At 95 years old, she expressed several times she was ready to die when she entered Heartwood. She and I had always said that our hope was that she would die in her sleep in her recliner in her apartment, but this is not how things have worked out.
Making the decision to place a parent in a care facility is not easy. The fact that she entered into Heartwood due to a fractured pelvis made the transition a little easier. Over the past year, she had been becoming weaker and she knew she was struggling to remember things. With failing health and early signs of Alzheimer’s, she has progressively gotten worse.
My brother and I are as prepared for her death as anyone can be. We were blessed to have had her with us all these years.
Although Mom has been in assisted living before when she was recovering from hip replacements or fractures, this time was to be a permanent placement since she would no longer be able to live independently. From those experiences I learned that and was prepared for the fact that Medicare covers 90 percent of the first 20 days, then it flips and Medicare covers only 10 percent of the cost of assisted or skilled nursing care. This leaves the remainder to be paid out of pocket.
Another way of handling the cost of nursing home care is to qualify for Medicaid and/or to apply for Aid and Attendance through the VA if the person or his/her spouse was in the military during certain periods of war.
I have been applying for Medicaid and the VA benefit for my mom. Fortunately, my mother was a good record keeper because, with any of these applications, a number of records are requested such as death certificates, marriage license, discharge papers, bank statements, asset paperwork, life insurance, deed to cemetery plots, etc. A long time ago, she put me on her checking account, which allows me to pay her bills and access bank records needed to verify her income and expenses. I also have a Power of Attorney document that is required in some circumstances to work on her behalf.
There’s a commercial on TV that asks different people if they have made plans for the care of their parents if they should need nursing home care. They then ask if they know how much this would cost. Those are both good questions.
In answer to the first question, there are two levels of care that I am aware of: assisted living and skilled nursing. The level of care a person needs determines what type of facility that would be able to meet that need. The staff-to-patient ratio can vary as can the skill levels of the staff. These are things to look into when choosing a placement.
The answer to the second question about how much assisted living or a skilled nursing facility costs is — “a lot”! I have visited several of the care facilities in the Tri-Cities area and costs per month range from $4,500 to $6,000.
Charges vary depending on the level of care the person needs. Some facilities charge a one-time, non-refundable fee of $1,500 to $2,000 at the time of admission. If the person does not have Medicaid, there are additional charges for on-site dentist, podiatrist, audiologist and eye doctor services each at $60 per month. Beautician services are not covered under any plan. Laundry, meals, linens, TV service and room cleaning are covered.
This is a lot of information to process at the time care is needed for someone. It is advisable to have some discussions about this issue with anyone you might be involved with helping find a placement. Talking about finances with parents or other family members may be uncomfortable initially, but having some discussions about how to handle payment of services is most helpful when the time comes for action.
There now are attorneys who specialize in elder law. They can help a family with estate planning that addresses the possible needs of the person in the future should they need to be placed in a care facility. Their main goal is to help preserve the family’s assets should this need occur.
I have been writing this piece in terms of the process I have gone through with my mother to establish care for her. In doing so, it also makes me think about how would my family handle this should the person needing care be me? Are my records organized? What assets do I have? Do I need to consult with an elder law attorney?
I know the answers to some of those questions, but when things become personal, that makes dealing with these questions more difficult.
— By Janice R. Beuschel, Tribune community columnist