<p>A dear friend of mine has a family issue, her brother has had some serious medical issues lately and it has affected him mentally, too. He never had any sort of job that would provide benefits and now he truly cannot take care of himself. The various siblings have taken turns staying with him, but they are all running out of time to do that.</p>
<p>Is there any state run, Medi-Caid, etc., type of option? He really needs 24 hour supervision and no one can quit their job to take care of him full time. I am trying to help her find the options in California.</p>
<p>This is a really difficult situation. Is he qualified to received Medicaid (basically less than $2000 in assets)? If so, there are nursing homes that accept Medicaid patients, although they’re of varying quality. Another option would be to contact Adult Protective Services in the brother’s county and see what services they might offer.</p>
<p>Ditto what vballmom said. We know someone with this situation. If the assets are not yet depleted, the home will use them up until they reach $2,000 or less, then Medicaid kicks in if he is eligible. Good advice about APS too, although we do not have first hand experience with that. </p>
<p>Also check into adult daycare situations. My grandmother (post-stroke, lived with my parents) used to take a handicap bus a short distance to an adult daycare that was associated with a church. It was a fantastic arrangement for my mom, and my grandmother had the socialization she was lacking sitting in my parents’ house every day.</p>
<p>One more thing - it sounds like he needs more than assisted living if he needs 24-hour supervision. Assisted living will not provide that.</p>
<p>A couple quick comments … both in my experience finding a place for my Mom</p>
<p>Some assisted living centers can provide 24 hour care and have dementia units and lock down units (to prevent wandering) … the big limitation compared to nursing homes is the level of medical care that can be provided … as long as the patient is physically OK some places would deal with almost anything else.</p>
<p>Here’s the tougher one … some of the assisted living centers we saw that would be good for my Mom were privately run and did not take medicare … some did take Medicare but they also required the remaining portion of the regular bill to be paid somehow … so these were all expensive options. For my Mom her long term care insurance allowed us to pursue assisted living … when the LTC insurance runs out we probably will be moving her to a nursing home on Medicare.</p>
<p>As rule, if there is to be subsidy of Assisted Living level of care, it is done through Medicaid or an “emergency aid to elders and children” type of program that varies by state. There is rarely subsidy for standard assisted living (hotel-style with 3 meals and add on personal care services), as a medical component with nursing staff that administers medications for example is needed to qualify . Assisted Living is not one level of care and it is important to know how different facilities operate and what they are licensed to do. Medicare does not usually pay for long term care, though this person sounds like he might qualify for SSDI (Social Security Disability) which is not age dependent and requires a high bar for eligibility. </p>
<p>Local resources to research this could include:
Councils on Aging, groups that support the disabled or mentally ill, half-way houses themselves, state organizations for the specific issues, and hospital social workers as others have suggested. Additionally, there are sometimes support groups for relatives that network and share resources. It may also be worthwhile to see if there are any social work or other professionals with an expertise in his problem who could be hired hourly for help with placement and applications. </p>
<p>I feel for this family and hope they are able to come up with a viable solution. Usually, it takes time to get this all set up and though I don’t live there, California’s budget issues may impact available options.</p>
<p>He would need to be declared disabled to qualify before age 65. A good option might be a home health aid, but this will require considerable effort to select someone appropriate. The program allows for family members to be paid for their time providing care. It was on the chopping block during budget cut season but I believe it was preserved because home care is less expensive than institutional care.</p>