I need a roommate. Actually I need two but at least one to start with. I’m writing this blog directed towards friends, family, friends of friends, friends of family, family of friends etc. in hopes that someone knows someone who can move in here and help be my caregiver. The idea is that they would live here rent-free with free utilities, free Internet, free cable and use of the house in exchange for part-time responsibility of taking care of me.
I currently can get nursing care from 8 AM until 6 PM on weekdays. I also have a home health aide who comes on Saturday and Sunday morning for 2 to 3 hours. She gets me bathed and dressed and up in my chair like the nurses do. But because of the rules and because I have a trach in a G-tube she cannot be alone with me. So these hypothetical roommates would be required to be here evenings and weekends. I may also be able to get some additional nursing hours called respite hours but they might only be 10 or 12 hours per week. These respite hours are not flexible so we would have to come up with a regular schedule
I need two people because it’s a full-time endeavor. If one person does it, they wouldn’t have a life beyond going to work while my nurses are here and taking care of me the entire rest of the time. But if I have 2 people sharing the duty it becomes a much more manageable job. Currently my sister Carol is doing all of this on her own. The idea is that we will recruit a roommate who will share the responsibilities with her and then if it works out we would recruit a second roommate and Carol would be free to move on with her life
Anyone with normal physical ability who can follow simple instructions can do the job. It doesn’t have to be a nurse or a trained caregiver. None of this is rocket science. I can train them to suction my trach and do G-tube feedings. I can train them to put me to bed using my Hoyer lift. They would have to undress me and put a diaper on me. Is a simple task to put me on the ventilator overnight. While it’s quite a job to get me up and dressed, the nurses and aides will do that. Putting me to bed is relatively easy. It’s a law of physics that is easier to tear things apart that it is to put them together 🙂 The only nasty part of the job would be getting me on and off a bedpan and getting me cleaned up. While wiping my ass is not a fun job, as the children’s book says “Everyone Poops“. You wipe your own ass and it’s no different than wiping mine.
So what I’m asking you to do is to look around and see if you know of someone who might be interested in the job. At some point I will probably do some advertising to recruit a college student or perhaps even a nursing student. It doesn’t have to be a nursing student but they might be more inclined to take the job. It would be much better if it was someone that I knew or someone that you knew and could say that they were a decent reliable person.
That’s the short version of the story. But anyone who knows me, knows that I can’t tell a short story so I invite you to continue reading while I give you all the background on how I came to this point and why I need these roommates.
This idea is fraught with problems. Where do I recruit such people? How do I trust them? Sure we can do a background check or a drug test but that doesn’t mean I will find the right people or that I will find two of them and all three of us get along. What do I do when one of them quits? What are the legal issues? Can I write a roommate agreement that is not 80 pages long like Sheldon Cooper on “The Big Bang Theory”? These are all questions I can’t answer right now. But I have to pursue this idea because it is the only way I’m going to be able to avoid ending up in a nursing home.
What did he say? Nursing home? Oh no!
For many years whenever I mentioned to someone that at some point in my life I may end up living in a nursing home, the most common reaction has been a very quick “We can’t let that happen.” It takes a variable length of time however before the person saying that realizes there really isn’t a whole lot they can do to prevent it if it comes down to that. Let’s face it I am an extremely high maintenance person 🙂
In recent years I’ve become even more so. Basically I need someone to take care of me 24/7. It is not at all safe for me to be alone for any length of time. At one time it was common for mom or dad to leave me alone for up to an hour or two while they would run an errand. But in recent years it became less and less safe for me to be alone. Dad began scheduling his trips to the grocery or to the doctor at a time when my home health aide was available to take care of me.
Once I got my trach, things changed significantly. According to the rules, a home health aide or certified nursing assistant (CNA) is not allowed to deal with my trach or G-tube. In has to be a real nurse. A CNA is not allowed to be alone with me. That meant that dad had to change his schedule and cannot leave the house while the aide was here. Fortunately we were able to recruit a nurse who was permitted to care for me. He would come regularly one day a week and had some flexibility that he could come on other days as well.
My need to have someone here ALL of the time was clearly illustrated in an incident about a year ago. Dad went outside to do some yard work. He was only gone about 15 minutes before I found myself in real distress needing my trach suctioned. This was despite the fact I had told him before he went out the door that I was okay. I really thought I was.
Dad was able to do it these past few years basically because he didn’t have a life beyond caring for me. When he did go to a retirees meeting or go out to lunch with a friend on occasion we had to recruit other friends to stay with me. But dad didn’t have much of a social life so he didn’t have to give up much to be here all the time. In my eulogy of him last month I told the story of him coming to visit me in the hospital despite terrible weather that should’ve kept him home. His response was simply “I didn’t have anything better to do.” And that was the truth. I could rely on his care 24/7 because he didn’t have anything else to do.
That’s what it takes to keep me out of a nursing home. And that’s why all the people who say “We can’t let that happen” really can’t replace him. My other friends and family have a life. They have jobs and friends and commitments. They can’t devote their entire life to me and my care no matter how much they don’t want to see me in a skilled nursing facility.
When dad became ill this summer, my sister Carol moved in with us to help care for the both of us. She did this even though she herself was battling some very difficult health problems. She had surgery for throat cancer which was completely successful however the doctor still recommended an extensive round of radiation treatments which were devastating to her. Although she is back at work she still has a long road of recovery ahead of her. She’s been unable to eat enough to keep her healthy and recently had a G-tube installed so that she can get sufficient nutrition to heal. Her sacrifices for dad and I over the past many months have been phenomenal and I am totally lost for words to express how much it has meant to me.
Even when dad was doing well and Carol had not yet begun her difficult radiation treatments, I found myself at times overwhelmed at the thought of what she was going through to take care of us. I’ve needed pretty much this level of care my whole life. While I understand that mom and dad had made sacrifices to care for me for 60+ years, they are my parents. Taking care of your kids is part of the job. I don’t want to say that I ever took them for granted because I didn’t. But it just seemed natural that we had the kind of relationship that we had. On the other hand although Carol is family, what she has done for me in these past months has been way above and beyond the call of duty.
When all of this started, Carol expressed her commitment to stick with us to the end that we knew was coming from my dad but not necessarily for my entire life. We always knew that this would be a temporary situation for me. I intend to do everything I can to honor that concept that she wouldn’t be here forever.
In the late 1980s my grandma Osterman lived with us through all of her final health issues for about five years. The stress on my mom being a caregiver for grandma and I was overwhelming. Perhaps you didn’t see it but during those years it changed her personality. Much of the time she was on the verge of a nervous breakdown. We all made sacrifices in those days but we understood that it was important to grandma to be here among family and it was important to my mom that she be able to care for her. After grandma passed away in 1990, mom recovered and became again the happy, kind, giving person that she had been prior. Dad and I spoke many times that we wanted to make things as easy as possible on Carol having seen what it cost my mom to take on such heavy responsibility.
Throughout the process, we’ve been exploring possibilities for my future once dad was gone and it was time for Carol to move on with her life. Although a skilled nursing facility was at the bottom of my list of options, unfortunately we had to explore it first because it was a bit of an emergency. It was questionable whether Carol would be able to continue to help out while recovering from her surgery and radiation. At one point she did move back home and dad and I were on our own. Fortunately dad was still in good enough shape that we could get by with the nursing help for several weeks. If dad had gotten worse before Carol was ready to come back, I needed somewhere to go.
When we weren’t certain that Carol was going to be able to continue to help out, I went looking for an SNF that could handle me. We had help from my caseworker from an agency called CICOA who handles my Medicaid paperwork. It turns out that finding a facility that will take someone who uses a ventilator is not easy. Most SNFs don’t have the staff to handle it. While anyone could do the job in my home, because of liability and other issues such a facility has to have highly trained people. I don’t really use the ventilator to keep me alive. It’s really just like using a CPAP or BiPAP to help me sleep at night. Before I had the trach I used a CPAP. But once you say “the patient is on a ventilator” that triggers all sorts of problems.
We finally found a facility called Greenwood Health Care in Greenwood. My friends Rich and Kathy drove me down there one afternoon for a tour. It was a reasonably nice place. I would have to share a room with another person and it would be a small living space but there is ample common area that I can hang out with the other residents. The minute you say “nursing home” it immediately conjures up all sorts of bad images. Someone like me doesn’t want to end up stuck in some wing with a bunch of Alzheimer’s patients.
One of the key things that I asked the staff in Greenwood was “Are there other people here like me? Are there people that, for the lack of a better term, I would consider peers? Are the people who are here because of their disability not because of age or medical condition?” She said that in the respiratory unit there were naturally lots of sick people. However in the unit adjacent to that there are people like me and I would have ample opportunity to make friends and interact with them in the common areas. That was a great relief to me.
I came away from the tour feeling greatly relieved that even if I had to take this worst-case scenario of a nursing home that I could get by reasonably well.
Obviously a nursing home was not my first choice. What I really would like to do is be able to stay in this home which I’ve lived in for 60 years ever since I was three years old. We talked about the possibility of my sister Karen, her husband Terry, their son Cole and their friend/roommate Dawn moving here. Even though it would be a little bit easier on them because there are more people to share the load, uprooting their family and moving here is just too much to ask.
I talked to my case manager and asked her what is the maximum amount of nursing hours she believed I could possibly get. She indicated that I might get 45-50 hours per week of what is called “preauthorization” or PA hours such as I was getting from 8 AM – 6 PM currently. And additionally 20-30 respite hours per week. That just isn’t enough to get me 24/7 care in my home.
Another option is to find one or two other disabled people each of whom could get authorization for maybe 10-12 hours per day. Then between all of us combined together we could get 24/7 care by utilizing each of our authorizations sequentially. That has worked in other cases. The problem is we would have to find someone very much like me who needed nursing care for a trach and a ventilator and not just a regular home health aide. Finding two or three such people has pretty much proven to be an impossible task.
Another option is what’s called a residential group home. This is a regular house managed by some agency that would have three or four disabled residents sharing caregivers 24/7. Again the problem is finding one that would be staffed by people who can handle the trach and the ventilator. To the best of our ability we have not been able to find such a group home. I had other reservations about the group home setting. I’ve heard some bad stories about them that actually made a nursing home sound like a better place. But given that there aren’t any group homes that can provide the level of care that I need, this one is off the table as well.
I have been exploring other Medicaid programs beyond the one that I currently use. But I don’t think any of them are going to qualify me for 24/7 care simply because if there was such a program, you wouldn’t need group homes to exist or at least not in the numbers that they do. I’m still looking into alternatives but I’m not at all hopeful that there are such programs.
All of our efforts have been directed at trying to get more nursing hours. We explored the possibility of trying to get private funding to hire more nurses. All of those people who said “We won’t let that happen” might be able to contribute something financially to hire more help. But I keep going back to the fact that I don’t really need a nurse. The only reason it has to be a nurse is because that’s the only way Medicaid will pay for it. I just need a reasonably able-bodied average strength person who won’t freak out at the idea of wiping my ass. And recognizing that one person can’t do it all alone… I need two of them
One of my nurses told me the story of another client she once served who had a college student living with her. The student would take care of her when the nurses were not on duty. That was the inspiration for the plan that we are pursuing.
I don’t need a place to live. This house is paid for.
I don’t need nurses. Any able-bodied person can do it.
I don’t need other disabled roommates.
I just need someone to be here when my nurses are not and to do some basic care.
While looking for the exact proper solution to the problem it occurred to me that what I was looking for was a unicorn… A beautiful mythical creature that probably didn’t exist. But the odds of finding and able-bodied roommate to come here and sharing the responsibility of caring for me doesn’t seem like such a long shot. I think I’m now looking for a horse instead of a unicorn.
That doesn’t mean this is going to be easy. Finding the right people will be hard. Finding someone who can get along with me and the other caregiver will be hard. Whoever we get is likely not going to stay forever so there will be turnover. These are the issues that Carol seemed most concerned about when I proposed the idea to her. They concern me as well. But I always have Greenwood as a fallback position. And I really can’t see going to Greenwood until and unless I have given this my best shot.
So look around… Think about your friends and neighbors and coworkers. What about nieces and nephews and cousins and their friends. Put out the word and help me find someone to be my roommate.
Sometime soon I’m going to put up a webpage with perhaps a YouTube video designed for the general public to view and you can direct them to that page. By the way if anyone is interested and it makes a difference, I live in the Eagledale area just north of Speedway. It is a four bedroom house and the caregiver would get their own bedroom.For now this is just directed to people I know. I’m hoping you can help.