for how she's helping them out (for a mere 20.00/day...a third of which goes for gas for the week to get to their house and back).


Anyway, I degress... I need the advice of all of you. Yesterday my brother (age 66) had a heart attack. They rushed him to the hospital by ambulance and he proceeded to have three stints put in. He hopes to get out on Monday. Theresa (my best friend) told me that the Doctor said he's not to do anything streuous for up to a month.


The problem is, dealing with my SIL, who has no legs and is a large woman, requires strenuous work from time to time, without a doubt. I've suggested they try to hire someone to come in at nights for a few weeks, but money is a big issue with them. It's going to be even bigger when medical bills start coming in for my brother. He failed to get the supplemental insurance last year when he went on Medicare and they are going to take a hit for his copays and portions of his upcoming heart attack care I'm guessing.


The hospital has given him a list of home health care aids, but they all want 20.00/hr and, though they have some money saved, they can't afford that and afford to live on their SS alone with the medical bills they will be dealing with.


They are in Ohio, I am in Arkansas, and can't help them at all. Theresa will try to help as she can, but she's 65 herself, and has her own large extended family that she also takes a lot of responsibility for. She can't do more then she's pretty much already doing.


This is a dire situation for both brother and SIL. According to Theresa, SIL does very little for herself and has relied on him for most everything since the loss of her legs, including bed pans, cleaning up, getting her from the bed into the wheel chair using the Striker (sp?) and back again, bathing, shopping, food prep... she spends most of her time in bed watching TV and depends on him for soooo much. He's just not going to be able to do everything for him now that he's sick too!


My heart aches for my brother... He made his mistake when this all started. He's the type that doesn't like conflict so found it easier to do for her then to go through the effort required to try to make her do more for herself...and now he's paying for that. And she can be quite the demanding woman. I'm afraid that he's going to end up killing himself if they can't get help in some way, if things slip back into the way they were when he goes home and begins to recoup a bit.


Sorry so long. Any ideas or suggestions will be Greatly Appreciated~


Dustien
A loving sister who's really worried...

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Could your brother go to rehab for a few weeks?
Of course that isn't helping your SIL, what is she doing while he is in the hospital?

And I've read on the forum about community medicaid, is there any possibility of that where they live?
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Instead of him in rehab, can she go to a LTC facility. If their finances are as u say, maybe Medicaid will pay for her care. Your brother can do rehab at home. If they feel he needs therapy, they can come to him. I just had a friend who had open heart surgery and he recouped at home just fine.

I would suggest that brother try for Medicaid health insurance for his secondary. My GF was a diabetic with am amputation and her health problems continued to grow. It may even work out better that SIL is in LTC for good since brother really can't afford outside help. He will become the Community Spouse and have enough to live on. At this point, I don't think SIL has much choice. Its either do this now and have a husband or wait and he has a heart attack that kills him then she has no one.
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Sounds like brother needs to go to rehab for a few weeks and SIL needs to go a facility for “respite” while brother is away. And during that time someone needs to work with the social workers to come up with a plan for their care in the long run.

as you know, your friend can’t possibly provide the care they both need on her own. Ohio doesn’t have the best state programa for home health care unfortunately. I agree that they need to look in to Medicaid, their out of pocket medical costs will help them qualify for it.
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It seems to me that both your SIL and your brother have a real medical need and might get at least some help through health insurance providing their doctors order it. I would actually try to get them each covered services if possible. Your brother might not get as much but if he isn't going to rehab first and doesn't have any help or oversight at home (I wouldn't mention the help from your friend) it would be fairly routine to send him home with VNA services and PT, when they evaluate his needs they will see his responsibilities and might even question whether he should be home already or not but it's key that he be honest with them about what he will end up doing because there is no one else. Also they may not want him driving for several weeks or even months meaning they are home bound since they don't have anyone else around which might qualify them for MOW, van service...various things depending on their local. Someone should get in touch with SIL's doctor as well to let them know that DH is not able to do the same care giving he has been and it seems like they should order some care giving services as medically necessary, It's like the hospital releasing each of them and needing to know there is a safe and good plan for care giving in place, one the doctors know that doesn't exist they should take an interest, responsibility in helping to facilitate what is needed. SIL may need to change her perspective on caring for herself here, does she realize how close she came to loosing her husband and how important it is that he not do most of the things he has been for her? Is this a conversation you can have with her? Maybe just tell her you are concerned because his doctors are saying he has to take it easy, not lift more than 10lbs (whatever it is) and follow direction or he could do even more damage and you know all he wants to do is make life easier for her so he's bound to do the things he always has when he comes home even though he is not supposed to be. Enlist her help in figuring out how to make sure he follows doctors orders and doesn't kill himself or worse by not listening.... Put some of the responsibility in her court and take the burden off yourself a bit, you can and should certainly offer to help but her husbands well being should be of importance to her (even for selfish reasons) and something she should take responsibility for. I'm guessing recognizing it as in her control and responsibility might help prevent push back and help her rise to the occasion.
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Wow...good advice already. They are very private with their finances so I can't say for sure what they have. I'm going to share all that's been suggested in here with my brother and also check myself into community medicaid. I will say right now that I doubt very much SIL will go into a rehab (though I think it's a great idea myself), or if she even can insurance wise and I don't see any possible way to force her to.

She has pretty much ruled the roost their whole marriage, him being who he is and never wanting to rock the boat and her being very dominant. She's also always made more money then him so she always did the finances and he just had an Allowance. I just can't see him, after 30 years of marriage, changing his character and trying to force her into rehab.

If SIL ever found that I was posting their situation on this forum, even though it's anomous, she'd be livid and no doubt take it out on my brother. So I don't dare tell them about it or have them come read the posts. So, sadly, I need to simply do what I can, and passing your suggestions onto him as if they are coming from me, is one thing I can do, as well as looking into what help in organizations for aging might be available and hope he takes some of this great advice.

I will see if I can't get Theresa to come in here and read your suggestions though. It will do her good and she is in a better position I think to nudge him in the right direction and to see to it that he follows up.

Thanks All!

Dustien
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Found a couple organizations in Akron that might be of help. Talked to my brother tonight and told him about them and asked his permission to contact them myself and he agreed I could. That's best for the initial contact I think, since he does tend to be socially challenged.

Right now my friend Theresa is staying with SIL while brother is in the hospital. Brother said the hospital did mention that he's eligible through Medicare for home health and rehab, and possibly even for a rehab facility, but he doesn't see how he can be that long away from SIL since she needs him so badly. If it's in-home I only hope that what Lymie says is true, that whoever comes out to help him see's the situation he's in as the only care giver to a double amputee and tries to help them in some way.

I was afraid something like this was going to happen eventually, their situation being what it is. I just didn't expect it to happen so soon. My brother is only a year older then me. I feel so helpless...
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