Anonymous wrote:Has anyone used Visiting Angels? I'm looking for home care for a family member. She is end stage cancer, 83years old, and needs help with hygiene. Her husband and sons are not able to assist (I don't think she wants them doing this work). She wants to maintain some dignity. She is willing to pay out of pocket, but I'm trying to get her insurance information to see what it may cover. We are in DC. She is over the income level for government assistance

Unfortunately she will have to pay out of pocket unless she has long term care insurance and has kept up with the payments. It’s a huge hole in our health care system.

Not to add to OP's crisis and heartache, but inpatient rehab quality is extremely variable. Even the good places required serious, constant advocacy on our part for our elder. There are staffing and quality issues. I spoke to hospital nurses and social workers about the quality of rehab facilities, and they were concerned too.
Elder care is rough. There's not much of a system in place. Feel badly for OP and wish them all the best.

Sometimes things just have to unfold or a crisis has to arise to force decisions to be made and actions to be taken. Your parents have capacity to make their own decisions, from what you describe but there are consequences to refusing inpatient rehab. It’s gut-wrenching but you are not in a position to monitor them 24x7 and if your dad is as weak as you describe, he may have a fall/hospitalization that leaves no choice but to go to rehab or even LTC (the facility’s financial office will work with families to apply for Long-Term Care Medicaid).

If you call A Place for Mom, they can provide you with information about less costly ALFs, which are usually privately-owned group homes.

Anonymous wrote:If your parents are indigent they may be able to get home health caregivers paid by the government.

I have a private duty caregiver that we pay for but the caregiver told me that her mother who is late 50's and indigent gets free caregivers that come to her house paid for by the government. She told me her mother is morbidly obese and wheel chair bound or scooter bound.

I don't know the details on this but I would ask your doctor or social worker.

This is only covered for Medicaid recipients through the Waiver program; there is a waiting list so it can take several months.

Anonymous wrote:

Anonymous wrote:Has your dad’s illness involved a hospital? What you need is a social worker, and hospitals have them. A social worker can help you figure out what if anything can be paid for by your parents’ insurance.

Unfortunately there’s no way to get home health aides without money. So if you don’t have it, you need to try to work whatever insurance policies are active.

Yes, he was in the hospital twice. They do have Medicare A & B and a supplemental. I’ll look into that. Thanks

NP. That insurance will pay for rehab but not caregiver support or home health aides. Could you afford a few hours of private duty caregiving (whatever the agency’s minimum hour requirement is) and select the hours that would be most beneficial, in terms of your parents’ daily routine? For example, perhaps someone can come in the morning, help him bathe/toilet/get dressed, and prepare and serve breakfast. You could also get your dad one of those life alert necklaces. And as PP said, you can Google a list of adult day care programs in your community.

Unfortunately, there’s not a lot of other options, if any. Meals on Wheels can be good, and you can check out your county’s office on aging for any free resources.

we went down this road three years ago. My parents too insisted on staying in their home forever. But getting them out of their home into an apartment (CCRC - not that i would recommend that) was a game changer. You say they are with it mentally but in my experience elderly people will hide their deficiencies. Unfortunately it took my mom falling and breaking her hip that got them to move. Are they driving? Yeeks there is that concern too.

The issue is people their age thought they would just drop dead or decline rapidly like their parents. Not true today! So staying indefinitely in their suburban home with many stairs is just not realistic.

Hire a aide to help part time

They can only get free help if they are on Medicaid.


You’re better off just getting some part time help so they can die peacefully at home

Anonymous wrote:I'd be careful with inpatient rehab and only go if it is truly necessary. Most aren't masking anymore. I know three people that got covid in rehab. One is ok, one died, and one couldn't get paxlovid and has long term effects that means his care is even more expensive because he is more disabled. So, rehab could lead to more issues.

What exactly does your dad need help with?

It's a HUGE blessing that they are mentally ok. That means they can interact with and help manage whoever comes in to help you.

I remember hearing this a lot after the vaccine with regard to AL and it scared my mom out of going to AL. Every single one of her friends who went residential is in far better shape than she is and a few did get Covid. He would get good care at the right rehab and have others in the same boat and the social interactions with perky staff. It's not the same as being home with a wife who is probably overwhelmed with all his issues and someone coming in now and then. Plus, when your mom visits she will likely be better rested and less stressed because the issues aren't in her face 24-7.

Sure there is the chance he could get Covid and die, but there are plenty of things that can kill you at that age. You have to think about his needs and the mom's needs. This isn't the early pandemic. Yes, covid sucks for many elderly, but so does aging and the death rates are far lower.