Archive for the ‘Long-term Care and Medicaid’ Category


Adult Day Care Question

Thursday, July 2nd, 2009

Question: I am the primary caregiver for my elderly mother. I have become aware of the daily stress and emotional and physical impact it is having on my health. What can I do to give myself a break?

Oast & Hook Answer: We recommend you look into an adult day care facility in your area. Adult day care respite is two-fold. It gives the caregivers much needed time to themselves, and it gives the caregivers’ loved ones social and interactive therapy with their peers.

Many adult day services offer such things as:

  • Social activities; music, movies, crafts, excursions;
  • Meals;
  • Fellowship support;
  • Assistance with daily living;
  • Nursing care;
  • Help with activities of daily living;
  • Medications;
  • Physical therapy; and
  • Transportation.

Finding an adult day care provider takes a little investigating on your part. It is important to know what you are getting and that your loved one is comfortable with his or her new surroundings.

First: Ask for recommendations. Check with your local senior center, Area Agency on Aging Services, mental health centers, physician, clinic, family, friends and neighbors. The best recommendation is by someone who has used the adult day care or is familiar with those who run it.

Second: Phone and ask the facility to send you information. Ask specifically to be sent the application, eligibility requirements and payment information. Ask to see the calendar of activities, menus, hours and days of operation to be sure they fit your schedule. Ask about availability of transportation to and from the location and what is the cost. Ask who runs the facility. Is it private, non-profit or a franchise or part of an assisted living facility or a nursing home?

Third: Visit the adult day care facility. Go visit the provider location along with the person for whom you are providing care. See if the staff is friendly. Check that it is clean and odor free. Ask about the experience of the staff. Request a list of references.

Fourth: Find out the cost and payment requirements. A survey from NCOA/NADSA provides the following information on fees: “Fees for Adult Day Care providers range from $25 per day to $70 per day, with the average around $50 per day. Many facilities provide services with a sliding fee scale.”

One last word of advice. Don’t feel guilty about taking your loved one to adult day care.

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Long-Distance Caregiving

Monday, June 22nd, 2009

Question - I live in a different city than my parents. Keeping in touch by telephone and making long trips to help my parents with their needs is very time-consuming and not nearly as effective as being available full-time in person. What are my options to make this easier for me but to also make sure they are taken care of.

Oast & Hook Answer - Living in a different city or state, miles from aging parents, can be difficult.

The long-distance caregiver is a new role that is thrust upon children and younger family members. Families used to live closer together, with children residing and working near their parents. But nowadays family members are more distant from each other. Society, today, is recognizing this. Some caregiver services have tweaked their programs to work as liaisons between long-distance caregivers, senior loved ones, and local medical professionals.

Professional care managers, also known as geriatric care managers, elder care managers or aging care managers, represent a growing trend to help full time, employed family caregivers provide care for loved ones. Care managers are expert in assisting caregivers, friends or family members find government-paid and private resources to help with long-term care decisions.

They are professionals who are trained to evaluate and recommend care for the aged. A care manager might be a nurse, social worker, psychologist, or gerontologist who specializes in assessing the abilities and needs of the elderly. Care manger professionals are also becoming extremely popular as the caretaker liaison between long-distance family members and their aging loved ones.

The most important thing is to find a geriatric care manager where your loved one lives. This geriatric care manager will have knowledge of all the services in the area and can be your eyes and ears.

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Stimulus Payments for Seniors and Persons with Disabilities

Friday, June 5th, 2009

The American Recovery and Reinvestment Act of 2009 (ARRA or Stimulus Bill) includes a one-time payment of $250 to anyone who received any kind of Social Security benefit, including retirement, survivors and disability benefits, Railroad Retirement or Veterans Administration (VA) disability compensation or pension benefits during November 2008, December 2008, or January 2009. Most people who receive Supplemental Security Income (SSI) will also receive the one-time payment; however, persons in nursing homes who receive a monthly SSI benefit of $30 will not receive the payment. Most payments will go out this month and all should be received by June 4, 2009. Children receiving Social Security benefits who are under the age of 18 (or 19 if still in high school), will not be eligible for the payment; however, adult children who receive disability payment on a parent’s record will receive a payment. Additionally, children who receive SSI will receive a payment.

Eligible recipients will receive a notice regarding the payment. The payment will go to the recipient using the same means as the regular benefit. For example, if the usual monthly benefit is directly deposited to a bank account, the one-time payment will also be directly deposited. If the usual payment arrives by mail, the extra payment will be mailed as well.

If a person is in a nursing home, and the usual monthly benefit is sent to the nursing home, then the one-time payment will be sent to the nursing home as well. According to ARRA, the nursing home must set aside the $250 payment for the nursing home resident to use as the resident sees fit. The law specifically states that “The entire payment shall be used only for the benefit of the individual who is entitled to the payment.” The nursing home is not permitted to keep the funds and apply them toward the resident’s nursing home costs. The Centers for Medicare and Medicaid Services (CMS) has advised nursing home surveyors about the one-time payment and residents’ rights to the payment.

The one-time payment will not count as income for federal, state or local benefits. The amount is also excluded as a resource in the month in which it is received, and for the following nine months without being taken into account for purposes of determining eligibility for Medicaid. If the funds are not spent by the end of the ten month period, then the remaining funds will be counted as a resource. The payment will not count as earnings for Social Security disability benefits. Additionally, the payment also will not count as gross income for income tax purposes.

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