No Safety Net - Elder Care In America

[morgandawn]

This is an actual conversation I had this morning. Note: the programs described are not actually for broken legs - I just simplified. Our state - which is more generous than most states - offers fragmented and complicated programs for seniors on low income. If you sign up for one, you are locked out of all the rest. Yes you can switch, but you go back to the end of the line. For some the wait list is 2 years.

Me: Hello, I understand there's a program that will help my mom if she breaks her leg again. Can you tell me more about it?

Social Worker: Oh you mean the program for people who break their ankles?

Me: No, the one for people who break their legs and need intensive care because they can't get in and out of bed

Social Worker: Oh that program, well does she have a broken leg now?

Me: No. She had one last year and it was a nightmare and she almost died because of it. We just want to find out what the program is all about so that we can plan ahead because she has fragile bones and is likely to fracture her leg again

Social Worker: Well that's handled by a different department and I don't know much about it. I'll refer you to Case Management Program A instead.

 

Me: I know the Case Management Program A. I reached out to them last week and they told me that they only handle cases where someone breaks their left leg.

Social Worker: Correct. For right legs we'd send your mom somewhere else when the time comes.

Me: Can you direct me to basic information about both the right and left broken leg programs. Are they the same? Are there any qualifying criteria? Does she have to be over 65 or have a certain income level? We just want to know what help we can expect when she breaks her leg again

Social Worker:. Well qualifying is complicated, and it takes a lot of work for us to figure out whether or not she belongs in the right broken leg or the left broken leg program and frankly whether she even qualifies for any broken leg program. So you just have to wait and find out. In the meantime, l can refer you to Case Management Program A to help guide you to the various options

Me: Will they be able to give me an overview about both broken leg programs?

Social Worker:. Are you only interested in the broken leg programs?

Me: I'd like to know about all the programs that my mom might be eligible for. Broken ankles, broken legs, broken arms, broken wrist, broken heads. Who can give me this overview?

Social Worker: Well it depends on what you're looking for

Me: (thinking: Help with broken things???) Okaaaaay... I'll talk to the Case Management Program A again. I think I spoke to a different case management program last year. They were called Case Management Program B and they had a 4-month waiting list

Social Worker: Oh yes that's Case Management Program B. They have a 4-month waiting list. I'll be sending you to Case Management Program A.

Me: Does Case Management A have a waiting list?

Social Worker: I don't know. You'll have to ask them

Me: What's the difference between the two case management programs?

Social Worker: Well they both offer case management services

Me: Yes? Do they offer any different types of case management services?

Social Worker: Case Management Program B can provide respite services and can get your Mom into adult day care programs. Case Management Program A can only tell you about the programs. They don't have any funding to get you into those programs

Me: So why would I want to go to Case Management Program A if they can't actually get my mom into these programs?

Social Worker: Well Case Management Program B has stricter criteria as to who they let in.

Me: . I guess that's why they have a 4 month waiting list. So once I start with one of the case management programs, can I switch? Could I start with Case Management Program A because they don't have a waiting list and then switch over to Case Management Program B once I get in?

Social Worker: You can switch but you can only pick one to apply to at a time

Me: So I either apply to one with a 4-month waiting list, wait for 4 months to find out if Mom qualifies. Or apply to one right away that is easier to get into but that doesn't provide that many services. But I cannot apply to both at the same time?

Social Worker: Yes.

Me: Who do I go to to switch? Do I contact you?

Social Worker: Well if you wanted to switch to Case Management Program A, then yes you would have to go through me first. But I think you can switch to Case Management Program B without going to me first. You'll have to ask them.

 

 

Comments

[elayna]

That reads like a bad Monty Python sketch. :-(

[tabaqui]

Sounds about right. It's utterly baffling, infuriating, and grotesque, what we put our seniors (and their families) through.

[lilysea]

It's utterly baffling, infuriating, and grotesque, what we put our seniors (and their families) through

Not just our seniors - almost every severely chronically ill/Disabled person in their 20s/30s/40s has a similar story. :(

(I do. I had an experience where I was unable to get out of bed for weeks and the agency told me they couldn't help me, even tho I was more unwell than many people that they WERE helping, because I was under 65)

[tabaqui]

Yes.
One of the ladies I work for uses a wheeled walker. If it breaks and she needs a replacement, the wait for a new one is TWO YEARS. She literally cannot get around without it.
Insanity.

[lilysea]

There was an article recently in Australia

a man who is profoundly deaf has Australian federal government
National Disability Insurance Scheme (NDIS) funding

funding is not one bucket - you can only use the funding for the specified items

his hearing aid broke

they told him he couldn't get a new hearing aid, as you can only get a new hearing aid funded every 10 years

but there is $30,000 of "social inclusion/social participation" funding allocated for a carer to take him to social events where ***he won't be able to hear anyone***

he asked if he could use some of the $30,000 for the hearing aid he needs, and they said no

[lilysea]

I use a power wheelchair, and I have been scolded/told off/threatened with nonhelp from a state government agency over needing my wheelchair battery replaced "too often"

I ask for a replacement when the old battery no longer works, about every 2 to 3 years. Apparently that is "too often"

[tabaqui]

So much fucking bullshite.

[nondenomifan]

*hugs you for pointing this out* I'm right there with you, thanks to a drunk driver. Don't require a wheelchair at all times, but I need a motorized scooter at the grocery store and a walker for any walks longer than 20 feet, and my knees and back require periodic pain management.

[nondenomifan]

*hugs you for pointing this out* I'm right there with you, thanks to a drunk driver. I don't require a wheelchair at all times, but I need a motorized scooter at the grocery store and a walker for any walks longer than 20 feet, and my knees and back require periodic pain management.

[princessofgeeks]

*beats head against wall slowly*

I am so sorry.

[klia]

1) I loathe our healthcare system SO FUCKING MUCH. It needs to be nuked from orbit.

2) I hatehatehate how opaque and hoop-jumpy these government programs are. Like anyone who's not a health insurance specialist or attorney will *ever* be able to figure this shit out.

3) I'm so sorry you're having to deal with this frustrating, exhausting, enraging shitshow.

[zana16]

It is infuriating. I’m encountering this with autism supports for my son, with the added layer of “whether you qualify depends entirely on what insurance you have but your insurance doesn’t have the information about what programs exist or whether they are covered by said insurance, and neither does the program itself,” and the county government list of programs to call is more than a decade old.

It’s purposely designed this way, that is the only conclusion I can make. They don’t want people using the services because then they have to fund the services.

[kass]

sad;flkawjdsf;lkdsjf;lakdsjf;aldskfj

I have no words.

[ladyjax]

Back when we were on county-based health care, it was fairly easy to navigate, long wait times and all. Then the Medicare expansion came along and all the programs got rolled into something else. When I went to take us off the program because we had employer-based health care again, it was a months long nightmare of us insisting we never had a case worker (never had one before) and someone from Medicare insisting that we had to. For me to get us out of the program.

[morgandawn]

There is such a cognitive dissonance when I'm asking these questions. Half the time they're puzzled anyone would ask any questions. The other half of the time they're puzzled at the questions themselves. The most charitable thought I can come up with is that they're used to pointing people to other programs to get them off their plate because they're desperately under staffed, regardless of the outcome. And that's the charitable perspective

[amalthia]

omg...what the hell????

[the_shoshanna]

How absolutely enraging, GAH.

[nondenomifan]

That sounds like the same routine we got waiting to see if Mom qualified for under-water beebe-stacking therapy after her surgery. *wink, wink, nudge, nudge* By the time we heard from the organization, she was pretty much back to pre-surgery ability and they told her she didn't qualify for anything.

Red tape should be called spider's webbing; once you've entered, you rarely find your way loose safely.

Have you tried your local senior center? They might have someone who could help you navigate the bullshit a little better. (Area Agency on Aging is another good option. Ours changed its name to Well-wise, so I don't know if all the government offices of that name did or not.)