I am doing a trial at a place later this month for 61 yr old DH, late stage 6, and will have a few days of overnight respite for the first time ever. I am exhausted. I think the place feels right for DH, and takes medicaid, but I am so scared to start that process and spend down, etc. After talking to my attorney that's pretty much my only option. I know I can't keep up with a more than full time job, 2-4 hours spent commuting to work/daycare in the snowbelt, and caregiving duties (total incontienence/pacing) much longer.
I wish I could hold out longer for DH's sake and for the financials, but I predict crisis within the next year (my health or his) and then the opening won't be there.
I also find it scary how hard it was to find memory respite care in my city for a week.
dog--I'm not there yet in terms of placement, so I'm sure others will be along who can answer your question about the fear. One thing I can tell you a friend of mine experienced was extreme relief once placement was done and the approval for Medicaid came through. At least then she knew the financial burden for care was taken off her shoulders. If I place my husband it will most likely be a combo of insurance/private pay and I will have to deal with the uncertainty of paying for his care for as long as he lives.
I guess I would need to know what are you afraid of? We all have to make decisions as we progress in this disease. We really have little control, other than the choices we make. I would seek input on those decisions and know that there are no easy decision, but you are doing the best you can do for your mate. Are you feeling rushed to make a decision about spend down so that you can get a medicaid bed? I know that some areas the beds may not be available when you need one. Depending on how much money you might talk to an elder law attorney about options.
I have a question that might be helpful for those of us who are not yet at the place where we need to place a spouse. How far ahead should we be looking and getting the LO in a list. And what happens if he or she is at the top of the placement list of the facility but still can be at home? Do they lose the spot on the list or what and do we have to put some kind of downpayment to hold a space? In my case, my spouse can be left alone while I go on errands but not over night nor if I were to be away. He absolutely knows his home and often remarks " this is the first home I have ever owned" meaning we have no mortgage. So while he knows his surroundings and does not get lost in the house I would be loathe to place him unless there were some medical need like falling or his other health issues play a bigger role...mainly the heart irregularities. I know of places in our area but have not visited them yet. Any suggestions? As to in home help, I would have to scope out agencies and go that route or our CPA could help set up whatever we had to do for all that with holding, payroll etc stuff which I would see as a money pit but might have to consider.
dog, it is difficult to find an adequate memory care facility whose staff is capable of handling the younger AD clients, particularly since most of the clents are elderly and are generally further along in their disease. It is a good thing that you're trying it out for a few days. When I placed DH in an ALF for respite, I was advised that ideally he should be there a week because it takes 2-3 days (or more) before they adjust to the new environment. I believe this to be true, so if he doesn't settle in in a few days it may be because he wasn't there long enough. I understand your fears about the finances. Like Marilyn, we most likely will be private pay for a long time and may never qualify for Medicaid and that scares me because should I survive this terrible journey all our retirement savings will have gone to pay for his care.
Mimi - I was advised to begin looking for a facility at least a year before I needed to place DH. I found one that was acceptable, put his name on the waiting list and was required to put one month's fee ($4000) to secure his spot on the list. I was called several times that they had an opening but we were not ready to place him because he was doing well at home with a 24/7 aide. If he's not ready for placement when they call, just tell them to keep him on the list and go to the next person. In our area, he did not lose his place on the list. After a year, the facility returned my check (they never cashed it) and took him off the list. In home help has worked well for us and even with LTC insurance it is very expensive. Our LTC insurance requires we have an aide through an approved agency and cannot hire privately if we want the insurance to pay a portion of the cost.
Dog, if your husband is a Vet, the VA has nursing homes.... My Dh is in one, It's a state facility, but only for vets and their families. i couldn't be more pleased by the care he's getting. Check your atty also concerning 'right of refusal' which, I believe means, although they take his funds (pension, ss, whatever), they do not have a right to your salary. I am not in that position, but both the ELA and the finance person at the VA mentioned it to me. As for the feelings that you have, Dick has been in the facility since the beginning of March... I cry almost every day. It's not what we ever want to do but I know that he's safe and well taken care of, better than I could take care of him. BTW, if he is a Vet, let me mention, there are a number of younger men there, even in the AD area. Briegull, I would have thought the opposite, that they would want men, because most nursing homes are almost all women. In fact, that's one of the reasons I checked out the VA.... because there would be men. and there are male CNA's as well. Men need to be around other men. More comraderie.
Dog, I am sorry you are facing these impossible choices. In my area there was NO place that would take my husband for respite care. We were also told to start putting his name on lists a year in advance. No matter how prepared you think you may be, you will never be ready to place your DH. Even when my own health was in danger, I still fought it tooth and nail. In truth, I waited entirely too long. In hindsight, I can now see it would have been kinder to place him earlier when he might have adjusted better and been able to enjoy all the activities they offered. As Bob said, there just are no easy decisions. We do the best we can in an impossible situation. Follow your heart and KNOW your choices are made with love in your heart. Its hard, I am thinking of you ♥
Thanks for the supportive comments. Last fall I tried to get him on a list for a top rated home with memory care. After preliminary evaluation they indicated they were reluctant to handle younger male AD patients, even though he isn't violent.
I will be private pay until that's gone and then medicaid, and he's not a vet. I think that is what's scaring me the most even after consulting with an attorney. The whole "bag lady" mentality. The place is a non profit redidential group home specifically for memory, all stages, and will do end of life. The other residents, a mix of ages, male and female, look well taken care of. After working thru a transition, I think he would be ok there. I just wish I had a crystal ball about his future so I could better plan for him and me.
dog--I totally get what you're saying about the finances. People give me pat advice about getting more help or placement--I know they mean well, but what they don't take into consideration is that when the couple is younger, the life span of both the patient and CG may be for a long number of years. It is so difficult to make decisions when you need to ensure that resources will last long enough for both.
chris--I am assuming that what Briegull meant is because there are more women and most rooms are semi private, there are fewer male patients who need a roommate.
MarilyninMD, You just said what I have told so many people, when your loved one gets this disease at a young age then of course the nest egg has to last longer not only for the loved one but also for yourself. I have had many family members and friends tell me I need to start spending, even Hospice keeps wanting me to get more help for me to get out and about. I told our Nurse just this week if I start spending our resources on things like that then I will not have enough when it comes down to either hiring home help 24/7 or having to place him. I told her it is not a bottomless pit here and when they are young the disease although it does not last longer than most it just causes the one left to have to have to make the nest egg last longer, you can't spend it too soon or else bag lady is what you can expect. This disease will bankrupt a person if they start spending too soon.
If I had hired home help too quick then now that I really need the help I would have exhausted our resources as far as me having anything left. This has been 11 years. I have had people tell me I needed to hire a housekeeper so that I would have more time, hire a cook so I would not have to cook, take him to day care etc. WELL, 11 years of that and who would have much left.
To Dog, Don't dispair about the spend down and Medicaid, your Attorney has not briefed you on all you can do, Medicaid will look after the spouse at home. I don't know what State you live in but most are very liberal with the community spouse. You need to have the most money you can have at the time of application, do not let anyone talk you into spending down too soon, much of it is not necessary.
MarilyninMD........I think we must have very simaliar situations. Tomorrow I am meeting yet again with ANOTHER social worker to try to figure out how in the world to pay for NH care for my husband. Again, he receives SSD and LTC (for 13 more months) and the only asset is our house. Right now, due to the LTD payments, he is above the Medicaid level. However, in 13 months, that will be gone........along with any hope of paying a mortgage. Do I try to sell the house? Maybe, but where would we go? It is unlikely to sell for what we owe on the remainder of the mortgage. It is still winter here and NO ONE is looking to buy a house in need of basic repairs!
I spent all of Friday talking with Senator Leahy's office in hopes that they would have some suggestions.....Legal aid? We don't qualify, however, AFTER everything is gone......we will be.......They were the most helpful so far......After 4 years of trying to get this all in order, what the heck am I missing here? He qualifies for NH care, but we can't even cover our own bills...........just basics......The only thing we pay extra for is basic tv and a landline. We are home 24/7. Do I cancel those things too?
No one plans for this, or any disease, but we are being punched while we are down. I am so tired of the same paperwork. At least I am being told that I needn't bother, because we won't qualify. Yet, I have to decide whether we eat or buy medications. Hmmmmm......something's gotta give.
I know I have vented about this so many times and thank you for listening! I have NO idea of why I even try anymore.......
Haven't slept in 3 days.......Maybe sleep would help? IF I make it through this, I promised that if I can help just one person get through the agony of this family disease, my job on Earth will be worth something.
Do you have a spare bedroom and 2nd bath? If so you might consider renting the room out for income. Do you have a life insurance policy on DH? See if you can sell it. Sell off any assets and put the cash in a safety deposit box at the bank. Do they count jewerly for medicaid? Use any skills that you have to get more income. ask your doctor if DH can use generics
Small spare, bedroom but not an extra bath. Husband's major life insurance policy was discontinued with his employeer after being DX'd with EOAD. Thank you Rite Aid! The other life insurance we have is term. We don't have ANY other assets aside from a small 10 year old car. They do count jewelry, but again....not something we have...We are allowed to keep wedding bands.... I have a degree in Elementary Education. He requires 24/7 care. How could I possibly work and even break even to pay for help? As you know, if I was hired out to do this for someone else, I'd be making money....... We do use all generics. Finally have stopped the Namenda. Ironic.......he was a pharmacist.
Keep the ideas coming! Helps me to become more organized. What happened anyway? I was always the queen of organizational skills.
moorsb I fail to see your reasoning for selling any assets and placing the funds in a safety deposit box. If you are suggesting this in order for Medicaid qualification you are way off base with that one. First, if AnnMW1157 sold off assets and did not have records of where the money from those assets went then her DH would not qualify. Second, she will be asked on a Medicaid application if she has a safety deposit box, that is one of the questions, Third, she will be asked if she has any cash, answer these questions falsely and then you have Medicaid fraud.
Let me tell anyone, when applying for Medicaid, you better be honest and up front with everything because they have most bases covered.
AnnMW1157, What State do you live in?
I would not suggest selling your house because the liquid money you would receive from the sale of the home would be a countable asset, as it stands the house would not. You would want to wait to sale the home until your husband was already qualified for Medicaid and the house was in your name alone. You would want to consult with the Medicaid office before even beginning to sell the home.
AnnMW1157--If I was in your shoes, I think I would try to look for a job with the hope of hanging onto your house. (Is it possible to refinance and get a lower interest rate?) Depending on the timing of finding a job, you can then place your husband. If that's beyond the 13 month period and you have all your financial ducks in a row, he will be ok for Medicaid, correct?
Jane--your points are well taken about being careful with spending when a younger person is diagnosed with dementia. I think it is so hard for people to understand because it's a relatively rare situation and differs from the norm.
I am curious, what have people said when you explain why you can't spend more for help at this point? From my experience, they make the comment without considering the financial impact. It's sort of "you have a problem--why don't you fix it" as if that's all there is to it!
I understand what Jane is saying about being careful with spending when your spouse is younger. I had to place my husband because of behavior problems I could not handle alone...when it became clear that I could not afford to private pay any longer, thankfully, the behavior problems have improved. We have been dealing with dementia for almost 10 years now. My husband is healthy other than his mind, so I expect him to live many more years. Hopefully, I will be able to care for him at home. There is no way I could private pay again.
Lynn is on Medicaid, and has SS. I have SS for full disability. That is the only income we have. No savings. No retirement. Lynn use to joke with me that no one could accuse me of marrying an older man for his money LOL. We have the house, (with a mortgage) and I am thankful Lynn had the foresight to put that in my name only. People were ALWAYS telling me I needed to hire help. I couldn't afford to and it put in me in such an awkward situation. I wish people would think before they speak.... if I was able to have hired help, you can bet I would have!
Ann, we had no LTC, so Lynn did qualify very easily based on our income. While doing the paperwork to enroll him in Medicaid, they did not count any assets like jewelry. I wouldn't think such standard things would be different from state to state.
I agree with Jane, it is always better to be truthful. The reason I say that is because these people KNOW all of the laws and they are able to help you IF they have all the facts. I was so afraid we were going to lose the house. But they were very kind and patient helping me understand the laws. They even advised me not to place Lynn in a VA home as they would take most of his SS. Whereas a Medicaid approved nursing home would allow the spouse to keep most of the SS to support the house.
I am not sure what position you are in, but I do remember how very frightened I use to be. I still get very afraid at times. I am not sure how I will support the house "after". Lynn has just a small burial life insurance and all I will have to live on is just my measly SS disability. I am 43 now, and I wont be able to draw on his SS until I am 55.
I am not sure if this will help, but one thing I did was to re-mortgage the house. I was able to re-mortgage for a 30 year loan. This lowered my monthly payment and made life easier for the moment. Is that something you could do to pay the mortgage once the LTC runs out? Or before?
With all the hell we must face with this disease it is tragic we must also worry so much about finances!! grrrrrr
Jane.....I live in Vermont. I don't think that the house should be sold either......Wouldn't that just be considered liquid? I can't imagine trying to sell our house in this market, not to mention the confusion for my husband! I still don't understand the spend down aspect either.....We don't have anything to spend. We can't make ends meet now! How could we spend anything?
MarilyninMD....My husband was working one morning and later that day was told he could no longer work... ever again....per MD. Our son was still in school. We have 7 years left on this mortgage. I am trying to refinance, but after the loss of his income, it doesn't look good. We lost everything that day........in every manner.
Husband was to be placed over a year ago........Every day he declines....I am with him 24/7. I can't imagine changing that now. It has been suggested we look for an apartment and then hope for placement. He can't remember where he is in THIS house......How could I do that to him? If I work, I'd still have to pay for care. I'm not sure I could find something with enough pay. That being said....I'd LOVE to be working OUT of the house!
I've been trying to work this out for years. With 13 months left, I have a feeling that -poof- everything will happen at once. It is unlikely that either one of us can go on like this for another 13 months.
We have very little available to us in Vermont, especially in our county. I really do believe that I have filled out EVERY form at least a dozen times over.
I have a feeling that neither one of us are going to make it out of this situation.
I am still trying to figure out if it makes ANY sense to have the house in my name only......But again, how would I pay the mortgage when I was told that I would be allowed 1000/month total and of that I could spend 1/3 on housing costs? When I talked to the state department about this, they had no clue of who I should talk to. In fact, FOUR people told me that they had never heard of Choices For Care.......and I was calling the number on the top of the form!
Ann, I think it is time to get yourself a lawyer. Now before you get tense (like I did lol) there ARE very good lawyers who can help you for free. I needed to get one for Lynn when I had to get legal guardianship of him. Due to my low income, the court waved all of their fees and appointed Lynn a lawyer.
I am not sure who is giving you this information, but it is different from the information the Medicaid officer gave me in our meeting. And that is why I think getting a lawyer would be a wise choice for you. Based on my disability income, I was given all of Lynn's social security to support the house except for 30 dollars a month for his personal needs, such as hair cuts etc. They helped me fill out all of the forms at their office, and our housing expenses certainly exceed 1/3 of our SS!!
Thanks Nikki........You are right....I need to breath! Prednisone is keeping sleep at bay.......I haven't slept in 3 days. Did I already say that?
Yes, I did talk with the senator's office re: Legal Aid.......Again, we are not within the income limits. The suggestion was just asking for pro bono. The amount of money that I was told I would receive wouldn't even come close to pay for heating fuel, much less the mortagages, taxes or insurance! Yes, Vermont IS expensive and I do hope to move to a small condo in a warm place......someday!
I keep talking about the house.....I don't care about the house as far as having it remain for me. I am concerned about my husband having a place to live until he is placed....If I have to live in a car, I will. That being said, someone has to help my husband in the meantime!
Having Lupus myself, I am very concerned that this may take me before him. Should that be the case, he would have to go into a nursing home.
We did meet with an attorney when he was Dx'd 4 years ago........All of the POA and wills are in place....This attorney did not feel she knew medcaid law well enough to handle the house except for telling us NOT to place it into our son's name.
Question........maybe Jane? If the house can be transferred into my name only, would part of my husband's SSD still be awarded to me for housing costs? ---Love that...awarded! We've been married for 25 years and together for 30. We both have always worked, but I started in volunteer work many years ago....especially when our son was very young.
AnnMW1157 You need to actually go to the Medicaid office and ask questions if you are unable to afford a certified elder law attorney. Dealing with just any Attorney is not acceptable when dealing with this. The Medicaid office will also give you answers and help you. In Vermont you will be allowed $1,821.00 per month to live on as a community Spouse, this can come from his SS to make up the difference in what you alone make. Say your SS is $1,000 per month, then they would award $821.00 per month of your husband's SS to you, to make up the difference.
Medicaid does NOT count YOUR income when you apply for your spouse, only his income and this is only after certain deductions, the complete income is not counted.
You need to make tracks to someone who knows the rules as I find it hard to accept that you would not qualify after the deductions for medical etc are taken into account.
Jewelry and personal items are NOT counted and it sounds to me like you have not been given the whole picture here from people you have talked to.
Can you elaborate on your statement below regarding Medicaid and spend down? I am so clueless on some of this stuff.
"You need to have the most money you can have at the time of application, do not let anyone talk you into spending down too soon, much of it is not necessary."
dog, depending on what State you live in, MOST states will allow the spouse at home to keep half of the resources up to $109,560, so if a person spends down too soon they will have less. Example: if a person has $100,000 in countable resources, not counting the non countable such as home, car, personal items etc. Then the spouse at home would only be allowed to keep half which would be $50,000, in the same Example if the countable resources were 221,120.00 then the Nursing Home spouse is allowed $2,000.00 the at home spouse is allowed 109,560 and the rest of the $109,560 is the part that has to be spent down, with this many States allow the spouse at home to buy what is called a Medicaid qualified Annuity with the remaining $109,560, thus allowing the Community Spouse to keep all the resources.
This is the reason to have more at the time of application, wait until that time to start the spend down.
Dog, I am not sure what State you live in but if you would post that information I may be able to tell you more.
Being 53 years old myself with a DW of 51 years of age who is in Stage 6, I also have a concern about my financial resources. From what I understand every state is a little different in the application of Medicaid. In my case, I did consult an Elder Lay Attorney and received what I hope is sound advice.
My understanding is also that your home is off limits till death. Have you thought about moving up your eligibility for Medicaid by paying down your mortgage? By doing so, the money is "protected", and could be available latter through an equity loan, or sale of the home.
If you were to return to the "paid" work force, would your net income, after paying for care, be greater or less than providing care yourself? It's also my understaning that your income is not counted in determining your spouse eligibility for Medicaid. So.... he could be placed in a NH (if needed), paid for by Medicaid and your income wouldn't be used for the NH. Just a thought.....
moorsb, That is the reason to consult a qualified elder law attorney. the house is off limits unless it has been transferred or put into an irrevocable trust and the look back not made before placement. The House is protected for the community spouse and AFTER the loved one is approved for Medicaid, then if the spouse has POA and can transfer the home into their name alone that spouse can sell the house, use the money, place the house in a joint deed with someone else and Medicaid will not touch it even after both spouses pass away.
There are certain legal ways to avoid the home ever being touched and that is why I keep telling folks get a Certified Elder Law Attorney, they know the Medicaid rules. Don't go by these things that you have heard.
JANE! Before I forget my thought.......I actually understood what you were saying about spend down! I can't believe I now understand that! You make total sense.....However, I am soon to forget this, so forgive me in advance! lol
aalferio.......Certainly it would be great to try to pay down the mortgage, but we never have 5 dollars left by the end of the month. Usually it is a negative amount, 5 bucks would be a giant amount for us. An outside job for me might bring in the income, but would seem that I would break even, at best. I haven't taught for several years, and I would guess that my starting pay would once again be on the lower side. My husband is a very kind man, but only wants me. I should feel important, but I don't!
My husband also have the PCA variant of AD. I am always concerned that not all caregivers understand what different problems this can create. ---If WE are new to this, imagine the lack of educaton of this in the regular community. ---I now carry a printout explaining PCA, should anyone care...--- ;)
We are having yet another snowstorm/blizzard today, so I am having to postpone the 90 minute drive to my husband's neuro office.
JANE.....The woman I spoke with on Thursday. She remembered me from a meeting 3 years ago. She said that she remembered me because of "how much money my husband made"! Can you imagine how I felt with that statement? She told me that we would have to pay $7,477.00/month to the nursing home and I would be allowed an additional $1,000/month for my...as she called it.....alimony. How did she come up with these random figures? For some reason, she thinks that this is more wanting to divorce him vs. doing what is best for his care.
AnnMW1157 Again as I stated in several posts, Vermont is NOT and income cap state, in those states the NH patient cannot make more than 2.022 per month or the rest has to be put into a Miller Trust in order to qualify. Yours is NOT one of those states. They do not count YOUR income. You are speaking is circles. If you have to private pay for the NH then you are not allowed anything for as you say alimony. Something is wrong here. If you make so much money that they remember the amount as being so much then you need to make tracks to an elder law attorney while you have the income coming in.
Jane.......Now you now know how I feel.........It doesn't make sense.
However, I did receive a call from Sen Pat Leahy's office today. As mentioned before, I had discussed this situation with them and after hearing the story, the staff was so upset, they called Legal Aid, Medicaid, etc.. themselves. So, I am waiting for another call to see how to proceed.
I'm sorry I am talking in circles........That is exactally what has been happening. Jane, I am listening to you and not to those in our state who are just trying to confuse me. (easy to do) If they don't understand the law, why in the world am I talking to them? I read the law the same way you stated it. For some reason, no one else does......(here--our state anyway). The first question.....What is your husband's income, what is your income?........Sorry, you don't qualify. At this point even I have had a few choice words for these people.........
Thank you for saying it the way it is.........So glad to know that perhaps I was correct in the very beginning? Thank you again, Jane.
The alimony reply was by the woman who said she knew the law......It was not MY remark. And, if we had private pay and could afford an attorney, there is no way I would have even thought of dealing with this on my own! This woman said I didn't look the part and should start shopping at the dollar store. I said if I had the money to shop their, I would be happy to start! Instead, I use coupons and we eat whatever I can find.
AnnMW1157, I have been thinking, you may be talking to people who think you are trying to apply for Medicaid NOW. You cannot qualify for Long Term Care Medicaid Until your loved one is in a skilled nursing facility. The rules are different for Assisted Living, Home Medicaid etc. You cannot even start the application process until your husband has been admitted to the Nursing Home.
AnnMW1157 Therein ls the problem Ann, Choice of Care is different than when you are already in a skilled nursing home and then apply for Medicaid. I don't believe I am wrong but I could be. I am not well versed in the waiver program that Vermont has. This program has not been around very long maybe 3 or 4 years. I think Vermont also has a straight Long Term Care that does not include the home based benefits. Check into it.
dog, I am not good at this at all, just worked in it for many years and did extensive study. The rules keep changing all the time and it is really harder and harder to keep current.
in your State dog, you would be allowed all that I have previously posted with the exception of the spousal annuity having MAYBE a few more restrictions, be sure to check with an elder law attorney before applying for Medicaid but don't be too upset over the spend down as I stated before, Medicaid protects the community spouse in many ways.
I do think some of the fear a person has is when they hear the stories of how a child had to spend down when they are applying for the parent and there is no spouse left had home, the rules are very different then and much more strict as far as what is allowed and countable, so you see dog, it is all different for different people. Just as in AnnMW1157 case, she is trying to apply for benefits that also allow home benefits and so the rules are different there as far as resources go, I think the most you can have in that situation is around $5,000 at the present time if you are married and if not maybe $2,000. It is like trying to apply for Medicaid while still out in the community.
ANNMW1157--Glad you are finally getting some information. Make sure you get all the info. on home-based care (Medicaid Waiver) vs. Medicaid for long-term care in a NH, because as Jane says, they are different programs with different rules for qualifying, etc. I Googled Choices for Care and it looks like under that program you may be able to be paid as your hb's caregiver. Perhaps that would be your financial solution that would allow you to afford your house payments after the LTD policy runs out. Keep us posted.
My husband was not eligble for Choices for Care in August of 2010 because of a home visit. He had just returned home from the hospital, so I had spent the time cleaning the house and preparing my husband. Everything matched, and I served refreshments to the nurse. WHOA.........was I WRONG! She asked him to get a glass of water........and he did! He hasn't been able to do that for 4 years! She carried on a conversation with him. In fact, as soon as she saw him, she said he would qualify. My husband's neurologist was disguisted with the lack of knowledge of the disease by this nurse, that he contacted her. It didn't work that time. This time he said he will write to the state to try to over-ride the decision, along with my husbands PCP.
When that was mentioned I was suddenly told that he made too much money and would not qualify for Choices for Care. However, if you have ever filled out the form, it is obvious that we would. The people telling me that they are able to make these decisions are not qualified. But again, until he is approved for Choices for Care and in the Nursing Home, as Jane said, would not qualify for medicaid.
One of the requirements for highest care is being bedbound. He isn't. He was for 2 weeks, but my husband had forgotten how to walk. Again, he has the PCA version of Alz Disease which has been compared with AD with blindness. But, he can talk! It may not make any sense, but he can talk. Being from the medical world, his favorite thing to say is......remember the HIPPA law! He can't read or write or identify colors, but he can say HIPPA!
So, at first it was based on a home visit and now it is based on income.......according to the program and the many people who work for the state who think they are in charge.
Since his health has been good, the 3 day hospital stay most likely won't be the situation. After all--last August they kept him 2.5 and sent him home, only for him to return 12 hours later for another 2 days. I've been told it will take a broken hip or the like.
We now have a hospital specialist, who makes the decision who stays in and who doesn't. This is new for us and hard to understand. If his own doctor was able to admit him, he would have been placed 2 years ago, when the time was right.
We are in the same situation as many here.................I am his only caregiver. My health is now poor. But, I only want the appropriate care for him. He is a danger to himself and anyone around him. He needs more care than I can provide. I feel he is slipping even faster because I can't keep up.
This is such a monster disease..........
Does any of the above make sense?
Thanks again!
Ann
PS.....I've heard of the caregiver being paid, which would be hard for me to accept, but it doesn't seem to be available.
AnnMW1157, Until your husband qualifies medically for long term care you are fighting a loosing battle, the Choice for Care that you are trying for is too much like home care as far as resources so when you can go for the long term nursing home care, get your Doctor to fill out an FL2 form and forget the Choice for Care, you obviously do not qualify.
Doctors have (and will) admit a person to the hospital for a minimum of 3 days for medication adjustment..in order to satisify the 3 day hospital stay. Just depends on the doctor you have and if they truly understand the situation.
I did a similar thing the first time Hospice visited. I told her all about Foster and his background and talents and he smiled and nodded,,.. He was dressed to the nines... and he was denied. The second company I called came over, and although my DH was clean, he was not dressed up, so to speak, no iced tea, and I remained silent. Half way through the interview, he had to go to the bathroom. I helped him get up from his chair, and he managed on his own to go with his walker. When he returned, the front of his pants were wet and his zipper was down. He had not been able to either (1) get there on time or (2) didn't pull his pants down enough. We had to excuse ourselves, and change his underwear, and slacks..along with his socks. You guessed it! APPROVED!!! right on the spot. No way could I have known the bathroom incident would have occurred, but it was just one more "check mark" on her paperwork. The first time, I made sure he had pottied before the nurse arrived. You don't want to stage anything, but you don't want to set up the house and LO in an un-natural situation.
I got so tired of always being told "No, you don't qualify" first thing, and had to keep on and keep on until I found someone who would at least consider our situation more carefully before saying NO.
Nancy B, I am not suggesting that Ann does not qualify for Long Term Nursing Home Care, I am stating that it is obvious that she does not qualify for the Choice Program of Medicaid. That is like applying for straight Medicaid and the rules are what they are, if the income is too high she does not qualify. It has nothing to do with his medical condition. If she were to place her husband in long term care then she WOULD qualify I am most sure of that.
The rules are different as night and day, the resource qualifications are what rule, not the medical necessity with Choice of Care.
FLR2 Form? I'm sure his doctor knows what that is, but I'm not. Does it appeal a decision?
Our local doctors no longer have admitting rights. That decision is left to the hospital specialist. The only ones allowed to admit patients are the surgeons. This was all news to me last year after the very special, specialist admitted my husband to the hospital after an ER visit. This too, is the very same hospital my husband started the very first pharmacist dept they had ever had..........(not that it matters)!