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Aging in Place

by Nichole Salva
Thu, Jun 11th 2015 02:00 pm
The Wedge Newspaper  [ View Original Article ]

 I have yet run across anyone who wants to live in a nursing home. I work daily with individuals that are aging and struggling with chronic medical conditions trying to stay healthy and safe enough to remain in their homes.

Skilled Nursing Facilities are a necessary option for some who truly required that 24/7 skilled nursing care. However, I have found most people prefer staying in their own homes if at all possible. When I talk to people in the community who need services they are always shocked to find out that Medicare does not cover long-term care services.

If you need an aide to come in and help you with meals, household chores or take a bath on an ongoing basis it is not covered by Medicare, the primary insurance of most people over the age of 65. You can get skilled care in your home for acute care, but on short-term basis paid by Medicare. Most people are able to get this service for instance upon a hospital release - but what are the options if you need care ongoing to stay safe? 

If you have money, you have many more options such as Private Pay, Independent Living and Assisted Living settings. Some people have also been able to plan for Aging in Place --Not Easy or Cheap, says  Robin Didas-Mott for the future with long-term care insurance policies. 

Most of these options are not affordable with the modest income and resources that most people have. Even if you planned well for the future, people are outliving their savings. I went through this scenario personally with my own father as he aged. He wanted to stay in his home but required 24/7 care. When we sat down to figure out what this care would cost, it was more than double his income and his limited resources would only last a few months. In his situation, a skilled nursing facility was the safest option for him based on his medical needs and so we started the process of applying for Medicaid Insurance to cover the cost of care. 

I wanted to write this article to let people know that there are other options to consider if you want to stay in the community safely with supports and have limited income and resources. That other option is Medicaid Insurance with long-term care services. Medicaid Insurance does cover long-term care services if medically necessary. Our community offers many options for Medicaid Long-Term Care. Are you afraid that you or your loved one would not be Medicaid eligible? It is worth exploring with someone knowledgeable of the criteria. Individuals with chronic medical conditions or who are already deemed disabled can get eligible for Medicaid Insurance even if they are over the income guidelines. Medicaid requires a "spend-down" which means you must spend any excess income before you can get the insurance. People can also legally put excess resources and income into a Special Needs Trust account to get Medicaid eligible. Special budgeting such as spousal refusal is sometimes used not to impoverish the other spouse. This is very clearly a complicated topic, and I could never go into all intricate details in one article. My primary goal is to inform people that other options may exist. Lifespan is an agency in our community that is a good resource to explore options or contact this writer with questions at rmott@ ventureforthe.com. Robin Didas-Mott, BSW, is a Community Outreach Coordinator at Venture Forth Inc. a Licensed Home Care Agency.