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07-23-2015 09:24 PM
People in this country are extremely naive when it comes to the cost of care for the elderly. The average monthly cost for a nursing home in a semi-private room is $9000.00 A MONTH. The government does not pay unless the person has spent down to their last $2000.00 nor should they. Nursing homes do not want to take Medicaid patients because the reimbursement rate is so low and limit the number of Medicaid beds available in their facilities. There are often long waits to get a Medicaid bed in a facility. More and more people are turning to in home health care whenever possible but if a individual needs skilled nursing care the only option is a nursing home.
07-23-2015 09:34 PM
First of all, my thoughts are with your aunt and your family. When looking for a placement for your aunt, be sure to find one with a continumm of care in case your aunt needs more care as she ages. The second thing to ask is if she will be able to continue her residency after the funds are depleted and she becomes eligible for Medicaid. Some facilities have a certain number of beds for Medicaid patients. If there maximum number is reached when your aunt goes on Medicaid, they may ask her to be moved. In addition, be sure that they are aware of and can handle the diagnosis of her mental health issues. It can be upsetting to everyone if she is placed and then is asked to be moved after a short period of time.
In addition, here is a link to look at results of inspections of various facilities in your area. This might be useful. http://www.medicare.gov/nursinghomecompare/search.html
This link is to a 56 page publication that will give you a good start and good information.
My mother was in three nursing homes---a nursing home affiliated with a religious denomination which had to close due to financial problems, a regular nursing home, and then another nursing home affiliated with a religiious denomination. Based on our experience, the two places with religious affiliation were far better than the public nursing home.
Good luck to all of you. It is difficult and a challenge at times, but there are resources out there.
07-23-2015 09:36 PM
Thank yu for your replies! Aunt is 79 so I know she gets medicare and I think she gets medicaid; shes been on disability due to the schizophrenia. Mom has found a nice place for her for now. Its a nice place; we had a friend from church who stayed there. I dont think its a private room. I dont know how my aunt will handle that, but I dont think a private room is in the budget. No assets in her name. The brother that died had a house and land and stated in his will that he wanted it divided between the remaining siblings.
Its for sale and if they get the asking orice, that may fund her care for a year. Mom and Dad dont want moms share of the profits and it will go to care for my aunt, but until that house is sold that tiny nestegg will probably pay for six or eight months.
I will research the options you all have provided and let my parents know as well. Im an only child and I plan to take care of my parents as long as I can. So far they are doing fine and I cant imagine them slowing down. I dont want to; it means that there will be a day when they wont be with me and I cant bear that thought. Im glad they were smart with their finances and its been a wakeuo call for my finances as well. I need to research long term care for myself.
07-23-2015 10:59 PM
It is best to find a good nursing home now so that your aunt goes in on private care and will then convert to Medicaid when she spends down her funds. In some states, they are not permitted to transfer you when you convert to Medicaid but will decline a Medicaid new admission to keep their quota. As suggested, all nursing homes do not take admissions with psychiatric conditions or dementia. Medicare has a checklist on line re finding a good nursing home and what to look for. At my place of employment, we had a dependent care service and consultant who assisted employees with child/elder care and they searched for reputable facilities in my area; you may have a similar benefit or the department of aging in your state can assist you as well. I hope you find a facility where your aunt will be well cared for physically and emotionally. Facilities re to religious affiliations tend to be a bit better, that has been my experience.
07-23-2015 11:27 PM
Thank you for u again. Talked to mom tonight. She is putting a deposit on a room tomorrow that will be available on the first. And its a private room!!! I asked mom if they knew her medical history and she said yes. She skirted around the mental issue. i think mom is hoping her sister will forget she s paranoid. Will seE hiw it works out. I sent her the websites your u all provided. The plan is to spend her nest egg and once depleted, let medicaid kick in. I dont know if where she is staying takes medicaid. Aunt doesnt know yet, but all family members agree that she will be told that mom wanted her to live closer to her. They dont want her to feel bad.
At least theres a place for her.
07-24-2015 12:40 AM - edited 07-24-2015 03:22 PM
I've been through some of this with my mom. She was in an assisted living wing of a retirement center after my dad died as she was not really capable of taking care of herself by that time. That lasted until she had to be amputated (diabetes, kidney failure, etc.). She was then put into a nursing home and actually did very well there until she died 5 years later. We were private pay. Medicare does not pick up the bill for that unless you are only there a short time while convalescing. It's very expensive. Part of that facility was for Medicaid patients who had depleted all of their funds and had no other means. You have to be down to your last $2000 to qualify. My mom was down to her last $30 to $40 thousand when she died. We did private pay all the way, but help was available if we couldn't.The only thing I noticed about the Medicaid residents is they didn't get quite the attention that the private pay did, and most of them had no visitors at all. They were all segregated from the private pay people in one section of the facility. When my mom died, I sent all the art work and others things in her room to that part of the facility, including her clothes. It really bothered me that for all intents and purposes, these people were the forgotten people. I was glad my mom didn't end up in that section.
07-24-2015 12:56 AM
I would like to thank OP for starting this conversation. I am also very naive about elder care.
That is the one area of my life that terrifies me! My parents are gone now, and I am 60, with absolutely no plan of what would happen to me if or when I need this kind of help.
I, for sure, know that my children would not step up to take care of me (which is the basis of my aging fear!), but I keep ignoring the little chirp in my mind that says "take care of setting something up, or at least have all the information in a folder if needed, when the time comes".
I know very little about 'aging out', and I know I am not alone. I think even in functional and loving families, gone are the days when Gram and Gramps just moved in with children until the end. The Walton Family is only fantasy in most people's lives.
I gathered a lot to begin my reading up on this subject just by reading this thread. I know I have to stop pretending I will never get old. Learning about elder care is something I need to be doing now, not when it is too late to have a say in what happens to me.
My mom died suddenly, so it did not become an issue with her. My Dad, on the other hand, had his papers in order, his finances in order, he even had his funeral all pre-planned and pre-paid! All we, as his kids, had to do was take out the folder and follow his plan.
He only had a very short (4 months) amount of time where he could not stay living alone due to illness, and I cared for him to his end. Something I would do over again in a heartbeat. It was such a good feeling to love on him when he needed it most. He died with our hands entwined and my head on his shoulder. The peace that descended upon us in that moment will live with me forever.
MY children, however, well....let's just say I raised some good kids, but they seem to have become pretty self-centered. I can just hear them now. "Not me, no way, I am not taking her", "well, not me either...".
07-24-2015 07:20 AM
Interesting the way some people are disappointed that there kids would not step up to take them in when they are not able to live alone while others like me shudder at the very thought of having to live with their kids. Both my father and mother in law lived with my DH and I for a period of time when they were no longer able to care for themselves and I know firsthand the incredible stress it puts on the caregivers entire family especially the female care givers. The men seem somehow to disassociate from all the issues surrounding having a aging parent moving in. I love my daughter and we get along very well but move in with her? Never! That is why DH and I pay a small fortune every year for long term health care insurance.
07-24-2015 08:44 AM
@meowing kitty wrote:
My mom was in a similar situation a couple of years ago. She didn't have a nest egg and ended up in an adult day care facility until she passed away two years ago. Basically they took all her monthly Social Security and pension funds for the room and board. I did manage to get the state Medicaid to cover another chunk of the bill, but never found out how much. Just be careful and don't get to involved or chummy with these people who run the facilities. The amount they receive is never enough and they will try to guilt you into dipping into your own saving or anybody's pockets for more money. They will try to tell you they can't afford to keep her on what they are getting paid, and they will smile through their teeth to get money from you. Don't let them get to you, because they are ruthless. My moms caseworker wanted us to sell our house so we could pay for her care. They even suggested we take second jobs or drain our retirement savings for her. I know it sounds cruel but you will need to make sure the word "NO" is in your vocabulary. I know for a fact that my case was not out of the ordinary. I worked with a few people in similar situations. I even got into a shouting match on the phone in Lowes because the case worker was being unreasonable. If you can get a fiduciary to pay all bills. That way no one can accuse anyone of stealing money. It may cost around $40.00 a month but well worth it.
Actually, it probably true that Medicaid does not fully cover the cost of care. They pay significantly less than a private care patient pays.
I know it sounds cruel to you to have them ask you to help cover costs - and much simpler to expect the Government to do it, but it also raises the costs for private care patients.
Considering the extreme increase in Medicaid usage due to ACA, it may not be long before either Medicaid does not cover nursing homes or pays so little of the cost that nursing homes refuse to take it at all.
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