Last week I said we were going to the doctor on Monday because Marjorie’s hand and wrist hurt and looked swollen. I arranged for transportation to the doctor on Monday in hopes we could get in to find out what should be done about it. Monday morning I decided to call the Hospice referral line in hopes that Marjorie could be assessed right away and I could ask their advice about her hurting arm and get their opinion and advice about Marjorie’s condition in general. Thankfully, they were able to come to visit Marjorie right away. A social worker and an experienced RN came to the club to meet with us together. They talked with me for about an hour while Marjorie was sleeping in her reclining wheelchair next to us. Marjorie woke briefly and the nurse asked her a couple of questions, and then Marjorie went back to sleep. The nurse did not recommend going to the doctor. She said there probably was a break in there somewhere, and if there was, the doctor would want to do surgery to repair it, and that would mean another stay in the hospital and in her present state that would cause more suffering. She recommended putting a brace on it, which I had already done. I asked Marjorie if she wanted to go to the doctor about her arm and she said no.

The social worker and nurse agreed that Marjorie was eligible for Hospice services…in other words they estimated that she had less than six months to live. Guessing when someone is going to die is an art and not a science. There is no way to know for sure. But this is for sure: Medicare will not pay for Hospice services to be rendered at adult day centers like Aging With Grace. Medicare laws need to be changed. Taxpayers could save millions of dollars if Medicare would cover services performed at adult day centers. Patients heal more quickly when they are able to sleep in their own bed at night. After my father had his heart operation, he needed help to get through the day. Medicare payed for a nurse to come visit him at home for check ups and wound dressing. He still needed someone to keep an eye on him and cook for him and help him bathe and dress. Fortunately my step mother was there to help him. If not for her, he would have had to go to a nursing home (Medicare pays their charge of $200 per day), because Medicare would not have paid us to take care of him at the club ($73 per day). Of course, I would have taken care of my father at the club at my own expense if not for my step mother, but you get my point. For working people, an adult day center makes perfect sense. The recovering person could get their needs met while the working person (spouse, child, grandchild), with whom they live, is on the job.

I want to do the best thing for Marjorie. I want her to have Hospice services. She has Medicare and Medicare pays for it. So I have a choice: send her to the nursing home or figure out a way for someone to be home to let the Hospice people in when they come. I can’t afford to pay someone to be at home with Marjorie. I don’t think sending her to the nursing home is the best thing for Marjorie. So I need to figure out a way for someone to be home with her. To be continued next week…

May you and yours be blessed in the week ahead.