Jane, I am not still sure I have the answer. I talked with the Social Worker and she said there is no such thing as a "temporary" Medicaid bed. She says the facility director was saying that she would apply to her superiors for a temporary bed for DH if he had to wait for one to become available in the facility. The Social Worker said once he is approved if the facility doesn't accept him they will help me find a different facility. She also said DH is in a good facility and DSHS has not had a problem with them and they seem to always work it out. This particular worker worked with placement not the financial end and she referred to me someone in Financial. That person didn't seem to be abe to grasp the question and referred me to someone else that was no better. They both said if he qualifies they didn't see a problem. I also spoke with the Director of our local Area Agency on Aging. She has worked for DSHS for years and is very knowledgeable in this area. She says that the annuity is protected income. I believe that is the same as what you said. I am wondering if I should go back again as I wasn't able to speak to a supervisor the first time.
DeIs, At this point I would go back to my Attorney, tell him exactly what I have told you, That having a Medicaid bed is not what qualifies you for Medicaid, tell him to call the Supervisor at the Mecicaid office you deal with and get this information. You are paying him to do this anyway, make sure he makes the call while you are in his office, either to your caseworker or the Supervisor. If you don't feel you can be sure he knows how to ask the question, then by all means call a Supervisor at your Medicaid office. The Medicaid bed is not what qualifies him, What qualifies him is the assets, the 30 days of in house facility and his Medical condition, if he qualifies other than being in a Medicaid bed, he qualifies, regardless, Just get the word from someone in the Medicaid office. If you are on a spend down right now then timing is important. You need to be talking with the Medicaid office, not a Social Worker in the facility nor a financial person in the facility. These people do not know or understand the delicate details of Medicaid. You need to talk to the Medicaid office only to get the answer. I am saying that if he qualifies he qualifies, makes no difference if the annuity stream has already started.
Just because he qualifies for Medicaid does not mean they will pay all room and board UNTIL he is actually in a Medicaid bed, but it has nothing to do with when the annuity pays. The Spousal annuity will have to be an immediate payment it cannot be a future start date, it has to be an immediate annuity.
If your Attorney is unsure of this then by all means make sure he is using the correct tables and getting the right type of Medicaid spousal annuity. Medicaid will have to be the beneficiary if you die, is he aware of that? If not then I would wonder if he knows enough to set this up.
Please know that I am a person just like yourself, just trying to offer information and help, I am not an attorney and what you do with the information is up to you.
Dels, please do follow up with us on the board, I am really wanting to know what the final verdict is on this. It will help us all.
All of the social workers I talked to were at the Medicaid office that was why I was less than impressed. The facility knows nothing of my finances nor will they. I did talk to a Medicaid supervisor on the phone today and she said if a Medicaid bed was not available that facility when he was approved I would have to move him someplace that did have an available Medicaid bed or he would be denied. She said the income stream the annuity wouldn't matter except to determine how much of his income I would be allowed to keep. My DH is severly impaired, probably Stage 6,so I am not worried about him being medically qualified. The Elder Law attorney and Financial Planner are both out of town for a couple of days, but I will be seeing them. They are both aware of the type of annuity, the payout schedule timing, and state beneficiary. I am putting the whole thing on hold until I get more answers.
DeIs, Thank you so much for the update, we have all learned from this. I was right that the annuity payout would only affect how much of his income you would be allowed to keep but I am very surprised that he would be denied if no Medicaid bed was available I would have thought that he would be qualified but they would not pay until he was in the proper bed. I just went through this qualification with a friend of mine, not even in a Medicaid bed at all, was in Hospice in patient for 30 days assets qualified and was approved. Medicaid paid.
A lot of people think Hospice is fully funded by Medicare but once a patient goes into the in patient part of Hospice they need skilled care, they can then be stepped down to intermediate care, which is what happened with my friend, the intermediate care was very costly and had to be private pay, that is why we applied for Medicaid for them, and YES it was approved and paid. The Hospice in patient facility counted as the 30 days because he had been in there for that long
I know you are finished asking the Medicaid office anymore questions and I don't blame you but I still wonder if the Supervisor meant that he would be denied as far as payment on the room and board or just plain denied in general. Bet you would not want to ask her once more and clarify if he would be totally denied or approved and just not room and board paid until the bed was available???? Do I make sense? Sometimes it is the way the question is asked.
Again, I am just going by what happened in our situation. Patient was approved, issued a Medicaid number, and of course was never in a medicaid bed..
Dels, I did not mean to imply that your Attorney was not a good one, I just wanted to be sure they were aware of the guidelines since they questioned the payout affecting Medicaid approval, please do not think that I was judging.
continuation to above. Dels, I keep thinking and thinking about what the Supervisor told you. I don't mean to keep on about this but I am just having a hard time with it. I wonder if you worded to the Supervisor just what I said about what does qualify the person, 30 days in a facility, Medical need, and assets, then ask her again if she just means that they would not pay for the room and board but that he would still have the Medicaid when the bed became available and would pay the medication etc. I just wonder if it were worded that way if she would grasp the question as it really is.
I know from experience that she has to be incorrect. I remember one time a friend I had when we went through the process we had to read the part of the Medicaid rules to the case worker showing that the lady's rental house which actually joined the home was not countable, they were going to count it as an asset.
As for the Annuity be sure it is one that cannot be sold or exchanged, either the income stream nor the contract as a whole. They send the annuity to a place that looks at that wording also.
I hate to ramble on about this but I just hate to see you miss out just because someone is not applying the rules correctly. Once you have done all you can then it will be whatever they say in the end but I would not go down without trying.
Well, I now know the where, when and even why dh will be placed. But now I don't know HOW! I got a call today telling me there will be a room available at the Clare Bridge AZ care facility by sometime next week. It's not quite 30 miles from here. They just have to clean the room and replace the carpet, which they do after every resident. When I got the word I actually started hyperventalating. And, this on a day when he is so much more alert and involved with me. It was all well and good as long as I thought about it as being "soon, maybe in a month or so", but now it is real. I feel so bad and just don't know how I'll be able to actually walk away when I take him there. My daughter will be with me when I do and will stay about 5 days after, and that will help, but none of the kids actually seem to realize how this is ripping me apart. Not only that, I have to get his clothes and personal things ready and labeled. I don't even know How many changes of clothes, etc, etc. I've ordered him some flannel shirts and sweat pants, but don't know if they'll be here in time. They prefer that I don't visit for the first few days so he can bond with his new caregivers. I know it's probably best, but don't know if I'll be able to do that. My tears have been flowing all evening. OH HOW I HATE THIS!!!!
Thank you, Jane for your input about medicaid. I have checked it out as you suggested. I have the applications and they will actually start the process as soon as dh is in the facility and will be able to tell me right away how much I will have to "spend down" of my assets before they will be able to start the benefits. I would not have known to do that.
The sales & marketing manager for Clare Bridge facility will make an appointment to come to our house early next week to finish the final paperwork. I'm sure she will give me a better feel for what I need to supply. I know it is the right thing to do and I tell myself not to feel guilty, and this is the best thing for him. However, I'm not sure my "self" will be able to pull it off (Not feeling guilty, that is). Well, I'm not going to worry about it for now, but just enjoy Thanksgiving and having him with me for it. I am so thankful for all they good years we have had together and what a good husband he has always been. And I am thankful for this site, and for all of the wonderful people here.
Gmaewok, yes, it IS the right thing. And of course you feel guilty. I feel guilty about sending dh off to day care this morning, even though I know it's the best thing. Have a wonderful Thanksgiving, enjoy your last few days with him at home, and go for it! Keep posting about how it's going.
gmaewok, we're all here for you as you work your way through this. It will be a wrenching change for you, but it will work out. Your caregiving will continue, just in a different way. I'm so glad your daughter will be with you. I hope you do enjoy your Thanksgiving day with your DH. Don't forget to hang on tight to the rope. We can send more as you need it.
gmaewok, my heart aches for you. I can only imagine how you feel but I know I would feel exactly the same way. I am sending you warm thoughts and prayers.
Hi Gmaewok, I'm thinking about you as you start this transition. It will be okay. Remember that you will be just down the road and you can bring things that he might need as you discover what he needs. It doesn't have to be so final on the day you leave him to stay. It's not like you are dropping him off never to return, right? I'm sending you Pixie Dust.
Gmaewok, just take it a day at a time. You know in your mind that this is the right thing to do but our heart doesn't want to except this. You will still be a loving caretaker only in a different way. I am not there yet but I know it is only a matter of time before this will have to be done. From 5 until I can get him in bed I am ready to put him in the car and take him right then and then and the next morning I say thank you God and start another day with doing the best I can. I will be thinking about you and praying that everything will go smoothly for you.
My heart goes out to you. Placing Charlie was the hardest thing I ever did. You are not abandoning him. You are doing what is best for both of you. The days ahead will not be easy but they do get easier as time goes by. Try to relax and enjoy your time with him, both before he goes and after he gets there,
Gmaewok, I am glad to hear your husband will be going to Clare Bridge, I understand it is one of the best, however our Clare Bridge here where I live does not accept Medicaid, you are fortunate that yours does. I am thinking of you.
Gmaewok, oh how I feel your pain. Just take it one breath at a time. You WILL survive this. I still shed some tears 3 mos into DH's placement. Some days are worse than others, but I always know that this is the right thing for him and really for me too. We have fun visits, I take him to lunch, or bring my lunch and have it there with him. We go for walks, sit outside, go to the computer lab, etc. You WILL find ways to have enjoyable visits. Just put one foot in front of the other and breathe. Feel my arms around you, Susan
Well, I have the exact date of placement now. It will be this Thursday, December 3rd. I just got the call this morning and am literally going in circles. Too much pressure and too much to do to really take time to think of the actual placement and the "after". The facility placement worker will be here Wednesday morning to do the final paperwork and take the first month's payment. Then Wednesday afternoon I will have my respite worker one last time while I go buy a few clothes I'll need to take with him. Wednesday evening my daughter will be here from Seattle and I'll go to the airport to pick her up. Not thinking too much beyond that point. I know I need to calm down, but right now it's "I gotta do this....no, gotta do that first. Is it always like this?
gmaewok, i have a tendancy to overthink and drive myself nuts as you are doing:) take a breath and think of what you must get done to get him lined up for thurs. sweatpants, teeshirts, extra shoes, whatever you need and label his name in them. its not a disaster if you forget something you can always run it up there and leave with nurses later. just relax and think of how many others here have had to do the SAME thing and go thru the SAME daunting stressful days but have come out ahead and are now looking back with less tensions. dont think of after just get thru the process and the drop off and for sure having your daughter there will ease the process. go to a movie and relax if you can. or do a nice lunch as you KNOW your DH would want you to do if he could tell you himself. hugs, its not easy but its for his good in the longrun. prayers it goes uneventful for you both. divvi
gmaewok I've been where you are. Don't worry. There is nothing that can't be brought to your husband later. In fact-it's easier if you start light and add things as needed. A note of precaution-don't bring anything you want to see again. The residents wander and appropriate everything. All evens out in the end.
gmaewok--good luck on Thurs.--I hope everything goes smoothly for you both. I'll be thinking of you. Hoping that once he is in the new place, things will be better.
Breathe sweetie! You will get through this. It is hard, it is emotional, it is necessary. Know that we love you and are here for you. Keep up posted on how you both do, we care :o)
I agree to take less to begin with. Wait to see when he will actually need and how things disappear. When my mom died my sister gave all her clothes for the NH to use which they welcomed. Where my FIL is, his clothes disappear so my BIL just shops the thrift stores for sweat pants and shirts (he would never set foot in a thrift store before).
You will make it and you have great support here from those who have already been through the trauma/heartache of placement.
gmaewok, like all the others said, it is a step no one wants to do but sometimes it`s for his getting the best of care ,one person cannot do it alone, and the caregiver must think of themselves too, it will be hard and tears will flow but hang in there you have your daughter to be with you, let us know how you are afterward, I needed to talk to anyone who would listen and still do, don`t let the thoughts stay in your head talk about them. and yes you can always bring stuff later that you forget. Gail
Gmaewok - I really feel your pain. I know the time is coming soon for me to have to face the same thing. People are now suggesting I begin making plans, but it's so hard. I know exactly how you feel. But as everyone has said here, this is something you need to do. It's for your good and for his. Just follow all the good advice you have gotten here. Take one step at a time, breathe in and out, and keep in touch with us.
Please remember that we are a family and we deeply care about you and all your pain. You are not alone.
Dear Gmaewok: I am also thinking along the same lines...checking out some facilities...not easy to find the right one...This is a hard step in our lives..it is not easy...but it is necessary...Take one day at a atime...I will pray for you...Hugs...Rosalie
Thank you!! Thank you all so much for all the kind words and encouragement. It helps a lot to know I'm not in this alone. I finally did calm down and made a list of things that MUST be done, along with a list of things I'd like to get done before Thursday. I don't feel so paralyzed like I did this morning.
gmaewok, bluedaze is absolutely correct. DO NOT take anything you ever want to see again and that includes a wedding ring and wrist watch if he wears them. Everything disappears; to where no one ever seems to know. I haven't posted for quite some time because I had no news, I guess I have just been lurking. My husband has been in a Clare Bridge since August and if this is the best there is, I am not impressed. I know it could be worse, but I don't have anything to compare it with. When you have to turn and walk away it will probably one of the worst days of your life. Keep your daughter close. I still cry when I leave.
Jane. I took the leap and purchased the annuity and applied for Medicaid. I am still waiting to hear if he will be approved and be given a bed. He has been alone in a "Medicaid" approved room since August, so I don't see how they could possibly say they didn't have a bed available. To cover myself, I found a backup facility that said they would take him if Clare Bridge backed out.
Dearest Gmaewok...I know what you are about to do is the most difficult step we have to take. I am posting to tell you a litle about life after placement. Initially it is heart breaking but it DOES get easier. The time I spend with John is now quality time. I am able to give him hand and foot rubs, take quiet walks, just sit and hold hands. The backbreaking daily routine is taken care of by the staff. I now understand that taking full care of John made me impatient and soo tired. There was no time or energy for the nice things I mentioned. After about 3 weeks I began to sleep better and think clearer. My attitude improved greatly. I began to feel I was moving forward in life not stuck standing in wet cement. Maybe we were lucky John adjusted quickly but I hear more good stories about placement than bad. I take John out about once a week. Even bring him home for several hours at a time. When he's here and I'm saying lift this foot now the other one, oh my goodness your nose is running, please don't let the dog out, John you can't eat that, I know I did the right thing for both of us. Even more important to me is the way he lights up when we return to the facility. He grins from ear to ear and seems relieved to be back. He also gets much more stimulation there than I could ever provide at home. Groups come in to entertain, they have little parties often, and daily activities. If he wanted to sleep away the afternoon at home I must admit I let him. The residents spend very little time in their room except to nap and sleep at night. My heart still breaks everytime I leave but my soul is at peace. I sincerely hope you and your husband find the same comfort John and I have. xox cs
I bring home all of DH's laundry. We haven't lost anything. He on his own left a jacket in the courtyard and it was taken before he discovered it missing. He also misplaced his cell phone and the staff all searched but to no avail. I re-activated an old one for him. I guess we've been lucky. His wedding ring no longer fits, I wear it on a chain with my cross around my neck. I've decorated his room for each holiday, no problems, yet. Fingers crossed.
Oh, thank you all!!! My daughter, Tina and I left at 1:30 to take DH to the care facility. He was a bit uncomfortable at first. He and I sat on a couch in a common room talking with Colleen, the adm asst that did the intake. Clyde kind of rememered her and felt very comfortable with her, but refused to take his coat off for about 1/2 hour. Meantime, Tina unpacked all his clothes and personal items. Then she came and sat with them while I went into his room to put up pictures and things. He basically just sat on the couch observing for nearly 2 hours, then Tina and I were invited to stay for dinner. They set us up in a private dining area with just the three of us. He ate well and then started to open up a bit. When Tina and I were ready to leave the caregiver walked Clyde around a bit. We told him goodbye and we would be back later. He seemed to take it well and just hugged us and said goodbye. (I wonder if somewhere deep inside he knew, or sensed that he was going to be living there now.) Walking out the door was one of the hardest things I've ever had to do. Good thing Tina was driving home. Lots of tears flowed. This is the very best for him, but it is breaking my heart. At this point, though, I think I am hurting more for me than for him. It is so hard being here knowing he will never live here again, and now I am just a "visitor". The caregiver called this evening to let me know how he is doing. She said he did very well, and they all loved him already, and that he has a wonderful sense of humor and would joke and talk with them and the other residents. They got him ready for bed but as of the time of the call he wasn't ready to go to bed. It is so great knowing that no matter the time of day or night he wants to be up "wandering" there will be someone to keep him company. I am feeling so much better about him being there. I am sure he will adjust much better and faster than I will. I think I'm still somewhat numb and the next days and weeks will be a hard adjustment period. We have never slept in separate beds so this will be a new situation, too. We are going back in tomorrow to take his recliner, which he loves, and some of the pictures he has painted to decorate his room better. This site, the ups, the downs, the happy and the sad, the questions and the advice given, the laughs and the tears; they have all helped me make it this far in my AZ journey and I know will continue to buoy me up. Again, thank you all for all the advice and support. I'll let you know how this progresses. {{{{{{HUGS TO ALL}}}}}}
Gmaewok...so very happy the first day went well. I know how you felt going out the door with out him the first time. The second time the fourteenth time and the thirytseventh time will be hard too but it DOES get eaiser. Sounds like the facility has a great staff. That will be a comfort to you in the days ahead. There will be bumps in the road but you've already done the hardest thing any of us will ever have to do. Please keep us up to date on how things are going. xox cs
gmaewok, it's so good to know things went smoothly. You've done a very unselfish thing, giving up your Clyde to a place where there are many people to help take of him, keep him company, provide stimulation. Please continue to let us know how he and you are doing.
Gmaewok, so happy to hear that it was relatively painless. I know your heart is broken. But now you can take care of yourself while still overseeing Clyde's care. I am sending hugs....
Gmaewok - I'm so happy you've come through the first step. I can feel you pain as you walked out the door, leaving your LO behind. But, it is for the best. I know you know that. And it will get easier as time passes. I'm so happy your daughter was with you.
Please know that you are in my prayers. You have time now to heal yourself and your visits will be great. Please keep us in the loop.
Thank you for sharing your "most difficult day" with us. It helps those of us who aren't there yet to understand what may be ahead and how to handle it.
Gmaemok so glad things went well. You are right-whenever Clyde is up and wandering there will be someone there to keep him company, I can remember oh so well the first time I came home to an empty house, aweful, lonely feeling. It will get better.
Gmaemok--I know how hard this has been for you. It sounds like your dh will make a good adjustment. And you will, too. Time will take care of it. I send you love and caring.
I am glad that things went smoothly for you. I am coming up on the 6 month mark since my husband was placed and it does get easier. Knowing he is well taken care of makes the heart break a little easier to handle.
Oh I am so happy to hear how well Clyde is adjusting. What you mentioned about it being harder on you than him is oh so true. I've been keeping busy decorating his room, first for thanksgiving and now for Christmas. It makes me feel better and I think he likes it too. You will find ways to feel more included and less of a visitor as time passes. Now breathe deep, get some much needed quality sleep and enjoy your visits. Arms around, Susan
Thank you for telling the rest of us about your experience. Our daughter thinks it is time for placement for my wife, but, I don't think so yet. Knowing her like I do (56 yrs of marriage), this will kill both of us. I tried to picture you walking out the first time and imagine me doing that. I think you are stronger than I am. At this point, I just don't think I could do it. Because of this, I admire you because you did what had to be done.
Still wishing you well and looking forward to reading your followup posts.