November 2, 2014
November is National Caregiver Month! Every month should be, but nonetheless, let me take a moment to remind you how important you are.
– You give your time and energy even when you don’t have it.
– You have patience and strength beyond comprehension.
– You are creative and a good problem solver.
– You make really hard decisions, and you know how to defend and advocate.
– You’ve been late, missed personal appointments and put your own needs second.
– You worry and your heart hurts, and sometimes you cry.
– You are wonderful and you are just human. Remember that, and please, for goodness sake, take time this month to do something, ANYTHING, for you.
A massage, a nice dinner, a day off with no guilt. Ask for help! You probably do have a friend or relative who will respond if you ask for something specific. Heck, buy yourself some flowers for your desk or table.
And here is a resource for you:
The U.S. Department of Human Services Administration of Community Living and the Administration on Aging have program called The National Family Care Giver Support Program. It gives you information for resources that support you in caring for your loved one so you can keep them home as long as possible.
We’re in this together and I am here to listen, give information and find you as much help and support as I can!
I will leave you with a quote from Rosalyn Carter, First Lady and wife of President Jimmy Carter:
Happy Care Giver Month all!
October 27, 2014
It is rare that I meet with a caregiver who is eager to move their loved one into a nursing home. What I usually get instead, are questions about what kind of help can be arranged at home so they can keep them there longer, and potentially avoid a nursing home altogether.
Here is the best information I can give you about your options for getting help for your loved one at home:
The term “home care” includes skilled nursing care and rehabilitation services as well as what is referred to as custodial care.
Medicare, HMO’s, and your States Medicaid plan will all cover home care services. Of course, you can always get home care by paying for it yourself through a private agency.
Medicare: Part A, B, and C, and HMO’s cover part-time skilled nursing care and rehabilitation services at home as long as the need is considered temporary, the services are approved by a doctor, and the person receiving the care is considered “home bound” (home bound means that the person can not leave the house without assistance and does not mean they must be confined to bed.) The benefit is designed to assist people as they are recovering from an injury or illness and will end once the person is considered to be stable.
Skilled nursing care is provided by an RN who will visit, a maximum of once per day, to help with something like a daily injection, a dressing for a wound or surgical site, or set up and run an IV (yes, this can be done at home). Rehabilitation services such as physical, occupational, or speech therapy, are also considered skilled needs, and are a provided by therapists who make visits to the home as determined necessary and covered by Medicare, probably 2-3 times per week. A home health aide can also visit, up to 20 hours per week to help with personal care like showering, grooming, meal preparation.
Medicare Part A covers this home care when the person is being discharged from a hospital or nursing home stay that was paid for by Medicare and was a minimum of 3 days long.
Medicare Part B covers home care when there has been no hospital stay and services are typically arranged by your doctors office.
Medicare Part C (Medicare Advantage Plans) cover extra services and will likely have different co-pays. You can click the link for more information about Medicare Advantage Plans and their services. http://www.medicare.gov/sign-up-change-plans/medicare-health-plans/medicare-advantage-plans/medicare-advantage-plans.html
HMO’s will have individual benefits for home care services so you will need to read the policy carefully. Most HMO’s base the services they offer on the Medicare model that we have been outlining above.
But please remember: Once your loved one is considered well enough to no longer need the skilled services e.g. the wound is healed or can be managed by a family member, the IV days have completed, the therapy is finished; the home care case will be over and all of the assistance stops. For more information on Medicare coverage for home care go to: http://www.medicare.gov/coverage/home-health-services.html
This brings us to:
Medicaid and “custodial care”:
When Medicare home care ends but your loved one still needs someone to assist them, or would not be safe if they were left alone, Medicaid can offer increased home attendant services on an ongoing basis (not temporary like Medicare/HMO’s.) Medicaid is a Federal benefit for healthcare and every State runs it’s own program. To be eligible for Medicaid you must have low income and limited assets.
At this point in conversations with families, I am usually asked about owning a home, because lots of folks do! You ARE allowed to own your home – this is factored into the application process.
It is important to keep in mind that not everyone will be eligible for Medicaid benefits, or if they are, they could have a surplus of income that must be paid into the Medicaid system in order to receive the benefits. I recommend using an elder law attorney if your financial situation feels complicated to you.
To learn about the specific Medicaid eligibility requirements for your state go to: http://www.benefits.gov/benefits/browse-by-category/category/MED
Of course, there is so much more to talk about when it comes to getting help for your loved (and you!) Stay tuned for more discussion about making home care work for you, other resources, and tips to handle your stress! And by all means, share your experiences with me and and let me know what you need more of!
August 11, 2014
The day before yesterday a woman came into my office. She looked stressed out and on the verge of either losing her temper or crying, could have been either, or both. Her mother had just been transported from a hospital to a nursing home. The reason, according to her was “short-term rehab”. She was overwhelmed. As if dealing with doctors and hospital staff and discharge planners was not enough, now that her mother was settled in her bed in the nursing home, a whole new level of concerns took over, including, but certainly not limited to:
This is just one example of the many things that cause stress for the children of aging parents. Aging is a problem for a lot of us. We spend a lot of time and money trying to stay young and vibrant. Our society values this. I guess it shouldn’t surprise me then, when I encounter clients like the woman I mentioned above.
Aging, and the problems it creates, are well, a problem. And this is where I live. Right where these problems surface; when medical problems exacerbate, causing financial issues to be considered (often too late), and all of this usually leads to an emotional minefield for parents, adult children, and others involved in the situation.
No shortage of issues to talk about here and I am going to dig in. I have a whole bunch of experience and information to pass along and I think this is great place to do it. Stay tuned for weekly posts, and by all means, comment, and offer scenarios that you could use some help with.
Until next time,
Christine Davis, LMSW, ACSW
Certified Life Coach and Licensed Social Worker
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