Have tried nearly 3 yrs. to assist my parents with home health and Meals on Wheels. My mom has Multiple Sclerosis, unable to perform any ADL's. Any advice?

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Have tried nearly 3 yrs. to assist my parents with home health and Meals on Wheels. My mom has Multiple Sclerosis, unable to perform any ADL's. Any advice?

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My dad, age 75, has been her principal caregiver prior but is now with increasing memory loss and taking Alzheimers meds. Where can I find some help and direction for their best, proper care? I am terribly stressed and tired with a wife, job, home and 2 aging, ill parents who reside in senior apartment? The door seems to close if one is $2 above the poverty level.🙃

Burnout Care Decisions Home Care Paying for Care

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Your area agency on aging should be able to tell you about options available in your area, and if you are finding that income is a barrier a good elder law attorney should be able to help with that.

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Medicaid can help pay for LTC once they qualify financially and medically (which is an assessment made by a physician). In most states, the Medicaid application has a 5-yr lookback period, so it matters now how they or their PoA manages their finances since some transactions may appear as "gifting" and therefore delay or disqualify their abiliity to get this benefit. Just telling you this now so that you know this is a resource for them but care must be taken to give them the best possible chance of qualifying. You may also want to consult with a Medicaid Planner for their home state.

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Thanks! Never heard of a Medicaid Planner but will investigate that.

Will try Dept of Aging again. Past experiences, they said over income or would put them on a waiting list.

After talking with a friend today, I will also follow her suggestion to deeply explore VA sources to assist with facility placement, home healthcare and services as Adult Day Care, Memory Care and many other needs. My dad is a Vet.

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My father was a veteran and my mother is his survivor. I've been working with a third party organization called "Patriot Angels" who assist in navigating the VA red tape. I tried to run the gauntlet on my own with no success. The VA is a nightmare of forms and rules and endless hoops to jump through. They also do not recognize POA. There are a few of these third party organizations and in my opinion it's worth a call for a free consultation to see if they can help - then you can make up your mind if it's worth the fee - around $1200.00. It was worth it to me.

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Have you contacted the MS Society to see what ideas they have? My friend contacted them when his Dad died, leaving behind his Mom with MS and none of kids lived close by. He found their ideas and suggestions helpful.

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You can try Agency on Aging again. If they don't seem to help much, get a social worker from the local hospital or the state involved. You can do that by asking one of their doctors to send a referral to the SW office. The SW will come out and do an assessment. If the SW believes they are no longer safe alone at home, they will take action. If in home support is not available, they may recommend NH placement. Mom will qualify for LTC Medicaid if she can't perform any ADL's.

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Are either of your parents Veterans?
If so contact their local Veterans Assistance Commission or your State's Department of Veterans Affair's.
OK, I see in a response that your dad is a Veteran. There are many programs that are intended to help keep Veterans in their home.
And depending on where and when dad served some of his medical conditions could be liked to his service. If so he will be entitled to more help.
Your or their local Senior Center may have a Social Worker that might help find other resources.

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On my soapbox:
America has failed, and continues to fail, elders - who rarely can advocate for themselves. It makes me mad. You shouldn't feel you are caught between a rock and a hard place. What would happen if YOU weren't there - contemplate that. :-\

As for your options:
1. Continue to care for your parents yourself, with whatever assistance your parents can afford or find through a complex of agencies.

2. Find an elder law attorney who can work the system (legally), to get your parents Medicaid eligible and then explore getting them into the P.A.C.E. program so they can stay home. See https://www.naela.org/findlawyer

3. Move them overseas to an affordable LTC facility (e.g. https://baanlalisa.com/en/). I am preparing myself for this eventuality, though in your situation I imagine it would be only a last resort.

Wishing you the best. You are on a rough journey.

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elisny, what kind of advocacy do you suggest?

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You are a very loyal and caring son. An astute, Elder Care attorney can help you negotiate these muddied and befuddling waters, and it will be money well spent. You are going to need Medicaid eventually, and the attorney can assist you in properly documenting the "spend down" of your parents resources so that eligibility for low income can be attained. I don't know what 'state' in the USA you reside in, but sometimes an American Legion or VFW post have caring members who can be helpful to fellow Vets (your Dad). Are you the POA? I hope so, but if not, getting that established would be very helpful. I cannot emphasize more strongly how much an astute Elder Care Attorney familiar with the "spend down" for Medicaid eligibility can assist you! Medicaid is a 'dual eligibility' qualification process: Documented disability (physician) + low income qualification. In my large city (Austin) there is a 'for fee' agency called "Accountable Aging" which (for a sum of money) can help you negotiate these numerous and frustrating "steps" and documentation. One step at a time, is what I can tell you. I am the Guardian for my youngest sister, and I have helped my niece get her disabled brother's eligibility established. Don't give up, but please DO purchase yourself some guidance from astute folks!

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First get a Medicare supplement plan. Many provide for limited in home care. Many senior residences have onsite services that may help too. Also do not be afraid to hire someone. Once you spend down the “$2” extra you will then qualify.

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Check out these options in your area:
1 - Assisted living facility and additional home health aides for your mom.
2 - Skilled nursing facility that can phase dad and mom to memory care when the time comes.

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You mention the door closing if one is above the poverty level, but the door you refer to must be the one of qualifying for "free"help. Hired help and out-of-pocket facility placement are not closed, just frightfully expensive.

It sounds like your parents need placement or far more in-home care than what they have now. You may need to apply for Medicare to get them on a waiting list while you spend down their assets to Medicare levels. If they actually have too much regular income to qualify for Medicaid, the ir facility expenses may have to be out of pocket.

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So sorry for this situation which you and many many others face.

Contact their PCP and have them both assessed for "level of care needs"; the PCP will tell you whether you need to bring them in for a new face to face. Tell the PCP that you are facing " safety " issues with them at home as well as the other issues you enumerate; ask the PCP to assign you to a "Case Manager" who is usually either a Licensed Social Worker or sometimes an RN whose job is to help patients and families find appropriate care whether in home or in facilities. They should know the " systems" well and how to navigate you through this difficult time.

Or you can call 911 and have your mother and/ or father transported to the hospital, where you can then have this conversation with the staff there; you can insist that one or the other not be brought back home due to " safety" issues.

And/or speak with an " Elder Care" attorney who can best navigate you through the financial and accountability issues involved with caring for the aging.

Or, you could call a local hospice of your choice and speak with the " clinical supervisor"; share your parents health status; hospice may be helpful in helping you communicate with the PCP also, if in fact you choose to have one or both parents assessed for hospice care appropriateness.

The safety issues that you describe with your mother's incapacities and your fathers Alzheimers certainly sound like you are in a precarious situation and, both possibly need facility placement/ skilled care and or memory care for their safety and well being as well as your sanity.

Start with the PCP ( primary care physician).....

Practice self care ...... you are important too !!

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This is the advice to follow. Have the physician send a referral to the social work department. Get the SW onboard to direct a needs assessment and placement if necessary. If NH is needed for medical necessity, Medicaid can be obtained to cover the cost.

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Get a rx for aidesand nurses. If he has Medicare and medicaid it's no problem. It will give you some you time. Which you need. Also install cameras so you can watch them when you go out. I know your tired mentally and physically. But I wouldn't have given anything to take care of my lo for as long as I did. Unfortunately my mom passed almost 1 year ago. Make sure to hug and have fun with your dad everyday.

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Cissyeyes, Medicare will pay for prescribed in-home PT and OT ONLY IF the patient is homebound. Medicare does NOT pay for in-home aides and nurses other than what might be covered IF the patient is in hospice. Medicare Supplement plans do not pay for such care, either; they supplement only the part of medical care costs that are not fully paid by Medicare. Medicare Advantage plans do not normally cover in-home care, either. There may be some coverage under Medicaid; I am not familiar enough with it to comment. You should probably check with n eldercare lawyer to be certain your parents' financial situation cannot be structured so as to make them eligible for Medicaid, in any case.

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at least they are in an apartment and not in a big old house with a lot of repairs...and a huge yard that needs mowed all the time! Maybe we all need to write to our government about taking better care of our elderly.

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Yes! Amen. We do! Over and over again. We need more affordable adult care places open in the morning through the evenings. Better pay for physical therapists, nurses, healthcare aids, etc.

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https://www.nia.nih.gov/health/paying-long-term-care#:~:text=for%20more%20information.-,Medicaid,vary%20from%20state%20to%20state.

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Thank you so very much for this wealth of knowledge! One of them must have a line you may cross to obtain help.

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Airpap: Start with their town's COA (Council on Aging) who should have on staff an elder case worker and also a social worker. Many of us have dealt with aging parents, a lot of whom have not planned ahead. You are not alone.

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What do you mean by senior apartment? Independent Living? A 55+ community?

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It is an apartment for seniors, mostly independant. Lobby areas are on each floor for those who are ambulatory and/or use wheelchair. There call bells in several rooms if assistance is needed. They do not provide care.

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Have tried nearly 3 yrs. to assist my parents with home health and Meals on Wheels. My mom has Multiple Sclerosis, unable to perform any ADL's. Any advice?

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