Definition of Advocate
1: one that pleads the cause of another; specifically: one that pleads the cause of another before a tribunal or judicial court
2: one that defends or maintains a cause or proposal
3: one that supports or promotes the interests of another
Definition of Insurance
1: the business of insuring persons or property
2: a means of guaranteeing protection or security
The conflict between these two definitions lies in the absence of guaranteeing protection and security while focusing solely on the business of insuring persons resulting in the persons pleading for protection and security…and so the hamster wheel spins for the Advocate.
Corey’s feeding tube was pulled December 17th. Insurance has decided she no longer needs skilled nursing (RN/LPN), a home health aide will do. An aide can only take vital signs; they are not trained to assess a patient’s clinical needs. They can not administer medication/shots. Corey has a VP shunt for hydrocephalus. She gets weekly migraines which could indicate the shunt needs a setting adjustment; an aide is not trained for this. She has a seizure disorder. Home health aides are not trained to recognize signs for seizures nor carry out seizure precautions. She is at risk for aspiration due to continued swallowing issues; oh and let’s not forget she has a traumatic brain injury resulting in severe memory loss and behavior issues that trained professionals at Bryn Mawr have difficulty managing. Have they not read the reports of the issues we have had with skilled nurses handling this case?
I received a call today that Insurance has received all our documentation and they now have 10 days to review the case and make a determination. I will be notified by mail.
They get to decide…Bottom line is; the business of Insurance…a home health aide earns half as much as a skilled nurse.
I NEVER discuss politics or my views on the subject, but the day to day nonsense that the average American must cope with is an absurd waste of time. We need to do away with the Democratic and Republican parties and begin the HUMAN PARTY. The Human Party needs to stand up to the bully on the playground; aka Insurance (private, federal and state), it’s time to say enough! Some how, some way I will find my way to that big house and cross both sides of the aisle to educate the decision makers that their choices are not benefiting their constituents. They need to think of their children, husbands, wives, parents and extended family. Then they have to role play being their sole caregiver without the luxuries they are currently privy to; ie, top of the line durable medical equipment, availability to specialists, skilled care and unlimited coverage for health and therapy.
I pray that every one reading this post NEVER gets sick or needs any assistance from the Insurance world. Perhaps we should invite the decision makers to live with us for one week, one month or one year…how many would last one day?
Many of you have asked me how I have stayed positive and motivated the last two years without expressing our daily frustration. This is an angry, weary post. Normally I would file it in a private folder but tonight I felt it needed to be made public.
There is nothing we can do. Waiting for another person to determine the direction of the path you are on feels like a violation. It is easy to become consumed which will only undermine our long term goal. Tomorrow will come and there is much more work to be done. We can not stray from our focus.
Corey and I stopped for an errand on the way home. As I was in line to checkout she pulled me close to her. “I can not be in this wheelchair anymore”. I was concerned she was tired or sore. She corrected me, “I don’t want to be in this wheelchair for the rest of my life”.
A moment of clarity; Corey is directing our path…no one else! xoxo