You are so lucky!!
When my perfectly healthy 85-year-old mother fell (off a curb into a parking lot while chatting with her friend who almost didnât see the curb either) two years ago and broke her kneecap, the surgery was outpatient, and she was released to me without any discussion of what would be required for her post-op care other than not to put any pressure on the knee for (I forget how many) weeks, thus a wheelchair. So, I brought her home, set her up on our couch, and quickly learned that she was basically helpless, and that I would have to do everything for her, including helping her to the bathroom, washing her, etc. And this was two months before my own hip surgery when my pain was at its worst, and I was partially immobile myself. Later, when she moved to a walker (still at my house), we BOTH fell as I was trying to help her transition to the couch. Fortunately, that fall was on both of our âgoodâ sides, but we were both scared and lucky to avoid further injury.
As I posted on the other thread, that incident was a good test of the design of our house, but it triggered serious discussions about how unprepared and ignorant we were about how insurance works and what caring for someone with mobility issues really means. My mother has a BCBS Medicare plan that covered her bills but, as others have posted above, would not cover any rehab or in-home nursing. Also, she has SS and a pension that adequately cover her monthly living/spending needs, but my brother and I own her house and car. She has no savings to speak of; three months in a facility at the prices listed in these threads would wipe her out. So what will happen to her if/when something else happens?
After living through her knee injury, DH is adamant that no one will be living with us (not his parents or mine). We split our time between AZ/ME, and my only sibling and SIL split their time between MI/FL/SC and cannot take her in either should it ever come to that. DHâs parents (both âhealthyâ PhDs) are suffering from early-stage dementia and have the resources for in-home or (eventual) facility care, but they are fighting the person who recently started coming in the afternoons to ensure their pills are taken correctly and to grocery shop, do light housekeeping, and make them dinner.
Right now, weâre in the magical thinking place that we have time as both my (divorced) parents, now 87/88, are in good health and live active lives on their own. My dad is married and has resources, but my single mom worries me. Iâm following the caring for parents thread, but it scares me as my mother has no money. If she ever requires full-time care again, we have no idea what will happen. I know that this is a discussion for that thread, so no need to respond here.
To the point of this thread, though, my family is in the great-genes pool with zero health issues â until there were. I had a hip replaced at 65, my brother fell 12 feet off his boat in dry-dock face down on the cement and will suffer for the rest of his life with chronic pain, my mom fell off that curb, and my dad was diagnosed with non-Hodgkin lymphoma two years ago (cancer-free now). Life happens. The Serenity Prayer sums it up for me.
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Sending you hugs. This is challenging for sure.
And the arguing with the home health aid⊠ugh. Does not get better, even when itâs someone your elderly parent actually LIKES and has bonded with!!!
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The insurance stuff is my greatest fear. My dad was career military so mom has Tricare and we have not worried about her medical at all. But as she gets more physically disabled in part because of the dementia my siblings and I, who want to honor her wishes and keep her at home, will struggle with her care. My SIL already doesnât do basic things like dump her bedside potty so itâs only going to get worse.
Three months ago, while I was there taking my shift, I brought a guy in to talk to us about how much hiring an aide would cost. The SIL who wanted to hire someone for 14 hours/day changed her mind really quickly about that once she understood how much money is involved. I am so thankful that hospice is providing an aide three times a week to bathe mom.
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H isnât yet 70 but is close, and he definitely is in denial about what he can or should do now compared to 40 years ago. Iâve learned to hire people to do certain projects on the house and tell him only after theyâve been scheduled, otherwise he insists on doing everything himself. One day of intense work outside results in him needing soaks and naps for several days, if heâs been lucky to not get badly injured.
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Itâs great you and sibs agree to make that a priority. But if at some point she declines badly, itâs possible she wonât appreciate the difference being home vs elsewhere. (Speculation, based on my grandmotherâs Alzheimerâs⊠eventual nursing home after years of my mom caring for her parents full time.). At that point I suspect the âold normal momâ would want have been OK with you moving her elsewhere. The main thing is the good care at home before that point.
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My MIL was adament that she stay at home - and she was showing signs of dementia in her early 60s. Her husband wouldnât let anyone move her. Nobody was ever really clear about it, but we think he had a mini-stroke in his 50s. He was fine, but just not as sharp as someone with his education and job (diplomat) should have been. It turned out home health aids cost about the same as putting the two of them in some kind of nursing care where they would have been separated cost about the same. But it was pretty stressful for years. When my MIL finally passed away (wheelchair bound and unable to talk) we were able to persuade my FIL that he needed to go to assisted living. It was great for him as he was extremely gregarious.
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or not, thereâs just so many different experiences and no way to know. My father always said âdo whatâs bestâ but by the time he declined through âgets tiredâ and âsometimes he canât thinkâ he was solidly in âimaginary thinking and fixated on itâ so you arenât having a conversation at all. So heâs not oriented to real life, but certain that he is.
Nevertheless, he was totally fixated on going directly home, sure that we had conspired, furious with my mom, who was heartbroken at his anger. I had to tell the people tranferring him to hospice to put him in restraints. It was just so traumatic, but we had to move him anyway to save her. I wouldnât wish it on my worst enemy.
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At this point, itâs not my mom by my siblings who will be the biggest obstacle to moving her out of her home. They are adamant so I wonât fight it. Eventually, likely, they will need to hire care. But my sister doesnât want strangers in the house. 
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Iâm typically pretty trusting of people, even strangers. But⊠when I thought weâd be hiring care for my mother at her apartment, we decided to send the valuables over to my house. Of course she was the real precious asset, but my sister had already set up cameras by then.
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Try checking the costs of companions or assistance before deciding whether you can actually afford them. In our case, they were >$24,000/month! They varied on their level of skill and some times were totally unavailable and family had to fill in the gaps.
As was said, they can have differences about the minimum # of hours they will work and you have to be sure they are paid for all benefits they are entitled to, including workerâs comp, social security, overtime, medical insurance, etc.
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My friendâs insurance will cover much of the cost of a non medical aide, even if it is a family member. That is unusual but not unheard of, and can make a real difference. Her niece quit a p/t job to be the laundry/food/cleaning/companion person, and was paid to do so but nobody had to worry about the valuables, etc.
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Yes, LTCi each has its own terms and conditions. When it allows the hiring of family members or loved ones, it allows more flexibility and itâs great that family was able to pay someone that the patient preferred.
When you self-pay, you have more options, as long as one can afford those options.
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My mother had decent LTC, $200/day. When I went through the motions to invoke it, we did discover that home care was only $100/day. (She died shortly after, so I never submitted the bill for the single homecare visit).
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And to add to Colorado Momâs post-- do not assume ANYTHING with a LTC policy.
You can have a parent who is significantly compromised and then have claims rejected, because the insurance company will send their OWN person to evaluate and make a determination. Theyâve got a rubric-- theyâll decide if the deficits meet their interpretation.
Fortunately I have an acquaintance who runs a home health care agency (not in the state where any of my parents/in-laws lived) who was able to give me some filing tips. The bills you get from a facility may or may not be broken out and itemized in the way your LTC insurer needs to see them in order to pay on a claim. E.g.-- Meds management. If you are paying for someone to show up in a parents room twice a day to administer their meds, it needs to show up on the bill as âMeds Managementâ with a daily rate. Not a fee that is ârolled intoâ the overall service package (facilities love a service package). You need an a la carte bill to get reimbursed, not the âall you can eat buffetâ at a Vegas casino!
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I was lucky with my momâs LTC policy. While waiting to be sure she met the ADL criteria, I learned that just being on Hospice seemed to be enough. I initiated policy by phone - if there was any follow-up proof paperwork to submit (donât recall) it was easily accomplished. I have heard lot of complaints from others on this topic, so like I said⊠I got lucky.
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Exact same experience. We called it in when my husband was put on hospice care. LTC started while he was still mobile and handling most needs himself. He wanted to remain at home and LTC helped us make it happen.
We were lucky.
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