MIL after stroke

[vazny]

Right now we are in a situation where my mother-in-law was taken away by ambulance a week ago with a very serious stroke and they had a hard time saving her. It was basically a miracle with God's timing, even the doctors see it that way. (If only my in-laws, who are agnostic, saw it that way).

But with that, our vacations, holidays, etc. totally broke down. We have to care for my father-in-law at home and go with him to visit mother-in-law in the hospital. And when they come back from rehab, they will need help. And the outcome of how functional the mother-in-law comes back from the hospital will depend on the intensity.

How do you do this in the US where everything is far away, relatives live on opposite sides of the state, someone might be a soldier subject to orders, etc.?

One more thing, what kind of cell phones do you use for old people so they can use it even if they are clumsy, their hands are shaking, etc.?

[DoveGrey]

First, I am sorry to hear of your troubles. I will keep you and your family in my prayers. I hope others here have cell phone suggestions.

In the US, we handle this in various ways:

If you're wealthy or your family member has exceptionally good health insurance, you can put them in a long term care facility or hire a home care provider. If you aren't able to provide that level of care, then someone in the family either relocates closer to the ill person, or the ill person is moved to be closer to family. Then, the family has to either share the responsibility or assign one person to be the caregiver. If there is a family member who isn't employed outside the home, it often falls to that person.

More often in my humble experience, someone has to take time off work to be a caregiver. We are guaranteed 12 weeks of leave for this across all 50 states, and it's unpaid. 12 states currently have active programs to pay workers who have taken time to care for an ill relative. These programs typically cover partial pay for 12 weeks, although some are as low as 2 weeks. Some states have paid leave that is waiting to be active. 29 states offer no protection.*

Consequently, many of our sick and elderly stay alone all day, going without any kind of care until someone comes home from work. That's going to vary widely depending on family income and situation, plus whether or not you live in a state that offers a paid leave program.



* https://bipartisanpolicy.org/explainer/ ... s-the-u-s/

[Olorin]

I am sorry to here of your MIL and will be praying for recovery.

In our case, my father and DW's parents moved into retirement homes near where we live so we could take care of them. We were fortunate that both my father, and my wife's parents had saved enough to afford nice retirement facilities. Their faciities were/are only a 10 minute drive from us, so we could see them as much as necessary. My father and father-in-law have passed, but my MIL is doing well at 91 years of age and we see her multiple times a week to help her shop, take her to church, take her on fun outings, etc.

As for cell phones, near the end of his life my father could not easily operate his phone, so we purchased an Amazon Alexa and put it in his room. Using an app on my phone, I could say 'Call Dad' and it would 'ring' the Alexa unit in his room and he could answer without having to do anything.

[Paradox]

How do you do this in the US where everything is far away, relatives live on opposite sides of the state, someone might be a soldier subject to orders, etc.?

In our situation, I moved to our community after medical training for a work position; both my parents and DW's parents, moved here after their retirements to be closer to our family. My wife's sister and her family moved here because they liked coming here to visit, and her husband had started his own business.
My FIL died in his home near us at age 86 about two years ago (10 miles away), and all our family pitched-in. He was chronically ill. My parents built a small house on our ranch property about 10 years ago; my father died in his chair suddenly at age 78. Both of our mothers are becoming crippled and are about to need help. My MIL may hire part-time help, but will probably move into our home within the year. My mother will also need to move into our house within the year.
My wife, her sister and my children will provide their end-of-life care in our home. My sister will travel here to help when she can. My MIL has enough money to pay for outside help, but my mother does not. It is looking like my wife and I will be working hard, perhaps round-the-clock, for the next couple of years.

[Doug]

Every family handles it differently. When my inlaws health failed, my wife moved in with them several states away. She was their primary caretaker 24/7 for close to a year. It was hard on me, harder on her, and was definitely a challenge to our marriage. With that said, looking back, I don't think I would want to do it again, but I am glad we were able to do it then.

[vazny]

In the Czech Republic, in the middle of Europe, it is now the case that as a European country we have compulsory health insurance (actually a health tax ), which everyone has to pay to chosen insurance company at the rate of 13.5% of income: 2/3 is paid by the employer, 1/3 by the employee, and self-employed people pay the full amount, at least from the minimum wage. For children, pensioners, students, disabled people, mothers caring for children, and registered unemployed people, etc. the state pays it unless they have no other income. Those with no income must pay it themselves, otherwise they incur a debt to the health insurance company and can have their property seized by the bailiff.

Currently, MIL's insurance pays for a maximum of 3 weeks of rehab at the hospital's rehab center. She's mainly learning to walk again. So far with a walker, but he needs to get in shape because in their apartment building there are stairs from the elevator station between floors to the apartments. She did it 2 years ago after an endoprosthesis, so hopefully she can do it again.

If MIL needs help at home, the wife can apply for care leave for up to 90 days, paid for by a health insurance policy (different from health insurance). It's significantly less than salary (like 2/3 for low income and maybe only 10% for high). But the employer can refuse it if they have very serious operational problems. My wife is a pedagogue assistant for problematic children in kindergarten and a kindergarten assistant, she has a two part time job and it is likely that the director would end part of it (she can give her notice on one part). And DW loves her job...

In case of a more serious problem, there are more alternatives. The harshest are the hospitals for the long-term sick, which are sometimes morgues in oblivion with large rooms for many patients. Often burned-out nurses serve there, and rumor has it that they will sometimes open a window on obnoxious patients to get rid of them through pneumonia. Often their branches are in remote small towns.

If one is permanently ill, one can get a care allowance of about $400 a month in the worst cases. But also maybe only $40. It take minimal 6 month to organize it, many papers etc. The Social Security Administration's assessing physician will decide. It is paid from the same fund as the state pension.

If the person is in a nursing home (public - county, city, or church or private), all this money and ca 90% of the pension goes to that institution. If it's not enough to cover the cost, they try to negotiate with the family to make up the difference.

If the disabled person is being cared for at home, then the care allowance goes to the family (for now), as a small compensation, and the years of care are partially counted towards the years of service for the pension (every person must have 35 years of work and insurance in CZ and retirement age). The care allowance can also pay for some social assistance such as shopping, food delivery, simple cleaning, laundry and hygiene help. But the money is not enough to do this, and at the same time social services are hugely underfunded.

The doctor should also provide patient visits but many do not. However, he or she can also prescribe a home-care nurse, but only for medical tasks, not social.

The biggest problem are small apartments, often in prefabricated buildings from the communist era (avg 600 sqft) and most people live in condos or rent appts houses. This limits the ability to move into one apartment. Selling and buying an apartment in our country is also very difficult administratively and practically impossible if there is a mortgage on the apartment.

BTW. We have to pay additional 31.3% for pension, unemployment and sickness insurance. At the moment, the conditions for the pension are getting stricter as the number of children and thus payers in the pay-as-you-go system are decreasing. We have to pay 31.3% for pension, unemployment and sickness insurance. At the moment, the conditions for the pension are getting stricter as the number of children and thus payers in the pay-as-you-go system are decreasing. Realistically, we pay our parents' pensions, but we don't know if anyone will pay ours.

[vazny]

Thank you all for your prayers. Grandma (MIL) is at home, the rehab still practiced walking up stairs with her and without a walker.

All the doctors consider the result a miracle, as they managed to suck out practically all the thrombus from her brain and all that is left is more fatigue and a little bit of "hangover-like" dizziness.

Now, to make the miracle move the practical - materialistic grandmother more towards God. She grew up and lived her whole life under communism, and it just has a big effect on her thought patterns.

[OnlyByGrace]

Praying for your MIL, as well as the whole care situation.

I have never thought of how different aged care is in different countries, even though general medical care is very much different.
In Australia, Aged Care Assessment Programs (ACAP) will assess the aged person's ability to care for themselves and support networks, and assets. Then they may be provided varying levels of care packages, including community based care and respite care, to residential care.
Assets are considered to determine the copayment when deemed necessary to move into residential care. However, this is usually a slow process, and elderly often find their way to hospital, and can spend weeks there before an aged care bed becomes available. They can state preferences for a home, but this is not always possible.
Homeowners and those with medium/high liquid assets pay to enter the home - and pay a reduced fortnightly amount for cost of living there. But low income, and financially disadvantaged people also have access to federally funded places and pay a larger amount of their fortnightly pension towards the cost of living there.