For all the bad moments, there are always good moments. I would love to say that I’m feeling a lot better, that whatever is brewing with my MS is gone, but I unfortunately can’t.  However as always, I’m back to my normal, my usual somewhat positive self. I think that might have to do with the fact that my little sister is in from California and I’m seeing her today.  The sun is out, although that wind is howling, but anytime the sun is out it makes for a happy day. Actually my mood lightened up when my daughter went to the gluten free bakery by my house and picked me up some vegan sweets. It’s amazing what a vegan cupcake, a sweet daughter and 2 dogs can do for a person.

Now that the dust settled comes the next decision. Do I need an aid? Do I need someone to come in to my home for couple hours a day and help me?  Would I even qualify for it at this point? Do I need it need or do I need a helper? This is the next issues that I have to deal with. I’m in agreement. especially with my daughter going to school, I need help.  What I don’t know if I agree with is if I need a nurses help. If I need a nurses help then I have to go through my insurance. I’d have to contact my doctor. He’d have  to write an order or a recommendation. I’d then have to be evaluated. I have to meet criteria and the insurance company makes a decision. it could be yes or no.  Like everything else I fight with the insurance on a daily basis, would be one other situation. Unfortunately, I don’t think it’s the nurse that I really need. Besides the fact that I do have all my marbles, warped  is they might be, I can dress, feed, shower, toilet, and walk.  Yes there are issues of all these things, but I do have devices to make it easier and accommodations to make myself successful to do it alone. I worked in a nursing home for 13 years, to get in home nursing care certain criteria need to be there. For those who have Medicare, I know that they DO NOT cover for long term nursing needs. For Medicaid, I can only go by New York State where I live, each state governs themselves, but I found this:

Home Health Care Programs in New York Paid Through Medicaid

Home health care can include skilled nursing or therapy services, home health aide services like medication management or bathing assistance, and personal care aide services like meal preparation or cleaning.

New Yorks’ managed care programs Program for All-Inclusive Care for the Elderly (PACE) and Managed Long-Term Care (MLTC) both offer home health services as part of their benefit package, so if you are a participant in those programs, you can receive assistance from skilled nurses, home health aides, or personal care attendants in your home, as long as your doctor or care coordinator has authorized those services for you according to the requirements in your particular managed care plan. (Read more about these programs in the first part of this article on New York Medicaid managed care programs.)

In addition, New York offers personal care assistance to Medicaid beneficiaries through its Personal Care Services Program (PCSP). PCSP covers assistance with in-home activities like housekeeping, bathing, using the toilet, and preparing meals. Your doctor must send a physician’s order to your local social services district, and then a nurse assessor will visit your home and interview you about your activities of daily living and your need for assistance. The assessor will decide what kind and how much assistance you need. Generally, your local social services district selects the agency that will provide services to you.

Another way to get personal care assistance is through New York’s Consumer Directed Personal Assistance Program (CDPAP). Like the PCSP, you need a physician’s order and a nurse’s evaluation to qualify for help. However, in CDPAP, you get to select, train, supervise, and fire (if necessary) your own service provider(s). In addition, CDPAP will cover skilled nursing services in your home, not just personal care services.

Finally, New York has the Long-Term Home Health Care Program (LTHHCP). LTHHCP provides a wide range of services, coordinated by registered nurses, with a goal of allowing individuals who would otherwise be institutionalized to stay in their homes. To qualify for LTHHCP, you must be a Medicaid beneficiary, and you must meet the nursing home level of care. You can get medical and therapy services, home-delivered meals, modifications to your home or assistance moving to a more suitable home, and social services.

To apply for Medicaid or any of these programs, contact your local department of social services in New York.

I think for me what I need is housekeeping help with laundry, vacuuming, cooking, running errands, help putting the groceries away when my food delivery comes, getting my mail, and things like that. I don’t think I need a nurse at this stage, at least, not yet. I do need help and I need to seriously think about getting that help. There are definitely limits to what I can and can’t do now and it’s time. As I do more reasearch I’ll blog about it I’m sure, but it’s nice to be calm again. As always with multiple sclerosis, accept, adjust, adapt.