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We hear it all too often at AgingParents.com from the adult children with aging loved ones. They consult with us and want advice about where to find a place to care for the aging parent. They mention that their parent lives on Social Security, or has little savings or doesn’t want to spend any investment money on care. Of course, the adult children don’t want to have to bear any care costs themselves, a prospect that really bothers them. There is an expectation that somewhere “out there” such a place exists and that some government benefit will cover the cost. They just want Mom or Dad to be happy.

Let’s bust that myth. The government does not provide “a great, safe place” for your aging parent who needs care, particularly when the parent is low income or has no savings. Confusion reigns over the differences between Medicare and Medicaid among many adult children. With either program, there is no great safe place for Mom or Dad to go and get wonderful care so they’ll be happy. That’s what families want and wish for. Unfortunately our society has never offered any government program that pays for this.

 Reality Check

Older folks who run out of money as they age right about the time they need care are in a bad way. Medicare covers your loved ones’ stay in a hospital, and for a limited time in a nursing home/rehab facility after hospital discharge. That is for the purpose of getting physical therapy, occupational and speech therapy with skilled nursing supervision. Sometimes, skilled nursing is also covered for other conditions in a nursing home when these therapies are not needed, but the limits on what Medicare pays for are extensive. Medicare has never paid for unlimited nursing home care, assisted living, memory care nor care in smaller, private homes that are a little like assisted living, called “board and care” homes. Once the elder is discharged from the nursing home when it is decided that they have reached their maximum rehabilitation potential, it’s typically the case that the elder has to pay out of pocket for any further care for maintaining him or her at home or anywhere.

Medicaid is a different program altogether from Medicare, as it is based on income eligibility. In other words, it is for low-income folks. Each state supplements what the Federal government contributes to Medicaid and each state can control who meets its own eligibility criteria. Some states are far worse than others in deciding who can receive this government benefit. Regardless, it is generally true that Medicaid will pay for long term (sometimes lifelong) care in a nursing home. I can assure you that nursing homes are most often not “great, safe places” for your aging parents to go. (I’ve worked in them, spent time visiting family in them, and as a lawyer, sued them for neglect). In many states, Medicaid will pay for limited in-home care from workers the elder must hire on their own from a list of workers. If an aging parent really needs full time or 24/7 care to be safe at home, Medicaid will not cover that much help.

What Can A Family Do With Your Low Income Elder In Need Of Care?

 The average person cannot afford the exceptionally high cost of things like assisted living or memory care. High net worth and high-income elders can, and those are the ones filling up our best assisted living and memory care homes. In CA, one of the most expensive states for these services, the cost of “a great, safe place” for an aging parent can easily cost $12K to $15K per month or more.

Full time home care, which is the best way to avoid “going to a home” to receive care can cost $350K per year and up in CA and other high-cost states. Other locations in the US cost less for these services, but the cost is high everywhere compared with what most people imagine it to be.

If your aging loved one has assets, such as rental property, an IRA or other investments, these are often sold off to cover the costs of care in the better places to live out one’s days. If those assets are not available family must give the care themselves. It is a very difficult burden for many family caregivers

If you see the need for care coming as an aging parent develops numerous disabling physical conditions, or dementia, get advice so that best planning can take place. If your loved one runs out of money and needs full time care, a nursing home, paid for by Medicaid, may be the only choice when family cannot deliver that care themselves.

If you are stuck with that one choice, nursing home, at least learn how to choose wisely. We have a lot of information and publications available at AgingParents.com so you can avoid the pitfalls. Call us at 866-962-4464 to set up a consultation for this and other healthcare, legal and family dynamics issues you have. We offer strategy with compassion

Carolyn Rosenblatt, RN, Attorney, Consultant, AgingParents.com

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