NPR addresses how to talk about financial and health issues in their story “How to Start Talking Details With Aging Parents.”
It would be nice if everyone could get along…
When a parent needs long-term care and siblings are involved, it’d be nice if everybody just got along, wouldn’t it? But so often, that’s not the case.
Caregiver expert Linda Rhodes writes about this from a financial perspective in a recent blog post at the website for Pennsylvania newspaper The Patriot-News. She answers a question about siblings not being able to agree on how much money to spend on their mother’s care.
Rhodes says there are four basic money styles: savers, spenders, avoiders and worriers. If, say, you’re a saver and your sister is a spender and your mom wants to move to assisted living:
Instead of arguing with your sister over “what’s best for Mom,” use your differing perspectives to cover all the bases in exploring her options. Your sister could take your mom to view different places and make a list of the pros and cons of…
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Really helpful advice and suggestions here about how to talk to your parents about the really tough issues! While you’re there sign up for their newsletter, it’s excellent.
I can’t tell you how many times a patient comes into “a” skilled nursing facility for physical therapy and/or skilled nursing care and they assume that they receive all 100 days of their Medicare A benefit. Here are some things you should know if your parent needs skilled nursing care.
- They must have had a 3 night inpatient stay in the hospital. (We’re seeing more people being admitted under observation; this will not qualify them for a Medicare stay in a SNF- skilled nursing facility.)
- The benefit is 100 days per qualifying stay/condition; however the patient needs to meet the criteria in order to receive their benefit. What this means is that they need to have orders from their physician for physical, occupational, and/or speech therapy and/or have a daily skilled nursing need such as IV antibiotics. As long as the patient continues to improve in therapy or that need for daily skilled nursing continues the patient continues to receive their Medicare benefit. I always tell my patients that the SNF will want to keep you on Medicare as long as possible because they get reimbursed at a higher rate, therefore, they will not want to cut your therapy short. If you disagree with the facility in the discontinuation of your Medicare coverage you have the right to appeal. The facility is required to give you a notice of non-coverage AND the number to call to appeal the decision.
- The first 20 days Medicare pays 100% of you skilled nursing facility daily rate (as long as you continue to meet criteria). 21-100 days Medicare pays 80%, usually your supplemental insurance covers the additional 20%, but you should check with your supplemental insurance company. You can contact your local SHIP (Senior Health Insurance Program) office to discuss insurance coverage. This is an excellent resource. https://shiptalk.org . Another good resource is http://www.medicare.gov.
Medicare coverage in a skilled nursing facility, sub-acute rehab, nursing home (whatever the facility wants to call themselves) is determined by:
- Three night (inpatient) stay in the hospital.
- Meeting the criteria to receive the benefit AND continue to meet the criteria.
This Time Magazine article on building a financial plan with aging parents has great suggestions. The slow transition approach has really helped our family adjust to our new roles. We have slowly started to accompany our parents to doctor, accountant and banking appointments. We also talk openly about aging issues. By being transparent with our parents they are less threatened with our ever increasing involvement in their lives.
Extra income is available to pay for the home care, assisted living, or nursing care of veterans!
1. If the Veteran: received discharge from service under any condition other than dishonorable, served at least 90 days of active military service 1 day of which was during a war-time period, AND (or Surviving Spouse) is age 65 or older.
2. The Veteran is permanently and totally-disabled, AND total countable family income is below an annual limit set by law.
Periods of wartime are:
World War I: 5/9/1916-11/11/1918
World War II: 12/07/1941-12/31/1946
Korean Conflict: 6/27/1950-1/31/1955
Vietnam Era: 8/5/1964-5/7/1975
Persian Gulf: 8/20/1990-present
As a general rule assets cannot exceed $80,000. A veteran or spouse’s home and a vehicle are exempt from the asset test.
Will the pension benefit pay a nonlicensed homecare provider?
VA does not pay providers directly but provides extra income to make up for the cost of licensed medical care. Medical conditions or injuries or diseases that require a need for ongoing licensed homecare will allow the applicant to reduce household income by the cost of homecare making it possible to receive the additional income from a pension award. If the beneficiary has an aid and attendance or housebound allowance, VA will allow deductions for nonlicensed providers as well. If the beneficiary receiving care in assisted living has received a rating for aid and attendance or housebound, VA will allow expenses paid to assisted living for aid and attendance or housebound ratings — including room and board — to be counted as unreimbursed medical expenses. The cost of assisted living being used as a retirement residence is not considered a medical expense. It does not warrant a rating and cannot be deducted.
www.longtermcarelink.net can provide assistance in finding help in your area.
If you suspect that your parent is lonely here are some suggestions for ways to help: