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Old 01-16-2018, 10:50 AM
 
Location: Raleigh
8,350 posts, read 6,200,449 times
Reputation: 11665

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Quote:
Originally Posted by FREE866 View Post
The recurring phrase I see on this thread is "to prepare". If someone could clearly define that it would be helpful.
Have a plan for the common "what-if's" as much as possible.

Put yourself in a position where you're making your own decisions instead of being forced into a hard decision by those close to you.

The ugly question mark is of course dementia.

But, if you've prepared, put yourself somewhere where there aren't stairs, where the bathrooms are accessible, made arrangements for your lawn care, etc, well ahead of time, it makes things easier.

One elderly relative had her hand forced when she simply couldn't navigate the stairs to her bedroom and bathroom without sitting on her bottom and scooting down, and the laundry was in the basement.

Another held on longer than could have been expected since he had a single step into his house, and paid a housekeeper to do his laundry, and bought almost exclusively pre-prepared food that he just microwaved most of the time or would eat sandwiches. What ultimately spurred his move into a senior apartment was the distance from the bedroom, kitchen, living room to the bathrooms. He wasn't incontinent per se but couldn't move fast enough to the bathrooms sometimes.

This relative was actually "counseled" by his brother, who was mildly disabled from Polio. His brother was a mechanic who rebuilt hot rods, but also lived on some acreage. In the winter, he'd walk into his heated garage, open the door, and drive his snowblower (attached to a garden tractor) to plow his 1/8th of a mile driveway...He'd back it into the garage, have four steps to the door.

I think the big thing is the inability to get to the Dr/Drive, and the inability to cook, etc...

Last edited by JONOV; 01-16-2018 at 10:59 AM..
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Old 01-17-2018, 03:54 AM
 
10,604 posts, read 14,232,720 times
Reputation: 17208
Quote:
Originally Posted by reneeh63 View Post
Just to clarify, I don't think you are talking about different quality of care within the same facility. While their may be beds with different levels of necessary care, there is NO difference in the quality of care given to Medicaid and self-pay residents in the same facility.

It IS however entirely possible that facilities with a higher proportion of self-pay residents end up with better employees, etc. and so the overall quality is better, across all beds. Lower quality facilities may end up with more Medicaid residents and then they're stuck in a downward spiral - that again, affects ALL their beds, not just the Medicaid beds.
Correct, I'm not talking about a different quality of care within one facility. How would that work? LOL All the crappy CNAs get assigned to the Medicaid beds?

LOL you seriously think that people think there's some dividing line of care between a specific headcount/bed in the same place depending on the method of payment? I have to say, if that's the case there is no hope for the human race if they have that poor cognitive skill or research ability. Then again, this IS the internet.

The only dividing line on paper is that you'll end up sharing a room on Medicaid.

I'm talking about "all the good beds" as in - all your better facilities versus the last choice facilities (and I know of which I speak since that happened to my mother who happened to have enough cash to pay private Registered Nurses 24/7 even AT HOME indefinitely but it did her no good).

I'm talking about Medicare paying about DOUBLE what Medicaid does - for that 100 days and then any self pay thereafter. Why wouldn't a business seek out those type of clients? (they do)

It's all about "the beds" with Medicare and Medicaid and even self pay residents. Finding a good resident. A resident finding a good bed - and therein a good facility - is worth it's weight in gold and you can't put a financial price on it.

Case in point - one near me (a combo rehab and SNF) was a crap hole. Then it was bought - now it's really nice. Everyone is fighting to get into it. My neighbor, a seasoned private caregiver, just managed to finesse her sister into it as a permanent resident. Her family member happens to own a business doing Medicare/Medicaid billing for a living, too. But if she didn't know what she was doing - the social services at the hospital during her last admission and even the woman's own daughter and even her own Eldercare lawyer would have fallen for the "if she gets better" line...and sent her HOME AGAIN only to repeat the cycle of needing to go to the hospital for the 5th time in as many months and struggling to find placement in the GOOD SNF if they didn't jump at the chance to get in there right NOW.

It was lucky my friend went to the last appointment to the lawyer with her niece and caught the mistake of them suggesting they "let her go home" until they got her (very limited) finances in order. FOR WHAT? There was a permanent placement offered to her NOW. She needs it. She wants it.

So you want to stretch out her case so you can make a few hundred dollars in billable hours more? Making up dumb trusts and stuff instead of letting her take her $40,00 and pay for her care in a GOOD PLACE after her Medicare 100 days runs out?

You know, these lawyers all have connections, too and they have their own agenda. Which also happened to my mother. Her well connected lawyer got HIS mother in the BEST facility and simultaneously failed to do anything for MY mother except trick her into signing a scamm-y POA to him.

And it's weird because I live in a very desirable FL county with alot of wealth. But not a lot of services for senior placement. Also weird and ANNOYING because all these wealthy people spend all their free time and money on charitable causes for CHILDREN and don't seem to understand the needs of their own demographic. For example, in just ONE NIGHT this most active group raised over $300,000 for CHILDREN at a "Dancing with the Stars" event. Stupidity.

My guess is they're trying to virtue signal "Oh, we aren't those mean rich people everyone's mad at".

Last edited by runswithscissors; 01-17-2018 at 04:10 AM..
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Old 01-17-2018, 04:13 AM
 
11,190 posts, read 8,579,925 times
Reputation: 28217
Quote:
Originally Posted by FREE866 View Post
Thanks. When I said "they" I guess I meant the admissions of the facility...meaning if you have income of less than $30,000 you are entitled to some type of aid even if your assets exceed $700,000

I have POA already....I need to learn more about this whole process.....bottom line is right now she isn't going to voluntarily move into any home ...shes fully functional..I know that can change any day, but I can't force her into a place
Wow. This attitude is somewhat appalling. Why not use the assets to pay for the needed care? Instead, you want aid because of low income? You want other people to pay for wealthy people?
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Old 01-17-2018, 05:17 AM
 
1,049 posts, read 487,467 times
Reputation: 1435
Quote:
Originally Posted by charlygal View Post
Wow. This attitude is somewhat appalling. Why not use the assets to pay for the needed care? Instead, you want aid because of low income? You want other people to pay for wealthy people?

Umm...Why do I have a feeling you get into internet fights quite often?

The $700,000 number is just a rough number and would also include sale of her house so it's not like its just sitting there in a bank account. As I said, I'm early on in this process and still learning and simply wanted to know what the guidelines were.
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Old 01-17-2018, 05:27 AM
 
Location: Central IL
15,250 posts, read 8,572,788 times
Reputation: 35701
Quote:
Originally Posted by reneeh63 View Post
Just to clarify, I don't think you are talking about different quality of care within the same facility. While their may be beds with different levels of necessary care, there is NO difference in the quality of care given to Medicaid and self-pay residents in the same facility.

It IS however entirely possible that facilities with a higher proportion of self-pay residents end up with better employees, etc. and so the overall quality is better, across all beds. Lower quality facilities may end up with more Medicaid residents and then they're stuck in a downward spiral - that again, affects ALL their beds, not just the Medicaid beds.
Quote:
Originally Posted by runswithscissors View Post
Correct, I'm not talking about a different quality of care within one facility. How would that work? LOL All the crappy CNAs get assigned to the Medicaid beds?

LOL you seriously think that people think there's some dividing line of care between a specific headcount/bed in the same place depending on the method of payment? I have to say, if that's the case there is no hope for the human race if they have that poor cognitive skill or research ability. Then again, this IS the internet.

The only dividing line on paper is that you'll end up sharing a room on Medicaid.

I'm talking about "all the good beds" as in - all your better facilities versus the last choice facilities (and I know of which I speak since that happened to my mother who happened to have enough cash to pay private Registered Nurses 24/7 even AT HOME indefinitely but it did her no good).

I'm talking about Medicare paying about DOUBLE what Medicaid does - for that 100 days and then any self pay thereafter. Why wouldn't a business seek out those type of clients? (they do)

It's all about "the beds" with Medicare and Medicaid and even self pay residents. Finding a good resident. A resident finding a good bed - and therein a good facility - is worth it's weight in gold and you can't put a financial price on it.

...
Yes - that's EXACTLY what I'm saying so thanks for confirming in detail. I've read people on these boards acting as though there are separate wings within a nursing home - you know, Nurse Ratchet beating up on the cheap bums who aren't paying - which is not the case. At least knowing this helps someone understand how the system works and perhaps how to work it for themselves.
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Old 01-17-2018, 07:17 AM
 
11,190 posts, read 8,579,925 times
Reputation: 28217
Quote:
Originally Posted by FREE866 View Post
Umm...Why do I have a feeling you get into internet fights quite often?

The $700,000 number is just a rough number and would also include sale of her house so it's not like its just sitting there in a bank account. As I said, I'm early on in this process and still learning and simply wanted to know what the guidelines were.
No fighting. I was just astounded how a person with assets that can be liquidated (i.e sold) would want others to foot their bills. What about personal responsibility? Our nation has a regular discourse about getting rid of those mooching off of taxpayers. One type of mooching isn't better than another.
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Old 01-17-2018, 08:29 AM
 
251 posts, read 114,804 times
Reputation: 409
My grandmother is 82 and refuses any outside help for now. My mother is retired so she comes over every other morning to make sure she has anything she needs. Grandmother has limited use of one of her arms due to a stroke as a baby but aside from that she is strong as an Ox. So who knows. Maybe you won't need any help. Physically she is still going strong, mentally she is slowing down a bit in terms of the mid-term memory (anything that happened within the past 5-7 years is starting to get fuzzy). Just make sure at least one family member is checking in once a week to make sure the attendant isn't pulling any funny stuff.
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Old 01-17-2018, 08:34 AM
 
6,869 posts, read 3,889,822 times
Reputation: 15660
Quote:
Originally Posted by LesLucid View Post
Interesting/useful comments so far. Thanks all.

I should have mentioned, when it co and mes time that we will need daily medical care of some sort, we will just sell everything, bite the bullet and move to some sort of assisted living. We do not really have family we can fall back on.

jghorton did the right thing. I wish we had done something like that a long time ago.....not feasible now of course.

When you need daily medical care though, how in the world are you going to handle cleaning up your home for sale, disposing of your stuff, and finally selling the home? Then there is the task of finding an assisted living that will take you. These are things that children or other relatives usually help with, and it is often a lot of work for them. And what if one of you becomes totally disabled or dies everything is left to the other?
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Old 01-17-2018, 09:43 AM
 
Location: Paranoid State
13,047 posts, read 10,470,358 times
Reputation: 15684
Quote:
Originally Posted by LesLucid View Post
We could provide free room and board for a person in exchange for a few errands and chores.
Free room & board plus, say, $60,000 per year plus health insurance benefits should get you someone reliable.
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Old 01-17-2018, 10:16 AM
 
Location: Paranoid State
13,047 posts, read 10,470,358 times
Reputation: 15684
Quote:
Originally Posted by runswithscissors View Post

Case in point - one near me (a combo rehab and SNF) was a crap hole.
Are you sure it wasn't some 3rd World S***Hole?
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