<p>What is the maximum income and/or asset limit for the A&A benefit? Anybody know?</p>
<p>My mom is 90 ,and getting too frail for assisted living ,even with extra help .We have a case manager ,and she is looking into "board and care " facilities. They are usually smaller and more homelike ,and less money .</p>
<p>somemom. You can find info about A & A at [Veterans</a> Administration Aid & Attendance Benefit Program Information by VeteranAid.org](<a href=“http://www.veteranaid.org%5DVeterans”>http://www.veteranaid.org) .Essentially, you are eligibile(if the military requirements are met), if your assets are on average not more than $80,000(excluding home and vehicles) per the website.</p>
<p>My 20 percent is $150/day. It will start on Day 20 or 21. I am hopeful Mom will be rehabbed and back in ALF before that occurs.</p>
<p>In the meantime, I’m getting educated now even if that occurs, as there will no longer be any money for the ALF in a matter of months, and we will have to look at other options.</p>
<p>I am also hoping to get educated on what qualifies one for Medicare coverage for different levels of illness. Some of above posters mentioned being classified as observation and inpatient status for hospital stays. My mom was initially on observation, but was thankfully moved to inpatient. This is what enabled her to go to the SNF.</p>
<p>My fear is that she may get caught in a limbo of not being able to stay in her ALF and not qualifying for SNF and nursing home. Where does she go then?</p>
<p>I have a friend who knows some nurses who work with group homes, and I’m wondering if we might have to look into such a place as that as well.</p>
<p>My gosh, so much research. Again, thank you all so much for your input.</p>
<p>Now I’m off to get Daddy’s death certificate. Get ready for the waterworks. Just opened the mail for mom and dad’s marriage certificate, and am getting emotional looking at that as well. I will make many copies of it to send to my brother and sisters, so they can have it, too, if only for the sentimental value.</p>
<p>This has been the story of my life for the past six years with my mother. She had a major stroke and has declined steadily since then. She was in assisted living, but she was borderline. After two fractures, she moved to a small assisted living (the “board and care” type). Then she moved to a nursing home. Those three moves were difficult for her and h*ll for me. To be honest, she probably would have been better off in a nursing home after her first fracture.</p>
<p>Thoughts: Avoid multiple moves, for your sake and hers. You are wise to start looking now. Get all of her financial paperwork together now, including five years’ of bank statements. Get power of attorney (medical and financial) if you don’t have it. You may be able to work with the facility where your mom will be moving when you are applying for Medicaid. In my case that person is very knowledgable and has helped me cut through red tape. Hiring an attorney or a case manager is a good idea, too, especially since you are in another state. My mom had zero resources except for the cash value of an insurance policy and her social security, so financial qualification was pretty simple. So was medical qualification, in her case, because she could not perform most of the Activities of Daily Living (ADLs), which I believe is what they use for the evaluation. </p>
<p>The worst experience she/we had was with the “board and care”/small assisted living facility/group home. Be very careful. The quality of these places is all over the map (even in my mother’s county, one of the nation’s wealthiest, where they are strictly regulated). I wouldn’t do it again, though in theory they’re ideal. The “best” ones are quite expensive in our area.</p>
<p>Don’t be afraid of a skilled nursing facility for your mom’s long-term care. There are bad nursing homes, but there are also plenty that have kind and respectful staff, good medical care, a range of activities that provide stimulation, and nutritional meals. Don’t be swayed by lavish interior decor, which in my experience (from her three times in rehab) can blind families to what a place is really like. Given enough time to look, you’ll find one that meets her needs. Pay special attention to how the staff interacts with her and with you. My mom has acute anxiety due to stroke-related vascular dementia. She can be a challenge, but they handle her issues pretty well.</p>
<p>Good luck to you, montegut. It’s a tough road, but there are tons of resources out there.</p>
<p>Medicare actually doesn’t do 80/20 on skilled nursing. They pay 87.5 percent and you pay the remaining 12.5 percent for days 21-100. That 12.5 percent amounts to 141.50 per day this year. The amount is based off of their $1132 per day allowable amount in 2011. It sounds like your mother has what’s called either a Medicare Supplement Plan A or Plan B (those are the only two that do NOT pay a portion if not all of those copays on those 80 days). You might want to call BC/BS after this ordeal is over and see how much it would cost to possibly make a switch to a plan that does cover that. I don’t know what their guidelines to change plans are… You might want to ask them about either plans F or N (if they have it, that is a relatively new plan)… that way she has the coverage if this were to come up again in the future.</p>
<p>You also might want to go to <a href=“http://www.eldercare.gov%5B/url%5D”>www.eldercare.gov</a> and poke around to see if you can find any help with getting everything sorted out for her. I know you’re going through a lot of stuff right now so I’d definitely check it out. They have a ton of helpful information with dealing with various situations for the elderly.</p>
<p>HELP!</p>
<p>Looks like Mom will not be able to return to her assisted living facility.</p>
<p>Trying to decide between “putting her” in a nursing home or a residential care home.</p>
<p>Trying to go the Medicaid/VA qualifying route, but that may not work out because of inheritance problems. </p>
<p>At my wit’s end, because she has been progressing so well with her rehab, we thought sure she’d be able to return to ALF. Don’t know if there are underlying medical issues involved or not.</p>
<p>Seriously considering getting a short term lease in Houston to move over there to work things out, as this flying/rental car/hotel is getting expensive, and although I work from home, it’s hard to do from a hotel. Relatives in Houston are trying to help as best they can, but they haven’t been able to so far, they have young children and one spouse travels out of the city every other day for work.</p>
<p>Would love to hear any advice.</p>
<p>Thanks, guys!</p>
<p>Montegut - I am not sure I understand exactly what a residential care home is. My folks are in a continuing care community, which includes independent living, assisted living, skilled nursing. I want to make sure I understand the language. </p>
<p>Hang in there - for the last three months I have been involved with decisions about my dad (thankfully he is now at back at his independent living residence following surgery/hospital and two skilled nursing facilities), but I know how much there is to learn and how stressful it can be. </p>
<p>Somewhere in the midst of dad’s travails, I had an appointment with the doc and I ended up on BP medication and a refill for an anti-anxiety medication that he suggested I use a little more often. There have been a lot of days when I thought I dad would pull through and I was going to be the one in the wooden box!!</p>
<p>See my response on your other thread. The short-term lease sounds like a great idea if you’re able to swing it–would make this difficult period a little bit easier for you.</p>
<p>Is there a SNF near you, one that accepts medicaid patients? </p>
<p>I’ve only seen one reidential facility, but I’ve seen many ALFs and SNFs, so I vote for the SNF. I’d also want my parent near me, so I could drop in anytime and be there for major medical appointment.</p>
<p>In my area, there are some SNFs that are only private pay. Other nice ones accept only private pay, but have designated Medicaid beds for patient that have already been with them. Others accept Medicaid from the start. The outsider may see the private SNFs as prettier, with better food. What matters is the staff–are there many changes in Administrator? DON? (director of nursing) Activity Director? Social Service Director? Some older facilities don’t look smart, but are kept quite clean. Since it i hard to make a hift, I’d do it all first time around. Find one near you or another relative, and one that is not just private pay. JMTC</p>
<p>Montegut… So sorry to hear your Mom may not be able to return to her Assisted Living facility. Did the facility tell you she couldn’t return or are the rehab people saying she needs more care than she can get in Assisted Living? I’ve seen first-hand in my Dad’s facility some residents who become ill and never return, but others are in and out of the hospital and are able to return, even while requiring more assistance. The Assisted Living places are loathe to give up current residents because it’s just one more room they have to go out and fill, not an easy task given the current economic climate. Hopefully, your mother will make even more progress and be able to return to the ALF. Good luck!</p>
<p>Wanted to let all of you who were asking about the VA Aid and Attendance Benefit that my Dad was approved for the maximum amount- $1644 per month. I received the letter today. The VA received our application on November 19, 2010 and he was approved on February 19, 2011. From what I understand, this was quite a speedy approval. Kudos to the veterans at the Suffolk County Veterans Service Agency for all their help. I truly believe we would not have had an approval this quickly if not for their expertise. And their services were free! I heartily recommend working with such a group to others who are negotiating the slippery slope of VA Benefits.</p>
<p>Congrats, Peachy, on the VA award! That is quite a speedy turnaround!</p>
<p>I agree, the Veterans Service Agency people are great. The Houston office is in a terrible part of town, but I pay the extra 15 bucks a day for the GPS on the rental car so I get there safely. The young lady who has been working with me is awesome, so patient with all my questions, and giving me any and all forms I might need if I’m there in her office, or telling me where to get them on the website over the phone.</p>
<p>As it stands, our goal is to get my mom released on Monday, Day 21, which I will not be charged for, because it is her discharge day.</p>
<p>A Care Plan meeting is set for the following Wednesday, which I guess will be cancelled if she is released.</p>
<p>Unfortunately, the ALF nurse evaluated Mom last week, while she was still in a diaper, and of course, she said no to Mom returning. I have not shared this with my siblings, and definitely not my Mother, yet. The ALF director is working to get her another evaluation ASAP to hopefully get her back “home”.</p>
<p>I’m having a sinking feeling that it’s not just a mobility issue at this point for my mom. She is on oxygen all the time now, and even though there are people with oxygen at her ALF, I wonder if that might be holding her back from returning.</p>
<p>As of now, though, she’s not set for release, and I called the SNF business office to see if she would be able to stay longer. Of course she can, but we will pay the copay, but we can do a payment plan and even apply for charity. It’s not a religious facility, but she said they were not for profit, so we can apply for charity.</p>
<p>If it looks like Mom is going to continue to need skilled care, I’m going to have to have a family meeting to see if we should move Mom back closer to me, as I now have an empty nest, though I know she’ll get better care in Houston than in post Katrina New Orleans and surrounding areas.</p>
<p>I also will get the VA paperwork to the nurses to hopefully get to the doctor so I can have a doctor evaluation to give to VA, which is the final piece of paper I need. I have the marriage license and Dad’s death certificate, and I’ll hand deliver them to the VA office myself while in Houston next week.</p>
<p>Interesting that you said your Dad got the maximum of 1644. The residential care facility people get so excited when I say I’m applying for VA benefits. They think Mom will get a few thousand a month. I am quick to tell them that is not likely, we’ll be lucky to get a thousand. But every little bit helps.</p>
<p>Speaking of VA benefits, I was in a nearby town, less than an hour away, where there is a GORGEOUS war veterans home. It was absolutely huge, brand new, several wings. I wonder if spouses are able to go there? If not, those with Dads, or even Moms, who are veterans might look into such facilities for your parents. While many have complained of the qualify of VA facilities in the past, there may have been changes made and new facilities built.</p>
<p>Another VA question. I’m applying for benefits in Texas, since Mom has lived there for the last five years, but will she be able to transfer her benefits to Louisiana if she has to relocate to be closer to me?</p>
<p>Thanks again for all your support, and I’ll keep you posted.</p>
<p>Montegut – tough challenges. Really tough. Unless your mom has close family members who would be able to regularly (several times a week) visit her at a nursing home, I’d be thinking about moving her nearer to you or to another family member willing and able to keep a close eye on her. Even the nicest nursing homes have issues, and absolutely nothing beats having a family member who can observe what is going on and how the person is doing. At my FIL’s nursing home, which had a pretty good report from their inspection, here are a few of the situations we encountered:
- showers were scheduled early in the AM before his medication kicked in, and so he refused the shower each day it was offered. MIL interceded to get doctor’s order that his shower be scheduled at an appropriate time given his medication schedule.
- dinners sometimes had meat that he was unable to cut, and nobody noticed that he wasn’t eating his meat. Again, MIL had to intercede to have an order written that meat be cut for him.
- one roommate had severe dementia and was up all night saying things rather regularly, making it very difficult for FIL to sleep. Got him switched to a different room.
- He loved fresh fruit, and MIL brought him fresh berries, peaches, tangerines, and other premium fruit that the nursing home never offered.
- When it became clear that the twice weekly showers were inadequate for his personal hygiene, we arranged to pay an extra duty aide to give him a shower each of the other days, which greatly improved the condition of his skin and his b.o…
- One aide was a little too impatient and tried to feed my FIL too fast when he got to the point that he couldn’t feed himself. We needed to get someone else assigned who was not in a rush so that we didn’t have choking incidents. </p>
<p>This wasn’t a bad nursing home, by any means. It was clean, and the staff were generally very kind and helpful. But still, the need for someone to look out and identify issues was really important. We have an agreement with my MIL that if she needs nursing home care, she’s going to get it near our home for exactly those reasons. </p>
<p>Again, sending good thoughts – others may have had very different experiences, these were ours.</p>
<p>Montegut: Totally agree with Arabrab about moving your Mom near you unless there is a reliable relative willing to visit her at a nursing home on a regular basis. I notice even at the ALF, where residents are supposedly more self-sufficient, that things run smoother when a family member intervenes. I visit my Dad regularly, on different days and at different times of the day so staff are sure to know someone is checking in on him. Believe me, they all know who I am! lol I think this would be even more imperative at a facility where your Mom depends on staff for an even greater level of care.
I am not an expert on VA matters, but I can’t imagine why your Mom’s benefits wouldn’t transfer from state to state. The VA is part of the federal government so there should be no problem. We live in NY and yet the paperwork we received informing us of the award was sent from Philadelphia. Interestingly enough, each applicant receives a detailed explanation of their decision. Ours was 2 pages long! Wishing you good luck with the new evaluation.</p>
<p>Montegut, you really are in a tough spot, and it’s emotionally exhausting for you. I agree with the above posters, and I’ll add this. My mom stayed in assisted living for too long. They loved her there, and as a result I think they did not focus enough on how much assistance she needed. She was much safer once she moved to a nursing home where the care was more extensive and attentive. You are on the right track to move her close to you so that you can build a positive relationship with the staff–everyone from the social worker to the doctor to the nursing director to the CNAs who work with her on a daily basis. When you visit potential facilities, be alert to how they make you feel. Of course you want to assess how your mom would fit in, but if you do not feel that they respect you and your needs as the responsible family member, it might not be a good match.</p>
<p>Day 20 has come and snf learned mom does not have insurance to cover any more days, so she is released back to her assisted living facility.</p>
<p>Mom is holding court and gossiping up a storm about everyone she encountered.</p>
<p>I have been summarily dismissed, as she has gotten what she wanted.</p>
<p>She has no clue, nor does she care, that there is no more money, there is a lot of paperwork to be done.</p>
<p>I have been chastised because I threw away her month old crackers and other clutter in her room.</p>
<p>After two nights in a row of doing her laundry until 2 am, I am looking forward to a early bedtime and hopefully a plane ride home a day early.</p>
<p>Still trying to get medical poa, living will, dnr done, and doctor’s exams forms done, but can’t coordinate all the necessary parties to sit down in one place.</p>
<p>No sign of my 6’4, former state champ wrestler brother when it came time to move mom’s clothes, medical equipment, toiletries, out of her snf room and drive her across Houston back to her assisted living facility. </p>
<p>But, tears of joy as her “family” ran to the door to greet her and help me unload the car and get her settled in. They immediately brought her a cup of coffee and started their gossiping session.</p>
<p>Oh, well, she’s happy. That should be all that matters, right?</p>
<p>Don’t I wish.</p>
<p>Thanks for all your support on this forum.</p>
<p>OOh, montegut. I can soooooo relate. I have spent at least half, if not more, of every day dealing with my dad’s stuff-- dealing with the paperwork, the arrangements to clean/inventory/sell stuff, get things repaired, pay bills, change addresses, do taxes (for the 7th year) – essentially handle EVERYTHING that needs to be done. You name it, I am doing it. What did my bro do? Nothing. Oh wait- I take that back. He did something. He hired an attorney.</p>
<p>When I am next in NOLA we are going out for a drink!!</p>
<p>Montegut, I hope you hop on that flight soon!</p>
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<p>Classic. I cannot tell you how many friends have told me some version of this as they have dealt with aging parent issues. It is upsetting and adds more stress to an already tough situation. My sympathies.</p>
<p>Dad died a year ago, just yesterday I finally got rid of the last furniture item from the storage unit of things waiting to be dealt with. My local sibling does very little for Mom, my far away ones cannot do much, though sometimes I get annoyed with them that they simply live their lives and call her once a month or once a week whilst I have to think about her well being every single day. Then I finish my pity party and do the right thing ;)</p>