Posted on 03/15/2008 6:32:40 PM PDT by LouAvul
I have a friend whose wife has Altzheimers. She's fortunate because hers is not the mean type. She smiles all the time and giggles a lot.
But she's in a nursing home.
He also has bad health and had to go to the same nursing home. I almost choked when he told me it was costing them $9000 a month for the two of them.
He had to move out and move in with one of his children. She's still in the nursing home.
What on earth can he do? Do they have any options?
It’s a sad situation. But nursing home care is expensive. They can apply for Medicaid, but their resources will be considered first.
It’s probably too late for your friend, but I’ve advised folks to deed their home to the children and retain a lifetime residence. That way, when the time comes, it can’t be counted as your resource because you no longer own it.
For 9000 per month, he can pay his children to care for them both until their assets run out.
Prayers for your elderly friends. Today everyone has to be aware of the laws and,
unfortunately, inorder to apply for medicaid (gov’t programs) they must have rid themselves of any assets many year’s before they were ill.
We had the same problem with parents and caught the law 8 years before one became ill so we were successful in finding the loophole in the law. It is a very sorry position for the elderly and those that love them.
Democrats will surely change the law loophole if they gain complete power.
Many people are now buying long-term care so that they can have their own insurance and avoid government spend down requirements and reimbursement. People under 40 are projected to have an average $1.2 million dollar expense for these programs.
We had hospice care for my dad through his insurance. A nurse came every day and a careworker came 3 times a week.
The cost of nursing homes is horrendous...my understanding had been that if both the husband and the wife are alive, and one of them is in the nursing home, the spouse not in the nursing home, is allowed to retain the primary residence, one vehicle, and 60K in assets and still will be available for some sort of medicaid grants for the spouse in the nursing home...tho I am remembering from a few years ago, so things may have changed...however, when only one spouse is still alive and in the nursing home, that person is not allowed to have an auto, or a home, and less than 2K in assets...at which point Medicaid should kick in...in other words, a single person needing a nursing home, whether single as a result of never marrying, or being divorced or widowed, has to be destitute, before Medicaid will pay anything....2K total is all that is allowed single folks in nursing homes, in order to qualify for Medicaid...now, I am retired from working in nursing homes, so my own knowledge of the numbers and rules may not be quite current...
The advice given for folks to hand their homes over to their children, while retaining the right to live in the home, , until they can no longer do so, is sound advice indeed...seniors are also often advised to give those things they wish leave to their children, while those seniors are still alive, rather than after they have died...if you have something of value that you intend to hand down to your children, if you dont do it before you die, and then need a nursing home, that valuable will be counted among your assets, and may wind up being sold to pay your bills...of course, one must have complete faith and trust in their children, that they will do the right thing, if the seniors decide to hand over their assets to their children...as we all know, some kids will take advantage of this and it is the senior who will wind up hurt...
A lot of this depends on how these things are decided by individual states, and most nursing homes have some sort of a social service office in their facility, to help folks deal with this sort of thing..
I have worked in nursing homes for years, and saw this financial crunch come time after time...it is certainly better to be informed upfront and before the time may come, when you yourself may need a nursing home...
I took care of both my mom and dad at home, until they died...but not everyone can do that, and not everyone wishes to do that...so for many, nursing homes, will be their final home, and how to pay for that, is something to be wisely considered...
If one of the spouses still lives in their home, the nursing home can’t force him to sell it to pay for the other spouse’s expenses. Medicaid goes back 5 years in your financial history.(Until recently, it was 3) So if they sign over the house to the kids, the parents will still be liable for nursing home expenses before Medicaid kicks in. The dad should’ve stayed at his own house, with maybe one of the kids living with him. For what he’d spend on the nursing home, he could probably hire a private nurse to come to his house.
People should make themselves aware of the unified gift and estate tax credit at the IRS web site.
Also, they need to know there's a five-year look-back at assets which have been "dumped" to avoid the spend-down requirement.
There are agencies out there such as this one that make it possible for you to stay in your home and will cost a lot less than a nursing home.
http://www.griswoldspecialcare.com/serviceslist.asp
The sole surviving spouse can also keep the home when they go into the program if they express their intent to return to the house. Then the bill goes to the beneficiaries.
There’s an excellent book on this subject, “Saving Mom & Dad ... and You”
http://www.savingmomanddad.com/
How about the family?
Medicare/Medicaid could save fortunes if only it would give more support to families that take the do it yourself route and care for family members no longer capable of caring for themselves. Many persons in nursing homes would be far healthier being taken care of by their relatives at home. Sometimes as in the case of Alzheimer's that is impossible though as the patient must be in a security environment.
$4500 a month for inpatient care vs say $1200 in living assistance to families to help care for persons would likely significantly reduce the number of nursing home beds needed. Just giving the caregivers a back up support like a twice a week home health nurse visit would save money as well. Medicare limits that as well. But the nursing homes have a very strong lobbying machine and are not about to support or allow anything that cuts into their profits.
I've worked in nursing homes a total of about 6 years before disability retirement. I have been a home caregiver to my wife for 23 years. She too worked in s nursing home before her disability which is quadriplegia. I would say our number of home health nurse visits in the past 23 years are less than 24 totaled likely less than 20 during that time. As long as a patient is considered ambulatory {able to get out of bed even only with assistance} not much help is given the caregiver.
Personally I'll do everything within my physical and mental capabilities to keep my wife or my parents from ever going into a nursing home. I hope and pray a situation never develops where that is the only option left.
but there is a rub here.....that is, why shouldn't people have to pay for their health care?....somebody has to foot the bill....I don't think its necessarily a harsh thing to expect people with assets to pony up...the money they have is theirs, not their childrens', and they should use it to provide for themselves.....
having said all that, I hope to start within a few years to give more money to my adult children.....because they need it now, when they're young and have all those bills....not so much when they are in their 60's.....if one systematically gives his money away, the less there will be to worry about when you need to go to a NH.
with this economy, does anyone think we could go back to the days when a grandma or grandpa lived with one of the children and the grandchildren?....where you have 3 generations under one roof?
my mother's mother lived with us and its a very dear part of my life....my grandmother developed bone cancer and my mom took care of her....here we had a whole bunch of kids sleeping in two bedrooms and my father not making much money.....but my father loved his MIL...it was a good family situation even while my grandmother died.
“Many people are now buying long-term care so that they can have their own insurance and avoid government spend down requirements and reimbursement. People under 40 are projected to have an average $1.2 million dollar expense for these programs.”
My mother had Long Term Care insurance for 25 years before her death, and never could use a dime of it. The premiums kept going up as she spent $2,500/month on an assisted living facility, but because they weren’t an accredited “nursing home”, her policy wouldn’t pay. For 5 years, she was suffering from stroke related disabilities and Alzheimer’s. The last couple of years she was bed ridden, and then on Hospice care for 5 months, all the time paying for her LTC policy and getting nothing in return.
Obviously, I DON’T recommend LTC policies! A good financial planner can help a family shelter their assets, usually by moving it into their kids names upon retirement. Then medicaid pays for nursing home care and in some cases ALF care.
I have a real problem with that morally. That is stealing. Why should taxpayers pay to keep someone in a nursing home after that person's assets have been given to their children?
My mom is in a nursing home and we are doing everything to stretch her assets. Costs are out of control and one of the reasons why is that there are so many patients there on Title 19, and the state does not pay a sufficient rate to really cover the cost so someone has to make up the deficit and that person is the private-pay person. This is unfair.
“$4500 a month for inpatient care vs say $1200 in living assistance to families to help care for persons would likely significantly reduce the number of nursing home beds needed. Just giving the caregivers a back up support like a twice a week home health nurse visit would save money as well. Medicare limits that as well. But the nursing homes have a very strong lobbying machine and are not about to support or allow anything that cuts into their profits.”
Possibly, but it may just be a numbers thing. If the government were to start paying home caregivers 25% of a nursing home bill, then they would have to pay all the ones that are currently doing it without a taxpayer check. There may already be so many at home care givers and so few that would pull their parents out of the nursing homes for $1,200/mo that taxpayers would pay much more to subsidize at home care givers than we pay for nursing home care. And that doesn’t even begin to address the potential for fraud.
Also, in 5-10 years there would be a powerful “at home care givers lobby” complaining that $1,200 is insufficient and demanding more. No thanks, sound’s like more government expansion and cradle to grave welfare.
We are blessed that she is physically very healthy and has not required much medical treatment. She takes vitamin C and D.
She is proof, too, that second hand smoke doesn't kill. My dad smoked 2 packs a day and died with lung cancer and she breathed alot of second hand smoke.
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