If you are a senior in need of long-term nursing home care, your Medicare insurance is not likely to cover it. The good news is that if you cannot afford to pay for nursing home care, there is a chance you may qualify for Medicaid. The following are a few things to understand about Medicaid coverage.
You must meet certain income standards
Unlike Medicare, Medicaid was designed to be a welfare program to help the poor in need of health care; for this reason, there are income limits. Those who make more than this maximum amount will not qualify. However, it should be noted that these income limits vary by state. Although Medicaid is a federal program, it is administered at the state level. States may also have different income limits related to the type of long-term care that is needed by an individual.
There are limits to your personal wealth
Although there are certain assets that are exempt from determining your eligibility for Medicaid, the list is a short one. But these exemptions can be complex. For example, your house will likely be exempt if there is a chance you will be going back to live there in the future. In addition, there are rules regarding assets and married couples. But most assets will need to be sold. The thinking is that if you have assets, they can be used to pay for your nursing home care. And this is exactly what is done. If you qualify by the income standard but not the asset standards, you can sell your assets until you become eligible. This is sometimes called spending down. The proceeds of your asset sales will go for your nursing home care. Once you qualify, Medicaid will begin to pay.
Finding a nursing home and filing for Medicaid
Not every nursing home accepts Medicaid. This is important to understand because once you find that you qualify for Medicaid finding a nursing home can be another problem to be solved. If you are already in a nursing home, but have been using your own money to pay for it, the nursing home may provide assistance in filing an application for Medicaid, . However, every state has a medical assistance office, sometimes called a health and human services department. The people working in this office can help you apply and determine your eligibility.
Keep in mind that most people in need of long-term nursing care are elderly and are likely to have Medicare. This insurance is still valuable and should be kept to pay for health care costs. But the room and board expenses of nursing home care are rarely covered. In this situation, Medicaid can be an important option.
One of the most difficult things to face in life is when you realize that a parent is not able to function normally due to confusion and memory loss. While it can be disheartening to you that they cannot remember the simplest things, like their favorite nickname for you when you were a child, it can be downright terrifying when they don’t remember when—or if—they last took a dosage of their prescription medication. Here’s what you need to consider if your parent is showing signs of dementia.
Getting Cognitive Testing
It’s important for your parent to get tested to determine whether their cognitive function is impaired or not. This testing involves a series of questions and tests that can be given by their general care practitioner. If the results show cause for concern, your parent will be referred to a neurologist for further testing. Testing is important because sometimes people try to hide or deny that they are having memory problems, or they may not even realize that there is a problem. The test results will also give a baseline that can be referred back to in the future, and that is important because dementia does tend to worsen over time.
Making the Decision
Typically, when someone is showing signs of dementia, their doctors will suggest that it may not be safe for the patient to live alone any longer. In severe cases, a patient with dementia should not be left alone for any substantial length of time, especially when there are dangerous objects or opportunities around, such as the ability for the patient to leave the house and wander through the neighborhood. And since dementia tends to worsen, it’s a good idea to consider your parent’s living arrangements.
Changing Their Living Arrangements
As with many people in your parents’ generation, your parent may not want to give up their independence completely, and that is why assisted-living facilities are ideal. The staff can bring your parent’s medication to them as scheduled. That way, you won’t have to worry about whether or not they accidentally overdose due to taking their next dose too soon.
The staff at an assisted-living facility will be able to recognize if or when your parent is no longer able to perform daily activities of living, such as taking a bath and feeding themselves. At that point, it will be important to get another cognitive test done to compare against the baseline test to see whether the dementia has worsened.
As your loved ones age, they may prefer to remain in their own home, where they are comfortable and are surrounded by familiar scenery, and they may not want to move to an assisted-living home. When you are not able to provide your loved one the safety and attention they can have in an assisted-living home, you can use these tips to help you convert your aging senior’s bathroom.
Convert the Toilet
By adjusting the toilet height, you can make it safer for an aging senior to get on and off the seat without injuring themselves due to slipping and falling. A standard toilet seat sits at a height of 17 to 19 inches, and it can be hard for an elderly person to squat to sit themselves on the seat. To raise the toilet seat’s height, you can remove the standard-height toilet and install a new toilet with a taller pedestal to raise the height of the seat’s position. Then, to supplement this alteration, it is best to install grab bars around the toilet to aid your senior with using the toilet.
Or, as a second option, you can install a toilet seat riser, which attaches onto the top rim of a standard-height toilet. The riser mounts onto the rim of the toilet seat, adding several inches of height to provide stability and eliminate excessive bending and squatting when your senior uses the toilet. Then, many of these toilet-seat risers come with arms on either side in place of grab bars to aid your aging senior in climbing on and off the toilet.
Install Grab Bars
Grab bars in your bathroom can help keep your elderly loved one from falling when using the toilet facilities. To install grab bars around your toilet, you should follow the ADA’s recommendations for installation to make the bars as accessible as possible. The ADA recommends you install a grab bar on the wall behind and on the side of a toilet at a height of 33 to 36 inches. Then, the grab bar installed behind the toilet should be at least 36 inches long. The grab bar installed on the wall to the side of the toilet should be at least 42 inches long.
It is a good idea to install the grab bar’s attachments into studs behind the bathroom wall. This is to help anchor the bars to support the weight of someone using them for assistance. An electronic stud finder, which you can buy at most home-improvement stores, will help you locate studs in your bathroom walls.
Use these tips to make your senior’s bathroom more accommodating for their needs.
If your parent is no longer in a position to live on their own, and you are investigating assisted living facilities, then you need to make a checklist of what the facility needs to have. Some places will have more features than others, so it’s important that you know ahead of time what your parent will have once they move in. Below are three important things you need to make sure that the facility has.
Round-The-Clock On Site Medical Personal
You want there to be on call, twenty-four-hour medical support. This is very important for a facility that houses elderly people. This doesn’t mean that there needs to be a doctor on hand in the middle of the night, but there should be at minimum a night nurse. In a case where there is a medical emergency, seconds count and while the paramedics are traveling to the facility it is important that there is someone there who is capable of administrating medical help.
Housekeeping and Dining Services
This is not a life and death issue, like round the clock medical care, but it is still something that needs to be considered. You want to make sure that there are laundry services and housekeeping services in the facility. Some places might only have laundry machines and expect the residents to do their own wash. While this might be alright for some people, others might not have the strength or mental ability to handle this task. That’s why you want to make sure that the facility has the option of housekeeping. This way you can be sure that your parent’s cloths, linens, sheets, and other items are kept clean.
Likewise, there should be the option of eating in a dining room setting. Some places will have kitchens in the residents units, but it’s also important that they offer meal plans for those residents that don’t want to cook.
Dementia Care Unit
You should also look for a facility that has memory care services and also a dementia care unit. Some places will have a separate wing dedicated for residents who have dementia. This section might be reserved for patients with severe memory issues, including dementia, so that they are not mixed in with other residents. The staff will understand that they need more intensive care. The benefit to having the dementia unit located on site is that your parent won’t have to go through the emotional turmoil of moving to a complete new location when they begin to develop severe memory problems. They can just move from one floor (or wing) to another. They will likely see many of the same people (staff, residents) and it will not upset their routine too much.
When a loved one has been diagnosed with dementia, this doesn’t mean an immediate move to a nursing home for supervised care. People in early stages of dementia can still live home independently, with some safety measures put into place. Once the dementia progresses, it will be time for a more structured environment such as assisted living or a nursing home. You can set up your loved one at home where they have the support necessary to remain independent as long as possible. With medication reminders, meal delivery, and rides to doctor appointments, a person dealing with early dementia can remain at home with help.
Assess Their Ability in the Kitchen
One way many people learn that they are having memory problems is a newly developed inability to prepare a meal. It will start with forgetting that a pan is on the stove, or a meal is in the oven. It’s easy to get confused when you have dementia, even when you are able to keep yourself safe at home. If your loved one has trouble cooking, you can prepare meals ahead of time or have a meal delivery set up. Unplug the stove to remove the fire hazard and make sure they have a microwave to heat up meals.
If Your Loved One Still Drives
Another early sign of dementia is getting lost while driving in places that are familiar. If your loved one is still driving, it is likely time to consider whether they need to stop. To keep your loved one and others protected, you will have to have the conversation about no longer driving. This is a hard conversation, but if your loved one wants to remain living independently, it’s important to keep them safe from their own inability to drive safely.
Know When It’s Time to Move to a Higher Level of Care
While you can keep a loved one with dementia safe at home for awhile, you have to know when it’s time to move to a higher level of care. If your loved one begins wandering frequently, getting lost, or is fearful about living home alone, it’s time to find a more appropriate level of care. When your loved one is no longer to take care of their daily living needs, they will benefit from an assisted living facility or nursing home. While it’s a hard decision to make, the safety of your loved one is the most important aspect to consider.
Assisted living doesn’t equal full-on nursing care. If your parent (or grandparent) is heading out of an independent living situation, exploring assisted living facilities is likely to be on your agenda. With that in mind, knowing what to look for is an essential part of the process. You’re already on the hunt for a clean community that respects senior citizens and has well-trained staff. But what else should you add to your list of requirements? Check out these not-so-obvious points to put on your assisted care search checklist.
The majority of assisted living facilities in the U.S. meet strict fire safety standards. Ninety-seven percent of those built after 1996 have sprinklers in both common area spaces and resident rooms, according to the National Center for Assisted Living (NCAL). Each resident room (and shared area) should have a functional smoke detector. The facility should also have a posted evacuation plan.
Ask the facility staff what types of socialization opportunities they offer. Are there book clubs that meet once a week? Maybe there’s an afternoon dance club? Spending time with other residents and staying social is important to your loved one. Make sure that mom or grandma has the chance to meet other people and get social every day.
The learning process never ends. There’s always a new fact, concept, or skill to pick up on – no matter what age you are. Find out if the facility offers classes, lectures, or activities that promote learning. This could include anything from a guest lecture on WWII to a painting class.
No one wants to go out in the middle of a mid-February snowstorm to get their hair done. Some assisted living facilities have on-site services such as hair stylists that come to the resident’s rooms or even a full-service salon. Other services that the facility may have include an in-house medical office or even stores for some light shopping.
Staying fit and active is just as important for senior citizens as it is for you (maybe even more). That said, your 90-year-old grandmother probably isn’t out running a marathon or bench pressing her own body weight. Even though rigorous exercise isn’t on the activity menu, you still want to make sure that the facility offers physical activities that are appropriate for your loved one’s fitness level. This could include a chair aerobics class, water aerobics, swimming, or yoga.
Picking the ‘just right’ assisted living facility takes time and careful questioning. As you visit residencies, dig deeper than just the surface questions. Go beyond, “How many nurses do you have at any given time?” and ask about the safety and program features that will keep your senior healthy, happy, and active.
If your elderly parent recently fell down the stairs in their home and broke their hip, it’s time to take action. Once they have gone to the doctor and the fracture has been treated, you need to work with your parent to decide what will happen next. If they plan on staying in the home, then you need to make the home more appropriate, and you will also need to organize outside treatment. If they will no longer be living in the home, then you need to figure out where they will go.
They Will Be Staying in the Home
Retrofit the Stairs with a Lift
If your parent is going to stay in the home, then you need to deal with the stairs. Even when their hip has healed, they won’t be able to comfortably walk up the stairs again. Also, you don’t want to risk another fall. So have a stair lift installed. This will allow them to ride a small chair on a rail up to the second floor.
You can help them get back on their feet by arranging for a stay at a short-term rehab facility. This will allow them to have intensive guidance and help from expert rehabilitation specialists. They will learn how to move so that they don’t endanger themselves by taking quick or awkward steps. Also, should they need to use a walker or cane, they will learn how to do this at the rehab facility.
They Will Be Leaving Their Home
If you and your parent no longer think it’s safe or appropriate for them to live in their home, then you should investigate an independent or assisted-living facility. These are not quite as severe as nursing homes, and they don’t sound as scary. Your parent can have their own apartment in the facility. These spaces provide easy access to medical professionals. They will also have on-site washing services so that they don’t have to handle laundry or vacuuming. Additionally, they can take advantage of the dining room, and that eliminates the need for them to cook their own meals. These facilities will often have transport to take the residents into town to shop or see shows or other entertainment.
If you find an independent living facility that also has an assisted-living wing, then your parent can easily transition from one area to the other when the time comes.
Alzheimer’s disease is a progressive, incurable disease that slowly takes away one’s ability to care for their own needs. In the beginning stages, a person may only experience slight forgetfulness as they go throughout their day. Some often feel as though they are just aging normally, being a little confused every once in awhile but able to manage most of the time. As the disease progresses, people become more confused and more likely to get lost while out on a familiar route. They may start to have trouble cooking, leaving hot pans on the stove to burn while they begin doing something else. Once the disease has progressed to this stage, many people find that assisted living is the next logical step.
Why Assisted Living is the Answer
It’s important to give anyone who is dealing with Alzheimer’s disease as much independence as possible but help them to remain safe at the same time. Assisted living facilities offer daily support, medication reminders and meal preparation for those dealing with mild to moderate impairments but who are still able to perform basic daily living skills like dressing, grooming and bathing. In assisted living, residents are able to live in their own apartment but have staff come in to check on them to make sure they are safe. As meals are prepared for everyone, each resident has the option of community meals three times a day. People who are dealing with the progressive nature of Alzheimer’s don’t have to feel alone in their struggle.
Assisted Living and Dementia Care
As a person living with dementia becomes more confused and less able to remain safe while on their own, most assisted living facilities will have a dementia care unit. This means that residents on this floor are more closely monitored and kept safe with alarmed doors that lead off of the unit. While this is restrictive, residents are still expected to do their own personal care, and they will have their own apartment on the unit. There is often a fine line between a dementia care unit in assisted living and nursing home care, but as long as a resident can take care of their own grooming they are appropriate for an assisted living facility.
If you or a loved one are in the beginning stages of Alzheimer’s, it’s important to plan for the future. Set up an appointment to tour an assisted living facility, like Haven Care, and see what your options are before you are unable to make the choices for yourself.
The decision to move your parent into a senior independent living community is a difficult one, but one that could provide him or her with the help needed. Before moving into the facility, you and your family have to make a plan for paying the costs. Here are some ideas that could potentially help with the costs.
If your parent is a veteran, he or she is most likely to receive benefits that would help with covering the cost of moving into an assisted living facility. There are several benefit programs available. Talk to a counselor at the Veterans Administration (VA) to determine which programs your parent would be eligible for.
To qualify for benefits, your parent will need to meet certain income requirements. Depending on the program, your parent might also need to show that any disability that he or she has is connected to an injury received during service.
Before contacting the VA, you need your parent’s Social Security number, his or her income documentation, and a list of assets that he or she has. You also need a copy of any insurance your parent has. By having this information ahead of time, you can avoid a delay in processing his or her documentation for assistance.
Some people use a reverse mortgage to help cover the costs of an assisted living facility. A reverse mortgage gives your parent the cash value of his or her home in a lump sum or monthly payments. The money owed to the lender is not due until after your parent has passed away. At that point, your family can choose to sell the home to pay the balance.
There is a catch to a reverse mortgage though. A homeowner has to remain in the home. Some families choose to add a family member to the home’s deed and he or she move into the home while the elderly parent is allowed to move into the assisted living facility.
If the family member wants to continue to live in the home after the parent has passed away, he or she will need to pay back the balance of the loan. Using any funds received from the life insurance policy is an option that is available.
There are many other options available for covering the costs of assisted living. Consult with the financial aid counselor at the facility you are considering to learn which options would work best for you and your parent.
Contact a center like Mayfair Village Retirement Community for more information.
If you have come to the point in your life where you need a bit of help with your daily routine and have decided to move into an assisted living facility, you are probably a bit nervous about the move and your new home. Here are a few tips to help you have a smooth transition so that you and your family are happy with your decision.
What to Bring and What to Leave
As you are packing your belongings, remember that you are probably not going to have as much space in an assisted living facility as you do in your current home. While it is important that you have your own things, you need to ask what will be provided for you. If they provide items that you already have, you may be able to ask them to remove their things so you can bring your own. However, before you do, make sure that yours will fit. Ask to go to your apartment and measure the rooms. You do not want to get there with your things and realize that they will not fit. However, pack all the little things you want. If there isn’t room for them all to be out, you can store them and rotate them throughout the year.
While some of the residents will make a point of seeking out newcomers, you need to be willing to make the first move too. Read over the event calendar and make a point of attending the activities. This will give you a chance to get used to the people and decide which things you like to do. Now is not the time for being shy. It is okay to take a day or two to unpack, but the sooner you get involved, the more the place will feel like home.
Your apartment is your home. You do not have to open the door and let others in if you are not comfortable with it. Meet people in the common areas and get to know them before inviting them in for a visit. Of course, you can have your family and friends from outside the facility in to visit as you please too. Keep in mind, depending on the type of assistance you need, the staff may have a key to your apartment. Of course it should only be used when there is concern you are inside but cannot answer the door yourself.
Assisted living communities provide you with the bit of help you need, but allow you to remain independent at the same time. Do not worry if you feel a bit depressed or sad when you first make the move; this is completely normal. If you find you are having trouble getting out of the funk, ask the staff for help getting involved. Once you get into the swing of things you will wonder what you had been so worried about.