February 1, 2011 What I Did Last Summer When I was in grade school, the first day of school usually involved writing an essay entitled what I did during the summer. This is that kind of an essay. Late in the spring, on a perfectly unremarkable day, I received a call from my mother in Florida that she was on her way to the hospital because she could not have a relatively simple procedure done on her leg because she had congestive heart failure. That’s how these things start, as a complete surprise. Oh yes, and she added, “you can’t do anything because you’re not here, but I just wanted you to know.” After some thinking and conversation with my wife and siblings, I decided to fly to Florida the following morning so that some member of the family would be there (and lucky for me, tax season was over so I was relatively free. My siblings were not). I flew down, was met at the airport by my mother-in-law who dropped me off at my mother’s condominium so I could use her car. Now, I had wheels! I drove straight to the hospital and saw my mother and heard from her that an expected procedure to cleanse a wound would not be done because it was deemed too dangerous in her condition and she was expected to be in the hospital for several days. I asked to see the doctor and was met with disdain. I should add at this point, that I am the person listed on the health care proxy and have power of attorney for my mother, as well as, being her lawyer. Later in the day, my mother was informed not in my presence, that a procedure would be performed. When I asked the nurse to obtain the doctor so I could find out what had changed that it was not so dangerous to do the procedure, the nurse said the doctor said so. Again, no doctor appeared to talk to me. I took my mother’s valuables and returned to the condominium to collect the valuables there and placed them in the safe deposit box. The next day, my mother-in-law and I sat in the surgical waiting room and waited for results of the surgery; the surgeon never came out to talk to the family. Later, when my mother was taken back to her room, I asked the nurse to see the doctor and find out if the infected wound was the cause of the congestive heart failure. Again, no doctor appeared and the nurse said the doctor said the wound was not the cause. I should add at this point, that the medical personnel did not speak in understandable English and constantly used medical jargon, which they did not describe. My mother, as well, does not ask questions. At this time, my laptop computer became my best friend because I would instantly google any term I did not understand and my MacBook Pro instantly provided answers. While my mother was still under anesthesia, the patient coordinator came in to state that my mother would need to go to a facility for physical therapy and she would be discharged within two days. I innocently asked how she would determine that, being under anesthesia and bed ridden. The answer was that my mother could interview up to three representatives from institutions, which maintained representatives at the hospital for that purpose and could look at brochures. But, the hospital would not offer any help in the selection. Again, my mother-in-law was a help as I asked her to accompany me to visit the institutions because she, having been in some, could look at them with experienced eyes and know what to ask. We settled on the smallest facility with the lowest ratio of personnel per patient, where the “residents” ate in the dining room and not in their rooms and where the “residents” congregated in the common areas and engaged in conversation and activities (and where two of the staff were “Brits”; my mother is British). I made myself a nuisance and my mother’s personal physician agreed to see me at his office at 8 am the next morning and agreed to my request to help obtain a handicap sticker for my mother’s car (she always refused to have one – “they’re for sick people”) and said they still did not know what caused her congestive heart failure. The next day, the hospital finally got around to examining an abnormality in her kidney function and determined my mother had renal artery stenosis, another bit of jargon. Out popped my laptop and lo and behold it translates as hardening of the arteries in the kidneys. In laymen’s terms, as well as wikipidea’s, it means less of an ability to remove fluids from the blood stream, which leads to congestive heart failure. Voila! The treatment is by diet, exercise, and medication. At the end of the day, my mother was lucky to have that seriously infected wound which, but for that, her many doctors would have continued to miss her main problem. Now, I asked the facility how long she could be expected to be there and what was the procedure for being released. They were non-committal and would not be of help in explaining what Medicare paid and what my mother would be responsible for. My mother’s insurance agent was no better. She did not know what my mother’s long term care policy covered. The bright light here was the long-term care insurance company, which explained the coverage by dollar amounts and days of coverage. We reserved a specific room in the facility for the expected arrival of my mother. As luck would have it, my mother complained of chest pains so a new medical work-up delayed her transfer to the facility by a day and the facility lost its note as to the room reservation. Additionally, since my mother was transferred on a weekend, she could not get a new prescription for painkillers (since prescriptions do not transfer from a hospital to a facility) and the doctor doesn’t do rounds until the following morning. It was a painful weekend for her. The overriding problem that then emerged is, I am from New Jersey and I have to go back some time and need to make arrangements as to when I need to return, and will my mother need in home care, and how do you find such people and companies, and what questions do you ask them. The facility did not provide any leads. I left Florida the afternoon of the day after my mother arrived in the facility. Arriving back in New Jersey, I called companies and talked with friends and relatives who had experience with aides. Now, I was deluged with stories and found out this experience that I just went through was not uncommon but, was the normal experience and far too many people I knew had been or were going through it. One unexpected fall and a two week delay later, I was back in Florida over a month later with my sister and niece who helped to interview an aide and company and worked to make my mother’s condominium safe for her, as well as, removing all inappropriate foods from her pantry and refrigerator so she could stay on her new diet. While the facility told us what her diet should be, they would not go through her pantry and refrigerator and point out the offending foods. It was also better for my mother to talk to them because for me to talk to her only raised her blood pressure since as a guy and a lawyer I solve problems, I do not engage in the “process”. My sister and niece were better in understanding a woman’s feelings of trying to keep control of one’s life and to be intermediaries in my mother’s relationship with her aide. Meanwhile, I made the financial arrangements to pay for the aide, filled out the innumerable forms and engaged in a continuing dialogue with the insurance company. 90 days later, all financial transactions were smoothed out; nothing was made easy. The story has a happy ending, because by Fall, my mother no longer needed the aide and could resume an independent life (although why a person would not like to have a chauffeur, housekeeper, cook and general go to person who is paid for by someone else I will not understand) and she has obtained the Life Alert button (just in case!). We Offer Long Term Care Insurance The reason I could be so glib about the trials we as a family went through, (there are so many more details and family member contributions I left out) was because financial cost was not an issue because I had obtained an excellent long-term care policy for her. In the past, I had not entered into this field because I did not see it as a business for me. Because I have seen the benefit it provided, I obtained the proper licensing so I can be part of the process of a client obtaining the insurance and have partnered with one of the recognized experts in the New York, New Jersey area to best serve my clients. Feel free to contact me about this insurance. Appointments can be held in my office, in the Long Island office of my associate or possibly in your home as well as by telephone. We Offer Elder Care It is great where an elderly individual is surrounded by a caring family. However, in many cases, like my mother’s, family is hundreds of miles away, or the individual has no family or does not like or trust the one that they have. Who will be there to monitor treatment or the cost of such and handle problems that occur? Remember, that my mother was asked to pick a facility while bedridden and under anesthesia. Nobody cared, certainly not the hospital, which was only looking to transfer her. Who will pay the bills, transfer funds, and arrange for lawyers and social workers and aides. Our answer is your Private Wealth Manager who will help to arrange for Certified Public Accountants who will review the bills, authorize payments and arrange for the aforementioned persons. With almost 70,000,000 Baby Boomers aging this will be tremendous growth area and in the nature of one stop shopping we are stepping up to the plate to fill that need. And as I have told my new partner, Melissa Lisch, she will spend the bulk of her professional career tending to the needs of aging Baby Boomers. If you think we can be of assistance in the area, please call Melissa or me. As always, if you have any questions about these or any other matters, do not hesitate to call me. Remember, We’re Here For You!