My mother, 86, was fully independent until May 2022 when she was hospitalized for A-fib and CHF. When she was admitted she was only taking blood pressure medicine. When she left, they had her on seven different medications, one of which was Digoxin. Fast forward 3-4 months, She became more confused, lethargic, and lost strength to the point she could barely walk with her cane. She also was not eating and lost a lot of weight. Seems like she had a kidney issue and taking digoxin did not help her condition.
In reading about Digoxin, it looks like it’s something that should’ve been closely monitored based on the information I read. When I asked the doctor who was in her room yesterday about what does “closely monitored” mean, he said that wasn’t his area of specialty and wouldn’t comment on that. The doctor tried to say that she missed a couple of appointments. I told him I took her or made sure she got to follow up appointments after she was hospitalized in May. I took her to have blood work done twice that her primary care physician ordered. I don’t know about any other tests that were required for following up Digoxin or anything, else. It was the first I knew when I read about it yesterday.
The hospital is now mentioning what’s going to happen when she’s released, since they feel she has a fall risk; it doesn’t sound as if they feel she will be OK alone. She was having home care in three hours a day five days a week. (Although she would not let them do a lot of things that they were able to do for her.) It seems as if the hospital wants to put the burden on me after she’s released but I’ve read in this website that hospitals try to get someone else to take ownership of this kind of thing to get them out of the hospital.
I currently have no real authority to do anything. My mom has always wanted control over everything that affected her so currently there are no POA’s etc. for anything. She keeps saying she wants to be in heaven and she does not want to be resuscitated but I was unable to get her to sign the paperwork for her doctor to sign in the event EMTs came and she was unconscious—DNR. I’m going to work on that when I go visit her next week as well as try to get some other paperwork in order. But I’m not quite sure what the hospital is going to try to get me to do or what I should be thinking about when they talk to me, etc.
She’s in Delaware and I am in California. For many reasons, living with me is not an option. Since they’ve got her off of the digoxin, she appears much more alert. On Friday, I would’ve said she’s probably not gonna be around much longer but now she looks like she could be around for months or years. Her mother, my grandmother, lived until 96 but was in better health than my mom. I am thinking it would be good to see how she is once they get her medication straightened out to see if maybe a week or two in rehab would be good and she could walk better but at the same time she’s very noncompliant when she doesn’t want to be bothered with things and generally going to a rehab facility is not something she has ever wanted to do.
Having no real authority at this time, I also wanted to look into Miller Trusts but I don’t know if this is something you set up before it’s needed or at the time it’s needed. She has SSA, a very small pension ($300/mi) plus a small IRA. I’m not sure if I should try to get her to be able to stay in her apartment, or look for a nursing home, or look for a care home in someone’s residence that provides care to people like her? I just don’t know what to do. Should I leave it up to the hospital?
I apologize for all the rambling and various bits of information. I would appreciate any and all feedback. To my knowledge my mother has not been diagnosed with dementia and possibly she had delirium as opposed to dementia after her hospital stay in May and all the medications they put her on.
If mom lived alone, that presumed that she understood what the doctor was telling her about medication monitoring and was taking her meds accurately. Are those things true?
If mom doesn't want to go to rehab, what is her plan for getting the care she needs?
I took her to a follow up visit with her PCP and arranged for her to have a ride to a follow up visit with the cardiologist after I left. I also took her for two rounds of bloodwork. To my knowledge no one ever discussed the requirement for tests for digoxin levels monitoring. I used the lab at the hospital outpatient area for her blood work. If there were outstanding orders for tests for monitoring Digoxin, I would’ve thought the lab there would’ve had them on file. There’s been no phone calls, texts, or letters indicating that this is something that was overlooked or should’ve been done. Had I known this was a requirement, I would’ve made sure it happened.
"When an IRA is in payout status, the payments that are received will count as income but the IRA will not count as an available asset in terms of eligibility for Medicaid."
I would wonder if this means for tax purposes. At 71 1/2 if you have not cashed in ur IRA you must have the interest pulled and taxes paid on that interest. For me it was $1000 I received in a check and a 1099 showing that pull for income tax. Meaning I had an added income of $1000 for the year. If Mom is having the same thing done, that is added income.