How to Receive Financial Assistance

Comrade

Good Morning and Merry Christmas.

I retired to caregive DW and am unprepared financially for what is ahead. With DW suffering from dementia, I am concerned what skilled and compassionate care may cost down the road.

Both of us receive social security, own our home and have limited investments. I don't want to lose everything in the search for her care and my future. If selfish, please tell me. 

After almost 3 years of caregiving, I am know my limitations will begin to affect DWs care. Love is not "all you need" in our collective situations.

Are there avenues that can help guide for the present and the future? Is this the job or an eldercare attorney or trying to establish a relationship with a facility and work something out?

I am trying to "forecast" something that is not easily charted, but know I need to prepare.

Help please.

Jimbob59

Yes that is the job of an eldercare attorney and you need to see a good one. You will be able to keep your home and your money up to a certain dollar amount. You are allowed a monthly income that will keep you as the community spouse from becoming impoverished. Seek out an eldercare attorney as soon as possible.

Mint

JimBob gave you good advice.  Welcome to the forum.  Continue to hang out here and you will learn and have people to connect with that understand.

LadyTexan

Good Morning and Merry Christmas.

I agree with engaging an elder law attorney. I was reluctant to do so, but am very glad that I did. Allow me to suggest that the sooner you do this the better.

For context, we have a mortgage on our home, my only income is a pension and DH's income is SS disability. I retired early to be DH's caregiver. 

I am aware that DH's future needs are beyond my ability. No doubt he will need placement in the future and Medicaid will be the life boat. By engaging an experienced elder law attorney, I am now more educated about the Medicaid regulations in Texas, exempt assets and income limitations.

Best wishes to you on your journey.

-LT

Crushed

I fully agree with consulting an eldercare lawyer who will certainly give you the bad news that Kentucky is one of the stingiest  states in the USA  . the Lawyer will also under stand the acting process.

All is not lost if your acting ability is high enough and loved one in need enough.  The state knows  that if your loved on is medicaid eligible for the nursing home they will have to pay. But if you are a self- sacrificing Mother Teresa you will get no help whatever

 So you don't do that You just say she needs placement
At that point they will do everything to discourage you from placement.  They will tell you lies they will then tell you you are a horrible person and how you will make your loved one suffer.   
This is where acting ability comes in.  You want to make the Wicked Witch  of the West look like a Saint/.  You insist on placement NOW.  

if you appear  tough and mean enough amazingly they then routinely  find money under the medicaid waiver program to keep her at home  

Here is the key However, unlike the state plan, Medicaid waivers have enrollment caps. This means once the maximum number of participants has been met, there will be a waitlist for services. .

 The waitlist is where the Mother Teresa's wait and wait and wait 

   

  

Quilting brings calm

Crushed - you understand the Medicaid rules and eligibility better than I do. 

This may be an odd question.  Would it be a good idea for Comrade to consider a move a couple hours away to Illinois?  I know our cap is $110,000 and we are a 100% community spouse state.  I don’t know how long you have to be a resident to be able to apply in Illinois. 

What about any of the other states surrounding Kentucky? 

I understand this would be a significant disruption but it might be worth it for Comrade’s own future financial stability.  

Crushed

IMHO It is state policy in many states to try to export dementia patients.  No one wants dementia patients.  They are very expensive .  The more vicious and nasty a state is  the more likely the families are to move out of state.  It's the same with special education.  We have lifelong Texans in our family who moved out of state to be able to care for a terribly disabled granddaughter.   

States use low out of state medicaid payment rates to try to get people to move.  they aslso limit facilities 

 Florida for example has a slightly older population than New York but a much lower density of nursing home beds 119 per thousand while New York is 176

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Crushed

Victoria2020 wrote:

Crushed wrote:

This is where acting ability comes in.  You want to make the Wicked Witch  of the West look like a Saint/.  You insist on placement NOW.  

if you appear  tough and mean enough amazingly they then routinely  find money under the medicaid waiver program to keep her at home  

Here is the key However, unlike the state plan, Medicaid waivers have enrollment caps. This means once the maximum number of participants has been met, there will be a waitlist for services. .

 The waitlist is where the Mother Teresa's wait and wait and wait 

   

Victoria wrote

I've read this a few times and am confused. Is the goal placement or in home care?
 

Neither. the goal is unpaid in-home care by family caretakers.  

Quilting brings calm

==I've read this a few times and am confused. Is the goal placement or in home care? ==

I believe Comrade’s( the author of this thread) goal is to find out how to pay for skilled care down the road. 

I believe Crushed ( the comment you quoted) was trying to explain to Comrade the hoops he would need to jump through to get institutional Medicaid and that he would most likely get offered Medicaid in home waivers instead - which is limited by capacity. As Crushed later  said, state Medicaid goal is to turn people away. You have to be very persistent and bowl about the fact that you cannot care for the patient in your home. 

Crushed

Quilting brings calm wrote:

==I've read this a few times and am confused. Is the goal placement or in home care? ==

I believe Comrade’s( the author of this thread) goal is to find out how to pay for skilled care down the road. 

I believe Crushed ( the comment you quoted) was trying to explain to Comrade the hoops he would need to jump through to get institutional Medicaid and that he would most likely get offered Medicaid in home waivers instead - which is limited by capacity. As Crushed later  said, state Medicaid goal is to turn people away. You have to be very persistent and bowl about the fact that you cannot care for the patient in your home. 

Close but not exact.  By law there are no limits on institutional care  so they make it as awful a prospect as possible.  For in-home care there is a wait list so long it may exceed the patient's or caretaker's life expectancy 
Voila the state has solved the problem

How long is the waiting list in Florida? Florida has almost as many people waiting for services as it serves. You can expect to wait 7 or more years before getting waiver services in Florida.  http://medicaidwaiver.org/state/florida.html

(now that is for all services but it gives you the idea) 


  Here is Maryland

How long is the waiting list in Maryland? You can expect to wait many years before receiving Medicaid waiver services in Maryland. There are nearly twice as many people waiting for services as those receiving services.

How many people are currently receiving services in Maryland?  

• Waiver for Older adults 3,365  (that is our loved ones)
• 
  

How many people are on the waiting list in Maryland?

• Waiver for Older Adults 21,800

  
  6x times as many people on the waiting list as being served

From what I can see Kentucky is awful Here is what they claim

National Family Caregiver Support Program

The National Family Caregiver Support Program offers flexible benefits and support services to informal caregivers of people 60 years of age or older, an individual with Alzheimer’s disease or a related disorder and also for grandparents and relatives age 55 or older caring for a relative child no older than 18 years of age related by birth, marriage or adoption. The services include:

• Information about available programs and services. 
• Assistance accessing services.
• Counseling, support groups and training to help caregivers make decisions and solve problems related to their caregiver role.
• Respite care to give caregivers time off from care giving responsibilities.
• Supplemental services on a limited basis, to supplement caregiving tasks.

Contact your local Area Agency on Aging and Independent Living for more information about this program.

In other words TALK but no action
  
  

Crushed

Here is the key Kentucky sentence (scl is support for community living )
https://chfs.ky.gov/agencies/dms/dca/Pages/scl-waiver.aspx

Currently, there is a waiting list for SCL services and supports.  Placement on the waiting list is determined by the date your completed application is received. Applicants will be served based on category of need and order of application as slots become available. After you receive a slot, Medicaid will determine if you need the level of care provided by an ICF/IID and are financially eligible for Medicaid coverage.

If you need more information about the SCL program, please email DMS or call (844) 784-5614.

  I read "category of need" as whatever saves the state the most money.

they award the slots BEFORE they do the medicaid analysis

60 falcon

Check with your local/county ADRC.  I was surprised to learn that I qualified for financial aid through some federal program for respite (adult daycare for DW). It wasn't based on financial need.  There was also a state program with the same purpose that we did not qualify for because our income exceeded the limits for that.  

This kind of help might not be what you're looking for but my point is that there may be some help out there that you don't know about until you ask the right person.  I got a nice check to offset costs of adult daycare and mileage to and from, and I can reapply in the new year.

Crushed

To be truthful almost  NO ONE is prepared for the cost of Alzheimer's.   Dementia is the most expensive disease in the USA.  My wife needs a very high level of care , which we pay for privately in one of the most expensive areas in the USA

The cost is about $145,000  per year.  It was about $120,000 before Covid
For how long?  I had my wife at home at much lower cost for 7 years and she has been in her facility for over four

Comrade

Agree and thanks!