Remembering Our Lonesome Elders

This is my tribute to the elders in our communities who have been so terribly affected by  the COVID-19 pandemic restrictions.

Untouchable; Alone (April 16, 2020 Central Jersey)
(c) Linda S. Ershow-Levenberg , all rights reserved

Untouchable. Alone. He wants his daughter. Every morning she brought coffee and some news.
She would tell him of the books that she was reading, trim his hair, or polish up his shoes.

The cherry blossoms burst in bloom without him.
He couldn’t leave his home to touch those petals with his hands.
The daffodils and hyacinths a memory.
He gazes out the window, but he just can’t understand.

Untouchable. Alone. He wants his daughter. Parcels just get left outside his door.
A step or two, he must sit down, so tired.
The empty streets are yawning; no one’s working any more.

The television’s off – it was relentless. He turns for comfort to his magazines.
Turning all these pages, he can travel –
to Calcutta, to the Tetons or to New Orleans
to Calcutta, to the Tetons or to New Orleans

Still, untouchable. Alone. He wants his daughter.
Every day he tries to find a way to make it new.
There’s solace in the sunshine in the morning.
And he’s breathing. He will find a way to see this through.
He’s breathing. He will find a way to see this through.

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Let’s hope that sooner rather than later our elders will again be able to enjoy in-person visits from their friends, grandchildren and children without fear and risk.

 

Call us about your elder care concerns …… 732-382-6070

Ideas on Overseeing the Care in a Nursing Home When You Can’t Enter the Building

Advocating for our clients in nursing homes during this pandemic has been uniquely difficult, but we continue to utilize whatever tools are at our disposal to help the family members oversee the delivery of care to their loved ones. Many rights are guaranteed, and right now much creativity is needed to protect those rights. Care plan conferences with the treatment team (nursing, dietary, recreation, physical therapy, medical) can be set up in which the family member/ health care representative/ POA (and the attorney, if desired) are on a conference call. Dietary staff can communicate with family about menu selections at the start of the week, using scans or faxes + emails.  It is important to monitor diet because the lack of communal eating and snacking may be causing significant weight loss in residents.

Arrangements can be made for the resident to be brought down to the Lobby so that the concerned health care proxy/involved family member can actually see them through the glass windows or doors. Arrangements can be made for nursing staff to call the family at scheduled times with a report from the shift.  As the weather warms, facilities should be scheduling outdoor visits with family on a regular basis.

Access to the medical record can be arranged, and state law requires the facility to provide access to records to the resident and their authorized requester. Ordinarily, a patient’s advocate/family member who has HIPAA authorization can review the chart during their visit to the nursing facility, in order to stay up to date with the care that’s being delivered, how the resident is functioning, whether there were any incidents and what medications the person is taking. Right now, no third parties are allowed on the premises of the skilled nursing facilities. Since the facility is obligated to keep the families informed about the condition of the resident, creativity and cooperation are needed. Have a discussion with the administrator about a reasonably convenient way that the facility can send this information out – perhaps once a week via fax or scan.

Updates on the COVID-19 situation as it affects seniors and those who care for them can be found here and here.  Many towns have put special programs in place to provide support for frail and housebound community members who are suffering due to the pandemic. The local Aging & Disability Resource Centers can also be useful as an access point for information and services, even though service delivery is not swift during these times.

For help with your unique senior care legal problems, call us at … 732-382-6070

New Jersey provides portal for complaints about Nursing Home Care

To say that the care-delivery system in New Jersey’s nursing homes in 2020 has been fraught with problems and perils is, of course, an understatement. Certain facilities are just now beginning to admit new residents, and many new procedures for infection control and care delivery have to be put in place. The NJ Attorney General announced on April 16th that he is embarking on an investigation into the way that the skilled nursing facilities responded to or handled care delivery in response to COVID-19 infection. Now the State has created a form for people to use to provide complaints or information that could be useful to this investigation.  The form is a fillable PDF that you can submit electronically by clicking “submit” at the end of the form. Here it is: :  https://covid19.nj.gov/forms/ltc

It’s vital that the public file this important information so that the investigation has access to a broad spectrum of first-hand information from members of the public.

 

Vigilance by concerned family members is even more vital than ever when it comes to the long term care and security of their frail elderly loved ones. For help and advice, call us at … 732-382-6070

Save your Selfies for the Medicaid 5-Year LookBack

Readers of this blog know that when he time comes to apply for New Jersey’s Medicaid/MLTSS program for either home care, assisted living care of nursing home care, a daunting array of proofs is required. The burden to prove eligibility is placed on the applicant.  Every single expenditure made by the applicant and their spouse during the previous 5 years is open for scrutiny, to see if it was really an expenditure or if it was actually a gift to somebody else. Every check written, every auto-debit, every wire transaction, every cash withdrawal is questioned. Many kinds of transactions are presumed to be gifts unless the applicant can prove otherwise. People who share their residence with other family members may find this process particularly hard to unravel because of the intertwined sharing of expenses. People who never managed the applicant’s affairs but are now stepping in may find it impossible to answer the hundreds of questions that are posed to them by the agency.

So save your selfies, save your receipts, save your letters and invoices and proofs that you took trips and excursions. Take pictures of your big purchases, and pictures of your caregivers. Keep detailed records of everything, as well as copies of all financial records and cancelled checks. Find your insurance policies, deeds, mortgage payment receipts,  and keep them with these records. Make sure your “trusted someone”  knows where they can find all these proofs when necessary. Banks are charging exorbitant fees to produce copies of statements and checks, so elect to receive statements & cancelled checks or make sure you receive them electronically. It seems you can never have too much proof. Collect and save the medical records. Save all of this for at least a five year period on an ongoing basis.

Forewarned is forearmed. The grueling MLTSS application process can be just a bit easier if you retain your records.

Call us for help with Medicaid applications for long term care ……. 732-382-6070

New Jersey COVID-19 MedComm Contains Big Announcements on Medicaid Terminations and Eligibility

An important new Medicaid Communication (MedComm) was recently issued by the New Jersey Division of Medical Assistance and Health Services (DMAHS). As we had previously discussed, due to the COVID-19 emergency, Medicaid has loosened certain eligibility and post-eligibility rules. The MedComm explains and reconfirms our understanding of the changes in these areas:

Terminations: If you were approved for or receiving Medicaid in March 2020, you cannot be terminated for the length of the emergency unless you wish to do so voluntarily.  Terminations occur for a variety of reasons, including changes in resources (like selling a house and getting cash), changes in income (like getting a new pension from a deceased spouse), change in insurance coverage (like getting Medicare for turning 65) or failure to provide information to a Medicaid agency (information is usually requested on an annual basis).  If you had been on Medicaid in March and have been terminated for any reason without your consent, you should be reinstated. Call us if you are experiencing problems with this.

Applications: Medicaid is allowing “self-attestation” of income and resources in certain situations where they may have previously insisted on bank statements or other proofs that cannot be gotten during the COVID emergency. “Self-attestation” is a sworn statement signed by an applicant or representative to declare what their income or resources are as of an application date. Because it is sworn, attestation is a process to be taken seriously in conjunction with legal advice.

Clinical Eligibility: MLTSS Medicaid eligibility will be processed in the emergency without completion of the usual face-to-face clinical assessments that were typically required, as long as the facilities or individuals follow the procedures outlined in this separate guidance from Division on Aging Services Call us with your questions about this change in process.

Stimulus Payments: No stimulus payment will be counted toward resource eligibility for Medicaid. No enhanced unemployment payment ($600) will count toward income eligibility for Medicaid. This reconfirms what we had discussed earlier this month.

Everyone’s individual situation right now is a little different, so this new policy guidance will affect each person differently when applied to the individual’s case. Contact us at 732-382-6070 to discuss how this will affect you or your family members.