When your home is your castle, it’s really tough to make the decision about going into a nursing home for long-term care.
Can’t you get the same care at home?
For the great majority of West Virginians, their first choice is to stay at home when they need more care.
That can prove to be a challenge. Twenty-four-hour services are expensive. Even when less care is needed, the costs must be factored in. Generally, Medicare and Medicaid will not cover in-home custodial care or help with your activities of daily living, such as bathing, cooking and dressing.
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Under federal law, those who qualify for long-term-care Medicaid are entitled to care in a nursing home. That entitlement is important for those who can no longer live independently and have very limited resources.
Medicare may still cover some nursing home stays but not for long-term care, only for skilled care up to 100 days per spell of illness. A qualified nursing home stay for skilled care can only be covered in full for up to 20 days, and then the patient has a co-payment for up to another 80 days until the coverage period of 100 days ends.
Also, under Medicare and Medicaid, there is no entitlement for in-home custodial care or care in an assisted living facility. Even though home-based care is less expensive and what most of us prefer, nursing home care is the only entitled type of care we can receive.
Low-income West Virginians who are medically eligible for a nursing-home level of care can apply for some home care through the Aged and Disabled Medicaid Waiver program, but it usually has a wait list and doesn’t provide 24/7 care at home.
Staying at home means planning ahead for all of the basics: who will do the laundry, how can I get groceries, what about doctor’s appointments? Will the care arrangements escalate family squabbles?
Also, is there enough money to pay for home care and for how long? Who can be trusted to handle all of the responsibilities? Who can be the back-up when push comes to shove?
Unfortunately, living at home can make a person with some level of diminished capacity a bigger target for financial exploitation. The exploiters don’t care who is hurt. They realize they can get away with it, and proceed to do so. Sad to say, family members and trusted friends can be among those who take advantage.
Those in the community who are concerned about an older person’s physical, financial or psychological situation can contact our state’s Adult Protective Services at 800-352-6513 to report a situation for further investigation.
Once in a nursing home, there are some institutional safeguards. Food is prepared under dietary standards. Help with daily hygiene needs are offered. Secure conditions can provide the safety not available at home. Responsibilities for medical appointments, daily medications and other issues are no longer on the patient’s shoulders. The long-term-care ombudsman program provides advocates for residents to handle complaints about the facility, staff, services or programs.
For families who must deal with the need for a higher level of daily care, working together is the most important thing you can do. It’s not an easy task, but planning ahead through cooperation brings the best results.
If you are a West Virginia resident, age 60 and over, with questions about nursing home or other legal issues, call the West Virginia Senior Legal Aid hotline at 800-229-5068. A staff attorney will assist you at no charge.
Date: July 20, 2018
Source: Gazette Mail