Medicare...Doesn't Care

For several years, my father has used the services of a home health care company. Before I moved in to care for him, I was grateful for the service because I knew his medical needs were being attended to and he was getting regular baths. Over the past four years, the nurses have changed and the service in general has slacked off. And it’s my fault…according to MediCare.  And his eligibility to continue the service is about to expire.

Because I live full time with my father and provide cleaning, cooking and other personal chores for him, I am considered a caregiver by MediCare standards. The government agency will no longer provide payment for a certified nurse aide to visit twice weekly to bathe my father; nor will it pay for the services of a nurse to visit weekly to check his vital signs and check on his general physical well-being. That leaves me entirely responsible for his care. I would like to note that I have no medical training and haven’t the first clue how to use a stethoscope, other to drape it in a cool fashion around my neck.  Because I am reasonably bright individual, the home health service has “educated” me on proper diet, medication interactions and safety precautions and feel I am well prepared to take over complete responsibility for my father. That makes me very nervous.

My fears exist on many levels, not the least of which is the frustration I am bound to feel when my father fails to comply with medical orders, as he is wont to do. Without the back up of his regular nurse, I will have no ammunition to fight him. That frustration, gone unchecked, can be dangerous. I am anxious that one or both of us may get injured, or if I make a mistake with his medicine, there could be adverse results. It’s an astronomical burden to place upon a family member to be solely responsible for the elder. I most worry about my father’s personal hygiene. He has been known to go more than six weeks without properly bathing and I depended on the home health agency to provide that service. Now, however, the responsibility falls to me. I want to provide my father with as much dignity and privacy as possible in his final years, and I don’t think scrubbing him down twice weekly is the way to go about it. It’s not so much that it will bother me; I’ve seen it already. I am more concerned for the psychological repercussions for him. I feel it will degrade and belittle him to have his daughter bathe him like a child. I know, I know…Circle of Life and all that, but still…

I completely understand that it was my choice to care for my father in his final time on earth. He adopted me when I was a helpless infant, fed me, provided for me, nursed me. I feel a strong obligation to him for that. I am equipped with the knowledge of his condition and its maintenance, but I do possess the skills to manage it. I firmly believe that some training should be made available to care givers of elderly patients. It would lower the hospital admission rate, perhaps lower elder abuse rates and at minimum, prepare us…for whatever happens.

Over the past few weeks, I have conducted extensive internet searches and read a number of articles, pamphlets and editorials on caring for an elderly family member. I don’t take my responsibility lightly, folks! A common thread in those publications is that caregivers must take time for themselves and request respite care. Will Medicare pay for that? Nope. Who, in the end, pays for that? The caregiver. 

Me.