This has been a most interesting week.  Lots has been accomplished, just showing me how much more needs doing.  Why do I put off the things that need doing — especially reports to the State of Delaware that are due monthly for my two handicapped ladies?  Over the past couple of years, things have increased when it comes to paper work.  I asked them last week if they wanted me to take care of my ladies, or if they wanted me to write reports.  I did not receive a satisfactory answer.

The State LOVES a paper trail.

I need to account for every penny of their money with receipts and dates and reasons for purchase.  These must be signed and dated.  (For years, they wanted Cecilia’s “signature” on the back of each of her reports, even sending them back if something wasn’t there.  I would drag a hard surfaced book to her lap, position the report on it, close her fingers around an ink pen, put it to the paper and make a scribble of some sort that would satisfy them.  I finally reneged at this senseless operation, and was granted permission to sign her name.)

I have to account for every prescription drug they are on, every OTC med they are on, and every time I give them something from their Standing Medical Orders.  I have to write down when I got the prescriptions refilled.  I have to write down how many refills are left on each one.  This doesn’t sound daunting until you figure out that Nettie is on 13 Prescription drugs and one of those is filled weekly, plus two over the counter drugs.  Cecilia is on 12 prescription drugs and three over the counter.  I figured out that, in a given month, I dispense almost 1,300 medication doses.  That is to be with NO ERRORS.  It is overwhelming!  It takes about 4 pages each to report.

I have to get a paper filled out and signed by every doctor I see with them.  As you might guess from the amounts of prescriptions, there are lots of doctors.  Family practice, Neurologists, Orthopedic specialists, surgeons, eye doctors, ear doctors, dentists, psychiatrists, gastroenterologists.  And Nettie is on a medication that dictates weekly blood work which needs documentation.

Then, there is a report that needs to go in every month concerning whether all the objectives were reached in their individual life plans.  With that, a report of all the activities they may have participated in during the months time.  And whether there are any concerns.  And whether there were any extra noteworthy achievements.  (This is all on one page, with the individual “must haves” set down in a chart with a blank spot at the bottom for the rest of the report.

My precious Cecilia.  Non Verbal.  Many behavior problems.  She hates the uncertainties of a store.  She is quite a trip.  This month, I got into trouble because the powers that be, somewhere up in the state, did an audit of her entire life account.  They wanted to haul me in for an all day in service to inform me of the proper procedures for filling out the spending money accounts.  One month, Cecilia had shingles, and Nettie had just come to live with us, and I didn’t get to the bank before the end of the month.  I pretty much didn’t go anywhere except where I had to.  So I requested permission to put some expenditures from August down on September’s account when I had withdrawn the money.  The team agreed.  They knew how intense those months were.  But it didn’t set well with the higher ups.  They also wanted “the provider to include Cecilia in a more direct way as to how her money is spent” (ha!) so they got all up in a heaval and instructed my case manager to make an appointment.  How blessed I have been with my case manager and staff nurse.  They were livid at this mandate.  They collaborated on a terse note to the perpetrators of said note and more or less informed them of the situation, that they were NOT going to make this 20+ year provider come in for an in-service and promised to “instruct provider” themselves.  There was a short note that came down the line agreeing to this “modest proposal” with instructions that “if there were any more problems, the provider needed to attend an in-service.”  I was pretty much going along without any knowledge of all this until yesterday when my case manager came out and gently informed me of what they had been through all on my account.

All I can say is that my Heavenly Father knew that I had all that I could bear over these last few months, and He tempered the wind that blew against me.  I could not be more grateful for His loving care over me and my two ladies.  I am even more grateful that His Protection came through the direct line of authority over me.  Through His grace, I had the trust of my case manager and nurse.  If they were suspicious of my motives, my actions or even uncertain about the care that Nettie and Cecilia have in our home, they would have had ample opportunity to bring me down.

Lord Jesus, once again I offer grateful praise!

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  1. Bless your heart I guess I had been unaware of the scope of in home health care. I worked in a nursing home for years and the paper work was tremendous……………which in no way at all made the residents more comfortable or increased the degree of loving care……We had my invalid aunt living with us but it didn’t involve any government overseeing me. I do not know when I would have had the time to do paperwork if it had been required. I like your phrase,”He tempered the wind that blew against me.” Nicely said. Take Care Dear Friend.

  2. I know they “think” they are looking out for the patients.  There may be some care takers that take advantage of the situation. But as I was reading your post my thots went, if there is another problem, I think they may need to do an inservice watching you in your loving, caring, giving, blessing, celebrating, and walk the trail with you—even taking them with you on doctor visits in the midst of snowy cold days.  Take heart in Ps 139.  HUGS!

  3. Mary Ann, I’m already girding up my loins…  If this ever happens again, I will gather up signatures and people and….

  4. You amaze me, expressing such praise and thankfulness in the midst of such adversity. My heart curses the propensity of the bean counters to create such mountains of incredible paperwork when all I really want or need to do is take care of the person! mw

  5. Oh, dear Mary Ann. And I thought foster care of teenagers required a lot of paperwork and appointments. I’m so glad our Father shielded you from the people that get to sit in offices and don’t know a thing about the daily care and routines of your ladies. I must say gokum’s comment struck my funny bone. That’s exactly how I was feeling, I just didn’t think to express it quite so well!

  6. it made me stressed out just reading your post….I think it might be worse than haveing a house full of toddlers!

  7. Just checking in on you and wishing you a Blessed Day!

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