What is your system for documenting care given under a care contract?
I drove Mom the 2.5 hours to see the elder law attorney closest to us about initiating a care contract. She was very nice & much, MUCH more informative than any of the precious 2 lawyers that I had consulted in our previous state.
Since my father was a Korean War vet, the lawyer suggested that Mom apply for VA benefits to help her pay me for her in-home care. In order to do that & to document for Medicaid that the money Mom will be paying me is not a gift, the lawyer wants me to document the various things that I do for Mom every day & how much time each task requires of me.
For those of you providing care under a care contract, what system do you use to document your care? Do you keep your info by date, e.g. 6/10/15 - Cooked Mom's breakfast: 30 min., changed Mom's bed: 15 min., took Mom to doctor: 1 hr. Or do you keep separate pages for each task & then record your date & time on the corresponding page? Also, how do I figure these times. For example, let's say it takes me 30 min to combine the ingredients for her dinner & an hour for it to cook. Do I record only the 30 min I was actively combining ingredients or 1.5 hours for the total prep & cook time? When it comes to washing clothes, do I record only the time to sort & place the clothes into the machine or do I record the total time from sorting to removal at the end of the wash cycle? Lastly, what all do you claim & document as care, other than the obvious like cooking, cleaning, bathing, dressing, feeding (if needed), med administration, grocery shopping & transport to appointments? I try to take her for a 30 min walk each evening (weather permitting) & occasional trips to gardens, parks or other tourist places. Can I claim that time under "activities/entertainment"? I keep a large garden to grow some of our own food & help hold down food costs. Can I claim that maintenance time, only if Mom assists as an "activity" or not at all? What about the time I spend caring for her dog? Mom tends to sundown. How do I document any time required to re-orient her and follow her around to assure her safety?
I know these questions sound ridiculous & obsessively hair-splitting but I want to make certain that things are getting documented correctly so Mom gets the financial assistance she deserves but I also don't want to over-document my time to the point that it looks like I "faked stuff" & red flags are raised if she ever needs a nursing facility & Medicaid does their look-back.
If you keep it all together on a spreadsheet, it's a lot easier to follow. You can also begin to code repetitive tasks with abbreviations, e.g., a trip to a medical facility could be abbreviated with info only on the location and facility. Once you've created a category, it would automatically include the driving time round trip.
E.g., if it takes 1.5 hours for a meal, break it down by assembly of ingredients, as you've already done: assembly of ingredients, cutting, cooking - make it a multi-part entry.
When I recorded time spent on trust management, I used the same system I used for time recordation by law firms - in .10/hour increments.
I used WordPerfect to create the basic table format, and entered tasks as soon as I did them. However, they weren't anywhere as numerous as yours. You might create a spreadsheet in Excel (if you have that software), keep the sheets in a 3 ring binder so it's convenient, and handle it that way.
As to the walks, entertainment, and gardening, I honestly don't know if all of those should be considered caregiving, especially the gardening (although it's very therapeutic and in my opinion one of the best activities a person can do).
My concern would be whether or not some of these activities would be done even if you weren't providing round the clock caregiving...i.e., would you go for walks with your mother if she didn't need care?
I do document travel time as well as mileage though, and certainly the cost of gas. To me, that's mandatory.
Although you didn't ask, I would suggest that you use a service organization such as American Legion or VFW to assist with application for VA benefits. I've spent a lot of time dealing with the VA, and found this was more efficient than handling some of the aspects myself.
Whatever you do, don't pay anyone to "assist" with the application.