Category: Uncategorized

  • May 12, 2026

    Anticlimactic

    Our oldest put in the work with his driver’s permit including studying the rules of the road through an online program, driving and logging a certain number of on-the-road hours with us as passengers, and completing a driver’s education program by driving around in different types of places under different conditions with a certified driving instructor (this one helps get us a break on very expensive insurance for him). He got his license this past Saturday and we were very excited! This achievement is one we are super proud of and we got to celebrate it with our firstborn on his first try!

    It spelled freedom for us. Freedom from the 20 minute drive each way (with in-town traffic, traffic lights, and sometimes school buses on their routes) to get him to work. As the sandwiched we work, then we jump in the car for our second shift jobs of running kids to their activities (and on top of that I run my parents to their appointments a few times a week). So another driver in the house felt like a slam dunk!!

    But in the last 6 months two of our aging SUVs left us. One left my husband sitting and was towed away for parts and the other seemed to be getting there so we sold it to a dealership who buys any car for what seemed like peanuts. My husband got a one year old SUV that is very nice to replace his and one perk of being Sandwiched under one roof is that I have been able to drive a little old car that my mom has had for decades (with excellent gas mileage) that is just around to take her to appointments because she doesn’t drive but also cannot get up into an SUV right now as only one knee has been replaced and the other is still bone on bone. So my little free rental is available to me and allows us to drag our feet a bit on getting another car for me.

    Unfortunately though there’s a big cost to our potential freedom from driving our oldest to work. He needs a car to drive. Sometimes he drives Mom’s old junky car that thankfully keeps running but we have to have enough vehicles around to get everything done for that to happen.

    Here’s my rant over text to my mother-in-law about this being an issue on Monday because I was severely hoping she would come take the big one to work and rescue me from having to run him (but I promise you she has been driving our kids like it’s a part-time job for large stretches during the last couple of years and asks for nothing in return so I don’t blame her for after telling me for not volunteering on this one). Here’s my text rant: “Unfortunately after telling me for years that I give the kids too many choices, (my husband/her son) decided to majorly drag his feet on getting (oldest son’s) car stating that it was because (oldest son) did not seem interested and because (oldest son) didn’t like what (husband) & I wanted to buy for him. So now we have no car for (oldest son) since someone bought the one (husband) finally chose yesterday and we are short on cars. Dad is going out of town today so I cannot use his SUV while he is at home and now (husband) is back to work in person (impeccable timing after he has been working from home for 2 weeks and 1 day due to a stomach virus followed by minor outpatient foot surgery) and has a meeting and cannot get home in time for me to use the (SUV) so that leaves the little white (car) and (oldest son) can’t take that because I need it to take (daughter) to Tumbling. I don’t want to bug you to take (oldest son) because I can be back in time from there to take (daughter) and you’re already helping other nights. Just venting because (oldest son) could take Mom’s (car) himself and bring himself home if we had another vehicle for me to take (daughter) to tumbling but instead it’s an hour and 20 minutes of my time to run him there (driving both ways) and back (driving both ways) simply because we didn’t really try to buy a car in April knowing when the driving test was.”

    It’s a time of musical cars and yet another first world problem. It’s expensive and time consuming to get more vehicles, but without them this season of life tends to become even more of a challenge. Crossing my fingers for a vehicle for the oldest one soon!

  • May 5, 2026

    I Have 4 Children and 2 Parents who Live with Us

    Some change is coming up for me professionally at my in-person part-time job and I had an interview yesterday within the same organization for a full-time position that is primarily in-person with some hybrid/remote work flexibility depending on a number of things.

    Of course I always experience some nervousness and as I reflect back on my answers I am not surprised that I find myself wishing for a do-over or a few.

    The team who interviewed me was incredibly warm and the position is exciting, inviting, and one to grow into in many unique ways, not to mention some terrific benefits. I am eagerly anticipating hearing back about potential next steps in the interview process.

    But I find myself as a sandwiched individual with so very many mixed feelings about the commute it comes with (an hour each way), the almost fully in-person work requirements when I am already doing what I do best remotely for another company very well, and occasional evening and weekend support involved.

    I am proud of myself because they gave me a chance to ask them questions at the end and one of my questions was about flexibility when something comes up with one’s family, sharing with them the composition of my household and asking if it is a dealbreaker to seek flexibility, understanding, and time if something comes up with one’s family. I stated that in some workplaces flexibility is not an option. And the woman on the team of interviewers stated in an encouraging manner, “Well, I certainly wouldn’t want to work for one of those places” or something very close to that.

    It did put my mind at ease, somewhat. But there are a lot of big feelings in this season of life for me because I don’t want to have to concern myself with not being able to step into a greater professional role for which I am qualified. I want to spread my wings professionally. But also I don’t want to leave my family in a lurch.

    Part of my story is that it’s just the truth that my husband makes more and will likely always make more money in his field and his position. It’s also true that part of what allowed him to get there was my diligence in covering most of what was happening at home which is extremely valuable. Part of what has allowed us both to work at times is the goodwill and support of our parents pitching in (primarily with support of the kids’ needs) and there was a time when we only had two children (before our other two children were born) when I worked full-time with a very flexible schedule and we had a nanny for a season. My husband’s attitude has always been that if I want to work that I am to find someone to fill in for me. He has covered some evening working hours here and there, but his point of view is that because his job provides the primary income (from which we do all benefit) that childcare especially and as many other household chores as possible are primarily my responsibility. He has grown into doing more and we now have the income to outsource house cleaning and lawn care, my parents do help with some things, and we are working on always getting better at training our children to pitch in and take on more age appropriate tasks. We even almost may have a teen driver in the family.

    But it is still true that as the Sandwiched secondary income earner and the primary holder of the majority of the household responsibilities and management and most of the mental load, I find myself facing unique challenges if I want to work full-time. And we know that we will very likely need to hire someone to help with a lot more of our family responsibilities if I receive an offer and we decide that the timing is right for me to take it.

    I’ve read many blog posts about how much mothers sacrifice physically, mentally, emotionally, and far beyond if they give birth, as they bring an infant home, as they raise each child. There are certainly exceptions, but in my experience and at my house we are experiencing another stage where ongoing change and sacrifices due to being a parent and an adult child is simply happening far less or is non-existent for my husband than it is for me as a mother and a daughter of aging parents.

    It is not lost on me that it is also a gift and an opportunity to serve the ones you love and to be able to have a choice to be able to be there for them that not every adult child or parent or loved one has. But from where I am sitting waiting for our youngest to finish her Tumbling Class I am feeling wishes in my gut that my husband and I could tag team it all with mutual willingness, that the after school activities for our four kiddos could land at enough different times that my husband and I could cover all of the driving and didn’t need to ask for grandparent help, and that I could know what it feels like to go to work knowing that my other half is covering at home with some kind of regularity just to see what that feels like to have the peace of mind to just get myself ready and go lock in knowing that the other parent has it. It must be a different feeling than when I am leaving a list, covering all I can before I go and helping everyone besides myself get ready, and checking in with instructions or answering questions by text, managing home remotely while trying to work.

  • April 29, 2026

    Fitting it In

    Outpatient PT at a facility extremely close to our home has been awesome as I have been able to take Mom there (and while drop off and check in is plenty of work because she still uses a wheelchair from the car pulled up outside of the entrance and into the facility) I am able to drop her off there and leave her for about an hour before coming back to pick her up. It’s one appointment I do not need to be involved in now that I helped fill out the intake paperwork. So I am able to get in a work session before picking up and once Dad was able to take Mom and that went smoothly as well. Unfortunately they are only giving her two sessions a week (which is helpful because there are only two of these appointments to go out to but it’s tough to see because she is not very active at home outside of the structured leading of a professional).

    Now that my third son is a little older more of the parents are sitting in their cars instead of on the sidelines during soccer practice. We are right there at every game but there is no longer the expectation that we sit and watch practice (particularly helpful on a rainy evening like this one). My daughter also attends a tumbling class where there really is not a parent waiting room and everyone sits just outside the door to the space in their cars. So I am blogging with my personal devices and completing work notes with an awkward set up using my work laptop in the car. I am returning texts and emails during most of my spare moments and I am coordinating and planning volunteer activities/events such as the VBS that my husband and I coordinate at our church.

    This is how the Sandwiched fit it all in, often from our parked cars (or driving cars and taking calls on speakerphone), seizing the downtime in life. Sometimes I enjoy scrolling my phone and I used to just enjoy the downtime more (videos, online shopping, reels) now I am scheduling appointments and getting back to people just to keep my head above water because Mom and Dad are now among those I am responsible for and the nest remains full.

  • April 23, 2026

    And My Sweet Neighbor Said it Sounded Like a Nightmare Scenario

    I sent the following text to my neighbor when life happened and I reacted big. She was wonderful enough to acknowledge that we have all been in THAT state before. Hope you can relate to my humanity here whether you have reached the life level “Sandwiched” yet not.

    Here’s the text I felt compelled to send after it all went down and my neighbor’s wonderful employees came to check on me.

    Hi- please do not worry about getting back to this with any urgency. I am SUPER embarrassed. It’s a long story but something stressful happened at a time when I am having just a tough week and month in general and I am fine and no one needs to worry about it. I just had this thing happen (explained below) and I overreacted (screaming) and I didn’t realize how loud I was and some ladies (kindly) came over to check on me. I think they may be working at your house. I really apologize for disrupting them. It was just an awful moment and I am fine now and hope we can forget the whole thing. They did at least come close to my house (not a problem) but I was yelling to them that I was fine because I just couldn’t get myself calmed down in the moment and my dog was getting ready to bolt out the door so I just needed them to go away at that moment. Please tell them I appreciate them caring and that everything is fine!! I am calm now so if anyone needs to see me to see that I am ok just let me know.

    Ok so this is what happened. I take care of my mom and she has had one knee replaced (mid-May will be the third or fourth post-op visit because she has had a bunch of pain in the knee that was replaced and the incision got infected- pain is improving and infection is fine now). Anyway, she still has bone on bone in the right knee so she cannot get up into SUVs which are what I drove, what (husband) drives, and what my dad drives so we still have this little old Ford focus that we drive mostly just to her appointments (and actually my suburban’s engine was about dead so we sold that last evening so I am driving her little car to work on the 2 days I work and to take her to appts until we buy me another vehicle). Anyway….i got her home from her appointment this morning, I have some stress from trying to balance everything I am responsible for here, and I pulled the little car into the garage and put the key fob into my front pocket of my sweatshirt. I got her a late breakfast and was lifting some boxes and didn’t know that at some point my body pushed the button on the remote start on the car so it was running in the garage for who knows how long and I didn’t know it. I got Mom back to her suite and opened the house/person door to step down into the closed garage to take some items out to recycle and I saw the car running in the closed garage and it was startling but I quickly pressed the buttons and opened both big garage doors because I knew I needed to vent the garage.

    I forgot where the key fob was entirely and I am panicking a bit hoping I am not breathing in too much of anything nasty and figuring that it’s fine because I opened the garage doors, but it was kind of the last straw when I went over to the running car and it was locked and I couldn’t find the key fob and I couldn’t remember if I had left the key in the ignition but I really thought I didn’t. And I started screaming for my mom asking her where my dad’s other key was and she didn’t hear me and then I was getting really upset because I couldn’t turn the car off and I was feeling a sense of urgency because I had an important errand I had to do before I had to be back to my computer for an afternoon session and I just got myself really worked up and was yelling something to mom like “oh my god oh my god I can’t get it to shut off call dad and ask him where his key is, oh my god I can’t find the key to get the car open and I can’t shut it off!!). It was louder and more shrill than it should have been and when they approached I had myself half in the middle of rational talk that going to this errand and getting the car shut off is not an emergency but also just angry and worked up that I couldn’t find the key I had and that I couldn’t find my dad’s spare key and was then screaming some more just in anger and frustration and dysregulation and then I realized they were outside and tried to assure them I was ok and was trying to keep the dog from getting out and it was just one of my worst moments

    Feel free to share this with them and let them know I found the key fob on my person shortly after they left and then I couldn’t get the button to work because it’s intermittently working because we need to get a new battery and finally it just shut off on its own.

    Again i apologize greatly for the disturbance.

    The text ended there and my neighbor couldn’t have been kinder. Hope my vulnerable moment helps you feel better through yours!

  • April 14, 2026

    You’re the One Who’s Home

    My husband worked from home quite a bit during the COVID shut down and ever so slowly the days he could work from home dwindled and when he took his new position it was said that one day a week could be remote. We are thankful because when he has an appointment or is sick he can work from home (and honestly he is able to lock in more at home than when he’s in the office and makes headway on projects that sit there when he is participating in more direct support of his team in person), but working from home one day per week has turned out to really not be a thing there unless really needed.

    I have flexible part-time employment from home and have taken a set schedule as a part-time contractor in person on a couple of other days of the week and have been balancing the two positions while also advocating medically for my parents who live with us which includes many appointments, phone calls, portal messages, sometimes inpatient visits, and beyond. I also try to keep afloat the management of our house through chores charts for the kids, communicating with out part-time house cleaner and landscaping company, and trying (and often failing) to pick up the rest of the slack around home while my husband, Dad, and Mom do things here are there as they can and my kids need a thousand reminders to pitch in.

    My husband does a number of things, but I am responsible for a whole lot more and he is resistant to coming up with a schedule where we take turns doing a number of things and plan ahead so we know who is doing what when. He grudgingly helps drive the kids to their activities because I am unable to be at multiple places at once and we don’t know what we would do without my mom-in-law’s help as a third driver, but he makes it clear that he would rather I take fewer clients and be the uber driver more often even though I have often “ubered” my aging parents during the day. I frequently hear, “but you’re the one who’s home,” meaning that I have more hours when I can be home during the week while he works full-time out of the house.

    It feels tiring and lonely to be the one asking “How high?” when each family member asks me to jump in their direction when they want or need something. My husband gives and does, but not to the same degree.

    He is not expected to divide his attention between work and home and between so very many Sandwiched categories at home.

    On Monday we had a gentleman come replace our carbon monoxide detectors and my husband’s understanding was that the plan was for the gentleman to also replace all of our smoke detectors. My husband scheduled this and put it on the family calendar on a Monday with plenty of notice, but in his mind when the company said this gentleman was arriving anytime between 8 AM and 5 PM, I would just clear my entire day. Monday is a flexible, remote work day for me where I make my own schedule (generally speaking- I still need to work when the clients can schedule their sessions), but that’s the entire day he is thinking I will keep open. On that particular Monday I had a 7 AM scheduled (fine of course as it was outside of the timeframe for his potential arrival). Then my husband got an email narrowing the timeframe and my day was not completely filled with back to back clients as is sometimes the case.

    But I determined that 11 AM was a possible timeframe for this gentleman to show up and had a client scheduled for that time and found out that my dad would be out of the house then. I did not want to leave the door unlocked because my mom would be the only other person home and she has mobility issues. So I had to call the company (got a very kind call center rep) and explain my situation and share that I can open the door before 11 AM and after 11:45 AM but could not let the gentleman in during the 45 minute session. The rep had to put me on hold longer to call the technician and she came back with a non-solution to my dilemma. Essentially it was no one’s problem but mine that I was working from home and this gentleman was scheduled to come to our home potentially while I was in with a client and I couldn’t really know when he was coming exactly so that I could plan.

    Found out we were the second job of the day and that he probably would not be there while I was on a Telehealth session with this 11 AM client, but there’s a chance and she explained to me that he can arrive and wait 5 minutes at the door and then must leave a note and we would have to reschedule. So I had to put the dog out back early (not a big deal) and then had to leave the front door unlocked just in case and gave verbal permission (through the call center rep) for him to enter the house if it was between 11 and 11:45. He didn’t end up coming until later than that so I was able to let him in but the first thing he said was that no one’s told him he was replacing smoke detectors (carbon monoxide detectors only) and that without a work order for the smoke detectors he doesn’t carry those supplies on his truck. So I called my husband and put him on speaker phone so they could talk about this and my husband asked him to just change the batteries in the detectors which the gentleman said he would do but looked annoyed.

    Thankfully my next client was not until 2:00 PM and he was heading out before that but I felt I had to hang around in case there were questions throughout that time and I walked him around and dealt with the little headaches that were part of getting that done because I am the one home.

    I have an interview coming up for a full-time in-person job that would be great for my career and we could hire some help to provide support for my parents and to start the chauffeuring of the kids to activities (along with our oldest who gets his license soon) while we make our way home from work, but it is clear that no matter what this job pays my husband does not want to pay someone to help us in this way and wants all of the things I am doing (or not quite getting done) now to remain on my plate.

    But I think I want to branch out from being the one who’s home because there’s more at home (especially in a Sandwiched home) than I want to continue juggling primarily on my own with expectations attached.

  • April 10, 2026

    That’s a Day I Work in Person

    What a privilege to be able to work remotely even part of the time and to make my own schedule for the most part at one of my part-time jobs. This is obviously a first world problem, but it’s one of those inconveniences for the Sandwiched who work outside of the home.

    When one of my four children, or one of my parents has or I have an appointment to go to, I have to recite the two days of the week when I work outside of the home during the college school year because (while not impossible) it is very difficult to switch my schedule of if I cannot come to work on those two days when the university is open and I am there all day and have many days when my schedule is packed tightly with face to face meetings. As a contractor at this particular job I do not get paid if I am not at work to do the job that I am contracted to do. I can switch to another day of the week and have done so a few times, but it’s often challenging for the students to switch and meet with me on a different day because their schedules are not always the same on the other day.

    And the days of the week I work at this job in person are consecutive so the scheduler at the doc offices or hair place or car place or vet or pet groomer etc tend to think that I said that I cannot do days that for them go together like Monday and Wednesday or Tuesday and Thursday or they think that I said a CAN do the days that I am explaining are the two days I am unavailable. So it’s pretty often that I am repeating what does not work for my schedule more than twice for the benefit of each place I am calling for an appointment.

    I think I am managing my expectations and getting ready to self-regulate, but it is also true that when it takes quite a bit of time from the moment I call and am on hold to when we finally choose a day of the week, date, and time that works, I’ve about had it by then and am not looking forward to the next call.

    And then there’s my husband who likes to try to insist that I schedule ALL appointments (except of course his) when I can handle them without involving him because he is the one with the full-time career and in theory less flexibility than I have and he wishes I wouldn’t work so much so I can take care of more related to home and I am doing my best to shift us into more of a team mindset as I enjoy the work I do and want to continue growing an expanding into different roles professionally.

    But in the Sandwiched season it is tough to find all of the flexibility needed to get everything done for everyone while working. Thankful on one hand that we can get by without me working full-time but on the other hand I worked hard to be where I am and want to continue to take advantage of more opportunities, but everything that needs to be done for the home and multi-generational family only seems to increase. My husband is doing more, but doesn’t want to be and our parents pitch in in certain ways but at the core of it is this is the assumption that it mine (a lot of it) unless I find a willing person to help out, not so much that it all belongs to us and we are figuring it out together.

  • April 3rd

    No Good Getaway Goes Unpunished

    The school district combined end of trimester conferences with an Easter holiday break and the kids had a half day Tuesday, off Wednesday, off Thursday, off Good Friday, off Saturday and Sunday and Monday too! Phew they have a LOT of half days and days off these days! In some ways it is nice to be able to have a random half day on a Tuesday or Thursday here and there to take them somewhere special and pay the weekday rate at a time when other districts are not necessarily off, but sometimes (usually on a day when I am working) and more often all summer long, I feel the pinch of having all 4 of them home arguing with one another while I have sessions and notes to complete. And I am torn about about whether to take the morning and take them somewhere to try to wear them out or stop before all the work is done and get them involved in some household chores while supervising them so that it actually gets done without a battle beginning between them, and then having to work all evening or half the weekend to catch up.

    So this time around my in-laws said yes to a very big deal! They took all 4 kids to their home starting Tuesday evening on the half day while we went to conferences. Then they had them while we both worked a full day in person on Wednesday and then they kept them through Friday while we got away to a lovely inn close to where I grew up that I had always heard great things about. We needed a belated 20 year anniversary trip and we were able to stay 2 whole nights 2 hours away while my parents held down the fort (and took care of the dog) at home and my in-laws entertained the kids. We had a wonderful candlelight dinner and a very nice stay and breakfast the first night into Thursday morning and then we made the foolish choice to get out our laptops and get some work done all morning on Thursday until after lunch. I was behind in paperwork as usual, he has a team to support in the field with ongoing projects and we are thankful for our work. But it always seems like the flexibility in our work and the ability to work partially remotely ends up adding up to us being available too often and just about from everywhere.

    Two of my kids started getting sick with the stomach bug and my tolerant in-laws kept them. They let us know but didn’t ask us to come home. I also spent some time reaching out with questions by email about jobs I am applying for to determine next steps when one of my part-time positions ends in Spring 2027.

    I mean I guess it’s not great to regret getting that done, but I truly do wish I would have seized every bit of that time! Because as we were heading out for a late lunch I just really didn’t feel hungry at all. Not super surprising as breakfast was plentiful and very filling, but after we ate lunch out and headed back to watch a movie in the room and by the time we got food delivered for dinner I couldn’t eat a bite of my dinner. I was nauseous and barely slept all night and right before we had to check out that stomach virus my kids brought home came right out of me and into the ice bucket.

    My husband splurged on champagne and strawberries greeting us when we arrived and we never did finish the champagne and really the part that stands out most in my memory was getting sick and sleeping the whole way home and the rest of Friday while my in-laws gave the kids dinner and brought them home close to bedtime. We were thankful for all they did but it felt like we barely got a day away, came home sick, and found a way to host a simplified Easter on Sunday evening before they hit the road to see my sister-in-law and her family 14 hours away.

    When you’re sandwiched it just really is never a good time to get away. But let this be a reminder not to bring your work along if you can help it because you never know when you’ll be checking out a little early after thoroughly cleaning the ice bucket and warning the front desk that you are probably leaving germs behind.

  • March 24, 2026

    Downtime

    Sometimes I hate to call her on it because I cannot imagine the pain of having bone on bone knees, but Mom tends to thoroughly complete the PT exercises that involve her moving her arms and legs in various ways while sitting or lying down, but struggles to motivate herself to choose weight bearing exercise for her knees. So far she has gotten one knee replaced about a month and a half ago now and her recovery was slow but steady at first as she transitioned from the smallest local inpatient hospital where the procedure took place to our favorite local rehab facility for intensive PT and OT. She was certainly making progress with daily therapy.

    Then she qualified for home health which we greatly appreciated because I am her primary driver, advocate, and support person and I work two part-time jobs (one from home where I primarily set my own hours and one in an office two days per week) and I have 4 children of varying ages and a husband and we all have a home to care for. It’s a lot and reducing the number of appointments we have to take Mom out to is very helpful because she does not drive due to her bad knees , not always being able to get in and out of vehicles and buildings without help, and many years of no longer driving. I also accompany Dad to many of his appointments so that I can be an advocate and a second set of ears. My dad is a back up driver for her but they do tend to stress one another out and he is a cardiac patient with a quadruple bypass surgery in his medical history so having him take Mom to appointments can be exhausting and some of the physical help she needs at times involves him exerting himself in ways that are questionable. But the options are limited when we have to get out to appointments for Mom. So we like it when the providers are able to come to the home.

    But as the weeks go by she no longer meets criteria for them to stay and they discharge her one by one. The nurse goes and will come back if signs of infection or another issue start, and really it’s a good thing to see Mom improve of course and we don’t want her to need providers, but sometimes it’s more that she does still need providers but not badly enough that they will drive to us. Next OT usually discharges Mom as she is very resourceful with her ADLs even when she has to make a lot of her own accommodations. She is brilliant that way and teaches the therapists tips and tricks that they have not thought of at times.

    The one who stays the longest given Mom’s condition is the Physical Therapist, but even when the Home Health PT first starts seeing Mom the most she ever has gotten approved for is 3 days a week with sometimes having a 4th or 5th day with another provider having eyes on her or working with her (nurse or OT) and I get it, staff is limited and funds for this kind of service paid for by insurance are limited as well. But coming from an inpatient rehab where Mom was doing exercises with a therapist typically 6 days a week or at least 5 to cutting that on half right away is a bit of a bummer of a drop off. She is supposed to do the exercises herself on the off days and she will tell you she does, but she is not doing any extra walking without a therapist standing right there pushing her because it hurts.

    And the biggest bummer, which quite frankly feels like a gap in the care plan and does not make sense, is when they say she can still qualify for home health PT but PT will only come to the home once weekly because that is all they will approve and she cannot (as far as I know- I have not yet asked a physician to order outpatient PT while Mom is still having home health PT but I doubt it is permitted) have two levels of care at one time in the same speciality.

    So then the therapist asks us to decide do I want her to discharge Mom and just go ahead and start her on outpatient PT (which she actually has never actually started before- she completed an intake before but then something happened such as a worsening condition or a hospitalization and she never started the outpatient PT). Well this home health PT has specialized training in lymphodema, which is another one of Mom’s complicating conditions, and does such a great job and we don’t want to lose her and I don’t want us to have to drive mom to and from PT 3 days a week selfishly as that adds to the schedule so we say “sure stay on for 4 more weeks.” But she’s only coming once weekly and she was just off for a week and they will usually send a fill-in therapist but it sounds like she got Mom to say it was fine to skip a week and Mom does not choose to do the weight bearing exercises when the therapist is not there. So Mom is only getting the full benefit of the PT one day per week because there are so many family-related factors that keep us dragging our feet when it comes to setting up outpatient PT and Mom certainly isn’t begging to go.

    Wondering if insurance companies and treatment teams have considered that if they just pay for a few times a week of home health PT for a patient who is not fully exercise-compliant on the off days the patient might have better outcomes and then discharging a patient like that (who is not going to do the hardest exercises on her own on off days- especially when the hardest ones are the ones she needs the most) directly to outpatient PT so that she is going from at least 3-4 days of working out with a PT coming to the home and motivating and guiding her though fears and roadblocks to 3-4 days a week of working out at outpatient PT so the number of days participating remains consistent in the transition to a lower level of care.

    And I realize that different patients have different needs and (seemingly even more importantly unfortunately) different funding sources approve different numbers of days and types of care, but patient outcomes are important too. And speaking about a patient like my mom who has had so many readmits and is not fully compliant with the hardest exercises that are the ones that will really build back her strength and have the potential to improve the outcome of the next knee surgery and recovery, wouldn’t it make sense to keep that at home PT coming four days a week for maybe a couple fewer overall weeks and then transition to 3 or 4 days of outpatient PT a week so someone is getting her to do the exercises instead of so much sedentary time?

  • March 17, 2026

    Home Health Highs and Lows

    Your loved one has a surgery or gets out of the hospital after being treated for a condition that is ongoing or has weakened them and sometimes they meet criteria for a stay in an Acute Rehab Facility where they receive nursing care, PT, OT, and sometimes Speech Therapy often with a private room reserved just for them and therapy for several hours a day in their room and in a state of the art gym down the hall. These places (at least the ones that Mom has recuperated in, 3 different facilities so far) are wonderful for ongoing care after they are stable for discharge from the main hospital. We couldn’t be more thankful that these places exist to help rehabilitate our loved ones before they head home.

    Side notes: be aware that these Acute Rehabs count as days in an inpatient hospital for the Medicare day count limits, there are Skilled Nursing Facilities (regular nursing homes, some of which are better than others, do sometimes provide rehab but are billed differently and do not always provide the same number of hours of rehab especially on weekends), and PT and OT while inpatient in a main hospital typically only happens for evaluation purposes to choose the level of care for discharge (if you’re hoping for rehab for your loved ones when they start recovering- it’s a great hope- but it’s really not likely to happen regularly. They come to assess when they have to and that’s about all they have the staff for).

    Then if you are fortunate and your family member needs home health because they cannot get out on their own to appointments, you get help coming to your home. Don’t get too excited. The help at home can be and frequently is great, but it is very limited and they won’t be there for long. Very rarely is a nursing assistant included in this (someone to help bathe and dress your loved one and do light chores like laundry or bringing a meal to them). What the nurse’s assistants do is a very short list and they do not stay long if you even get them at all. Dad had one to stand nearby while he showered after his quadruple bypass surgery several years ago. We were offered one this time after Mom’s knee surgery but not following her previous procedures and hospitalizations. You almost always (if not always) get a nurse assigned especially one to come check that all of the meds are in order and to do the intake into home health, but they typically examine the patient very little and, in our experience, provide education and talk with you but do very little hands-on care. Once Mom needed something badly that can be done on an outpatient basis and the nurse was still there at the time and I was coming home from work. The magnet from the agency says “Call us First” regarding help with issues and the nurse declined to provide the needed care and I as an untrained family member came home from working all day to handling a delicate and awkward situation with my own Mom myself because that home health RN doesn’t do that. Hmmm, ok. You did not even examine my mom that day but I suppose you collected all of your pay for showing up and being on the Olympic Standing There team. But this is what insurance pays for in home healthcare.

    We have had mostly great OT and PT home health staff members and Mom has needed PT the most so she qualifies for PT to stay longer while the nurse and the OT sign off earlier in treatment. Home healthcare stays for about a month, maybe two, but they do not come every day. Maybe the first week you could possibly get one person coming each day if the nurse is once weekly and PT and OT are cleared by insurance to come twice a week each. But they are there for about an hour to an hour and a half per day. This is not what it sounds like, care if your loved one needs someone to be with them at home, that’s not provided. It’s a check in here and there briefly and some therapy that you did not have to drive your family member to.

    I am grateful that they come to the home, but it is daunting as my parents continue to age and as I am committed to keeping them in their home with their family, that insurance does not pay for help to come into the home and provide supportive care. All of that is out of pocket. It sounds like Medicaid can provide a limited amount while the state takes all resources to pay for it if the person qualifies. It also sounds like there are some community resources one can sign up for if qualified, but agency care in the home is expensive and not covered by insurance unless your loved ones thought far enough ahead to pay into long-term care insurance (before they developed any pre-existing conditions) and even that really doesn’t cover much. Even going to an assisted living facility will cost quite a bit long-term (though I admit I have not looked into that because it is not an option we are considering at this time).

    So the family, usually the daughters, are left to figure it out when there isn’t really a long term plan. And for so many there is not enough income to plan well in advance. And to be honest even when there is it is a difficult choice to prepare for the unknown (who knows how much care a person will need?) versus using one’s income to enjoy a quality life while one is able to enjoy it.

    Home health is usually great when they are there. They are very knowledgeable and, especially the therapists, seem to put in a lot of energy and effort to providing great care. Today the PT found an infection in part of Mom’s incision while I was at work and alerted the surgeon’s office before my day ended. SO helpful that I did not have to do that today. But now the office hasn’t done anything and will call back in the morning while I am working again.

    OT and nursing have signed off and PT is the only one approved to stay for now but she only got approval to come once weekly for the last month. Mom struggles to push herself through the pain to do the exercises. When we get her approved for outpatient they will work with her more often in a week’s time but we will have to drop everything during the day and drive her because she no longer qualifies to get more than once a week to the house.

    I need to look into whether we could have started outpatient while home health was still coming once weekly. I doubt the service can overlap in any way….no matter how much it would make sense for the patient.

  • March 10, 2026

    We are experiencing an extremely high call volume

    I call the small hospital’s health system often. My children’s pediatrician is within this system as are most of my parents’ specialists and our primary care providers.

    At many of the offices now AI is answering and taking me through an annoying menu of options and asking me questions that I assume lessen their liability more than they are useful. Almost every time I call any of the offices I wait on hold for several minutes and hear a recorded statement “we are experiencing an unusually high call volume.” When a human being answers it is typically someone working from home and after I talk with them I typically am transferred to the front desk of the office I am calling (and stating the name and date of birth of the patient for the second time or more).

    Last evening as soon as I finished my final online session of the day for work I called the pediatrician’s office at 4:59 PM hoping I would get someone before they closed. After going through AI and getting the first person who took down my information I was disconnected while waiting on hold to be connected with the front desk of the pediatrician’s office. I was very honest in sharing that my daughter had not been feeling well for the second time in a month and explained why I thought the same issue had returned based on her symptoms. I repeated myself multiple times to multiple different people and they had no sick visits available for over a week. We have decent insurance benefits but I still asked them to squeeze my daughter in if not today the next day and one of the nurse’s that called said that they sometimes open appointments same day and that I should call in the morning while in the meantime my daughter is very uncomfortable.

    I told them, which maybe I shouldn’t have that I would probably end up going to their urgent care if she could not get an appointment to be seen but expressed frustration about this because it is more expensive to do that and it would be much nicer if our pediatrician was not just for well visits.

    My husband came home from work and decided just to spend his entire evening at Urgent Care with our daughter and she did in fact have something they found that needed to be treated. Someone from the office called me hours later once he had already left to take my daughter to Urgent Care Care and she was calling to let me know that the doctor looked at my daughter’s chart and wanted this staff member to tell us to just go to urgent care. Great.

    I can’t help but feel that they are funneling us to the urgent care facilities and don’t mind that we waste a lot of personal time waiting (and having our sick daughter sit and wait) instead of having an appointment scheduled because as an organization they then get to charge us more to be seen.

    Specialists are scheduling months out just for the intake appointment and treatment is further out. But you can receive waiting list texts for which you’d better stop everything you are doing immediately and check your calendar and respond as fast as you can or it will be gone.