U.S. Healthcare and Alzheimer's

It seems that Mom is going down very fast. If a couple of weeks have passed since you saw her last, the change would be impossible to ignore. As her needs have increased, I've tried to find ways to provide for them. Of course, the more that is required of me, the less there is of me to go around for everything else but that's just how it is.

When this first began -- and it took me a while to acknowledge what was happening. At first, she went on her own. Then she could not always find her way to the bathroom. Finally, she was afraid to go alone. She was perfectly content to have her nephew accompany her if he was sitting for me to do something. Because I tried to take Mom with me on errands (so she would not be left alone and because she liked to ride in the care), the worst problem I had to cope with initially was that despite going to the potty before we left home, she would decide that she absolutely HAD to go as soon as we got into a store. Sometimes she really didn't but I wasn't taking any chances.

Some public restrooms are more user-friendly than others but this experience always put me in a tizzy. There was enough thinking power left that Mom did not want to "sit" on a public toilet but if she just squatted urine went everywhere. (I learned that the hard way when I left her to go on her own in our motel room last summer.) If there were seat covers, I used them and convinced her that it was okay to sit on them. However, keeping them in place while she sat was sometimes a circus. If there was no seat cover, I would make one from toilet paper and try to keep it in place as she sat. I'm sure there is a comedy routine in there somewhere.

I discovered adult diapers. We started with Poise pads and then graduated to the panty as a safeguard for days when we went out. This was our routine for a while and we probably used no more than a package of the diapers in six months. But suddenly her ability to judge her needs lessened considerably and after two or three clean-ups -- more often associated with a bowel movement than the need to relieve her bladder, I decided that she could wear them overnight when things flared up.

About two weeks ago, however, her ability to walk became the issue. She seemed unable to put one foot after the other or even stand up by herself or holding on to something. When she needed to bend her knees to sit on the toilet, she was unable to figure out how to do that. When she needed to lock her knees in place to stand at the sink to wash her hands, she was unable to that either. I decided the time had come for full-time use of this elder care aid and the doctor told me "don't knock Depends, they're a Godsend!" So now I change her diapers.

But what was interesting was that a friend told me Medicare would cover diapers. The doctor and the druggist thought so, too. But when he submitted the claim, he learned that Medicare will cover diapers and bed pads for the elderly in a nursing home (where there are multiple staff persons to handle the patient and a laundry) that a patient whose family is trying to keep him/her at home are on their own. Only the federal government would think that was a reasonable solution.

Fortunately, I learned from a friend that Target has their own brand, Affirm, which is cheaper than Depends at Wal-Mart. It's a 35-40 percent savings. But it's one more indication of how our elder care policies are geared to the elder care industry rather than to the patient and his family. More on that in a future blog.