My Dad is almost 90. I would like to take care of him in my home. He would have his own bedroom and bathroom. My husband would help a lot. What could social security pay us as his caretakers? We would have home health care come in for speech occupational and physical therapy. His medicare and insurance would pay.
Just want you to remember that dad will not always be 89 and at the level he is right now. He will decline and need much more personal care than you might be willing to provide. In other words, you may be bathing him and cleaning his bum after toileting. Can you do that? Can you wipe creams on his buttocks and thighs to prevent bed sores?
There will be many joyous happenings as well, but I think that people sometimes forget the "care giving" that comes with having our elderly parents live with us. There may be personality clashes, he may feel like a guest and you are the hostess, he may feel you should help him do things he can do right now for himself, he may not recognize that you and your husband need "alone time", he may interfere with your plans and you may come to resent him being there. He may have dietary restrictions or preferences. He may talk to you and treat you like the child that he thinks you are. All of these are just things that I've lived with and others have written about as well. Read through the posts on this site and you'll be amazed at what you never thought about.
I know that sometimes people make the decision to bring their elderly parent into the house without thinking it through and I just thought I would give you something to think about. I wish someone had mentioned 1/2 of these things to me.
If you decide to go the route of Dad paying you to live there, I'd suggest a formal, legal agreement. Just to be all open and aboveboard.
Would Dad qualify for Medicaid? They sometimes authorize funds for caregiving.
But financial considerations are the tip of the iceberg in all the factors that need to be considered before moving a parent in with you.
Anyone considering this should do all the research BEFORE committing to bring parents into their home.
And if parents have enough resources that they don't qualify for these programs, then they should (in my opinion) be using those resources to care for themselves, whether that means paying a family member or a stranger.
I witnessed that with my parents [now mid-90's]. Back just 6 years ago both of them were walking 2 miles each and every day.... plus Dad was still driving. Today, Dad can barely get down the driveway with his rolling walker, and Mom is now legally blind so no more strolling on pathways for them.
Last year my parents were still able to rake all the leaves from the fall droppings. There would be a half dozen of yard bags sitting on the curb for pickup. This year nothing even though we have had a lot of good weather for yard work. They are aging quickly.
If your elderly parent is eligible for Medicaid, Medicaid's Cash and Counseling program may enable direct payments to be made to you, the caregiver; however, the program is currently only available in a limited number of states (at the time of print, these states included Alabama, Illinois, Iowa, Kentucky, Michigan, Minnesota, New Mexico, Pennsylvania, Rhode Island, Vermont, Washington and West Virginia). To find out if your state has a Cash and Counseling program, contact your LOCAL Medicaid office. Cash and Counseling programs are often also referred to as"Participant/Consumer or Self-Directed Programs." It is not much money and you need to qualify, be able to do his care properly, but worth checking into if he must stay home. Good luck!
For TX, Medicaid's reimbursement rates are super low & the regulations are daunting no matter what the program. I looked into CDS years ago when considering whether best to have mom @ home with help (via CDS) or go into IL. The agency that did CDS for my mom's region seemed to have huge turnover and there seemed to be little co-ordination or consistency in answers - it made mom's eventual NH Medicaid application dealings look simple in comparison. I think CDS can work if the elder needs just oversight care with a doctors note on need and is still able to do somewhat for themselves OR has family living in the home 24/7 who do caregiving so the CDS person is another set of hands to help. My mom was solo so moving into an IL within a tiered facility was going to be better as there was in theory more of a safety-net if needed. Also there seemed to be a lot of book-keeping with CDS on benefits, work-related expenses (bus passes, mileage), time sheets, bonus payments, lots of service provider turn-over which is expected for minimum wage jobs.I remember them asking what the exact distance was from my mom's house to the closest bus stop was……. I didn't live there so mom going into an IL was way better for me & her to manage and I think better for her as her day, meals and activities were on a set schedule at IL and more consistent staffing.
Jody - you may find that dad needs 24/7 oversight in reality. This means either AL or NH or a board & care home or that family does this. Now I will say based on dealing with NH in TX, that the bar for an applicant to medically qualify for a NH in TX is pretty low. At all the NH I've been to - whether in having family in one or doing a lookieloo - seem to have a residents who seem very competent and cognitive yet are in a NH - they can potty & dress & go to meals on their own but can't do medication management so qualify. My gut feeling is that in another state, these would be AL residents and not qualify for NH. TX reimbursement is $ 155 a day for NH room & board which is really really low. I'd imagine for NH the profit margins on that are slim so in many ways they (the NH) need residents who are not truly needing skilled nursing care as they could not afford to run the place with the staff needed if all needed skilled nursing. The better NH have waiting lists too - I was able to get my mom moved from NH#1 to a much better NH#2 at about month 9 (her Medicaid application took almost 6 mos to be done) - moving them once approved for Medicaid is pretty easy; the only real glitch we had was nastiness by nursing staff on getting mom's medications but the new NH had told me what to expect and what to take to get this done (Medicaid will not pay for duplicate medications).
Getting any support services from a CDS program is partially paid with Medicaid diversionary funding so MERP will be involved with a claim against the estate after he dies.