How Do You Manage Your Senior's Finances...and a Few Other Questions and Insights

Several months ago, I was contacted by a writer for NerdWallet.com.  She gave me a lengthy list of questions and asked if I would be willing to provide insights to help her readers who were caring for seniors.  I agreed and spent a couple of days compiling thoughtful answers to her questions.  She didn't use any of them in her story.  

Since I put so much time and energy into the information, I thought I would post it here, so that you, dear readers, can avail yourself of any insights you might glean.  So here goes...

1) Please tell me a little bit about yourself. Is your grandmother your mother? Did she raise you?

I have been married 42 years, and we have no children of our own. My father died in October 1999.  He was an only child, and his mother - my then 87-year-old grandmother - was still living alone in her own home, driving, and doing pretty well for someone nearly 90.

My mother helped my grandmother with many things - as did my sister and I...but Mother remarried in February 2002. Mother traveled a lot in her motorhome...in fact, she and her husband left after their wedding for a 6-week trip along the East Coast. That summer, my grandmother fell and required 3 months of therapy in a skilled nursing facility.  My mother was traveling with her new husband, and the care of my grandmother became my responsibility.

Mother was planning to spend the FOLLOWING summer (2003) traveling, and just as she was leaving, my grandmother again became ill and required a stay for rehab at the nursing home.  Mother handed me my grandmother's checkbook and said, "You're going to need Power of Attorney." So for the next 10 years, *I* was my grandmother's guardian.

My sister, brother (who is deceased) and I were fortunate to grow up in the same community as ALL four of our grandparents, and we were very close...we saw them on almost a daily basis.  My grandmother did not rear me...but we were very close, and she was very much a mother figure to me in the last 10 years...especially given how intertwined our lives were - and the fact that I was somewhat her sole caregiver.

In 2009, my sister's daughter had her first child.  My niece was a single mother attending college, and my husband and I kept the baby while she went to classes.  This morphed into us keeping our great-nephew for longer periods of time. By 2012, my niece had given birth to two more babies and gotten married, and my husband and I were heavily involved in assisting the whole family. So my "sandwich" was my great-nephews and great-niece - and my grandmother. 

My grandmother died in 2013...and the "sandwich" shifted from caring for her and the babies to caring for my mother-in-law (who is now 90) and these three children. This situation is not quite as "involved" as it was...the children are now 4, 5, and 7 - and all in school - and my husband is primarily responsible for his mother, so my responsibilities there are negligible.  But there are times when we have all three children and "Grandma E" together at the same time...and the dynamics of a "Sandwich Generation" situation are definitely there.

Our SUV has three car seats and a handicapped sticker.  When my grandmother was still alive, I used to joke that our car often contained a walker and car seats...and diapers and Depends!  For a "childless" couple, we are well versed in all things NickJr., baby - AND Medicare and geriatric!

My mother was diagnosed late in September 2015 with stage 3C Ovarian cancer, and she began chemotherapy immediately.  Two treatments in, the oncologist said the drugs were not working and the tumors were growing rapidly. She was hospitalized New Year's Day and placed in Hospice Care three days later. She died on January 12, 2016.  Prior to her diagnosis, my mother was an active 76-year-old great-grandmother who drove her own 40+-foot motorhome (with tow car) from coast to coast.  If she fit the "sandwich" mold, it was only the context of my caring for her needs those last few days - and attending to the children and fielding their questions when they would visit her.


2) What made you want to start your blog? 

 I first wrote about my grandmother on a personal blog after several frustrating encounters with insurance companies over the Medicare Part D Prescription Drug coverage, beginning in 2005.  I have never experienced anything more exasperating in my life...and at the end of the day, I had a Medicare rep from Dallas, Texas, on speed dial. This woman would become one of my most trusted contacts over the next few years until she retired...and I always had to reach out to her for clarification each fall as I selected my grandmother's prescription coverage plan.

In 2008, when my grandmother had to go to the nursing home for a third time in five years for "rehab," I decided that my experiences might be helpful to someone else - and I needed a place to vent. So I started "The Deli" blog. At that time, I was not in a "sandwich" per se...but I had friends who were, and I hoped that by sharing my experiences about MY grandmother, I could encourage others to open a dialog about THEIR situations.


What type of support have you found in the blogging community?

To be honest, I have not received as much support as I hoped.  I participated in some forums for caregiving and the Sandwich Generation on the AARP website for a while. And I all but begged some people to share THEIR story with me in a format that I could put on my "Deli" blog.  But at the end of the day, I think people are just too tired and busy with their "sandwiches."  If you are not a writer already - and inclined to document your experiences - it's hard to make time for spilling your guts to someone else. 

Having said this, I have SEVERAL friends who are currently dealing with the care of aging relatives - if not a "sandwich" situation - and I hope to maybe resurrect the blog a bit and get some of them involved in the dialog.  We will see what happens!

3) Were you the only one in the family in charge of your grandmother’s finances?

From July 2003 until her death, I was in charge of my grandmother's finances.  At first, I let her handle her own checking account, but I soon discovered that her idea of "balancing the checkbook" was calling the bank every couple of weeks and asking, "What's my balance?"  She would write that in her register and move forward. The impetus for me taking over her checking account came when she had to go to the nursing home for one of her rehab stints.  She had misunderstood the people at DHS and thought she was allowed to have more than a $2000 balance in her checking account and could still qualify for full Medicare/Medicaid assistance for a nursing home stay.  She had just more than $2100 in her checking account, but that was enough to cause a fee of $150 per day for about 5 days until she "spent down" her assets.  After this costly mix-up, she agreed that maybe I should handle her checking account.

Like many seniors in this country, my grandmother worked very hard all of her life, but she never made a lot of money.  She received a meager Social Security income each month that barely covered her food, utilities and medication co-pays. She lived in a home owned by my parents, so she had no mortgage or rent payment. She owned her very old car outright. I wrote checks for her groceries, her weekly hair appointments, and her church tithes.  Somehow, she always had a few dollars left at the end of each month!

The REAL WORK came in making sure that my grandmother was sufficiently covered for Medicare/Medicaid and Medicare Part D, which took a lot of time and was incredibly confusing.  How seniors who do not have an advocate manage this maze of papers and regulations and rigmarole is beyond me!  And don't even get me started on admitting someone to a nursing facility, Assisted Living facility - or even the hospital or Hospice.  The paperwork is astounding. I kept copies of a "cheat sheet" with vital info in my wallet, because it seemed like every other day, I was needing to supply this data to someone for something!  I would just hand them a copy of this information.

Honestly, I don't see a decent way around this.  Perhaps siblings could split the responsibilities financially...but for the most part, one person needs to be handling all of this, so that nothing falls through the cracks.  I think if my sister OR my mother and I had tried to share the management of my grandmother's finances, it would have been even more time consuming and frustrating.


4) You mentioned on Twitter that you were a signer on your grandmother’s account. And you also advised against sharing a bank account with an elder. What made you choose to become a signer? Had you done your research? How did you get informed?

I had to become a signee in order to write checks on my grandmother's account.  As soon as she went into the nursing home and needed an advocate, we signed a card for me to be able to do this.  


5) As a signer what were your privileges on the account?

My name was never on her account...I was merely a "signee." This meant that I could write checks and balance her bank account.  One caveat...when my grandmother died, she had about $130 in her checking account.  I took a death certificate and a copy of my DPOA (Durable Power of Attorney) to the bank and asked to close the account, and they would not allow it.  I was not the "designee" on the account for closing it out.

This is different, apparently, from being the "signee" on a checking account.  I was not designated as the person to close the account - my dad was.  Since he was already dead, the secondary designee was my mother. SHE had to return to the bank with these papers and close the account.  Lesson learned...if you are handling the finances, make sure you are the "designee"...and that you have the proper signatures in place to access a safe deposit box, etc., as well.


6) What approaches did you take with a banking account that worked for you and your family? For example, did you rely on money management tools or software to help you keep track of everything? Or did you choose specific accounts that perhaps offered lower fees?

I did not use specific software...the account was very simple and did not need something like Quickbooks. I did acquire an online banking account, so that I could login and check on things like the auto-drafts and verify that all charges were legitimate and necessary. I would note that I set the account up with my grandmother's name, and one time I locked myself out of the account.  When I called the bank and identified myself, they would not allow me to access the account, because I gave MY name, not hers.  They had to talk to HER for authorization.  She understood NOTHING about online banking...but bless her heart, she authorized me! After that, any time I called on her behalf, I pretended to be "her" on the phone!


7) Did you at any point consider a power of attorney or was that given to someone else in the family?

I was my grandmother's Durable Power of Attorney (DPOA).  This is different from a medical Power of Attorney, which only gives you authority to speak for the person in medical situations. The DPOA is more encompassing. I downloaded a DPOA form online and we signed it and had it notarized. We had to provide copies of this document many times over the years for several different things - applications for assistance, cashing her life insurance policy, and more. I would consider this a vital document to have on hand if you are managing any business activities for a friend or loved one.


8) Emotionally, how difficult was it to handle your grandmother’s finances? How did you manage to juggle those with your family’s?

I probably spent a couple of days a month managing my grandmother's finances. Since she had very little money, there wasn't much to manage. I can see where for someone with substantial assets, this could be quite a lot of work.  The real time consumer was the vast number of papers and forms related to Medicare, Medicaid and Medicare Part D Prescription Drug coverage.  

I cannot begin to calculate the hours I spent on those things. It can be emotionally draining to manage another person's finances while juggling your own family responsibilities.  But all of this is emotionally draining on many levels.  You learn to cope...and hopefully, you have others who can encourage you.  This is why I created the blog...to encourage others and say to them, "See...you're not crazy...look what happened to me!"  Most of the people I hear from say, "These are exactly the things that are happening to ME!" Senior care is universal in many ways.

 
9) Did you make any financial mistakes along the way that perhaps our readers could learn from? (for example overdrafts or missed payments while you tried to learn how to balance it all)

I do think there was an overdraft once when I paid a bill a day or two before my grandmother's Social Security deposit was made. It seems like the fee was about $30...which I paid out of my personal account. I know that never happened again! I don't think my grandmother ever knew about the overdraft.


10) What advice would you have (emotionally and financially) for anyone who has recently become a member of the Sandwich Generation?

You are not alone.  That may not help, but perhaps knowing that there ARE people who are willing and able to offer support will be comforting. Depending on the age of your senior and the circumstances, I would strongly encourage the investigation of long term care insurance.

I know families who have scraped together funds to pay for the care of a loved one who MUST move to an assisted living or skilled care facility.  The cost can be anywhere from $3000 per month and up...and that is just for the facility. 

If you go through the posts on this blog you will see that I have outlined the "extra expenses" that might be incurred...and they add up in a hurry!  No one wants to be in the position of telling Grandma she can't have her hair and nails done every week - or any other "extras" - because there is no money.  And most people don't want to have to liquidate every asset their loved one has in order to pay for nursing home care.


11) Do you have a contact that you met in the blogging community or a friend who may have more to say on this subject? I would gladly appreciate an introduction. 

I do not have anyone to recommend; however, my mother wrote a book about HER experience with HER parents and the nursing home…When Heads and Hearts Collide.   I HIGHLY recommend this book to anyone who has been charged with the care of a senior citizen.  It’s only $10 postage paid, and you can order with PayPal directly the sidebar on this blog.
 
Because of the things I experienced through all of this, I also wrote a book...What to Say and Do...When You Don't Know What to Say and Do. This book can also be purchased via the sidebar on this blog.

If YOU have questions...or a particular issue...that you would like to see addressed on this blog, please contact me.  We are all in this together, and as time permits, I will gladly address any and all inquiries and comments.  Hang in there!

Making a List... and Checking it Twice...

This week, I had to sign a paper at the Assisted Living Facility saying we do not want any more antibiotics to be given to my grandmother.  When I went to the administrator's office to sign the paper, I noticed that there was also an option (with a check box) for not taking the resident to the hospital Emergency Room for treatment.  That box was unchecked. I  asked, "Don't we need to check that box, too?"  The administrator asked, "You mean you don't want her taken to the ER?"  "No!" I replied adamantly.  "Hospice has assured me they will keep her comfortable in her apartment, and she does not want to go back to the hospital... for anything! 

The administrator nodded and said, "Then yes... you need to check the box."  Now honestly, I assumed this was already understood... and covered by the fact that my grandmother is under the care of Hospice. I was wrong!  So while I would have been able to refuse an ambulance (if I were called in time), one very might have been called if necessary.  For instance, the day my grandmother had the "coughing spell," the administrator said she almost strangled.  Had she lost consciousness, I am sure they would have called 911.  When she broke her hip last spring, the EMTs had already loaded her into the ambulance by the time my husband and I arrived... and we live five minutes from the ALF!

I am sharing this information to tell you that you cannot assume ANYTHING!  Ask questions... be sure you know what is documented... and that all agencies involved are coordinating efforts.

In a different vein, I've had some "fun" with other agencies recently that I'd like to share.  I had it on my list to call the insurance provider for my grandmother's Medicare Part D and verify that all of her medications are covered by this company.  Believe it or not, after having to change companies some seven times in six years (including one year when Medicare just arbitrarily changed us to a company that we did not select - and one that did not cover Mam-ma's medications), we have been with HealthSpring for 2 years now... and we will be with them again for the coming year.  The Medicare.gov website showed that all medications were covered again.  But I like to hear it from the company to be sure.

So I called HealthSpring to verify this, and the rep told me that "I'm sorry, but I cannot discuss this with you, because I do not see your authorization."  I explained that I was my grandmother's Power of Attorney... I've been calling this company for three years now and talking about her case, and a copy of the Power of Attorney is on file with them.  She insisted it was not... I insisted it was, because I've always gotten this information.  The lady told me several times that she could not discuss anything with me.  I tried to explain that Medicare.gov says that all of my grandmother's medications are still covered by their company.  I was merely trying to verify this with HealthSpring.  Finally, the rep said, "Did you say she has been our customer for two years?"  I told her yes, this was correct.  She continued... "Then all of her coverage will roll over to this next year."  "All of her medications will still be covered?"  "Yes, they will roll over."  I thanked her and said, "That's all I needed to know."

Now for the record, this is not necessarily always true.  Just because a company covered your meds last year doesn't mean they will this coming year.  This is why we moved from company to company so many times.  Some of the medications my grandmother took along the way were quite expensive, and companies loved to drop them from the formulary as quickly as possible.  So when I would get the formularies for the coming year, those expensive drugs would no longer be covered.  I still don't know what happened to the record of my Power of Attorney... but at this point, I have what I need, and I'm not going to pursue it any further.

Last week, I tried to pay my grandmother's pharmacy bill online, and I put in the wrong password on the account and got locked out. Usually, I call an 800# for the main bank (in another city), give them the info, and they unlock the account. This day, I got a girl with attitude who told me that she could see I was listed on the checking account, but the online account was in my grandmother's name (DUH) and only SHE could talk to her. I said, "Look, she's 100, she's on Hospice, she cannot talk, and she is dying. I'm trying to pay her bills." The girl got pretty curt, and I asked to speak to someone else and she said there was no one else to speak to. So I had to set up a whole new login/password account in MY name... and I lost all of my auto bill pays. The girl kept saying, "Let me try to explain this to you in a way that you can understand."  Really?  By the time I hung up, I was in tears, and the girl said, "Have I explained this in a way that it makes sense?" I told her no... but not much of anything makes sense right now!

So THEN I realized that I had a $700+ payment going out the next day to the ALF. I got worried that if I set up billpay again, as this girl had said I should do... it might pay twice and make an overdraft. So I called back. Guess what?! I got a DIFFERENT girl, who was much nicer...but by then I had set up a login and password for myself on the account. She said, "I can't tell you anything, but if you ask the right questions, I can answer them." So we did determine that YES... that payment was still scheduled to be made, and had I put it in again, we'd be in the hole and have to pay an overdraft of about $30! So much for Customer Service!!  

I get that banks have privacy laws, but the first girl said, "You gave me your name when I answered the phone, and it doesn't match the name on the account, so I know you are not Polly." In other words, if I had lied to start with, she would have unlocked the account. CRAZY!  I gave her the last 4 digits of MY Social Security number, my grandmother's, and other vital information... and she could SEE me listed as a co-signer on the account... and still, she would not help me.

In her defense, this girl was just doing her job.  And I am glad that our banking info is secure.  But it was more her attitude and her unwillingness to work with me in any way.  I told my husband that I guess that LITTLE thing was what triggered my BIG meltdown. I'm okay now... just one more lesson learned. My mother suggested that I should have hung up, called back and pretended to be Polly.  It probably would have worked!  I'm just sayin'!

These are the types of things that make life for those of us in a "Sandwich" so challenging. As if we didn't have enough to do already, we have to deal with Customer Service reps who seem to go out of their way to make life difficult.  I know that this is often a ploy just to distract and deter the elderly.  Somehow, I think that bank CS knew she had not exactly made my day...but never once did she say she was sorry or act the least bit sympathetic. If this had been my mother-in-law or another older senior, the conversation probably would have ended much more quickly. 

You would think that after all of these years, I would be better at "playing the game."  And I had to laugh as I thought of the many times that a CS rep would not talk to me and asked to talk to Polly.  I would call her on my cell phone and hold it up to the land line receiver, and this little woman would say something like "Sugar, you just ask Debbie whatever you need, and she'll tell you."  Somehow, that was acceptable and believable.  Kinda makes you wonder, doesn't it?!

The Scouts Were Right - Be Prepared!

In the last few days, I've been thinking a lot about preparation.  My niece will give birth to her second child on May 31st, if not sooner.  This means that Timothy will come to stay with us for awhile until she recovers from her C-section delivery and gets on her feet.  I figure he will be with us for several days, at least.  I know that this means I will get virtually nothing done while he is with us.  So I have been in "preparation mode" - stocking the pantry and planning meals, cleaning the house, doing laundry, and catching up on some writing projects... along with working out and trying to rest!

Thankfully, my grandmother's virus was short-lived, although she is still sore from her fall in the closet.  Her bruises look pretty mean, but she is up and about... taking walks outdoors, exercising and attending all of the regular activities at her retirement center -  and even shopping at Wal-Mart... so I know she is okay.  She has had quite a bit of company lately, and that has brightened her days, as well.

Our little Timothy - dirty face and all!

Aside from thinking about our own preparations for the new arrival and Timothy's visit, I've had conversations with several friends in recent days who are in some stage of caring for an elderly loved one... and each time, the focus has centered on preparation.  In a couple of cases, virtually no preparation had been done for the "what ifs"... what if Mom/Dad falls ill and has to move to an assisted living or skilled-care facility?  What if we need money for their care?  What if they refuse to cooperate?

I'm very thankful that my grandmother was at least somewhat cooperative.  My grandparents transferred ownership of their property to my parents in the 1970s, when the laws were different and there was concern that a sudden illness or disability could result in a move to a nursing home... and the loss of their homes to cover the costs.  The laws have changed now, and while I am not current on how they actually read, I do know that there are options... particularly if there is a spouse still living in the home... and the sale of the property may not have to be sold - at least not right away.

Meanwhile, I have advised my friends to start coaxing their loved ones to take some preliminary measures...

• Encourage your loved one to designate a Durable Power of Attorney who can assist with major decisions - both medical and financial.  Believe me, virtually no one will talk to you about your loved one without proof of Power of Attorney - from medical staff to the utility companies.  Without this document, you will have a long, rough road to travel as you handle your loved one's medical/business affairs.
• Add someone you trust to your loved one's checking account.  If you have a Durable Power of Attorney, this person is the logical choice.  Just this week, I cashed a refund check for my grandmother, and because she was not with me at the time, I had to add my signature to her endorsement on the backside of the check.  This was verified to see if I was, indeed, listed as a signee on her checking account.  You'll also need to be able to write checks on your loved one's account for everything from utility bills to the monthly payments to a skilled care facility.  This signature  authorization is vitally important!
• Try to persuade your loved one to begin thinking about designating - and dispersing - valuable assets.  If your parent/grandparent has an heirloom pocketwatch they plan to leave to someone in the family, why not give it to them now and get it out of the drawer?!  Don't risk having these valuable family treasures come up missing - or squabbled over - if the senior has to move to a facility.  And certainly do not risk having these treasures "lifted" at the facility. 
  
  When my maternal grandparents moved to a nursing home, my mother substituted a very nice cubic zirconia drop necklace for my grandmother's real diamond necklace.  They looked exactly the same, and my grandmother could not tell the difference.  But the concern of having her "real" diamond lifted or misplaced was alleviated, and everyone was happy.  You may have similar valued jewelry that can be "traded out" for less-expensive look-alikes.
• Understand that any assets your loved one has are subject to liquidation to pay for medical care, skilled care facility stays, and more.  While many seniors are stubborn or leery of suggestions to help manage their assets, there are things that must be done for their own protection.  The cost of consulting a lawyer to set up a Living Trust is well worth the investment.  This can help to protect many of your senior's assets, should a catastrophic event occur.  Long-term care insurance may also be appropriate.  It's expensive, but depending on the age and physical condition of your loved one, it may be worth the cost.
• At best, sit down with your loved one and try to get a handle on what assets he/she has.  Make a list of these assets - important policy numbers, at least an estimate of their value, and where important paperwork associated with them is located. Is there property, such as a personal home, rentals, and/or vacant land?  Does the senior have life insurance?  What about a pre-paid funeral plan?  Is there a safety deposit box... and what sort of valuables are stored in it?  Does the senior have CDs, an IRA, and other investments?  Does he/she own a car, boat, recreational vehicle, tractor, or other motorized vehicles?
• Make a list of "contacts" - people to notify in case of an emergency, the housekeeper, the person who cares for the yard, insurance agents, pastor, and more.  Once when my grandmother was ill, I completely forgot about a cousin who checks on her often.  Several days later, he phoned me - very upset - and wanted to know why he was not notified that my grandmother had been hospitalized.  It totally slipped my mind.  Now I have a list, and I carry it in my purse.  If/when something happens, I don't have to rely on my memory to make the appropriate calls.

I realize I am treading in delicate territory here.  Some of these questions may seem premature, at best - and downright intrusive.  But in order to do the best for your loved one... to provide the best care for him/her and to protect any assets... some plans must be made - TODAY!

Here are some links I found that might provide helpful information.  Please understand that this list does not represent my endorsement of these websites or their information.  I am merely providing you with some search results.

• AARP info - Ask Ms. Medicare
• Guarding Your Wealth
• SeniorJournal.com
• Medicaid Asset Protection Plan

Don't wait until there is a crisis.  Don't wait until you are in the shoes of one of my friends... paying thousands each month for residence in a retirement facility, the money quickly running out... and a parent who won't cooperate.  Start taking measures now to protect your loved one and yourself.  Be a good Scout and be prepared!

Paper Pushing...

They say a picture is worth a thousand words, so take a look at this one of the papers I have accumulated for my grandmother. I had misplaced a piece of information, so I sat down in the floor to sort everything and see if it could be located. This was the result of my "sort and purge" - and only a couple of papers were designated for the shredder!

It's been an interesting month. We got the ball rolling for my grandmother to move to an assisted living facility (ALF) the first week of January. My husband and I took her to preview an available "apartment" at the facility – called Southridge. She declared it "beautiful." We paid the non-refundable deposit on December 31st, and I began the process of completing all the papers that filled a large envelope.

There were papers for Southridge... a request for Medicaid assistance for an ALF, a physical evaluation and "orders" to be completed by my grandmother's family physician, and more. I set up appointments for a physical exam on January 10th. The papers were turned in at the Department of Human Services (DHS), and I was given an "interview" appointment for 10:15 a.m. on January 11th. It looked like I could get this ball rolling in just a few days.

On Friday, January 7th, a cousin phoned from a nearby city to tell me that her sister had died... my grandmother's niece. This woman was the daughter of Mam-ma's oldest sister, Minnie. The visitation was scheduled for Sunday evening from 6:00 - 8:00, with the funeral set for Monday afternoon at 2:00. We knew we would be unable to attend the funeral, since Mam-ma had her physical exam scheduled for that same time period. To add to the "fun," a major snowstorm was forecast for Sunday - with snow predicted to begin around 5:00 p.m. in our area.

I told my grandmother there was no way we could go to the funeral, and I really didn't see how we could get to the visitation some 30 miles from home - I was not going to drive in the dark in a snowstorm! Sunday after church, I checked the forecast - snow was still headed right for us. I phoned my grandmother, and she said, "Well, I want to go to the visitation." I told her this was not an option. She had also mentioned she would like to go to my cousin's home and visit with family members. I offered to take her early in the afternoon to visit with family members, but we could not make the visitation work. She started to cry and said, "But I want to see EVERYBODY!" (This included all extended cousins and nieces and nephews she assumed would be at the visitaiton.)

We ended in something of a tense discussion with Mam-ma saying, "Just forget it... we won't go at all." I called my cousin and found out where the family had gathered, and I pretty much insisted we drive down for a visit. Mam-ma's comment was, "No, let's not." I asked why she didn't want to go, and she started to cry again, "Because I can't button my pants." Now I laughed. "Do you not have other pants you can wear?" "Well, yes!" This whole situation revealed itself to me when we returned from the visit and Mam-ma said, "I've got to come out of some of these clothes." She had put on thermal underwear, and the bulk prohibited her from being able to fasten the button on her pants! She found something else to wear, we drove to my cousins' home and visited for a couple of hours, and we barely got back to our own homes before the first flakes of what would be about a 4-inch snow began to fall.

Even with the snowfall, I was able to get Mam-ma to the doctor's office on Monday afternoon. He filled out his papers while we waited - an answered prayer - and I marked that off my list. Next would be DHS on Tuesday morning. The case worker began going through my papers and saying, "You'll need this... and that... and something else..." and each time, I'd say, "Got it! Here it is! Yes, that's attached." I have done this three times already over the last 7 years to admit my grandmother to the nursing home for rehab, so I know the drill... or so I thought.

I had gone to the bank and gotten an official print-out of the most current bank statement - for which the bank charged $2 - and I had all of the papers. Because my grandmother is "full Medicaid" - the case worker informed me that she cannot have any assets that exceed $2000. This includes cash, savings, checking accounts, insurance policies, and more. In the past, when Mam-ma went to the nursing home for Medicare rehab, I was told that a small life insurance policy she has did not count. In fact, I was advised to "leave it alone" because cashing it would give her excessive assets and disqualify her for assistance.

Now, it counts. We went back and forth, and I was not successful at explaining that my grandmother’s pre-paid funeral encompasses the burial insurance and it has no cash value. So I left the office with a January 21st deadline to return with proof that my grandmother's insurance policies had either been irrevocably designated toward her funeral or cashed and spent down below $2000 - and I had to have receipts to show how I spent the money.

I understand how some of this works. You can't just cash out your checking account balance and put it in your wallet. You can't write a check to someone and make a "gift." You have to "spend down" the money on things that can be shown... does your loved one need a new mattress or chair? a new coat? We bought things Mam-ma will need at Southridge... Ensure, Depends, new towels and linens, etc.

I left DHS and drove straight to the funeral home and got a letter that stated that there is NO cash value to the burial policies - they are irrevocably tied into the pre-paid funeral plan. Within 30 minutes, I was back at DHS handing this information to the case worker. I wanted her to know I am serious. She had told me that we would see if we could get this done so that Mam-ma can enter the facility on February 1st. If not, she said, "we'll work from February 1" - which means that Mam-ma would get another Social Security check which would have to be "spent down" - and basically, we would start over on the finances.

The other piece of the puzzle is an actual physical evaluation that must be performed in-home by a nurse who represents Medicaid. She has to say that my grandmother qualifies for Medicaid assistance in an ALF in order for us to get any Medicaid assistance... which basically means she determines whether Mam-ma actually can go to Southridge. I asked the DHS worker if she would go ahead and send out a nurse for this evaluation, and she said she would.

I determined that I needed to cash the life insurance policy. Since I knew that this would not happen overnight, I asked the DHS worker if I could drain my grandmother's checking account (showing a paper trail, of course) and prove that when the life insurance check comes, we will not have more than $2000 in assets. She said yes, this would definitely work.

So my goal for the rest of the week was to get the life insurance issue settled and "spend down" the checking account. I called the life insurance company to determine how to proceed, and I was told that they were not authorized to talk to me. "We have to have power of attorney papers on file... and we don't accept any power of attorney that is more than five years old." Mine was issued in 2004. I asked how I was supposed to work with them. The rep said, "I really don't know - maybe get a new power of attorney?" I told her I did not have time to do this before February 1st, and my papers were good enough for DHS and Medicare, so I wasn't sure why they weren't good enough for her company.

I told the rep, "I do not mean to offend you, but I am on a tight time line... is there someone else I could speak with who might know how I could do this?" She put me on "hold" and was gone a while, then returned and said, "We need authorization from your grandmother. I can mail her an affidavit to sign about the power of attorney." I explained we don't have this kind of time. While I was on "hold," I recalled talking once with another case worker at another agency who would not discuss my grandmother's case with me by phone, and we ended up putting Mam-ma on the line via my cell phone, and she authorized the discussion. I asked this rep... "What if you could hear from my grandmother that this is okay?" She said that would work. So I picked up my cell phone and dialed Mam-ma.

I told Mam-ma what was happening and that she needed to tell this lady on the other phone that she could talk to me. I held the phones together, and Mam-ma said, "You tell her anything you need to and ask her anything you need to." The rep said, "All I got was buzzing from the cell phone." However, she offered to conduct 3-way calling with Mam-ma if I could get Mam-ma to hang up, and she would phone her directly. We did this, and the rep asked Mam-ma (who had been napping), "What are the last 4 digits of your Social Security number." "Just a minute," Mam-ma said, setting down the phone and going to find her purse. She could not locate the Social Security card, and she did not know her number.

So the rep asked, "What is your mailing address?" Mam-ma could not remember. I finally prompted with the first digit, and she was able to give the rest. Then the lady asked Mam-ma her birthdate, and Mam-ma said, “November 5, 1912. “ The rep said, "No, that's not right." "Yes, it is," I interjected. "No, that's not what we have." I opened the original policy from 1970 and looked at the information. "I am looking right at the original policy, and the birth date is November 5, 1912." The lady insisted she could not help us because that was NOT what her records showed. Mam-ma became upset. "Well, I know my birthday IS November 5, 1912." I laughed and said under my breath to the rep, "Bet you don't get very many 98-year-olds on the phone, do you?!"

Finally the rep said, "Okay, Mrs. Chandler, is it okay if I talk with Debbie about your policy?" Mam-ma replied, loudly, "Sugar, you talk with her about anything you need to. It's just fine." The lady thanked her... I told her we would talk later, and Mam-ma hung up. I was able to ask two questions... what is the cash value of the policy, and how do I surrender it? The rep wanted me to FAX some info. I told her I do not have a FAX machine at home, but if I had to drive somewhere and find one, I could. She then said she would mail some papers to me for surrendering the policy. I explained again about our timeline, and I asked if she could FAX the papers to me? She said she could, but it would take a couple of days for her to request the proper forms to send by FAX. I told her that I would call two days later and give her the FAX number, and she promised to FAX the papers immediately.

This all came together on Thursday, January 13th. I took Mam-ma to the beauty shop to get a permanent, and I went to my old office to pick up a FAX I'd received there and mail the original insurance policy back to the company, via expedited mail. We also had to go BACK to the doctor's office to have Mam-ma's blood drawn - the lab tech was not in the office on Monday because of the snow. Thursday was a raw, bitterly cold and windy day, and by the time I got Mam-ma home, she was exhausted.

Oh, I forgot to mention... on Wednesday morning, my sister had called to say that their household had stomach flu. Timothy was recovering from it, but they didn't want him exposed again... could we keep him a few days? So Thursday, I left Timmy and my husband at home together for four hours while I ran errands with my grandmother. Timmy stayed with us from Wednesday morning to late Friday afternoon... and we loved every minute of his visit! I am blessed to have such a wonderful husband who steps in and does whatever is needed... and who loves Timmy as much as I do! And thanks be to God, neither of us ever caught the stomach bug!

So... I felt I had all of the T's crossed and I's dotted... I paid almost of my grandmother's last utility bills. I bought the Ensure and Depends and other items she will need. We saw the doctor and I surrendered the life insurance policy. I was within inches of getting all bills paid, receipts printed, and papers returned to DHS. The only “fly in this ointment” seemed to be the telephone bill, which is auto-drafted. In December, the draft was on December 17th, but by January 18th, there had still been no draft. I needed to know the amount of this bill to complete my spending.

I decided to get an online account and look at the billing. In order to do this, I had to submit Mam-ma's telephone number, and someone would call her within 15-30 minutes with a "code" that was needed to complete the login and password. I decided it was worth a shot, so I completed the process and called Mam-ma. "Someone from the phone company will call you in the next few minutes and give you a code. Have a pen and paper handy and write it down... then call me." "Okay," she said. More than an hour went by, and Mam-ma did not call me. I knew that my husband had been at her house to deliver her Meals on Wheels and change a light bulb. I thought maybe she got distracted. So I phoned. "Mam-ma - did anyone call from the phone company?" "No!" she answered. "Oh... wait! Yes, someone called, but she didn't speak English, and I couldn't understand her... then a man came on, and I thought it was a sales pitch, so I hung up." I told her that was okay, and I dismissed it. A few minutes later, Mam-ma phoned me... "I think I messed up." "No, Mam-ma, it's okay... don't worry about it."

Later in the day, I decided I really did need that phone bill info, so I thought I would try again. I called Mam-ma and said, "Okay, we're going to try this again. This time, if you can't understand the person who calls, just say so and someone else will come on the line. Write down the information they give you and call me." "Okay," she said. A few minutes later, Mam-ma phoned me... "That man said if you will call 1-800, you can get what you need." "One-eight hundred what?" I asked. "Just 1-800," she answered. "OKAAAAAYYYY!" I said! I decided to move ahead and pray the bill was drafted in a day or two. Soon Mam-ma phoned AGAIN... "Did you ever get what you need?" "Yes, Mam-ma, I have everything taken care of... thank you!" On January 19th, the phone bill draft appeared on the online banking account. Thank you, Lord!

Now I had all I needed. I wrote a letter to the DHS case worker, outlining all of the payments I had made. I printed out a current bank statement and attached copies of checks and receipts to prove that I had spent the balance. I showed proof of receipt for the insurance policy I had surrendered to the company headquarters in Kansas City. I still wanted to show the current cash value of the life insurance policy, and I also wanted to verify that the company DID receive it and all was well. So I phoned the life insurance company again… and again I was told they could not talk with me.

Cut to the chase… get Mam-ma on the line… have her tell the rep I can talk with her. AGAIN, the worker argues that the birthdate is not correct. She says her records show neither November or a five. I told her it sounds to me like someone entered the data wrong on their end, because I am looking at a copy of the original policy – which they now have – and it clearly says November 5, 1912. She said maybe the agent entered the date wrong. I pointed out that this policy was created in 1970 – on what appeared to have been a MANUAL TYPEWRITER! The bottom line was that I had to FAX my grandmother’s ID to the insurance company with proof of her birthdate. I was able to verify yesterday that this FAX was received, and hopefully a check is forthcoming.

Meanwhile, I phoned DHS and asked to speak with my case worker. I also got in the car and drove to DHS and left my letter and receipts. The very helpful receptionist date stamped everything and said she had discovered the case worker was not in the office that day, but she should be back in the office on Thursday, and my papers were atop the case worker’s desk for her review.

It took three days and several phone calls, but I was finally able to speak to my case worker, who told me she had not had time to look at my papers. I explained what I had done with the money. I assured her that there is no money left - I've spent it down and left receipts to prove it!

The case worker had told me on January 11th that she would go ahead and send a nurse to evaluate my grandmother. To date, no nurse has come. I asked if she could please send the nurse. She said that the nurses were doing double duty with another agency, and she just didn't know when the nurse could get there. I asked about the February 1st deadline, and I pointed out that we were in the midst of a second major snow event, and I am on pins and needles that my grandmother will try to get to her mailbox and fall and break a hip before I can get her admitted to Southridge. The case worker said she understood, but she said that she is the only Medicaid case worker available presently - the other worker has been ill and is on sick leave. She said there were several people ahead of us who have been waiting more than a month already.

I asked, "So your comment about getting this done by February 1... is that not still possible?" She was not sure. And she could not tell me if the nurse would be able to evaluate Mam-ma before the end of this month... "If I told you a date, I'd be lying," she said... "because I just don't know." So I do not know WHEN we will be able to move. I told the case worker, "I'm going to hang up and say a prayer." She laughed, but I hung up and did just that.

At this point, I have done all I can do. But I do not underestimate the power of prayer. I have not told Mam-ma that we might not actually move on February 1st. I'm believing that God will work in this situation and fill in the gaps now where I am powerless. If you want to agree with me in prayer, that would be great! Meanwhile, I'm washing new towels, labeling everything with Mam-ma's name, and preparing for the big move in 10 days. I'll let you know how it goes!