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Enshope Asked October 2018

Hubby and I trying to keep 93 year old mother who has OCD and multiple health issues at her home. Any ideas?

Needs 24 hour care. She has severe arthritis, some age related dementia which comes and goes, mobility issues, Gout, and neuropathies...borderline diabetes. We are trying hard to keep her at home because of her OCD. The nursing care is much more than her long term insurance pays out each month. We have been turned down for financial aid because of this insurance policy which is leaving us to pay $10,000 a month! Rapidly depleting her small savings and we need options. It is so stressful. Any ideas? Thanks

DeeAnna Oct 2018
So your Mom has a LTC policy that pays for HOME HEALTH CARE.  Does it also pays for care in a nursing home or assisted living facility?

In regards to the "$330 per day", I am talking about the cost of room & board (room & meals) in a nursing home for a 24 hour day.  Medications are provided by and billed to the resident by an Independent Pharmacy.   The nursing home room & board cost may increase or decrease depending on the resident's ability to perform Activities of Daily Living (ADLs, such as getting into & out of bed, toileting, dressing, feeding self, etc.) and whether the person has any behaviors that need to be monitored such as wandering or emotional outbursts.
According to the website, https://www.payingforseniorcare.com/longtermcare/costs.html#title6: the cost of room & board (room and meals in 24 hour day) cost $330/per day. 

This website also has information about home care and how much it cost and financial assistance for home care.

https://www.payingforseniorcare.com/medicaid-waivers/home-care.html#title1    
Eldercare Financial Assistance Locator
Over 400 programs provide financial assistance for elder care. Help comes from federal, state, and local governments, the VA, non-profits, private organizations, and as many as 50 other agencies.  The large number of sources and different and often conflicting qualification rules makes determining one's eligibility a challenge… By answering a few questions, we help you find the programs for which you or your loved one is currently eligible as well as those programs for which you might become eligible as your situation changes.

Why does "The VA and a local faith based community service look at what is left of the long term policy and think this is an asset so have turned her down for help."?? 

Is the "faith based community service" a "stand alone" Health & Wellness Ministry located in a church or synagogue coordinated by a Faith Community Nurse (AKA Parish Nurse or Synagogue Nurse) or is the service connected to a large medical center/hospital group or company which employs a Faith Community Nurse (AKA Parish Nurse or Synagogue Nurse) who has an office in a church or synagogue?

$10,000/per month is a lot to pay for Home Health Care.  However, it sounds like your Mom's OCD warrants Home Health-type care instead of nursing home or assisted living care.

It sounds like you really need to talk to an attorney who specializes in Elder Care and Medicaid.

DrBenshir Oct 2018
Have you considered hiring a full time aid/companion for her? It will take some work to find someone reputable, but it should cost much less that what you are currently paying.
Enshope Oct 2018
I have had no luck trying to find a live in companion for her. Tried everything I could think of to find one. Two had ads...I did background check to find criminal backgrounds for BOTH!

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Ahmijoy Oct 2018
I agree with Golden23. You definitely need someone on your side in this situation. Medicaid won’t do that. Medicaid’s wheels move very, very slowly. I had to send copies of the same documents to them three times. And then we were denied anyway. Find an Elder Law Attorney to help you. It’s very worth the investment.

Countrymouse Oct 2018
If you are left with a *balance* to pay of $10,000 a month after deducting the ltc insurance benefit, that's some high end care you're paying for, isn't it? I'm not surprised it's rapidly depleting her savings.

How is the OCD expressed? I'm not clear how it relates to the decision about what sort of setting would be best for her care.
Enshope Oct 2018
Hi and thanks for responding. My mother has to have a strong measure of control over her environment. She has her condo just so and complains if anything is moved by a nurse or in a different place in her fridge. She gets very upset about these type of things...yells and shakes. Her doctor thinks it would not be wise to place her in assisted living because of this and also he thinks she needs a lot of one-on-one care which she would not get there. The VA and a local faith based community service look at what is left of the long term policy and think this is an asset so have turned her down for help. I have not applied to Medicaid but that will be very soon. How can I have her stay in her condo, which has a reverse mortgage, yet get her the care she needs? Seems impossible.
DeeAnna Oct 2018
Have you talked with an Elder Care Attorney or Medicaid Attorney about your Mom’s situation? Have you applied for Medicaid for your Mom? Is that the “Financial Aid” that you mention? How much does your Mom’s LTC Insurance pay out per DAY and per MONTH? 

Here are some Medicaid-related websites that you can COPY & PASTE to your browser.

https://www.medicaid.gov/state-overviews/stateprofile.html?state=maryland

https://longtermcare.acl.gov/medicare-medicaid-more/medicaid/medicaid-eligibility/financial-requirements-assets.html

https://longtermcare.acl.gov/medicare-medicaid-more/medicaid/medicaid-eligibility/general-medicaid-requirements.html

 See the Paying for Senior Care website: https://www.payingforseniorcare.com/ for information about possible options available for your Mom. (Copy & Paste URL to your web browser.)

https://www.payingforseniorcare.com/longtermcare/costs.html#title6
Cost of Care Calculator Results: Answer the questions below to see the cost of care in your area.
1 Choose a type of care: Nursing Home Care
2 Choose a state: Maryland
3 Choose a region: Baltimore Area
See Results:   Nursing home care in the Baltimore Area area of Maryland ranges from $330.00 to $330.00 / day.   The average cost is $330.00.

https://www.payingforseniorcare.com/longtermcare/resources/locator_tool.html Eldercare Financial Assistance Locator
Over 400 programs provide financial assistance for elder care. Help comes from federal, state, and local governments, the VA, non-profits, private organizations, and as many as 50 other agencies.  The large number of sources and different and often conflicting qualification rules makes determining one's eligibility a challenge… By answering a few questions, we help you find the programs for which you or your loved one is currently eligible as well as those programs for which you might become eligible as your situation changes.

 Hope that you can find some helpful information on these websites.
Enshope Oct 2018
Hi DeeAnna. Thanks so much...I am going to copy and paste the links to try beginning tomorrow. My mother has so many health and mobility issues and coupled with her OCD, it is hard to even find nurses that she can accept. Her LTC policy pays put $4560 a month and her weekly nursing expense for 3 shifts...24 hour care is about $3250 a week. I have tried different home health care agencies and the average pay is $23 per hour. When you say it is $330 a day ...do you mean for one 8 hours shift? I have three shifts a day. When I tried to cut back with the night shift...my mother called the paramedics to help her go to the bathroom! SO back we went to overnight care.
golden23 Oct 2018
Perhaps you should seek the advice of your local agency for aging and also an elder lawyer who is experienced with medicaid and other such options, Sounds like the insurance policy is getting in the way. Good luck.

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