Last week, we heard from Erin Kershaw of Concierge Care Advisors. This is a group that concerns itself with the inevitabilities that beset the aging. The two main issues concern housing and the management of one’s personal affairs. She stated the sobering fact that. sooner or later, a person will need help. Dementia, illness, or injuries will bring a person to this point. Dementia is extremely prevalent and at times may afflict even the relatively young. This said, what are the options, both for physical care and for the setting of legal and financial matters in order?
The domiciliary levels of care, tailored to the individual situation, are these:
–The home. If it is elected to keep a person at home, it may be feasible if private duty nursing care is in place and if medical care is gotten from the outside. It is to be noted that this is an expensive way to go, probably more so than another type of residence.
–Retirement and assisted living. This has the advantage of community, a social life, a common dining room, a bus for transportation, and a feeling of security. One must, however, bring about one’s medical care independently. Medicaid is generally not accepted.
–Adult family home. In such a facility, occupancy is limited to six. State guidelines prevail. If money runs out, transition to Medicaid occurs and the resident is not forced to move. These facilities do not accept Medicaid on a person’s arrival.
–Memory care. This is a type of facility that is attached to assisted living. It will not do Medicaid.
–Skilled nursing facility. This is more clinical and has similarities to a hospital. Physical therapy and short-term rehabilitation are offered here. While people rarely would choose such a place in which to spend the rest of their days, some have to. The cost is high. Medicare will not cover this when physical therapy and other modalities can no longer result in progress.
- The financial aspects involve methods of paying for these levels of care. Such as–
- Savings and other assets
- Pensions
- Medicaid
- Veteran benefits. This is geared to one’s income and whether one has been in actual combat. One who is married to a veteran may receive assistance under certain circumstances.
It is well to make one’s plans, prior to any crisis. These include–
- Will
- Advance Directive
- Power of attorney, given to one who can make decisions.
The speaker concluded with the matter of “tough conversation” with one needing help or one who makes the decisions for such a person. It entails wishes versus reality. A person’s wishes may be to remain at home, pass assets on to family, and maintain independence. Quite often the reality is that the individual and family are in denial about health care needs. The family cannot provide it. The home is not adequate for safe living. There will be social isolation.
And, she finished, correctly, with, “The TV is not your friend.”
Comment: ‘Tis always the other guy, till ’tis oneself.
