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Helpful tips for family caregivers

Protecting the house from Medicaid

Care in a nursing home is expensive. For an extended stay, most people will need to pay quite a bit out of their own pocket. If there are no savings, Medicaid—the joint state-federal health insurance for low-income individuals—will step in.

But it’s not a free ride. Medicaid allows recipients living in nursing homes to own a house and keep it, as long as they sign a document saying they intend to return. Upon their death, things change. The state is obligated to taxpayers to seek reimbursement from the Medicaid recipient’s estate.

There are exemptions to protect heirs and the home. Medicaid varies by state. As a rule, the government cannot interrupt inheritance and recover costs in the following situations:

• If there is a surviving spouse, no matter where they live
• If there is a child caregiver—meaning a daughter or son—who can demonstrate they provided care that delayed institutionalization. They can inherit the house if they are living in it at the time of death, and lived in it two years prior to the deceased moving to the nursing home
• If there is a surviving child under age 21 or who is blind or disabled. The child does not need to live in the house
• If there is a sibling who is a part owner. They need to be living in the home at the time of death and have lived there at least one year prior to the deceased’s moving into the nursing home
• If “undue hardship” can be proven. This relates to low-income situations such as a family farm where heirs rely upon the farm for income, and that income is limited

The laws surrounding Medicaid are complex. Work with an experienced attorney in the state where your loved one lives. Planning years ahead is the best course.

Reducing the nausea of chemo

If a loved one in your life is undergoing chemotherapy for cancer, very likely they are dealing with the common side effects of nausea and vomiting. Not fun.

To reduce nausea/vomiting

• Avoid strong odors: Reduce exposure to cooking, perfume, and smoke. Keep the house well ventilated. Spend time outside.
• Wear loose-fitting clothing.
• Do not lie down until two hours after eating.
• Do quiet but enjoyable activities that distract the mind.
• Address anxiety with relaxation techniques such as deep breathing and guided imagery.

Tips for eating and drinking

• Eat seven small meals rather than three large ones.
• Avoid foods that are smelly, fried, fatty, or sweet.
• Stick to mildly flavored, low-fiber foods: cream of wheat, pasta, potatoes without skins, yogurt, eggs, bananas, applesauce, jello.
• Eat dried breads such as crackers, toast, or pretzels.
• Sip broth or pureed soups.
• Drink fluids between meals rather than with meals.
• Avoid alcohol, caffeine, and carbonated drinks.
• Concentrate on clear fluids (herbal tea, bouillon, or light juices such as apple juice). Avoid orange juice.
• Suck on ice chips or popsicles.
• Chew spearmint gum or drink spearmint tea.

Although nausea sometimes begins as soon as a chemo session starts, for most people it’s not until one to three hours later. Eating a light meal during this time frame may be wise. At least crackers and broth. Most nausea resolves within 24 hours.

Some people experience nausea or vomiting the day before treatment. Or even when walking into the treatment building. Such “anticipatory nausea” is real and should be treated as seriously as nausea that occurs after chemo.