If I ask for help will they take him away?

Wilted

I heard the government can step in and institutionalize someone, spend all of their money on "care" and then kick them to the curb. Is that true?

loveskitties

For the best answers to your questions you should contact an Elder Care Attorney.

That person can give you information regarding your specific situation.

towhee

Wilted, no. Bits and pieces might be true if combined with other bits and pieces. 

Situation 1--Person with dementia is living alone or with family member who works or who is physically frail. Person ends up in the hospital, doctor judges they can no longer live at home without 24 hour care, family can not manage that, person is placed in a facility. Person private pays until asset limits for long term care medicaid are reached, goes on medicaid. If they have a spouse the spouse gets to keep up to 125, 000.00 ususally, amount can differ by state. It is important to choose a facility that accepts medicaid as not all do. Rarely, a shady facility will try to dump a person at the ER because they have a chance for a private pay patient. The government will fine them if they catch them doing this.

Situation 2-- person with dementia ends up in hospital and needs extensive care before they can go home (broken hip etc.) Hospital sends them to rehab facility. Rehab is covered by Medicare if you are 65, Medicare is medical insurance and is run by private insurance companies. They like to make a profit. Rehab is expensive. Sometimes they will stop paying the facility even though the patient is not capable of caring for themselves at home. Then while you appeal this decision you have to pay the facility privately, go on medicaid. or somehow manage with the person at home.

Situation 3--Might happen in retirement area. Shady lawyer finds older person living alone, applies for guardianship saying person cannot take care of themself. Puts person in facility and charges lots of fees.

If a person with dementia has a family member who is responsible and who has a Durable Power of Attorney and Health Care Power of Attorney, or who is a spouse they can advocate for their loved one and usually keep problems from happening.

Wilted, there is help and you don't need to be afraid to reach out. Give the members of the board more information about what you need and you will get more specific advice.

Crushed

Wilted wrote:

I heard the government can step in and institutionalize someone, spend all of their money on "care" and then kick them to the curb. Is that true?

Please tell us who you"heard" this from?  I warn people all the time not to believe what they hear about dementia from church buddies, bartenders, pole dancers,neighbors, nursing home workers, hair dressers and random strangers.  

Your reliable sources are normally elder care lawyers and social workers and nurses working as experienced case managers 

If you will give us more information about the case, we can help  

Crushed

Towhee

  Rehab is covered by Medicare if you are 65, Medicare is medical insurance and is run by private insurance companies. They like to make a profit. Rehab is expensive. Sometimes they will stop paying the facility even though the patient is not capable of caring for themselves at home.

1) People on SS disability are often on Medicare much younger

2) you are confusing Medicare and Medicare advantage   Medicare is a government program

Medicare advantage plans re run by private companies that have to follow medicare Rules

Medicare actually makes the final decisions on what they have to cover

What if I disagree with the organization determination?

If you disagree with your plan's initial decision, you can file an appeal. The appeals process has 5 levels. If you disagree with the decision made at any level of the process, you can generally go to the next level. At each level, you'll get instructions in the decision letter on how to move to the next level of appeal.

• Level 1: Reconsideration from your plan
• Level 2: Review by an Independent Review Entity (IRE)
• Level 3: Decision by the Office of Medicare Hearings and Appeals (OMHA)
• Level 4: Review by the Medicare Appeals Council (Appeals Council)
• Level 5: Judicial review by a federal district court

  

 
 
 

harshedbuzz

Wilted wrote:

I heard the government can step in and institutionalize someone, spend all of their money on "care" and then kick them to the curb. Is that true?

Another gobsmacked individual who is curious about from whence you gleaned this tidbit. 

It is possible for adult protective services to step in if a person is found to be unable to care for themselves and manage their affairs if that person has no one else named to act for them or if no family member/friend steps forward to look after them. There is a process for this that includes an evaluation of the individual and a court assigned representative to look out for their personal interests. If the person is deemed incapacitated, they would be assigned a professional guardian who would arrange for care and liquidate assets to pay for that care. No ironic quotes needed. Once the money is gone, the individual would be qualified for Medicaid which would continue to pay for his/her care. Medicaid is the safety net.

That said, because there are guardianship is a paid position, there have been scandals (looking at your Florida) where the elderly were preyed upon. 

Florida Hospitals Found Applying for Massive Numbers of Guardianships for Their Patients, seeking to Strip Away Their Rights (gierachlaw.com)

Your best defense around this is meeting with a CELA to discuss your situation and make a plan.

National Elder Law Foundation (nelf.org)

Towhee-

Medicare will discharge a person from rehab if if they are no longer making progress toward their rehab goals or if the patient is uncooperative or not participating. Rehab is about regaining skills, not custodial care. 

Quilting brings calm

Wilted… I’ve seen a poster in a Facebook group mention corporate guardianship and how they steal all the persons assets.  If this is what you are referring to… ignore people like that. They don’t understand the process. Like HB and Crushed are telling you,  IF someone needs to go to a facility,  some private pay will happen IF it’s deemed that you can afford to do so. Once a certain threshold is reached, then Medicaid will pay.  IF you need to have someone placed, make sure up front  the facility will accept Medicaid when that threshold is reached.  If they don’t, then yes, the patient will need to be moved to one that does. 

You ask about Help.  Help doesn’t always mean facility. There are agencies that provide caregivers and home health aid at your home for a fee.  There is hospice available at the appropriate time to help comfort your patient and you in the last several months of life. 

Quilting brings calm

Wilted… I’ve seen a poster in a Facebook group mention corporate guardianship and how they steal all the persons assets.  If this is what you are referring to… ignore people like that. They don’t understand the process. Like HB and Crushed are telling you,  IF someone needs to go to a facility,  some private pay will happen IF it’s deemed that you can afford to do so. Once a certain threshold is reached, then Medicaid will pay.  IF you need to have someone placed, make sure up front  the facility will accept Medicaid when that threshold is reached.  If they don’t, then yes, the patient will need to be moved to one that does. 

You ask about Help.  Help doesn’t always mean facility. There are agencies that provide caregivers and home health aid at your home for a fee.  There is hospice available at the appropriate time to help comfort your patient and you in the last several months of life. 

Cynbar

It would be very, very unlikely for the government to force someone into a nursing home when there is a willing caregiver in the home. I have only seen this happen a couple times in over 30 years practice as a medical social worker, and that was when the PWD was so unsafe that home interventions wouldn't help.

It is true that there is an agency called Adult Protective Services in every area. Reports are made to them if someone thinks an elder is being neglected or mistreated, or if the living conditions are unsafe. These reports can be made by physicians, friends, family ..... really anybody. APS then investigates. Sometimes they find true problems and open the case, sometimes they don't. If they do open the case, their focus is on trying to improve things. They set up a plan which might include services going into the home such as home health aides or a homemaker. They can order equipment, such as a hospital bed. The can assist with home maintenance issues or hoarding concerns, for instance. APS has money available to pay for this, although sometimes there is a charge if the patient can afford it. But their goal is to help the caregiver care for the patient, not take them out of their home. In fact, sometimes APS does not intervene when others see a problem because they feel a less than ideal home situation is better than an institution.

This all assumes that both the PWD and the caregiver want him to stay at home, and there aren't huge safety issues like suicidal threats or uncontrolled wandering. Some caregivers reach a point where they know they can't care for the person any longer. But if a caregiver is exhausted , overwhelmed, floundering, then the goal is to help improve things. Ask for help, call your physician or Elder Services, and don't be afraid that your LO will be yanked away.

A related issue is a report of financial exploitation, which APS does take very seriously. They might petition the court for a conservatorship to oversee finances, but would be unlikely to remove the person from the home.

This is the Spouse and Caregiver forum, so I've based this on a situation with a caregiver in the home. The situation is different for a person who lives alone. Again, APS would try to keep the person at home if he were competent enough to make decisions and wanted to stay at home. Some frail elderly can remain at home with Lifeline, intermittent caregivers, family or friends checking in ---- but not all can. APS has the authority to mandate 24 hr care or a nursing home if the person would be too unsafe being alone. In that case, the person's funds would be used and then they would apply for Medicaid. But if there is a way to avoid institutionalization, such as moving in with a relative, that would be the choice.

Rescue mom

Government does not want to deal with them. The most common way IME a “government” can institutionalize someone, is if they present a clear and imminent danger to themself, or to others. Or, in some cases, the person may be all alone, no other caregiver available (or no competent caregiver) and the person is so neglected their health is in danger. 

Abuse of an in-place legal guardianship is a different can of worms that has had some publicity lately. But the OP question doesn’t seem that specific. 

Pretty much every caregiver I know has asked for help, from a private caregiver or from a government agency, or from many other sources. Nobody get “taken away” because of that (maybe if extreme abuse is found but it has to be very extreme, IME).

Medicaid programs will outline financial requirements before you get into them; different states have different rules. I believe its best to have attorney help through that, although many do just fine without.

abc123

Dear Wilted, welcome to our family of caregivers. I’m glad you found us. I have learned many things about many different aspects of dementia here. We are like a family, we support each other with kindness, compassion and knowledge.  Feel free to ask any and all questions you may have. If you need to unload emotionally, we will support you. There are many wise people here with years of experience as a caregiver. We also have people here who are very familiar with the law. Once again, welcome!

Jo C.

Hello Wilted; I am so sorry you have been given truly bogus information.   Please disregard what you have wrongly been told.

 ALSO:   For free professional support and correct information you can choose to call the Alzheimer's Assn. 24 Hour Helpline at (800) 272-3900.

 If you call, please ask to be transferred to a Care Consultant.  There are no fees for this service.  Consultants are highly educated Social Workers who specialize in dementia and family dynamics. They are very supportive, have MUCH factual information and can often help us with our problem solving.  They can address your concerns.

Regular Medicare is a federal insurance - it is NOT run by private companies . . . . BUT:

 There is also another type of Medicare (still federal insurance) one can sign up for and NO ONE is on it unless they purposely enroll into one of them, (there are multipls of them) and that is the HMO model of Medicare which is called "Medicare Advantage."   There are many of these HMO models and theiy are run by private companies; many of them physician group owned.

 So you see; two completely different entities.  Even if in the acute hospital for muliple days, always check with the business office or admitting dept. to ensure your Loved One is categorized as an INPATIENT and now an outpatient; this  is very important.  If in the hospital for multiple days and you find your LO is listed as an outpatient; contact the physician and have him/her change that status as of such and such a date so your LO is established for that qualifying period should rehab be needed.

If rehab is needed, a person on regular Medicare must be in the acute hospital AS AN INPATIENT for three 24 hours . . .. this is called a, "Qualifying Period."  Once that happens and there is medical necessity for the rehab, Medicare covers rehab.

 There is a "deductible" for rehab; for 2021, it is a bit over $1,400.   However, that deductible is also considered what was covered in  the acute hospital, so most people going to rehab have already met the deductible.  Here is a very accurate and explanatory link:

 https://www.helpadvisor.com/medicare/how-many-days-will-medicare-pay-for-rehab

 NOTE:  If a person has a supplemental policy to Medicare, sometimes called a "Medigap" policy, most policies will cover co-pays. 

 NOTE:  If a person has Advantage Medicare coverage rather than regular Medicare, there is no three day qualifying period in most of these plans and no co-pays etc. to worry about in most plans.  IMPORTANT:  If one has an Advantage plan, it is illegal for anyone to sell that person a Medigap policy as it is not needed nor would it be honored.  One reason Advantage has no three day qualifying period for rehab is that it is much less expensive per day for rehab than it is in the acute hospital.

  No; the government cannot step in and institutionalize someone and spend all of their money and then "kick them to the curb."  Laws absolutely forbid that.

 If you have specific concerns or questions, please list them, we will provide answers BUT to ensure that you are getting accurate information, the Helpline can assist you or refer you to a place for information that is credible.

 J.

Jo C.

Second concern:  If you are asking for help in the home, the answer is,"No," the government does not step in and remove your Loved One away from you.

 Only way that could even be assessed to happen would be if the person with dementia had no care; or if they were actually being abused; or if there was no way to provide food, shelter and clothing and reasonable care.

Please call the Helpline number given above, the Care Consultants can discuss this with you and also discuss what help may be available.  Many people qualify for Medicaid if their income is at certain levels, that can often open doors for various types of assistance.

J.