Archive for the ‘Health’ Category
Applying for benefits
Posted by Hometownpulse | Filed under Elder Care, Health
APPLYING FOR BENEFITS
If you are applying for Medicaid benefits, you must prove that you do not have the ability or means to pay for your own medical care. The Medicaid process has been likened to the auditing process of the IRS. You will need to complete a lengthy questionnaire, disclosing all assets and income, as well as providing verification and documentation of your assets, income and personal affairs. You will be interview by a Medicaid caseworker whose goal is to get a “snapshot” of your current situation based on income, resources and expenses. Upon gathering the information, a decision is made as to whether Medicaid will approve you to receive benefits.
What are some of the things Medicaid will need to see at the time of application?
- Identifying information such as Birth/Baptismal Certificates
- Medicare, Social Security, Insurance Cards
- Verification of Marital Status: Marriage Certificate/Divorce Papers/ Spouse’s Death Certificate
- Power of Attorney Form
- Guardianship Papers if applicable
- Deed to House/Automobile Title
- Veteran’s Discharge Papers
- All statements of all resources (stocks/bonds, CDs, bank statements, etc) going back 36 months; with
- Explanations of all deposits or withdrawals $500 and over
- Verification of all current income
- Verification of trusts created in the past 5 years;
- Verification of a prepaid burial plan (preferably in the form of an irrevocable burial trust*)
- Verification of face and cash values of all life insurance policies (Medicaid currently allows for $1500 of life insurance in addition to a prepaid irrevocable funeral trust)
- Any unpaid medical bills (retroactive 3 months)
- Verification of health insurance premiums –Statement of Medical Necessity from a doctor to verify the necessity of long term care services
- Current PRI (Patient Review Instrument) for SNF/rehab facility admissions
Medicaid works in conjunction with Medicare and may pick up necessary expenses that Medicare and other programs do not cover.
Expenses that Medicaid May Cover Include:
- Personal Home Care
- Personal Emergency Response System
- Nursing Home Care
- Prescription Medicines
- Dental Care
- Routine Foot Care
- Medical Supplies/Equipment
- Health Insurance Premiums
- Preventative Health Care
- Hospital Care/Clinics
- Medical Day Care
- Transportation to and from medical appointments
There are also special programs available to those on Medicaid from outside agencies that will help with personal budgeting such as reduced rates for telephone service and Meals On Wheels.
This Is My Friend, My Care Manager
Posted by Hometownpulse | Filed under Elder Care, Health
This Is My Friend, My Care Manager
When Grace found herself ill-at-ease after her husband’s funeral, it was, of course, due to the fact that she would face an uncertain future without her companion of 60 years. The other reason was the fact that she had to say goodbye to her children who had come home for the funeral–one from Texas and one from California. Who would be attentive and understanding enough to be there for her if something went wrong? Or if she just needed a shoulder to lean on. Lord knew her friends and elderly relatives had lives of their own.
Fortunately her son, John, did some research and eventually enlisted the help of a local geriatric care manager to oversee his mother’s needs. The geriatric care manager had assisted in finding the most suitable nursing home for Grace’s husband earlier the previous year. The care manager had helped the family to know what to expect from the nursing home while offering support to Grace who was home alone and fighting off a natural tendency to be clinically depressed.
As John flew home after the funeral, he breathed a sigh of relief that someone nearby would check in with his mother regularly and alert family to any specific concerns. In the months that followed, Grace and her care manager developed a trust and a rapport. The strength of care management is in the ongoing consistency of a good relationship.
After her husband’s funeral, Grace began a difficult struggle– defined by a lack of motivation and perspective that comes when one is bearing a seemingly insurmountable grief. A devoted friend agreed to stay with her for several days following the funeral. One day during the course of the care manager’s visit, Grace had a period of unresponsiveness that landed her in the hospital. A week later she was transferred to another hospital for treatment by her medical specialist. Five weeks later she was transferred to an assisted living program and eventually returned home.
Her care manager was with her every step of the way to coordinate moves and services and to communicate with Grace in a way that she could understand the plans, goals and necessities of each step. The care manager communicated realistically with her family as to how she was progressing so that they could offer support and understanding. The care manager communicated with the doctors, nurses and other professionals to help them understand Grace and, in turn, helped Grace to understand them. To help them determine her personal needs; to help her to follow their orders and direction based on those needs, the care manager supported Grace through her transitions ensuring that her needs, rights and preferences were respected.
Grace has been home nearly 8 months now and with the support of neighbors, friends, family and her care manager she has found ways to stay inspired. She takes one day at a time. She is a survivor. And with the presence of her care manager she has learned a very important lesson. That you can never be too old to make a new friend or to share of yourself. After all, it is often in adversity that we make our dearest friends and learn our dearest lessons.
99 Year-Old Covers All the Bases
Posted by Hometownpulse | Filed under Elder Care, Health
99 Year-Old Covers All the Bases
When 99 year-old Betty found herself in the hospital with a broken hip, she wasn’t surprised when she was told that a nursing home was her only choice. Betty had never married, had outlived all of her family and most of her friends; those friends who survived were elderly and had problems of their own. She had some confusion as a result of the anesthesia, combined with some general disorientation from being in the hospital to begin with — not an uncommon occurrence. She wanted desperately to return home. No one seemed to listen to a confused 99 year old woman.
Enter her attorney and her bank financial trust officer. Betty had chosen wisely when she entrusted her affairs to these professionals. Not only did she have her will in place, but she had advance directives which stated that “at all costs” she wished to remain in her own home. She had a financial plan in place which ensured that her money would be managed and invested wisely on her behalf.
These professionals advocated for Betty, but were repeatedly told by the hospital that there was no other choice. Going home was too risky, to unsafe, too complicated. They contacted Kate McGahan, care manager at CNY Elderplanning to intervene. Two days later, with the help of her team of advocates, Betty returned home. The care manager created a plan of care and coordinated services which included 24-hour nursing care, Medicare services to monitor her condition and to provide physical therapy, and various social and housekeeping services. Betty learned to walk again, the confusion from the hospital lifted and soon she was beginning to resume most of her old schedule. While she could have received the services in a nursing facility, at home she was at peace with herself and rested easier to prepare for the daily demands of rehabilitation.
The important things that Betty did were the following: (1) She carefully selected professionals who would provide expertise with compassion at the same time; (2) She made certain that these people would understand and carry out her preferences and directives; (3) She stated these directives in writing; (4) She planned carefully for a financial future that could pay for her necessary home care services.
Betty celebrated her 100th birthday and continues to live happily in her first and final home. Without the right planning, she may have been lost in the shuffle of the healthcare system. While hospital and community professionals offer support and personal service, these qualities can get buried in the face of efficiency, reimbursement issues, risk management and other factors. It is imperative for everyone who faces aging and the possibility of confusion or incapacity to have desires in writing so that those desires can be respected. Sit down with your family, if you are fortunate enough to have one, and make your wishes known. Seek out respected professionals who can objectively guide you in your decisions– a lawyer, a financial officer, a care manager. Don’t hesitate to include long term care insurance agents and estate planners. It’s never too early to plan for an uncertain future.
Email Request For Advice
Posted by Hometownpulse | Filed under Elder Care, Health
Email Request For Advice
Dear CNY,
I am the adult child of an aging parent. I am nearly 56 years old. My Mom is 77. Mom recently came up from Florida… where she remained at a nursing home for approximately eight months after hip replacement surgery. She was temporarily residing at a Personal Care Facility while being medically evaluated, when she became ill this past Saturday. She has been hospitalized ever since. She has pneumonia. Also, other ills including OsteoArthritis and Osteoporosis and Incontinence. She does not wish to return to a care facility. We have discussed this. She wants to live with me. This is agreeable to me. I will have to move, as my place is townhouselike having many, many steps and also, there is only one bedroom and one bathroom. Can I get help for her in the home? She has Medicare Parts A & B. I want to be able to extend to her the dignity and quality of life in her golden years. I don’t know what to do or how to do it. I am an only child. Can you help? I would appreciate some input. Any input. I feel so alone and as though I am crumbling. I need a lifeline. I need to be strong for my Mom. Thanks for listening. I hope for a response from you and will look forward to it.
Sincerely yours,
Dear One:
I appreciate hearing from you and very much appreciate the situation you are faced with in caring for your mother… and caring, somehow, for yourself.
If your mother is currently in the hospital, you should ask for guidance from the Social Worker or Discharge Planner — and ANYONE else on staff with whom you may have connected during her stay there. It is important to know what she can and cannot do for herself so that you can make a realistic assessment of what kind of living arrangements will need to be made to accommodate her.
Depending on your locale, there may be a geriatric care manager (such as myself) who would be available to guide you objectively in these huge decisions.
Unfortunately Medicare Part A will pay only for hospital or nursing home care; while Part B will continue to pay portions of doctor, labs, Therapy bills, etc….., Medicare does not usually cover extensive care in the home. She may receive some covered services for a limited time upon returning home from the hospital.. you will need to ask the social worker/discharge planner/care manager. Make sure your mother doesn’t have a long term care insurance policy somewhere that covers nursing home and home care… more and more older people have such policies which can often take care of the majority of the bills.
My best advice for you - not knowing you personally- is to involve knowledgeable professionals who can help you be sure that you are making a realistic decision. Don’t lose sight of the fact that, while you are her daughter and you want what is best for her (that comes through loud and clear and I respect you for that) — be sure to find a way to have a life of your own at the same time. I have seen too many loving children “burn out” as primary caregivers for their parent(s) and have suffered themselves and ended up needing help themselves. If you can, hire professionals to do the actual CAREGIVING; try to focus your role as her daughter and you will find yourself much more resilient and caring and capable and healthy in the long run.
Be sure to reach out to any supports you may have: friends, extended family, support groups for children of aging parents. As an only child, it can be a painful and lonely experience with no one to share and commiserate with.
If you email me your approximate location, I will try to find someone who can guide you who is a member of the National Association of Professional Geriatric Care Managers. There may be any number of people there who will be happy to talk to you in a free phone consultation. If you want more they will help you to sort out the options, financing and, at the same time, support you and your mother in the process. Do whatever it takes so that you don’t feel so alone in this. And please feel free to keep in touch with me if you find it beneficial. I am happy to offer my support, limited though it may be.
Kate
Home Care services A La Carte
Posted by Hometownpulse | Filed under Elder Care, Health
HOME CARE SERVICES A LA CARTE
Many programs and services are available that may make it possible for an older person to remain living independently in their own home. Some of these services are as follows:
Home Health Care
There are certified and licensed agencies which employ nurses, physical and occupational therapists, social workers and aides to provide personal care assistance in areas ranging from catheter care and dressing changes to assistance with medication and bathing. Costs may be covered by Medicare, Medicaid, Medigap and Long Term Care Insurance.
Respite Care
Respite care provides relief to caregivers who have the responsibility of caring for an aging (60+) family member at home. Respite care can be provided either at home or in a residential facility for a period of up to 6 weeks. Short term respite is also available for those who need relief for just a few hours on a given day.
Day Care
Day care programs provide a variety of services including recreational and social activities, meals, personal care, physical/occupational therapy and counseling. Some programs specialize in caring for frail, older adults in need of supervision, such as those with Alzheimer’s Disease and other forms of dementia. Some are designed for those who have physical limitations. Many programs provide transportation. In New York State, persons with lower incomes may be eligible for partial or full reimbursement by Medicaid or Social Services. Most long term care policies cover Day Care.
Companion Care
Companion Programs provide a home companion to assist with personal care, housekeeping and laundry, meal preparation, chores and transportation to appointments. In most cases these services are not covered by insurance. Local social service agencies often provide homemaker services on a sliding fee scale.
Private Caregivers
Many people choose to hire a private duty nurse or aide or companion. Good caregivers can be found in every community by word of mouth, church bulletins and advertising. Be careful with this process, however. Without the “agency oversight” there is no recourse, no quality assurance and no coverage if the private aide does not show up for their scheduled time. Refer to the book Hiring Home Caregivers by D. Helen Susick for more detailed information.
Home Delivered Meals/Meals On Wheels
Meals can be delivered to those who are unable to cook for themselves. Meals are usually delivered by a volunteer once or twice daily, Monday through Friday. Kosher meals may be available. A nominal fee may be required, usually based on the ability to pay.
Emergency Response System
A device can be worn by the older adult which makes it possible to “ring” for help simply by pressing a bracelet or necklace pendant. When triggered, a message is sent to a response station that immediately phones the older adult. If there is no answer, there is are specific contacts (family, friends, neighbors) that the response station will contact to alert of the problem. If there is still no answer, an ambulance is immediately sent to the person’s home. There are usually a number of programs in each community that provide this service and can often be easily arranged through a hospital, home care agency or through your geriatric care management professional.