I've been on family medical leave since early November. I'm going to have to go back to work by the beginning of next month in order to maintain our health insurance. I need to arrange adult day care for my husband. But I don't know how I'm going to afford it. I'm paying for daycare for our youngest son at the same time. (crazy situation, I know.) Does anyone know if Medicare will cover any of the adult daycare expenses? DH is only 53, but he receives disability, so he should be eligible for Medicare. I'm working with a lawyer to apply for Medicare, but I haven't heard from her since I dropped off my insurance information. I feel a bit lost at this point, and a little panicky, since my time at home is running out.
Any advice on finding a suitable place and getting medicare to cover any of it is appreciated.
Kelly, is your husband on SS disability and receiving payments from them? If so, he should be eligible for Medicare benefits after he has been on SS disability for two years. At least that is how it worked for us. I don't think Medicare pays anything for adult day care but there may be private programs that could help subsidize it. You may want to check with the day care program to see if they know of anything. Being young and having AD leaves most people out of the loop for receiving any help....unless you are impoverished, then Medicaid kicks in and there would be more help. I feel for you, I can't imagine what you are dealing with.
Kelly, Medicare won't pay for adult day care but you can get a credit on your income tax if he is there so you can work. It works just like the child care credit...
Kelly, Do not be afraid to look into the Medicaid aspect of this. It may be that you qualify. The rules are quite different for someone at home with children than when a person is applying for long term care. In fact, it is very different. You may qualify for Medicaid, if so it would pay for Health care for you, your children, and husband, along with payment on the day care. Don't just assume you do not qualify. I sent one of my friends who just recently was divorced, she has two children, is disabled and did qualify although we thought she might make to much. It more than likely would be your husband who will qualify and not you. Just look into it Kelly, it will be worth your time.
This looks like a good thread to ask about day care costs.
I've got two questions: What are you paying if you are only using the service for one or two days a week? Is any of this tax deductible? I do not work.
Starling, the one mine goes to is subsidized by different organizations. I only pay for the days he goes (three days a week). It's $50.00 a day but you pay what you feel you can afford. If I had to pay $50.00, that would be my whole paycheck! I said that I felt like I could afford $20.00 a day and that was fine with them. She said that they liked a $10.00 minimum. Ask them all those questions.
i do think its tax deductible starling. any day care even for kids is tax deductible i see no difference and i do deduct home health care yrly for DH. divvi
in our area its 40-60/day-some churches i think offer some for free but they have to be within the guidelines , non hostile, able to use bathroom, etc..or you will need to find one that deals with AD persons is best.
My wife is in an adult day care program three days a week, usually from 9AM to 2PM, but this can vary depending upon my needs. We pay $12 per hour, so the charge per session varies with how long she is there. There is no help from Medicare, but according to my accountant, it is tax-deductible as a medical expense. With AD the medical expenses rise rapidly and soon exceed the percent of income needed to claim them. Last year my wife's medical expenses reach 60% of income.
If he only needs supervison - (as does your son) - could you find an individual who is not a professional health care provider to be at home with them all day. They usually work for $10-12 an hour and it would be a way to combine the expense into one.
I agree with many of the above posts. Many church day care facilities (for children) have 'scholarships' but people who are in need. Naturally, they do not advertise this. Ask to speak to the Director in private and state your case. If they don't have such a program, they probably know who does.
Help is out there for you, the secret is to know where to go and who to ask. Perhaps the United Way Director??
Day care for children are only deductible if you/both parents work. To put them in day care for a break does not qualify. For couples, if one spouse works and the other doesn't, they still can't deduct daycare because it is assumed that the non-working parent can watch the child(ren).
For adults, you would have to check to see if it is considered a medical expense. If it is done on the basis of childcare and you are working, then it should be. If not working, I doubt you could deduct it unless it is prescribed by a doctor.
Remember in these gray areas to check with a tax accountant or lawyer. Even calling the IRs will not help - they rarely know anything more than the basics especially around tax time.
OK Charlotte, enter NancyB who knows absolutely nothing about tax laws. Which is why I have a CPA. I'm the one who expects the world to use common sense and be nice! (LOL) But, if the spouse is not working because of a type of dementia, would that not negate the rules that say if one parent is home and the other works, day care is not deductible. But wait! That makes too much sense and the writers of our Tax Laws don't "get it".
I do know that my CPA said to estimate the time my housekeeper watches my husband vs. the hours she spends cleaning houses and he takes that percentage of her pay and includes it in his medical care. This is my respite time and we claim it!
That is why one needs to check with a accountant, CPA, lawyer that specializes in tax law. I would think Adult day care could go under medical if a doctor prescribes it. Knowing our government/IRS - if you are not working, you don't need a rest. hogwash!
Kelly, another thing to consider when you go back to work is the pretax dollars. I don't remember what it is called, but if you pay for day care, there is an account you can use where the money is deposited as pre tax money and is deducted from your paycheck at pretax rates. Then when you spend, it comes from that account. It works for medical expenses and child and adult day care. Not sure if your company offers it, but it can really make a difference financially if they do.
Remember - if it is pretax most of the time you can not deduct it. The point of tax deduction is to get credit for taxes on money that you already paid tax on. You are probably thinking about the medical savings plan or ones like it.
I called one of the day care services the caseworker suggested. It will be very expensive, but other than that is sounds very good. I've decided to go ahead and spend the money if they are willing to take him. I don't qualify for sliding scale but they do slide depending on how much help he is going to need. They don't do lock down, but since he is socially appropriate, and they loved that the caseworker told me to tell them that, he ought to fit. We are going to do a 4 hour visit on Wednesday.
It was very hard for me to make the appointment. I'm scared to death he won't want to go to the visit, or do the service, but I've decided to go ahead and try.
I looked at the medical deductions publication. I can't tell if this stuff is deductible or not. Next year I'll need to ask someone.
Starling, I am glad you made the call. I hope it all works out well for both of you. I truly believe that adult day care was what got me thru some horrible months...just being able to get out and be with people for a few hours or to be at home alone was just wonderful.......
Starling - good for you. I wish my dh was a canidate for some day care but he is just not a social animal. Even at home if someone comes, he sits in his recliner with his eyes shut, dozing or not? I think the social interaction is great for those who will try to respond. He will respond a little to the lady who comes a few hours every two weeks, but only when she really pushes him.
Depending on circumstances, it might be wise for you to stay with him the first day and try to help engage him in something. Just have to wing it. Good Luck.
lmohr, my husband was past the point of interacting with anyone when he went to daycare...all he did was pace and eat...but the wonderful people who ran the place put up with him because I was at my wit's end......plus the $50/day was enticing.....LOL....! A lot of the people there just sat in recliners and watched TV or at the tables and just watched the world go by. At that point, it wasn't for him that he was going, it was for me. Then, of course, there were the little old ladies who just visited, played bingo,worked on crafts and just had a wonderful time...they always tried to take care of my husband because he was so much younger...he must have reminded them of their own sons.
Thanks Sandi = I am keeping it in the back of my mind and you never know when the right time will come. Right now, he is really very little trouble. Just sitting and dozing, eating and sleeping. He still goes out with me daily and waits for me in the car. If he would interact with the others I can see a benefit but not yet.
Starling, I visited a day care, filled out forms, arranged a visit, and then my husband wouldn't go. At the time y'all said, next time just don't tell him in advance. I remind you of that now. Get him in the car before you get specific about where you're going. And maybe promise him an ice cream stop on the way home??
My plans were to tell him tonight that we are going to make a visit, tomorrow morning, to the day program that the caseworker talked about . I'm not sure how he will handle it, but that is what I think will work. I'll let all of you know how it works out. I'll tell him that he will be having lunch there as well. He likes eating lunch out.
I am calling it a day program, and I'm going to continue to present it to him as a place where there will be people to visit with and things to do, but that I don't know what else. We will see.
I told a little white lie to get mine to go. I told him that they needed volunteers to help out and I really laid it on heavy about all he would have people to talk to and he wouldn't be sitting home alone while I was at work. II knew that when I was as work, he would sit outside a lot just hoping somebody would come past to chat with him. I didn't stay with him the first day either. I've been very lucky with this daycare. They give him a lot of attention, which I know he eats up. He only goes three days a week from about 8:00 until 2:00. Staling, I hope yours will enjoy it.
maybe a 'recreation center' may make a better impression than day program? anything referrng to daycare i would avoid! good luck Starling,, dont be swayed-make it work- you need your days out! divvi
The subtle suggestion that Brigull made to her DH about getting an ice cream ON THE WAY HOME also reinforced the fact to him that he WOULD, INDEED, BE RETURNING HOME instead of being left there. Good psychology!!
Well I told him right after supper that we were going to try out a "recreation program" because the caseworker (who I think he remembers) told me to do that. He doesn't sound too happy about it, but I'll probably be able to get him into the car.
I think he knows that at some point I won't be there with him. I'll be "miles away" and he also doesn't like that. But he went out for TWO hour and a half walks today. He is bored out of his mind at this point. And there is no way for me to safely stop the walks. The caseworker noticed that I was upset about the walks and basically didn't seem upset with me about them at all. I think she "gets it".
Nancy, I hear what you are saying. I'll make sure he knows we ARE BOTH coming home. I'm not sure if the ice cream thing would work because we generally have that for desert when we eat out (like today). But I might just try it.
Starling--Keep in mind that even if your husband isn't crazy about the daycare at first, he'll adjust. Also, be prepared to do a "sales pitch" over and over until he gets with the program. I needed to do this the whole 2 1/2 years Steve attended; if he goes back, I'll probably have to do it again! But, it was worth it.
OK, here it is, and I have to admit I'm being strange and funny.
He did fine. He, of course, didn't know why we were doing this. I laid the "blame" on the caseworker. They gave me a free 4 hour sample. I told him I was going and the manager (also a nurse) stayed with him as I left. They run a good program. He, however, is almost certainly not anywhere near as far along as most (all?) of the people there.
We, tend to think in terms of the 7 stages and mini-mental tests. He is an early stage 6 (but may actually be a late stage 5 now that I'm looking at it differently) and profoundly demented according to the mini-mental. But by their assessment, which checks ability to do life skills on his own, he is at level 1 (out of 3 with 3 being in need of the most help).
And he is. He gets himself to the bathroom without prompting. He needs to be prompted for showers, but not for shaving and he does both himself. He feeds himself, and I still give him a sharp knife because it is easier for him to use that than the duller dinner knives we own, but he had no problem today at the dinner with their dinner knife. Etc.
They require a minimum of 2 days a week. I think that 1 day would be somewhat appropriate, but 2 probably is too much. AND I realized that I didn't know what to do with myself for 4 free hours and in fact came and got him early.
They run a monthly in-person support group. I can go even if he isn't their client. Their caregivers are mainly spouses. I WILL be going to that for several reasons. He will be coming with me and they separate the patients and caregivers. Sounds a lot like Joan's group and I always said that if I found one of those, I was going. It will be good for him to go back there once a month for a few hours even if I don't decide to continue with looking for a day care.
I will definitely go forward with the TB test that will be necessary. I will also call the other 3 or 4 day cares whose numbers I was given. I got a lot more info and can now ask better questions. And I've got a couple of other options that I have not explored yet that would get me some respite.
Starling--I may have posted this before--please read the section on Adult Daycare on the Bigtree Murphy site. She does a good job explaining the different types of daycare programs and will give you a much better idea of what questions to ask. I wish I had read it before I started the selection process.
Thank you, I will go there. I made a few phone calls today. I'm not at all sure if any of them were useful, but one sounds like it might be. It is still day care, but they are willing to start with one day a week instead of two days. The senior center is almost certainly useless, but I won't know for sure unless I visit, and I might just do that just to find out.
In the meantime, I'm going to make sure I take him out of the house more than I have been doing. It is better for both of us.