Posted on Wednesday, March 16th, 2011

Don’t Ever Put Me into a Nursing Home

Did you ever hear that from your mother, or someone a generation ahead of you?

Have you ever heard a doctor, or hospital social worker, firmly say “She can’t go back home, it just isn’t safe for her to live alone anymore”?

What do you do when you hear both these warnings, one after the other?

Sometimes there is no real conflict: there is a family member willing to move in, or perhaps already there, who has the ability, the time, and the willingness to provide the extra care after an older person has had a stroke, heart attack, accident, or anything which now means the end of independent living. Problem solved – for now.

In most case, it is really “problem postponed”. Despite the most devoted and competent care, there may be another stroke, another fall, pneumonia, the totally unexpected – and then a forced reappraisal. Now there may be a need for round-the-clock attention, the trained personnel and equipment that exceeds what can be provided at home.

The current cost of nursing home care in our area ranges upward from $8,000.00 per month. That’s around $100,000.00 per year. This may be another reason many older people don’t want to be put into the nursing home. By now, most people also realize that you can’t transfer your home, bank accounts, etc., to family members on the eve of admission to a nursing home, and become eligible for the government to pay your costs. Most also are aware that Medicare, available to everyone over 65, does not cover long-term care, such as in a nursing home.

In another twist of the knife, it is probably also too late to compensate the loving and devoted family member who provided those weeks, months, even years, of care which staved off the nursing home. Without a specific written contract explaining the need for care, and setting forth the services and basis of compensation, such belated payment would disqualify the ill or injured person from government medical assistance.

Those monthly nursing home bills will now have to come from the resident, until her savings and resources are “spent down”, to as little as $2,000.00. Only then will Medicaid assume the payments. If she had a home, there will be a medical assistance lien on it so the government can be reimbursed for what it paid the nursing home. When the nursing home resident dies, age 55 or older, any assets remaining will be subject to the priority claims of medical assistance provided during her lifetime – called “estate recovery”.

It doesn’t have to be that way. There are provisions in the law and regulations which allow fair compensation to one who provides essential care in the home, and thus postpones going into a nursing home. There are other steps, which if taken soon enough, can preserve the home from being taken in “estate recovery”. But timing is vital. Noah built his ark before the rains came.

Are you, or a family member who looks to you for guidance, possibly headed toward the need for long-term care? Consider calling us for an appointment to review your particular situation. We will provide an outline of what information should be brought in, and meet with you at a time of your convenience.

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