Last weekend we had an open house at the ALF for Mom’s 98th
birthday. She was thrilled to see
everyone and definitely enjoyed her ice cream and cake! The day was sunny and bright and although it
was too chilly for her to go out in the courtyard, we were able to keep the
door open and family members were able to check out the facility’s courtyard
and enjoy the sunshine.
Leading up to and now after her birthday, I can’t help but
wonder what is really needed for Mom.
She spends her days in her wheelchair or her favorite rocking chair
holding her favorite baby doll. She
enjoys sitting where she can view the entire room and into the dining area so
she can see everyone who walks in the door and what the various workers and
residents are doing. When she is awake,
that is. She snoozes a lot.
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| Happy day when she gets to hold a great grandchild! |
She’s not able to stand for very long and can walk only
short distances with help. That, and the
fact that she has forgotten all the ways to care for herself, means she has to
have help with dressing, baths and toileting.
At times she even needs to be reminded how to eat.
She’s definitely where she needs to be – in an assisted
living facility where they help her with all those “activities of daily living”
and understand that her memories are fleeting.
Her memories come and go from moment to moment but she is happy in her “home”.
Living in a facility is very expensive whether it is a
nursing home or an assisted living facility.
The decision to place a loved one requires a lot of financial planning
and quite often funding from Medicaid.
Not all facilities accept Medicaid and we knew Mom’s did not when we
placed her there. We had to plan for Mom’s
expenses to be paid from her income as Daddy’s surviving spouse. We really like the facility and so does Mom
so as time goes on and fees rise, it’s our job to find ways to keep her there
and also watch over the expenses she is charged to make sure they are needed.
Late last year I submitted paperwork to the VA to apply for
Aid and Attendance benefits for Mom. As
the spouse of a veteran who served during a war (Daddy was in WWII), she is
entitled to a monthly benefit. She
received her first payment on April 1 and while it is not a large amount, it
helps.
I’ve recently audited the charges from the ALF and my next
step is to look into hospice costs. When
hospice was first suggested, it was because there was suspicion of a problem in
her abdomen and finding the mass set the hospice wheels in motion. It seemed at the time to be initiated for a
good reason and I was told that Medicare would pay for it all. That might be true for most but as it turns
out, not for Mom. Daddy was a teacher
and she is covered under his medical as his survivor. The only Medicare they were entitled to was
Part B (physician) which doesn’t cover hospice.
The medical plan is actually the primary payer for Mom’s hospice
expenses.
Here we are, seven months later and there has been no change
in Mom’s condition. It fluctuates as it
always has but nothing out of the normal range.
She’s not in pain, not on any medication and they’ve put an oxygen machine
in her room that she has never used. Her
vitals are always good when the hospice nurse comes once a week. I know she has a ticking time bomb in her
abdomen that could hemorrhage at any moment but does that really require more
watching than she gets from the ALF nurse and aides? My siblings and I joke that Mom will still be
here to see 105!
It’s possible that the hospice expenses are less than if the
same services are provided by the ALF so it may make sense to have hospice
overseeing her care given her condition.
It’s something I will begin investigating this week and checking to see
if Mom needs everything provided – I’m thinking the oxygen can go if nothing
else.
