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Old 09-10-2008, 06:46 PM   #1
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Nursing Home vs Home Care

My 75 year old dad just entered Stage 7 of Dementia. His later stage 6 went by real quick. He was in the hospital for about 1 1/2 weeks and just 2 days ago was admitted into a nursing home.

Here is a little history <thanks for listening>: September 2006; my Dad got into a car accident and broke his hip. He was in the hospital and nursing home/rehab for 2 months. He came home to his house and fell down the steps and broke his hip for the 2nd time. Even though we set up a room on the ground floor; he was very stubborn and went up and down the steps.

After a hospital stay and rehab for 2 months; I did not want him to go back to his house. The rehab told me that he would need to live in assisted living for the rest of his live or move in with us. I visited him EVERY day that he was in the hospital/nursing home. My wife and I were living in a 1 bedroom apartment. My Dad moved in with us on Feb 8, 2007 in our 1 bedroom apartment. He slept in our bed and we slept on the couches. We sold his house and used the money to buy a ranch style house for the 3 of us. He has a life estate. We closed on the house at the end of April 2007. We have now lived in our house for 1 year 4 months and watched my Dad go through all the stages.

Now it is impossible for my wife and myself to take care of my dad. Even with the life estate; my Dad wont qualify for Medicaid for while. We are in jeopardy of losing the house if he stays in the nursing home <Long Story>. Medicare pays for the first 20 days. My eldercare lawyer wants $5000 to help fill out the Medicaid paperwork; which we don't have.

We live in NJ. What are my options in getting a aide to live in house to take care of my Dad. Will medicare / medicaid cover this? We can afford about $2000 a month for his care. My dad was in the Army. How much help can we get from medicare?

Anybody else take care of a parent/loved one with stage 7 at home with help of a nurses aide? Any suggestions?

I really love my Dad; but the Dad that I visited in the nursing was not the Dad that I as use to seeing. He really suffers from sundowners.

THANK YOU for taking the time to read my story!
Joseph

 
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Old 09-10-2008, 07:29 PM   #2
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Re: Nursing Home vs Home Care

Welecome to the forum Joseph. We all understand your feelings because we are there with you. There are some great caregivers on this forum. Some have kept their loved ones at home and some have them in facilities. They are at all stages. So keep typing. Somebody will be here with advice, an good ear, or a nice shoulder. We also throw snowballs, have an endless supply of towels, collect rocks, and have a glass of wine occasionally.

Veteran might have been the magic word. Does he get a military pension? Does he have Ticare? If so check with the Veteran's Administration. I know here in NC they have a facility for veterans. I am not sure of the medicade laws in NJ but most states have legal information much cheaper than you quoted. Check with your local bar association to find a lawyer or group that will help you. You can fill out the medicade paper work yourself. Lawyers just know all the hoops to jump through and when. Check with your social services administration for guidance. Also talk to the social worker at the nursing home your Dad is in. They should know the possibilities of help in your state. They should be able to give you the phone numbers you need and any information about your state. Call everybody you can think of or learn about. Eventually you will be the squeeky wheel in the right place to get the help you need. Don't give up.... keep trying.

I am truly sorry you are having to go through this with your Dad. My Dad has Vascular Dementia and my Mom has Alzheimer. We moved them into Assisted Living about a year ago so I do understand. Hope you stay for a while. I will keep you and your Dad in my thoughts and prayers.

Love, deb

 
Old 09-10-2008, 08:54 PM   #3
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Re: Nursing Home vs Home Care

Thanks for the quick response....It makes me feel better that I am not the only one going through this. I am 37 years old.

My wife even knows; that if I put my Dad in assisted living over a year ago; I would spend most of my free time there. It is starting over again...The last 2 weeks; after working 8 hours and a 45 minute drive home and spending a couple hours with Dad while he was in the hospital and now nursing home. I dont have any time at home for myself. The time that I have been home; I have doing chores. I guess I just care for my Dad too much (if that's possible) I just hate seeing home live in his little world now. He still knows my name.

I have 18 more days that Medicare will cover his care; to make a game plan.

No, my dad does not have a military pension. He had a honorable discharge; but did not spend a lot of time in the military.

I work in a different hospital (I fix computers for a living); even though its a different county; I am going to start there tomorrow and talk with the Case Manager.

I am just curious on how getting a "Home Health Aide" here in our house most of the time will work and cost?

Thanks again for your time,
Joseph

 
Old 09-10-2008, 10:08 PM   #4
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Re: Nursing Home vs Home Care

You are not the only one going through this Joseph. There are many of us.... too many of us.

The case worker would be a great place to start asking question. It might still be worth asking the VA what they will provide. The worst they can say is nothing and you are right back where you are now. You do need to check into the Medicade regulations in your area. Also talk to your physician. He/she may be able to validate the need for in home health care and have it paid through medicare at least for a while. Also check out Hospice. If your Dad has a medical condition along with his dementia they may provide some care. Contact your local home health care agency and see what they charge. It is different in different areas. It is also possible to find an individual that will come in perhaps while you and your wife are working. Your senior center, department of aging, even the hospital chaplin (where we found ours) might be helpful there. We had a angel of a caregiver that came in 8 hours a day 5 days a weeks for a year. By not going through an agency it was cheaper but you need to be careful since they come with no guarantees. You can also contact your local Alzheimer Association. They can be incredibly helpful answering any questions you might have.

I do know how much time care giving takes. I would just like to stay home. Mom and Dad lived 4 hours from me before we moved them. I would not more get home, run a load of laundry or two, fix supper, and they needed me back. I could make that four hour drive with my eyes closed. That went on for a year. Now they are ONLY 3 hours away. I end up making the trip now about every other week. I do have sisters that also help... which has it ups and downs. The fun part of my situation is that we have both parents with dementia. Dad is usually good natured unless he is riled at Mom. All he wants it to be with Mom and for Mom to be happy. Problem is, Mom is rarely happy. She is fighting this disease with everything she has in her. Throw in four sisters that don't see eye to eye and you have a recipe for chaos. But you and I and so many others keep doing it. It is not that we love too much. It is what caring and compassionate people do. We just have to figure out a way to do it smarter

Good luck in your search for answers.....

love, deb

 
Old 09-11-2008, 06:03 AM   #5
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Re: Nursing Home vs Home Care

Dear Joseph,
I just wanted to welcome you to this wonderful board....(sorry you have to be here though). My grandmother is in late stages of dementia and is cared for at home 24/7 by my uncle, with a little help from his brother. We live 3000 miles away and my mom goes back and forth every couple months to help, in fact, I'm driving her to the airport later today.
I'm not sure honestly about Medicare and how that all works, so I just wanted to say I think it's wonderful the care you and your wife have given your dad. I am a firm believer that one of the strongest medicines for someone with this illness, is a loving family. Unfortunately it tends to be difficult for the family to deal with, so it is wonderful you care so much for your dad.
Welcome again, I hope you can find an answer and if you need support, you couldnt have found a better place than the people here.....believe me...
Caroline

 
Old 09-11-2008, 09:06 AM   #6
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Re: Nursing Home vs Home Care

Hi Joseph!
Another kindred spirit! I take care of my father, who is entering stage 6 with a vengence. Daddy lives in the duplex next door to us (we moved him here to Colorado from Oregon when mom died in 04). Believe you me - I KNOW what kind of time it takes. I am married, 2 children at home, a stupid cat and I no longer have time to pursue MY career, so I am home now.

I am right where you are, Joseph. I need to move daddy to AL or NH, feel cast adrift when it comes to the "who, what, when, where", and of course, the money thing. Daddy has very very little money. Medicaid has a 5 year look back, and he had gifted my brother with a few thousand dollars a year ago, and that will toss him out of the running for Medicaid, so we cannot afford outside care. I am 53 years old, with a mighty full plate, and it looks like we have to move dad in with US for the rest of his life.

I am afraid I have no ideas for you. If I had any, I would use them on myself. Ha. All I can do is pray for you, and I will certainly do that, and tell you to just do what I do - hang on.

The towels Deb passes out are so helpful. I have an extra - I will toss it to you - it comes in handy for wringing out of frustration, yelling into, wiping off the tears you shed when you least expect it, winding up and snapping at doctors that don't listen to you (that's ok, right Deb? It's either that, or I commit a crime...), and mopping up the spills our LH make.

Welcome, Joseph. Hope to see you around....
...little deb

 
Old 09-11-2008, 11:15 AM   #7
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Re: Nursing Home vs Home Care

You are so right little deb... every caregiver needs an endless supply of towels and support!!! We have BOTH....

Little deb, Medicaid will not eliminate you because of the gifting. The only thing they might make you do is pay back the gifting. You always have the option of telling Brother dearest you have to have that back I am not sure exactly how gifting fits into the look back and spend down but I am trying to get a lawyer appointment to find out. Mom did some MAJOR gifting in 2007.

Hope today is a good day Joseph and look forward to hearing from you again.

Love, deb

 
Old 09-11-2008, 12:02 PM   #8
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Re: Nursing Home vs Home Care

Can't swear to it, but I believe what I read indicated that the gifts made during the lookback period only delay when Medicaid kicks in. So if your dad gave away 5K and is in an NH he'll be expected to spend down his assets and kick in an extra 5K before medicaid pays. I've no idea where he's supposed to get that 5K, but I vote for getting it from the person gifted.
Q

 
Old 09-11-2008, 12:47 PM   #9
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Re: Nursing Home vs Home Care

Thanks, ladies, for the advice re: gifting. Here's the issue...Bro could no way pay back gifting. No way. And as far as dad having to pay for care till the "gifting" is basically repaid...no can do that either.

See what a mess this is? Dad was in charge of his own finances then. He was FINE, mostly. He knew what he was doing, and it was generous and sweet of him. But now, it leaves a mess in MY lap.

This system is the P I T S. Hate it.

Deb - after you appt, would you let me know what you find out? Hell. I can't even afford my own lawyer.... *sigh*

...little deb

Last edited by skimps46; 09-11-2008 at 12:48 PM.

 
Old 09-11-2008, 02:09 PM   #10
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Re: Nursing Home vs Home Care

Understand what you are saying little deb. It will be next week before I can get back with the lawyer to finalize an appointment and then it has to wait until I go back to where Mom and Dad are. I am getting an appointment there so my other sisters can attend as well.

I think you are right Q. Little Deb.... would it be possible for brother to take out a loan to make up the difference. It is a shame to miss out on a major benefit for the want of a few thousand dollars.

Love, deb

 
Old 09-11-2008, 03:19 PM   #11
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Re: Nursing Home vs Home Care

Well, Deb, it seems that when lil' bro got a few thou from dad, did his obligatory visit out to see dad (trip ALSO paid for by dad), got a few MORE thou from dad...he had done all he needed to do, and for the life of me, I cannot get bro interested in his father again.

I can see what happened. My brother is an opportunist. He got some money, and now, doesn't see the need to write, call, or email me so I can tell daddy he's called. I talked to bro a couple of weeks ago, and he was singing the same sad song that made dad gift him, and I am not falling for that again. He never asked about dad, although I did tell him about his father. He seemed barely interested, although he did say he "thinks" about dad every day. Big freaking deal. Stop thinking and DO, lil' bro.

So, no, Deb, bro will in no way take out a loan. He can't even manage to drop a card in the mail for the man.

Makes me sick...

...little deb

 
Old 09-11-2008, 04:14 PM   #12
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Re: Nursing Home vs Home Care

Oh little deb, it makes me sick too. We're dealing with a similar problem with my mother-in-law. Lived in Florida near husband's brother and wound up "loaning" all her savings to brother, even co-signed for his drum set! The man is 50! Now she has a house in Florida on which she owes more than it's worth, spends all her income keeping up the bills on it because she was raised that way, and is dying up here in her daughter's house because the brother wasn't caring for her. We all want to kill the brother but will wait til she's gone as it would only cause her grief. I plan to call him and demand his 1/3 of the funeral expense. I won't get it, but I'll feel I've called him on his phony concern. You probably won't get anything either, but call your brother, explain the issue and force him to say no. He'll have to live with it, and you'll feel you tried.
Just my $.02 and worth about that, but those that don't contribute time should contribute money.
Q

 
Old 09-11-2008, 07:42 PM   #13
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Re: Nursing Home vs Home Care

I don't have a problem with calling a spade a spade. I would make sure brother knew the situation and what he was depriving his father of little deb. Even better than a phone call, a letter that he can read over and over. There's something about the hand written letter that seems to carry more energy than e-mail. Just lay out the facts and tell him what you father needs. Then ask for an answer. Lay it at his feet and as Q said... he will have to live with his answer. I'm not one for letting the nondoers get by with not having to respond because they haven't cooperated in the past.

Knowingly Mom has never been partial to one over the other. If I get something the other three get the same. If a grand child gets something then they all do. Her gifting was across the board... to all 10 (4 daughters and 6 grand daughter). I think.... no I know she knew what was coming and wanted to do that out side of the 5 year window.... just in case. I don't think she realized that a year later she would be in AL.

Keep working on getting help little deb......

Love, deb

 
Old 09-12-2008, 03:19 AM   #14
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Re: Nursing Home vs Home Care

Definitely call the VA. Even though he doesn't have a pension, he's going to be entitled to Vet benefits. There might be a waiting list, so you want to talk to them and find out his benefits (for ex., help with medications, a NH facility, etc.) asap.

 
Old 09-12-2008, 07:15 AM   #15
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Re: Nursing Home vs Home Care

Thank You to everybody for your kind words! My dad has been in the nursing home since Monday. I have visted him everyday. I work till 5; and get there by 6. Most nights his sundowners has been severe; last night he had problems keeping his eyes open;and very tired.

He is not a big guy; but ALWAYS had a HUGE appetite. Some times I don't know where all the food went. He always wanted seconds; and rarely took food home when we went out to eat. Every day this week; he has eating nothing more than a couple of spoonfulls. This is 100% not my dad. I am off on the weekend; so I can't wait to see if he eats better for lunch.

I have been getting home by 8 or 8:30; doing some chores around the house and eating supper really late. This is really starting to take a toll on me. I hate seeing my dad like this. I wear a beeper for work; but I very rarely get paged after work. Last night I was sitting with my dad; looking at my pager hoping I would get paged to come into work. {so I wouldn't feel guilty leaveing} I am always SO depressed after seeing him like this. My mind is playing with me; part of me says that I need to be there every free moment I have; the other side says that I should be home playing Xbox 360 and relaxing. My dad's nursing home is about a 10 minute drive from our house. I work 8:30AM to 5; Mon-Friday. My wife works different hours every week; she works in retail. My dad has been living with us since February 2007; where his Dementia was only in the begging stage.

Thanks again for taking your time and reading my messages.
Joseph

 
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