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Barbara P,   Geriatrician   in Brooklyn, NY        show your full name

Geriatrician at Professor of Geriatrics Mount Sinai School of Medicine edit

Certifications edit
  1. Geriatrician (MD)
Questions Answered: 18
Answer a recent question from a Brooklyn, NY caregiver.
About edit
Listed in Castle Connolly's America's Top Doctors •Listed in New York Metro Area's Top Doctors •Special Recognition Award in Geriatric Medicine for outstanding contributions and teaching, SUNY Downstate Medical Center (2007)
Your Website edit
Articles Written
Areas of Expertise edit
Advocate for Patient, Case management by physician, End of life options, Managing the Hospital Experience, Medical Decisions, Medication Management, Medication Review, Patient and family education,
Education edit
  • Medical School- SUNY Downstate
  • Residency- St. Vincents Hospital Medical Center of New York
  • Fellowship- Mount Sinai Medical Center
Caregiver Questions Answered by Barbara P
Answers Provided: 18

Possible Theft By HHC Aide My 94 year old great uncle has a caregiver who I do not trust. I am afraid she has access to his bank accounts and can run off with his money since he is quite wealthy. I suspect she stole around 400K so far because I saw a statement laying around his apartment with significant withdrawals...
When I asked my uncle about it, he appears a bit clueless. Not sure if he has dementia or what, but he's starting to get a bit out of it. I mentioned it to my cousins and we are trying to figure out what to do. What should I do? Your help is appreciated.
Barbara P.'s Expert Answer:     If the patient has decisional capacity and understands - he has the right to do what he wants with his money. If the patient is "clueless" about what is happening with his money - the bank needs to be notified about who is authorized to take money from his accounts. The first step is to have a medical evaluation of the patients decisional capacity and to know if the patient has authorized a power of attorney to anyone to manage his finances. If that POW was not written as "durable" it is no longer valid when the patients loses mental capacity. If there is nobody besides the patient legally in change of his finances, the bank can give you forms to complete for what is called a representative payee- the doctor will need to complete a portion stating the patient cannot manage his own finances. You should also call Adult Protective Services who can walk you through this process .
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Convincing Medicaid of the Need for Skilled Nursing My father was placed in nursing home and has been there for 37 days. I planned to make this permanent and am awaiting medicaid decision. I got community mediciad so I'm not sure what else medicaid reviews in order to get institutional medicaid approved and/or if I will incur any penalties for withdrawals made over 2,000. My father paid everything with cash or money-order so I had to use what receipts I had (my daughter and myself are on all the accounts). He also has a distributing IRA that went into one of my mother's accounts I am named on and I cannot provide receipts for 2,700 a year that went into that account for the past 5 years. (I am in NYC). In the meantime I thought I had 100 days of medicare coverage while waiting for the medicaid decision. Now medicaid says they ended coverage for skilled nursing. Meanwhile the home says he needs 24 hours supervision and doesn't advise he go home. This is his 4th fall and the police have found him wandering the streets due to sundowners syndrome. He takes aricept, namenda, prozac, depakote and trazadone. Obviously if I am applying for medicaid I cannot pay privately. What options are there for people like this who need 24 hour supervision? And can I fight medicare. IPRO has also declined and I am doing 2nd appeal. Is there anything I could provide that I could provide change their decision? Why wouldn't a person like this need skilled nursing? When you go on alzheimers website they say people like this need skilled people so they can be redirected, etc. when they have mood swings. My father had also threatened to kill himself in front of the social worker and she said I had to go to the hospital or she would call ADP. That led us to adding a psychiatrist to list of people we were seeing. In the meantime, I had to take all these days off to do these things and at this point, I can no longer afford to keep doing that. Help!
Barbara P.'s Expert Answer:     This patient appears to have chronic care, custodial needs which are covered by MedicAid, i.e. long term nursing home, home attendants. Medicare covers skilled needs - which means a nurse, or therapist need to help the patient intermittently. Redirecting a dementia patient is not a skilled nursing need. To help expedite and understand Medicare and Medicaid entitlements - i recommend an elder attorney or the NY Legal Assistance Group (a not-for- profit).
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Can I Set Up a Nanny Cam to Check in on My Elderly Mom My mom lives in another state. She can still live independently, but my sisters and I worry about what would happen if she fell and couldn't get to the phone. Can I set up a "nanny cam" in her house to keep an eye on her? Does such a thing exist?
Barbara P.'s Expert Answer:     You can set up a remote camera - and many people do. In addition, your mom should also get a personal emergency response system (PERS). Such systems, are about $35 /month- you wear a button on a necklace and if you fall and press the button it will alert someone to help you.
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