My parent has gotten sick very fast, other parent in denial, how to pay for nursing home in Virginia

[Anonymous]

Anonymous wrote:Why do you need nursing home care for both? It seems like your mom is fine. How much in assets do they have? Retirement accounts? This is what they've saved their lives for. I know it doesn't seem fair to spend 8k a month, but that's what the money is for. I believe your mom gets to keep her house and I believe some of her own retirement accounts, but all of your dad's money should go to his care until it's exhausted. And then medicaid steps in.

Side note- I would push for a medical diagnosis for your dad. Obviously something is wrong and they need to figure it out.

Where do you people get this stuff? No such thing as medicaid "stepping in"! You have to apply for medicaid and it is a tough process and you do not necessarily get appoved!!!!!!!!!! And most people do not have 8 grand a month to spend for what could be the next 20 years! Some of you people really do live in a freaking bubble.
If they had 8 thousand a month do you think she would posting on here in a panic??!

[Anonymous]

No diagnosis, no leaving the hospital. Even to go to a nursing facility they are going to ask what kind of diagnosis he has so they can determine if they can provide care

Insist, be there every single day every hour until you get one, request the surgery records, suggest the surgeon did something wrong and no I am not kidding. I had surgery, I am younger and had issues which they couldn't figure out, I asked the surgeon directly in a matter of fact way could you have nicked something during surgery, immediate answer was no; however the testing and care I received increased dramatically that day and I was diagnoised within a few hours and got proper treatment

[Anonymous]

Can you take a few days off and go there in person to try and sort things out? I think you've gotten some great advice up thread, and that implementing much of that in person.

And don't be afraid to ask friends and neighbors at home to help you out on the home front if needed to make that possible. These are the types of situations where people want to help and want to feel a part of a supportive community. Let them help you.

[Anonymous]

Anonymous wrote:

Anonymous wrote: - First things first: I know it is tough, but you have to calm down, don't panic. Think things through. You feel pressured and rightly so, but you need to take the time to be the best informed advocate of your parent.

- Contact your local office of aging. Get an appointment. Talk to the social worker there. See what in-home services they can provide your dad IF he were to come home. DO NOT TELL THE HOSPITAL THAT THIS IS AN OPTION!!!

- The hospital should have assigned your dad a social worker, make that person do their job and help you figure out the options available to your dad. Keep in mind that they work for the hospital, so still do not tell them that going home is even a remote option. Let them TELL YOU what the options are.

- The hospital wants him out, they want his bed. They cannot kick him out if he is immobile and has no where to go and no assurance that he is going somehwere he will get care. You need to make it very clear that he cannot go to your house and cannot go home. 'Your mom is elderly and cannot care for him'
- Again: Make the hospital social worker do his/her job

- Apply for medicaid, it is not easy, and your dad needs to basically be flat broke.

- Some nursing homes will take you medicaid pending
- DO NOT SIGN OVER YOUR PARENTS' HOUSE! That is CRAZYYYY! You need to think of the long term future, your mom needs to have somewhere to live.

- Do not believe the nursing homes regarding your parents' house and assets. They want to get paid. Medicaid cannot take your parents' house, if your mom is living in it.

- I REPEAT: THE HOSPITAL CANNOT KICK OUT YOUR DAD IF HE HAS NO WHERE TO GO TO GET CARE!!
BTDT -- and I made them wait, they even wanted my parent out so bad they finally did a psych eval to test his competency, so they could legally release my parent.

- Good Luck!

Forgot to mention regarding medicaid, your dad cannot start signing over assests, giving money to you or your siblings. Medicaid sees that as fraud and it will disqualify him.

Yup. You have to be savvy to defraud Medicaid. I had a former coworker that started the process of hiding assets about 5 years before Mom moved to a skilled nursing facility

[Anonymous]

We went through something similar this winter/spring. It's a tricky spot to be too sick for a rehab facility, but not requiring FT hospital care. My father almost ended up in hospice because of these factors. In the end, he was able to be taken off a feeding tube after a month so that he could go to the rehab facility and then had the money to pay for skilled nursing so that's where he stayed. But it was baffling to realize this weird no-mans-land of elderly medical care.

You need to get in touch with your parents' insurance liaison and/or hospital case manager to help you figure out if there is any facility that might be approved on a temporary basis. There are different types of rehabs and some specialized ones will take patients with high medical needs. Alternatively will the insurance pay for in-home assistance - visiting nurses etc? We also had a lot of help from the palliative care specialists at the hospital where my father was; we didn't even know they existed until he had been there for a month but they were really wonderful in thinking through the alternatives that might be available and appropriate. Good luck, OP.

[Anonymous]

OP, I think you've gotten some great advice, but I wanted to mention one more thing. If you have no payor source for the hospitalization, your father will be on the hook for payment. So, it's a good idea to work quickly, cooperatively and efficiently with the social worker. I agree that you shouldn't panic because you have a great resource - the hospital social worker. But, you can't sit back and not move things along either because your father isn't going to get to stay in the hospital for free.

And, seriously heed the PPs advice about not giving away your parents' resources to get qualified for Medicaid. It doesn't work.

[Anonymous]

There is a 5 year gap to give away assets. At this point it is too late.

[Anonymous]

You're in a bad situation because your dad needs to drain assets now, and your mother could live another 20 years. If you don't have a good handle on your parents assets, you need to sit down with your mom and get one. 70 is young to have spent through all retirement savings. You also need to have an honest talk with your mom about her long term plans and preferences. Does she want to stay in her home. Move in with you? Move to a retirement community? If you have a sibling or siblings, they should be included in this conversation. I agree with PP that someone under 70 who is healthy does not belong in a FT skilled nursing facility. Then you should probably find a reputable financial advisor who you pay by the hour (not one making a commission on investments) and develop a long term plan. I know it sucks to become the parent for your parents. Best of luck!

[Anonymous]

Thank you for all the replies. I really appreciate it. To clarify something's, 1) the quoted $8000 per month was for my father to be in a nursing home or have 24/7 nursing care at home, it was NOT for both my parents to be in a nursing home. And 2) my parents live a few hours south of DC in Virginia, they don't live near NOVA.

[Anonymous]

What does your mom want to do?

[Anonymous]

I second the advice to speak to the hospital social worker and The local department oh aging for the county your parents live in. My elderly grandmother was able to get a home health assistant For half a day at a very low cost after being discharged from the hosPetal through her county depArt net in rural va a few years ago.

[Anonymous]

Anonymous wrote:OP, I think you've gotten some great advice, but I wanted to mention one more thing. If you have no payor source for the hospitalization, your father will be on the hook for payment. So, it's a good idea to work quickly, cooperatively and efficiently with the social worker. I agree that you shouldn't panic because you have a great resource - the hospital social worker. But, you can't sit back and not move things along either because your father isn't going to get to stay in the hospital for free.

And, seriously heed the PPs advice about not giving away your parents' resources to get qualified for Medicaid. It doesn't work.

Definitely work with the hospital social worker as I suggested up thread, but please be clear that the social worker works for the hospital, and their endgame is to get that bed free. Is your dad on medicare? He has I believe 90 or 100 days of skilled nursing if he gets sent to rehab again. Honestly, I would not be worried about paying for his current hospital stay. Your big concern is long term, that is a much bigger bill. Right now, the fact that he is sick and their is no diagnosis leaves the ball in the hospital's court. Your dad is sick, immobile and UNDIAGNOSED.

[Anonymous]

Anonymous wrote:

Anonymous wrote:OP, I think you've gotten some great advice, but I wanted to mention one more thing. If you have no payor source for the hospitalization, your father will be on the hook for payment. So, it's a good idea to work quickly, cooperatively and efficiently with the social worker. I agree that you shouldn't panic because you have a great resource - the hospital social worker. But, you can't sit back and not move things along either because your father isn't going to get to stay in the hospital for free.

And, seriously heed the PPs advice about not giving away your parents' resources to get qualified for Medicaid. It doesn't work.

Definitely work with the hospital social worker as I suggested up thread, but please be clear that the social worker works for the hospital, and their endgame is to get that bed free. Is your dad on medicare? He has I believe 90 or 100 days of skilled nursing if he gets sent to rehab again. Honestly, I would not be worried about paying for his current hospital stay. Your big concern is long term, that is a much bigger bill. Right now, the fact that he is sick and their is no diagnosis leaves the ball in the hospital's court. Your dad is sick, immobile and UNDIAGNOSED.

OP, you've received some good advice here. I'll add that you may want to consider an elder care attorney for legal advice.

There's a community spouse resource allowance, so your mother is protected from destitution.
http://www.elderlawanswers.com/medicaids-attempt-to-ensure-the-healthy-spouse-is-not-impoverished-the-csra-12497

[Anonymous]

He gets the care he needs until he runs out of money, and then medicaid pays. He needs to move to a facility which accepts medicaid. They probably now need to live separately. As a couple they only have to spend 50% of their assets on his care. You mother will not be destitute. They will spend thru their assets, that's what happens.

[Anonymous]

Anonymous wrote:I will try to keep this as concise as possible. My father had surgery a month ago and has been on a downward spiral fast in decreasing health, he's been in and out of the hospital and rehab facitilities, and now is back in the hospital and they cannot figure what is wrong with him. He is in such intense pain he is completely immobile, cannot dress or feed himself, cannot sit up, walk, etc. Basically he needs 24 hour care which my mother cannot provide (she isn't strong enough to even lift him, etc.). This has all happened so quickly, and my parents both seem to be in denial as to how to care for him. Rehab hospital won't take him, they say he's too sick. The hospital says they can't do anything for him, so he eventually needs to leave (soon) so the options seem to be 24/7 nursing care at home or nursing home. They've been quote $8,000 PER MONTH for both. They cannot afford that. I cannot afford to give them that either. I don't think they would qualify for Medicaid. They are located in Virginia. My father is NOT a vet. They don't live near DC so I am not sure if them moving in with us is a real option.

Has anyone been in similar situation? How did you approach the financial issues for elder care? This literally keeps me up at night, and stresses me all day long. I don't know what to do. Any advice is very much appreciated

The way this works is they go into nursing care and spend every last dollar they have, depleting all assets, until they are bankrupt. Then they qualify for Medicaid, but may be moved to a facility that accepts it.

it sucks, but it's the way it works.