Kathleen A. Gagne

Kathie Gagne died 4,704 days ago.

March 20th, 2012 @ 12:11 pm

Here is an email I sent to one of my old college friends in the spring of 2012. His wife and her family work in the medical profession and had been offering me a bit of advice about mom.

From: Gagne, David
To: [redacted]
Subject: Re: Treatment Team Meeting 2.28.12
Sent: March 20, 2012 12:11 PM ET

Hey [redacted],

I am so sorry for not replying to you sooner and for not updating all of you in a more timely manner. The last three weeks have been a whirlwind.

After (literally) months of being under Dr. Caliendo’s care — first at Stewart-Marchman Act (SMA) and then at Halifax Psychiatric Center (HPC) — suddenly it was decided that my mom was stable enough to be discharged and the administrators (via Dr. Caliendo and the counselors at HPC) starting putting considerable pressure on us to get her out of there.

Incredibly my sister found Grace Manor Port Orange ( http://www.gracemanorportorange.com/ ) almost exactly at the same time that this was happening. I had several conversations with Janis Stovall, the administrator there, and was pleasantly surprised at how refreshingly honest, upbeat, positive, and — most importantly — COMPETENT she sounded. She was happy to email me and talked about using her iPad to take notes and the bedside touchscreen monitors they have in the rooms there.

She also told me that she thought it was unconscionable that my mother had not been granted Medicaid yet, and that this was something she could help us resolve and that she was willing to accept my mother as a resident and we could work out the details of the payments later. She said several times that she did not think my mother’s problems were because of brain damage but rather — as my wife and I have been saying — seem to be caused primarily by the massive amounts of drugs she was being given in the public health care system.

My mom has been at Grace Manor for a week now, and today she has an appointment with her old psychiatrist, Dr. Oh. My sister has slept on the couch or in a chair in her room several times and has spent a considerable amount of time at Grace Manor and she says that it is a truly wonderful facility. (She is the one taking my mom to the doctor’s office today.)

I unfortunately had to liquidate my mom’s State of Florida pension fund in order to pay for the (pro-rated) first month’s “rent” at Grace Manor. She had a little more than $10k in the pension fund and almost 25% of that immediately disappeared to taxes, but everyone in “the system” seems to think that it is basically irrelevant because regardless of what happens, she is soon to burn through that money and need to collect government support; and that it will actually be simpler to get government support *without* having that asset making her appear less needy.

So that’s the story so far. My mom still sounds awful, but at least now she (and we) all seem to have a bit of hope in our spirits and that has been a huge difference. I am crossing my fingers that Dr. Oh this afternoon will immediately stop the administration of Haldol (and several of the other drugs) and / or quickly and easily take a new tact in her medication regimen. I will keep you posted.

At this point I (still) have not contacted any of the legal professionals that [your dad] recommended, though I dearly, dearly, and sincerely appreciate having them as resources if I need them. Because we have not yet found a compelling reason for me to assume Power of Attorney over my mom, and because Janis and her team at Grace Manor have said they can handle the Medicaid applications for us, I am not sure why I would be contacting a lawyer right now and would hate to waste someone’s time. Please let me know if you think I’m crazy and that I should be doing something differently.

Thank you so much,

David Vincent Gagne
http://www.davidgagne.net/
Tweets by davidgagne

My friend’s wife’s dad responded to my email a couple of hours later:

From: [redacted]
To: Gagne, David
Subject: RE: Treatment Team Meeting 2.28.12
Sent: March 20, 2012 2:41 PM EST

David: Thanks for updating us and Glad things are working out well at Grace Manor. I agree that you should keep those names I gave you in reserve should you need them at some future point in time. As long as the Grace
Manor facility is working with you in completing the Medicaid application, just continue to work with them. Liquidating the pension was also a sound idea, because it would have only stood in the way of Medicaid approval. As long as you can prove (which you can) that the monies are being use for Mom’s care, Medicaid would support that.

We’ll stand by should you have additional questions. But it sounds like you, your sister, and Grace Manor are all doing the right things on behalf of your mom’s care. All the best, -[redacted]

A Response from Janis

March 16th, 2012 @ 10:38 am

Janis Stovall from Grace Manor (finally) replied to my email from March 9th. She wrote:

Good Morning David,

Just wanted to get back to you and let you know that your sister is doing a great job helping mom transition. Below are the answers to the questions you had.

(5) Payments are mailed to Grace Manor – 1321 Herbert Street – Port Orange, Fl 32129

(6) The phone to call is 386-310-4995 to speak to mom. I need you to know that the staff doesn’t have cordless phones for after-hours calls. I am looking to purchase, but have to match the phone systems in place. With that being said you may have to call back a couple of times if the staff in the evening is providing care to residents.

I spoke to the ARNP ¹ that makes visits to Grace Manor about seeing your mom. She has to bill Medicare and can’t accept private pay due to her contract with Medicare and traveling physicians. I spoke to your sister who is going to be in touch with Dr. Buck. I can go if needed to speak to the doctor and we can provide transport there.

If you have any further questions, please let me know.

Regards,
Janis

¹ Advanced Registered Nurse Practitioner

Closed Retirement Account

March 13th, 2012 @ 4:49 pm

I closed mom’s State of Florida pension fund this afternoon. Here is the email I sent to my sister, and to Jessica Butler and Janis Stovall of Grace Manor:

Dear Jessica,

I was able to successfully withdraw the remaining funds from my mother’s retirement account this afternoon. Of the $[redacted] she had accrued there, $[redacted] was immediately lost to federal withholding taxes and penalties. That left $[redacted] to be disbursed to my mother.

The funds will not be available in my checking account until “three to four business days, excluding holidays and weekends” after 03-15-2012. If I understand that correctly, it may not be until the 20th that my sister can get you a cashier’s check for the $[redacted] balance due for the rest of March (pro-rated) as we discussed.

If that is unacceptable, please let me know as soon as possible and I will research some other method of getting you the payment sooner.

PS: Can you please detail exactly how I should address postal mail directed towards my mother? I would very much like to send her cards, photographs, and letters, etc. while she is there.

Thank you sincerely,

David Vincent Gagne

Some Scattered Calls

March 13th, 2012 @ 6:50 am

Here are some of the phone calls I had today. All the times listed are Pacific.

6:23 AM
I tried to talk to my mom by calling the Halifax Hospital Psychiatric Unit. I spent eight minutes on the phone with them but was unable to get my mom on the phone.

6:30 AM
I had a twenty-minute phone call with my dad; most of which was spent complaining about how frustrated it is that I can never seem to get mom on the phone.

6:50 AM
My sister called to say that Jessica Butler at Grace Manor called to ask her about money.

6:56 AM
I called Grace Manor and left a message asking Jessica to call me.

7:27 AM
Connie Wade from Halifax called to say mom was being transferred today; she hung up very quickly

8:14 AM
I had a three minute call with my sister to discuss how we were going to pay Grace Manor.

11:36 AM
Jessica and I spoke for twelve minutes. She said that the pro-rated amount we owe Grace Manor is $1928.12. She also gave me her email address, and told me that the standard rate is $3095/mo

12:18 PM
I called the State of Florida retirement pension phone system and after just one minute realized that there was no way I was going to make any progress.

1:05 PM
I tried calling the number again. This time I worked the buttons for seven minutes before I was disconnected by a computer error.

1:12 PM
I called again and spent fifteen minutes trying to convince someone that my mother was unable to make decisions for herself and I needed help understanding how we could access her pension on her behalf.

Just another typical fruitless, frustrating day on the phone trying to help my mom …

Questions for Janis

March 9th, 2012 @ 1:59 pm

In response to a prior email, I sent the following message to Janis Stovall at Grace Manor:

Dear Janis,

(1) Once again there is a point of confusion here. Connie at no point during our phone call yesterday morning indicated to me that my mother, Kathleen Gagne, could “sign in for herself”. We discussed that Dr. Caliendo was going to have to approve that my mother is competent, and Connie thought that would be the case, but it was not definite. I’m VERY glad to hear from you that someone has said my mother can sign the agreement, but — for my own peace of mind — I would certainly like to know WHO officially made this decision and WHEN.
I’m actually a bit confused as to how my mother could simultaneously be at Halifax Psychiatric Center under the provisions of the Baker Act *AND* be competent to sign a legal document. But that’s irrelevant.

(2) As far as I am concerned it is “a go” for her to move to Grace Manor.

(3) Please coordinate with my sister regarding transferring my mother’s personal items to Grace Manor. What is she allowed to bring with her? Does she need her own furniture? (If she doesn’t require furniture my sister can likely handle packing a suitcase for her without the assistance of a moving company. We appreciate the offer, though.)

(4) What is the next step? When do you think the transition will occur? Please keep my sister and I apprised. I would prefer if my sister could be with her for the ride from Halifax to Grace Manor.

(5) How do we handle payment to Grace Manor, when is it due, and what is the amount? Right now my mother’s only resource is her pension fund, and I will need to investigate how to withdraw funds from that.

(6) At what phone number(s) will I be able to reach my mother once she’s been relocated to Grace Manor? What mailing address should I use to send cards / letters?

Thank you sincerely,

David Vincent Gagne

RE: Resident Agreement –

March 9th, 2012 @ 9:51 am

Janis Stovall from Grace Manor Port Orange sent me this email:

Per Connie at Halifax she has had a conversation with you and stated to you that Ms. Gagne could sign in for herself. I am ok with that. Just let me know if it is a go for her to move to Grace Manor. We will complete the move in paperwork with her and we also pay for her items to be moved. It is at no cost to her for the moving company if needed.

Just let me know if there are any other questions that I need to answer for you.

Thanks,
Janis

Resident Agreement

March 8th, 2012 @ 12:11 pm

Janis Stovall from Grace Manor Port Orange sent me this email with the subject line “Resident Agreement”:

Attached is the move in paperwork for your review.

Please let me know if you have any questions.

Regards,
Janis

Attached was Resident Agreement.pdf, a 4.5MB, 44-page file.

I replied to her via email about ninety minutes later, at 1:34 PM PST:

Hey Janis,

My only question is, “Do you need me to do anything here?”

I appreciate having my own copy of the agreement, of course. But I thought the first step was to determine if my mother is competent to sign herself into Grace Manor on her own.

I apologize if I am confused. Let me know.

THANK YOU!

I mean that sincerely, Janis. Thank you so much.

David Vincent Gagne

Janis then replied to me about five minutes later with:

This is just for your review. Not got an answer on mom just yet, but will get to you soon..

And then almost immediately I received another email from her:

I called back to follow up with the case manager’s at Halifax and both had left for the day. I will call first thing in the morning. I will get back to you then about her being able to sign herself in to the community. The case managers must leave around 3pm. I did get from them that she was ready to discharge Friday or Monday.

Regards,
Janis

I replied to that at 9:57 PM PST with simply:

Thanks, Janis.

A Long Call with Janis

March 7th, 2012 @ 2:17 pm

I had a fairly long phone call with Janis Stovall from Grace Manor Port Orange. Here are my notes from the call:

Janis spoke with EverCare, a diversion plan; possibly 30 days ¹
EverCare is a state-funded program
Department of Children & Families will give a list to providers, EverCare is on that list
assumes these programs are funded by grants
Janis was born in [redacted]; sympathizes with Baby Boomers
some strange ramblings about stem cells; she is afraid of having her stem cells harvested (?!) ²
ask about prescriptions; she said Grace Manor has a psychiatrist who comes in to talk to residents
she said Dr. Caliendo should be sending all the details he has to Dr. Shoemaker ³
EverCare will probably come through first; hopefully American Elder Care comes through, too
EverCare pays for rehab, hospital, bloodwork, etc.
can have psychologist or psychiatrist come in on a schedule to see mom ⁴
I need to sign a contract
mom “comes in as a respite” means she is doing a short-term contract, sort of a trial period
resident vs. respite – resident requires thirty day notice before leaving
monthly fee pays for cable, meals, activities
EverCare provides spending money
Grace Manor is working towards having a mini debit card for residents
said she’d email me a contract
memory care has only 116 people, assisted living has 38 ⁵
main difference is more stimulation on the ALF side; memory care side is quieter

¹ As far as I can determine, this was the first and last time anyone ever mentioned this program to me; certainly nothing ever “came through” thirty days after this call.
² I really have no idea how or why she started talking about stem cell research, but her views on it were disconcerting (to put it mildly)
³ I have no knowledge of Dr. Caliendo ever contacting or sending any information to Dr. Shoemaker at all; I highly, highly doubt this ever happened.
⁴ This was far less organized than she presented.
⁵ The implication was that because the facility houses so few residents, it is easier for them to receive personalized care and attention.

Mistaken Identity

March 6th, 2012 @ 1:18 pm

Here’s an email I received from Janis Stovall of Grace Manor Port Orange. The footnote I added is the best part.

Hi David,

I am still with residents and would like to call you later this afternoon. My days can be pretty packed as you can imagine. Mom was pleasant, but I did not speak to her yesterday. It was the other resident sharing her room you were correct. ¹

Regards,
Janis

¹ Janis and I had a very long and confusing phone conversation in which she insisted that my mother seemed completely coherent and lucid and she didn’t really understand why I was so concerned. She also told me that my mother repeatedly asked her for a cigarette, or take let her go outside to smoke. My mother detested cigarettes and smoking with the intense seething passion of a hundred suns. I tried to argue with Janis that she simply had to have been talking to a different person, because there was no way my mother — no matter how delusional she may have been — would have been asking for a cigarette. And, of course, I was right. Janis visited my mother again and realized she had been interviewing a completely different person and not my mother.

Confusion Again

March 6th, 2012 @ 12:40 am

In early March I forwarded to Janis Stovall of Grace Manor Port Orange the email I sent to Connie Wade at Halifax a month earlier. I prefaced the forward with this note:

Dear Ms. Stovall,

Here is a message I sent to Connie at Halifax on February 6. I have edited the original message by removing some things that are no longer relevant.

Note that in the first paragraph I explicitly granted permission to discuss my mother’s care and condition with my sister and my wife. Connie, Marilyn, and Dr. Caliendo — for some reason which I cannot understand — interpreted that sentence to mean that I was granting my sister full permission to make decisions regarding my mother’s care and to communicate ONLY with my sister. I truly cannot imagine how that sentence could be misunderstood so badly (and nonchalantly) by medical professionals, but the fact remains that since I sent this email Connie and Marilyn now almost exclusively talk to my sister and ask her what to do regarding my mother. It is very frustrating.