Caregiver Conference Legal Issues

After we had lunch at the Conference a lawyer was ready for his segments of the Conference. He discussed Estate Planning and Medicaid Planning for Eligibility. I never would have imagined you could plan for Medicaid but I guess you can and people actually pay lawyers to help them set it up.

Estate Planning

Keep in mind and Estate is everything you own. Planning for what happens after you are gone helps to protect your assets, provide for your family, and charitable goals. Sounds pretty simple.

Three Documents Everyone Needs to Have:

• Durable Power of Attorney (POA)
• Healthcare Directive/Living Will
• Will or Revocable Living Trust

Most of us in the military world know what a Durable POA is and/or we already have one for our spouses, but does our spouse have one for you?

Healthcare Directive/Living Will is your personal moral statement about your end of life choices. Life support and pulling the plug is never what any of us want to have to consider but it can be the cold hard reality of life. You need to ask yourself if you want to be kept alive indefinitely on life support or only for a period of time?

A Will is basically a statement of where you want your property to go. A Revocable Living Trust is a legal document which helps to avoid probate and can eliminate some of the tax burden that comes with inheirtance.

It is in your best interest to have your documents witnessed and notarized. With witnesses you will need to have a Self Proving Affidavit, a statement which declares they witnessed your signature on your document. The Self Proving Affidavit helps so your witnesses will not need to be tracked down at a later date and time.

Community Property Agreement is essentially a contract between spouses stating that if one passes first all property reverts to the surviving spouse. This contract will also mean no probate.

Before you begin you will need to inventory your assets in a general manner, inventory your liabilities, list your family members, and finally what you want to accomplish with your documents. The interesting part mentioned is that when constructing your Will and leaving possessions to family/friends you do not have to list everything and who they will go to in the Will, it can be stated to 'see attached document' and that attachment can be changed without changing the whole Will. He was asked if you can disinherit your family, of course you can.

Medicaid Planning

This was a lot of information and there was no hand out but simply put there is a way to protect assets for your family and still receive medicaid benefits for nursing home/skilled nursing care towards end of life. Unfortunately if you own property you will need to plan with about 5 years before you will need to care if you can.

Another thing to check out is Purple Cross Plan, which is like a savings account for burial expenses and is exempt from your medicaid 5 year look back period.

There are lawyers that specialize in this type of law and it is advisable when there is a life changing illness which will require long term specialized care.

Caregiver Conference Part 2

As a continuation of the Caregiver Conference the next presenter was Kyle Mamiya, Speech Pathology Seattle VA Medical Center.

Now honestly my first thought was how would a Speech Pathologist help in the Caregiving process? Boy I was really surprised and so happy he provided a handout of his presentation.

Strategies to Improve Performance on Tasks Requiring Memory, Attention and Problem Solving Skills

Topics Covered:

• Problems with cognition and effects on lifestyle
• The role of the speech pathologist in cognitive rehabilitation
• Information about views on cognitive rehabilitation
• Some approaches to addressing various cognitive difficulties
• Some strategies to use or encourage in different settings

Problems with Cognition

1. Caused by many reasons
2. Affect attention, memory, problem solving, communication, behavior, moods
3. May affect habits, work, interaction, care for self, fully engage in some aspects of life
4. Functioning Tasks, appointments to-do list, forgetfulness, control of emotions

Speech Pathologist

1. Patient Care Team
2. Assess and analysis of cognitive skills
3. Systematic, functionally-oriented therapy
1. Structured learning
2. Focus on Restorative and Compensatory Treatments
3. Include Caregiver/Family

Things to Consider

1. Identify specific goals or tasks
1. Use Caregiver/Family to help set realistic goals
2. Provide errorless learning opportunities
1. Clear expectations
3. Practice strategies
1. Provide feedback and tools for performance
4. Select meaningful activities

Speech Pathologist will work in the clinic face to face and in the community living centers as well as via telehealth, e-mail, and telephone.

Speech Pathologist will work to improve attention through different training methods, exercises, and repetition. Goals to improve focus, reduce distractions, staying organized or on schedule, get enough rest to help with the cognitive abilities, learn to break down tasks into several smaller, manageable tasks, as well as NOT multi-tasking.

Things to try

• Notepad and pen with you at all times
• Dry erase board for the house
• Routines and a schedule/calendar
• Place to always place your things (purse, wallet, keys, phone)
• Use lists everywhere necessary
• Electronic devices to assist

There are many other ways to work to help with cognitive abilities. The presentation itself was 27 slides long.

Another concept talked about was to NOT rely on the memory itself but do rely on the tools available to aid with recall of events. The tools are the best aides we can supply our Veterans with so they can gain some self confidence.

Recall Tools

• Simplify/reduce information
• Review information in different forms
• Ask questions, rephrase information, link to something personal to improve the focus/memory
• Mnemonics
• Visual imagery
• Voice recorders
• Planners
• Electronic devices
• E-mail, alarms, voice mail

I think one of the best things I discovered is that Speech Pathology can help with the Cognitive Issues many of our TBI/PTSD Veterans are facing on a regular basis. They can prescribe electronic devices if you have not been able to attain them in other ways. Another great discovery was about telehealth. The Speech Therapy has been able to utilize Skype to help patients living further from the VA. It was rather cool to sit in this 91 year old building and talk about the latest technology to assist our Veterans.

Caregiver Conference

Yesterday I had the opportunity to attend a Caregiver Conference through VA Puget Sound Health Care System at American Lake VAMC.

First was a Doctor from the Deployment & Combat Health Division, Dr. Stephen Hunt. He talked about the role of the Caregiver. He considers Caregiving, the most meaningful and important act, since it is a natural act for many the world over. Parenting is Caregiving.

Dr. Hunt gave us questions to consider about Caregiving:

• What does being a Caregiver mean to you?
• How have you learned about Caregiving?
• What was it like, being a Caregiver?
• What helped the most?

The answers are not surprising but I will not share those answers but there are definitely worth thinking about.

Dr. Hunt mentioned how attitude and support are key elements in Caregiving and that sometimes the Caregiver has to take the same approach with the same values as our service members used during their time in service. This made a lot of sense. There are times my DH responds better when I use a more military approach with him. He also talked about how the cost of service is family wide and support is not JUST about the Veteran.

Caregivers have a dedication to support one another. This creates new bonds but can also create Caregiver fatigue so the Caregiver needs to take advantage of any resource available to them.

The need for self care is so important for Caregiving and will create a satisfaction which is the cornerstone of successful Caregiving. The key elements here are personal care (more important than medical or clinical care), social support for the family, and to identify barriers of self care.

Dr. Hunt considers self care to be:

• self nurturing
• personal life
• healing activities - hobbies
• balanced life
• goals
• respite care

When the audience laughed he commented that while we laugh we should still consider all of the above at different times. He highly recommends Yoga for relaxation. He has worked with local (Seattle area) Yoga studios to help combat veterans and ended up with a total of 42 studios willing to donate time to assist returning combat veterans.

He concluded with reminding us all to  know yourself, value yourself, care for yourself.

Do not deny the difficulties of your work.

Cast loving eye on yourself and your needs the same as we do for our loved ones. This is about our lives.

Things That Irritate

We all have a bunch of different things that drive us nuts.

I have gone through points where I am irritated by women that get upset when their husbands do not call them at least once while they are at work. Hello, it is work they are not supposed to be at your beck and call when they are working for someone else.

I get irritated by people complaining about how little money their spouse makes BUT will NOT go get a job to help out the family unit.

I am frustrated with the people that will constantly argue with you about EVERYTHING!!!

"That's nothing, guess what happened to ME?!" REALLY, why is your issue more important? or if you make the mistake of sympathizing to find out the event in question happened many YEARS ago.

I have known people that have had every bad thing on the face of the earth happen to them or their family. Get real! These are the same people that end up fighting with everyone they have ever met.

I keep trying to be faithful and loving when I deal with other people but it gets increasingly harder to do the older I have gotten.

I have endured my husband's deployment and training, then R&R after only 3 months gone. While he was deployed he injured his knee. He was also unconscious at one point where it was reported to me at 3:00 in the morning that he was dead. I lived for 12 hours believing my husband was dead and trying to tell my children their daddy was gone.

My husband was a commercial fisherman in Alaska for years. He was frequently gone from our house but he called when he had the chance. I will tell you that a winter in the Bering Sea is actually worse than they make it out to be on TV. He called me one night and he had managed to get a hook through his hand between the thumb and index finger.

There was one time when I picked him up from the airport gate at 11:35 pm to have him back at the airport check in by 6:30 am the next morning. It was cheaper to fly home then to fly across the state of Alaska. I happily picked him up, did the laundry, and took him back the next day. I was told, why bother. Because I love him.

I am tired to people complaining about money, usually not having enough but they spend unnecessarily on things they want before the things they need.

I guess I am just a little bit irritated and crabby.

Crap We Go Through

Have you ever considered all the crap we go through on a regular basis?

We can't remember events or circumstances or we just block it all out.

Today I managed to upset someone I don't even know by offering my KNOWLEDGE on a subject I have become quite familiar with. WTH?! Why do people do that to each other. I am the first to admit that I don't know everything and there are times I am not sure I know much of anything but this was just a little over the top especially when I had been specifically to answer questions on this topic.

The topic in question is the issue of competency through the VA.

We are at Day 137 of the competency claim with the VA. I have used the last 4 months to research and know as much as possible about competency, what the VA considers for incompetency, what would have been the key trigger to begin this process, and what the steps are to complete this ordeal.

I initially made the necessary phone calls to the VA and the Federal Fiduciary Office to find out processes and information. I think did countless HOURS of research and saved a TON of documents to use as reference. I have made it my mission to understand the process so I can explain it to my husband in a way he will understand. It is not that he is incapable of understanding but over the last 5-6 years there has been so many changes in his cognitive abilities I cannot overload his brain with too much information.

I do not normally boast about my abilities but I will say that I can research anything and I am relentless. If I want to know something I will try over and over again to find the answers. I have been VERY successful in my research in over the years.

I am a research NERD and I am perfectly ok with it. My love for research probably started with an old Spencer Tracy, Katherine Hepburn film Desk Set. Spencer Tracy's character brings a computer into a TV Network's research department.

I guess what I am trying to say is that we all have struggles. Some of us rise above those struggles to help ourselves and those around us. Some want to continue to help strangers with the multitudes of useless knowledge we stick in our brains.

So while there are some events or circumstances I cannot remember for the life of me, if I tell you I RESEARCHED it, then you have be assured that I actually KNOW what I am talking about. When I tell you I am going through this carp RIGHT NOW, I am.

If you truly want my help, it is yours but do not get mad at me when you do not like the results.

Free You Mind Friday - Week 5

Here we are, Week 5 and another question to ponder.

What is the one thing you’d most like to change about the world?

I guess my first thought is why only ONE thing? I can think of many different things which need to be changed but honestly the one thing that stands out in my mind is NOT World Peace or War, although those are both great things to want to have they are also a little unrealistic. I think that one thing is ABUSE.

There are many different types of ABUSE affecting people the world over. There is child abuse, abuse of women, mutilation, abuse of the elderly, animal abuse, substance abuse, abuse of powers, the list could just go on forever I think. Some of these abuses seem to be acceptable in different societies, like the mutilation. There was a post yesterday from a friend that really made me think. Paraphrasing here, Animal Abuse cases can get more jail time than Child Abuse cases. WOW! Then I started to think about DWI cases and what the jail time is or with Vehicular Homicide cases. I will not comment on my personal experience with this until the sentencing is completed but I will just say it is not enough.

These abuses need to stop. The world can be dangerous enough without the added fear of abuse. Abuse of Power is something which seems to be increasing right now with the government trying to take away the rights of the people.

The abuse of the elderly is horrible and goes unnoticed, how said to treat our oldest citizens with such disrespect.

I could go on but I really think if I had the power to change only one thing it would be to stop abuse from happening all over the world.

One Word...Family

In a nut shell there is one word that can both evoke the most tender of feelings and some of the greatest rage we can ever feel...Family.

Family can and does drive us all a little bonkers. I love my family, I don't just mean my husband and children...I refer to the family I grew up with, but they can still drive us bonkers.

There are many things we can blame on what happens or why there are break down in communication within families but there is never just one thing, it is a multitude of things piling up over years and years which finally come crashing down around our heads. We have joked for years that our family puts the fun in dysfunctional. Sadly, it is not as true as we would like it to be.

We lived for 10 years in Ocean Shores, 1 1/2 hours away from the family, and it wasn't too bad. Family get together's happened but not on a regular basis and NO ONE ever just dropped by. Gotta love the lack of unexpected company.

There are times I really think that Debbie had the right idea of moving away. Distance can really help a family get along better. With distance you are separated from all the normal BS that happens. I think I miss the separation.

I thought with Debbie's untimely death our family would pull together again but even that has not happened in an overall capacity. There are ties which have pulled closer together, but like the shoelace which never stays tied regardless of how tight it is pulled, still manages to untie and go its separate way tripping you up every time you make a move. It is really hard to know what to do with the shoelace, you love the shoelace but you really would not mind just cutting if off and getting a new one.

The word for the year in my Project Life Album is Family.

Definition of FAMILY

1. a group of individuals living under one roof and usually under one head: household
2. a group of persons of common ancestry: clan

Origin of FAMILY

     Middle English familie, from Latin familia household (including servants as well as kin of the householder), from famulus servant
First Known Use: 15th Century

Good News for a Change

Actually got some good news for a change today compliments of the VA eBenefits website. They have actually moved on my husband competency claim and it is awaiting approval on the decision. After 133 days and weekly phone calls to the VA Call Center. We have no idea which way they are leaning but at least this chapter will be finished within the next 30 days.

The other day DH was trying to help with my computer since Firefox upgraded to 18 and is very slow. He wanted to take it back a bit and see if that would help. Unfortunately we lost all my bookmarks that I have saved for the last few years. On the positive side I had managed to save some in a Word Document when my Dear Friend lost all of her bookmarks, so not a complete loss. I have also shared enough links that others have been able to set me up.

Kind of crazy the things we forget to back up or to keep a paper copy. I think I have learned my lesson and will be saving some sites to paper and portable hard drive.

My mom heads back to New Mexico in March and we will be starting our Girl Scout Cookie Booths. Busy times coming up soon.

Free Your Mind Friday

Happy Friday to Everyone!

Week 3 Question 3

When it’s all said and done, will you have said more than you’ve done?

My goal in life is to do more than I say. I am not sure how easy that will continue to be but for now it has not been that hard. I don't always like to talk about what I have done, especially when it comes to the good deeds of life. I have offered support, researched questions, and given answers with no thought to what I would get in return. I have always been like this.

I enjoy working behind the scenes helping people. My greatest rewards comes from knowing the other person was able to get the help or information they needed at that time.

I plan to continue doing more than I talk about or if I do have to talk about it...I better be doing it as well.

Letter to My Beloved

Last year I did not submit my Love Letter to Family of a Vet for all to see and read but I gave it to my husband on Christmas Eve. I think writing to our spouses about why we still love them through the trials we face is also a reminder to ourselves about the love we have shared.

To find out more about the Love Letter Campaign click here.

Letter to My Beloved                                         February 14^th, 2013

Honey,

It is hard to believe it has only been 16.5 years together. We have been through hell and back together, never gave up. Don’t get me wrong there are times I think we both wanted to but we refused. We are stronger together then apart.

We have a good life, not a perfect one but a good one. We have learned to adapt to the changes we have had to make in our lives to keep on loving each other. The lessons have been hard and many times repeated but we have both learned a great deal from them.

Sometimes it hurts to not have a ‘normal life’, what is normal anyway?

When I look at you I see the man that was over joyed when Joey was born and how you would not leave our sides. I can still see you sleeping on the little chair/bed with Joey on your chest and the nurse coming in to check on us and wondering where our baby was.

I still see the look on your face when Veronica actually was a girl and not the boy the doctor thought. You were so delighted to have a little girl. You were also terrified to have a little girl. It was hard to imagine my husband who was a commercial fisherman and a soldier afraid of this tiny little bundle.

There are times I wish our life was different but I would not give up these memories for the world. I remember clearly the day I thought I lost you forever. So many emotions went through my mind all at the same time. I was so frustrated that no one could tell me anything so I waited and waited. I remember the sound of your voice when you told me you were alive. 8,000 miles apart and it felt like you were in the next room. I was happier on that day then I was when I married you or when we had our babies.

You were my rock in June when Debbie was killed and so many other times in our life together. I am not sure I would want this adventure of life with anyone but you. We have held each other up at different times, under different circumstances. Thank you for putting up with all my craziness on top of all your own. I know you will always have my back as I will have yours.

I Love You!

Pam

The Joys of the VA

There are times when I truly despise the VA and everything we tend to go through to get back to square 1.

Today we had a VA appointment for OT, have to get shower grab bars so DH doesn't fall anymore. This appointment was really productive and the Therapist was very helpful. She submitted everything so we could go to travel and get paid for this visit. Travel pay, what a joke that has turned out to be lately.

At the end of this appointment I got the return call from the VA Call Center to hopefully answer my questions in regards to the competency claim and if there is any progress. Another joke compliments of the Department of Veterans Affairs. They finally determined that they could report nothing new and I/We should have already been contacted in regards to the inquiry send to the Regional Office on January 10th. So the nice man on the phone put in another inquiry and told me if I do not get a call from the Regional Office within 10 business days I needs to call back and let them know so they can investigate further.

We then went over to Bldg. 16, which houses the Veteran Service Organizations Officers, there is nothing for them to help us with since the claim has already begun and we should have gotten VSO assistance in October. Sorry we didn't see the need for assistance since according to the VA due process is 60 days for this type of claim...we are on Day 126 and counting.

Well this was rather disappointing but we then went over to Release of Information and obtained a copy of DH Medical Records for the last 20 months at the VA. I was surprised, it was only 251 pages, but when you can almost never get in to see the doctor or they don't take you seriously, what would you expect.

DH tried to get a Dental appointment and was told the soonest appointment was in May. LOL I probably shouldn't laugh but how can I not, the OT appoint was booked in December and the Sleep Study, scheduled for March 5th, was also booked in December.

Free Your Mind Friday

Here we are...it's Friday again.

Question of the week:

If life is so short, why do we do so many things we don't like and like so many things we don't do?

Honestly I am not sure there is an easy answer to this question. Daily we have to do many things we don't like to do, but those things are necessary evils of life and living. There are other times we feel obligated to do certain things, attend family events, be nice, etc. We do these things to avoid fights and arguments with family members. I believe we chose to do some things out of boredom as well. We get stuck in a rut and can think of no way to change the patter.

Why do we like things we don't do, I think this comes down to making time for the things we like or enjoy. Fear, I think can keep us in our rut and from trying something new or different.

So the short answer would be fear and comfortableness keep us from trying the things we like and from doing so much we don't really enjoy.

Romance

So here it is February and there is talk of Romance in the air. I don't hate Valentine's Day but it seems silly to celebrate love only once a year.

For the most part we do not do much for Valentine's Day. With the kids being schooled at home there is no 'class party'. Since our Dear Friends moved back to Oregon there are no other kids to have over for the day either. Last year we did a lunch with our Friends and the kids all had a blast. This year will be fairly low key. DH usually makes a great dinner and we will spend the day together, who could ask for anything better than that.

I did read a post this morning about Valentine's Day. Here is how it was laid out:

• Remember how you got here
• Recover Relationship (if necessary)
• Romance takes time and focus
• Dates
• Make your other half feel loved

With those things in mind I think I will work on my Love Letter to go with FOV Love Letter Campaign.

When I think of how we got to the point we are now, I think of a long, hard journey where it seemed there were many against us. Everything that came to pass and try to knock us down, failed!

While our relationship is good and solid there are always areas which could use some improvement. Our whole relationship has changed with the addition of PTSD. In some respects it is almost like starting over with a history. We have to continually work on communication, without communication we would both be lost.

Romance takes time and focus...yes it does and what is romantic to one is not necessarily romantic to another. Taking the time to focus on your loved one is key. Keeping the romance alive can be just as simple as delivering coffee to the bedroom (yes I am spoiled).

Dates can be anything and anywhere. DH and I have shows we love to watch together and we set that time aside for each other. Usually by 8pm in is tucked away in the bedroom and I will go, grab my knitting and we will watch TV and talk. We take time together to just get coffee out together or take a longer route to the grocery store.

As for making my other half feel loved he says I do a great job of that especially since I never left when things got tough. Does he make me feel loved...every day, I am blessed.

Here is the song that reminds us both of what we have.

Love My Life

I have to say that I love my crazy life. There are days there is so much going on I don't even know where to begin. The last few days have been like that.

I have finished one homework assignment and submitted it for grading and started working on the next assignment. This term is over at the end of March and then onto the next term. I am currently working on a 25-30 slide Power Point for my class and all I can think of is WOW, that's a lot of slides. At least I started a slide outline and hopefully that will help.

The kids are doing great with their own schooling and my DS is almost finished with 2 subjects for the year. DD on the other hand is not putting her best effort forward. We are working on some improvements.

We have reached 120 days without any information from the VA so yesterday DH sent another letter to them with the hopes they will finally take him seriously.

My mom is still visiting and she is just about to graduate with her AA in Accounting. Very happy for her and glad we can be finished with school for a bit.

I need to remember to pull out my blog organizer so I can remember what it was I was going to be posting about over the next few weeks.

On the positive side I think we actually have a great med routine down with DH. The last few days he has actually woken up early and gotten up. He is awake more during the day as well. What an improvement from where we were a few weeks ago.

I think I need to pick one day of the week to post about my #1000Gifts. I guess I need to actually plan.

How can you not love a busy life!

Saturday Morning

Well it is Saturday Morning and I am thinking about what I would like to get accomplished today. I would like to get some work done in the garage and the office/classroom needs to be cleaned. I picked up some more storage totes at Costco the other day so that may help.

The garage is in serious disorder. There is just way too much 'stuff'. We know we will be moving at some point in the near future and my thought is if the garage is in order those items can just be packed to move easy. Don't laugh it could happen.

I really need to spend some time purging out the old stuff and getting rid of things but it is so hard to do at times. DH says I need to just pick one hobby and go with it, how can I pick just one thing when there are many different things I enjoy doing?! Granted there is A LOT of craft 'stuff' in the garage. There is sewing, beads, yarn, cross stitch and the list probably goes on. I am having trouble focusing on the cross stitch...I am picking large projects instead of small ones. My eyes are getting old as well.

The boxes of Christmas Decorations are still sitting in the dining room and need to be in the garage. There are many empty boxes in the garage right now that I am hoping we can use to pack up either donations for the thrift stores or garbage for a dump run. Regardless, the garage needs to get straightened out.

Tomorrow is SuperBowl Sunday and we have no desire to watch the game or the commercials. We would rather just spend some time together. I have noticed that for us the SuperBowl in the past usually meant friends either visiting us or we were visiting them but with some of the changes which have taken place in our life for the last 2 years, that connection is lost. It is really hard for us to go other places, DH anxiety levels start to skyrocket. There are so many unfamiliar things around him, it is so hard to relax and try to enjoy ourselves. Having people over can be just as hard if not harder at times.

I hate Saturdays and have for the last 7 1/2 months. I think there are times when I would just as soon stay in bed all day as to get up or leave the house. I have a picture of Debbie with my kids & her son over my desk and this morning it just struck me how she will never be physically here again. I hate moments like this. I hate the sadness and tears. I don't cry for her, I cry for myself and the kids. Then I get pissed a drunk driver took away someone so precious without any regard for the lives of those around him including his own children. While it would not help matters or change anything, why plead 'not guilty' when the BAC was .2975 in the field? Why can't he Man Up, plead guilty and tell my mom and brother-in-law how remorseful he feels and will feel for the rest of his life?

Well we have gone too far into the dark subject for one morning. Sorry for the rambling but I guess I needed to get things off my chest.

Free Your Mind Friday

Welcome to Free Your Mind Friday! I hope that you all will join me as I take on this challenge. Every Friday from today, until 50 weeks from now, Fridays will be devoted to answering one of the 50 Questions That Will Free Your Mind. You can add your link each week to my post so that you can connect with other bloggers, and challenge yourself to answer the questions as well.

These questions have no right or wrong answers.

Because sometimes asking the right questions is the answer.
 
Week 2, Question 2

Which is worse, failing or never trying?

I firmly believe that never TRYING is worse than failing. Failing shows you have at least tried one time, one way.

Refusing to try something never gives you the opportunity to even succeed or fail depending on the situation. At least with failing you have learned something.

I personally do not like to be told what I can or cannot do. The first thing I want to do when told I can't is prove them wrong and sometimes I have proven myself wrong as well. My daughter is a lot like me in that respect she will try and try and try not until she gets it right but until she is satisfied with what she has done. There are times the outcome does not matter at all it is the effort leading up to the outcome.