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Elder CareTips:
Mastering The Eldercare Maze™
November 1,
2005
Social Security
Will Talk To You -
If You Play By The Rules
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If you think getting information out of a
doctor is problematic with the new privacy laws, try getting
any information out of Medicare or Social Security for
someone you care for or about. Fahgettaboutit, as they say.
In a previous issue we addressed what to do if you are
trying to help someone (elder or not) who is incapacitated
and unable to manage their affairs. See the article "Social
Security Won't Talk
To You."
Becoming Representative Payee is necessary if the person
you're caring for needs someone to completely manage their
affairs, including receiving their Social Security check.
But what if your elder is perfectly competent but, for
whatever reason, wants you to help with the stress of
dealing on the phone with government agencies. Maybe there
is a question about a claim or an appeal and you just need
to get a straight answer. How do you do this if you can't be
there in the room with your elder when you call (so the
elder can verify that the representative may talk with you).
Dealing from a distance is impossible when you're talking
about Medicare and Social Security.
Unless...
...you have Authorization to Receive
Protected Health Information.
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In a nutshell, this is a release of
information form your elder can sign that gives you access
to his or her protected information. Once the information on
the form has been entered into the "system" you can call
these agencies from anywhere and get the information you
need, without having to have your elder on the phone as
well.
Go to the
Social Security website. On the far right corner of
their home page go to "resources", and then "forms." In the
search box enter 1696 - this is the number for the
authorization form you need. When the page comes up, click
the little blue "1696" in the upper left. The form will come
to you as a pdf. Don't be overwhelmed - because it's a pdf
and not a pressure- sensitive form it's in several parts...a
copy for them, one for the elder, one for you.
Have your elder sign the form and take it to your closest
SSA office (look in the blue pages of your phone book for
the closest office). Then you'll have to wait until the
information shows up in the system. There is no guarantee
how long this might take. As the representative I spoke with
said, helping the person standing at the counter takes
precedence over data entry, so it might take a while.
After a couple of weeks call SSA at (800) 772-1213 and see
if you have been entered. Keep calling until you know you
are authorized. Try not to get too frustrated or angry at
the system... you can't fight it.
This is why, if you think you might need to speak with
Social Security or Medicare any time in the future for a
parent or a spouse, get the forms filled out and turned in
now. It might take a while before you're up and running.
| The world may think you are
only one person - But to one
person, you may be their world.
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Guilt - Let's Get It Out Of The
Closet
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"You Shouldn't Feel Guilty." How many of us
have heard these four little words from the well-meaning
friend or counselor? And they're so helpful to hear, aren't
they?
When as an eight-year-old I "borrowed" a dollar from my
mother's purse I felt guilty, even though I don't think she
ever noticed. And rightfully so. I knew I had done something
terribly wrong - knew it while I was doing it and did it
anyway. The guilt I felt was justified. I hadn't lived up to
the standards my parents expected of me. I was ashamed.
Guilt is the emotion we feel when we know we've done
something wrong. If guilt is truly justified, then we SHOULD
feel guilt or shame.
If you're doing the best you can...you're not stealing from
your elder, neglecting your elder, or abusing your elder,
then why do you always feel "guilty?" Are you really
ashamed, or is it something else?
You could be feeling a lot of different things. If you
haven't done anything to feel ashamed of, you're probably
feeling something else and calling it guilt.
We would all be far better off if we could get "guilt" out
of the closet and call it by it's real name. In my
experience, if we can name what's *really* happening,
then we can deal with it.
What We May Really Be Feeling
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Feeling Sad: I'm sad that my elder is
growing older and more frail, and I can't stop time, no
matter what I do. I feel sad for both my elder and for me,
because I am...
Feeling Helpless: Deep inside I know I'm going to
lose this war, even if I win a lot of battles. I don't like
having to give up control to forces greater than me. Feeling
helpless also leaves me...
Feeling Angry: Doctors don't call me back, my
siblings aren't helping, and the dog just threw up on the
rug. I'm snapping at everyone. I'm...
Feeling Exhausted: There's never enough time in the
day to do the things I should do, much less the things I
want to do. I never get enough sleep. My boss is giving me
"the look" and I'm...
Feeling Trapped: I promised to keep my elder at home.
If I keep my promise I see no end to this stress until I end
up in the hospital, or worse. If I break my promise my life
may be easier (or maybe not) but my elder will never forgive
me.
When we have something to feel guilty about,
the cycle goes something like this:
I feel guilty.
I feel guilty, so that must mean I'm not a good caregiver.
I shouldn't feel guilty - I'm doing the best I can.
I feel guilty about feeling guilty.
...and so on. This is a paralyzing and totally useless
spiral that
leads nowhere but down.
Correctly Name the Feeling And
Then
You Can Do Something Positive
With It |
Feeling Sad: There is truth in the
sadness you're feeling. You're living the loss of an elder
as it happens, and before it happens. Only time may reduce
the sadness you feel. Acknowledge it as the true sadness it
is. If you find your sadness affects your ability to also
feel joy in your life, find someone to talk to.
Feeling Helpless: You won't win the life/death war,
but you can make an elder's last days or years better than
they would have been without you. Every load of laundry you
do, every joke you share, every phone call you make helps
both you and your elder, even if your elder can't recognize
or appreciate your efforts.
Feeling Angry: Anger is a great motivator to make
changes that may really be needed. Change doctors if you
can't get the information you need. Call a family meeting if
your siblings aren't helping. Even if they still won't help
you've gone on record about what you need and they'll have
no legs to stand on when you make other arrangements). Find
a support group where everyone will know exactly what you're
talking about because they've been there. About that dog -
you'll have to figure that one out
yourself.
Feeling Exhausted: GET HELP. I repeat, get help. Of
course no one will care for your elder they way you would.
That doesn't mean the care won't be "good enough." Get help.
Feeling Trapped: Hear this...promises made in
ignorance are never, ever valid promises. You couldn't make
this kind of promise because you had no way of knowing
whether you could keep it, or not. When you know you have
done your best to keep your "promise," and you know it is
time to look at other alternatives, then you have done
everything you can do. Your elder may or may not accept that
you have done all you can do. This may well make you sad
(frustrated, angry, name your
poison). It doesn't make you guilty.
Re-label your *guilt* and call it by it's real name.
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Elder CareTip:
Limits Are So Important |
Begin setting limits early in your
caregiving, so that the limits become a natural way of doing
things rather than an over-reaction to a crisis. Setting
limits early on helps to prevent the person you're caring
for from building unrealistic expectations about what you
can and can't do.
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