Medicare info needed

eileenlaunonenJanuary 10, 2008

My father is 89 and very ill right now he is in the hospital with double pnemonia..not good and also has been diagnosed with early stage of dementia and a heart condition....PROBLEM: he lives in his home with my dear sister (she works full time 7am to 4:30) shes a saint and does everything for him. We (me and my 3 brothers 8 grandchildren and 3 daughter in laws) all pitch in as much as we can ass everyone works full time. He has been retired since 1972 and has a minimal pension and Social security. We are in the midst of trying to qualify him for the interim I spoke with his doctor to see if MEDICARE can provide a nurse or aid a few hour at least Monday to Friday..his secretry made calls for us and the Medicare case worker said "NO" he is not entitled for us to hire PRIVATELY...there is NO money for this just a few thousand he has set aside for burial. My father is a WWII vetrean with 2 Purple Hearts and the Veteran Association denied care in the home too....A neighbor came across yesterday to my sister and said if the doctors will provide a script for Hospice Medicare has to provide nursing...IS THIS TRUE!!!!!!!!!!!!!!! HELP with any advice appreciated...we a distraught but yet my Dad is not at a place yet where a nursing home 24/7 is necessary yet he is incapable of fully caring for himself throughout a full workday....The VA has a outpatient program but its a 150.00 a day if you dont have MEDICADE....Guess the 2 Purple Hearts dont count either!!!!!!!!!!1

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One other way you might think about, is that IF he goes directly from the hospital to a nursing home, Medicare will pay for a certain number of days. (I think it's 120) Those few days might give you time to set up other means of caring for him while he gets a little stronger.

Look around and see if you can find a suitable nursing home in case this turns out to be the best solution for now.

    Bookmark   January 10, 2008 at 3:29PM
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I don't believe the government has ANY program thru any agency that will pay for help in the home. the only programs I know of where the government pays THRU MEDICARE is either home health service or hospice service.

You need a doctor's order for either one. Home health comes by to 'check' on things, perhaps do a little cooking, cleaning, etc; hospice offers more. You can go to your yellow pages and find both types, give them a call and ask what services they can provide. Check with Home Health first - they might be able to provide someone for a few hours each day.

My Dad has had live in help for my Mom for years and has gone thru a sizeable inheritance paying for it. When he runs out of money to pay for help, Mom will have to go into a nursing home.

You can also talk to the social services person at the hospital for more ideas.


    Bookmark   January 10, 2008 at 9:46PM
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Thank you for the input....I will contact the hospitals social services this morning...boy I never hit so many dead ends in my life...Im 42 and now completly rethinking about my future health care this is a very sad state of affairs for the elderly very sad!!!

    Bookmark   January 11, 2008 at 8:29AM
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He retired at the age of 54 and now doesn't have enough money? If his income is limited, he may get some money from the VA, but his house might make him too well off.

    Bookmark   January 11, 2008 at 10:05AM
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The WSJournal's Encore column deals exclusively with issues of aging. I copied this off it from 2006. Also, please check your state's website, as many have a department of senior services/aging, where a list of resources is available. However, you have been told correctly - home health services, and convalescent care (unlike long term nursing care), must be paid for either personally or through private insurance.

Recommended Reading
December 11, 2006; WSJournal

Few issues generate more mail from readers than long-term care and the possible need for long-term care insurance. A recent study published in Inquiry, a quarterly health journal, projects that two-thirds of Americans who reach age 65 will spend some time in their homes requiring long-term care, and one-third eventually will spend time in a nursing home.

To learn more about this topic, we asked Kathleen Kelly, executive director of the Family Caregiver Alliance in San Francisco (website:, for suggestions. Her organization offers extensive information and materials about long-term care, caregiving strategies, and legal and financial issues. Here are some of Ms. Kelly's recommendations and her comments on them.

"Long-Term Care: How to Plan & Pay for It," By Joseph Matthews
"Many people believe that Medicare will pay for their own or their parents' long-term health care. As attorney Joseph Matthews clearly points out, that's not the case, and families need to be aware of the decisions they may face as they age. An excellent, comprehensive guide to the field, written by the knowledgeable author of a number of books related to this complex issue."

 Consumer Reports, website:
"Great source for objective advice and ratings on long-term care planning. Issues featuring long-term care insurance (November 2003), assisted-living facilities (July 2005) and nursing homes (September 2006) provide an overview of the decisions involved in choosing long-term care and financing it."

 "Planning for Long-Term Care," By the United Seniors Health Council
"This short book offers solid, objective information to help consumers understand, choose and purchase long-term care services and insurance. It's authored by the United Seniors Health Council, a program of the nonprofit National Council on the Aging."

 "Talking about Medicare: Your Guide to Understanding the Program" From the Henry J. Kaiser Family Foundation, website:
"As Medicare gets more complex, balanced information is welcome. In addition to information about long-term care, this consumer's guide explains how the Medicare prescription-drug benefit works, how to choose a plan, and which state agencies can answer questions."

"The official government Web site for Medicare, this site not only includes information about the health plan and its intricate regulations, but also offers valuable assistance in long-term care planning, including features called Nursing Home Compare and Home Health Compare, to help consumers make informed decisions about long-term care. A wealth of information here."

 "How to Care for Aging Parents," By Virginia Morris
"Comprehensive, well-written and practical, this book is an excellent source for anyone who is -- or who might become -- a caregiver for someone with a long-term health condition. The author covers a wide range of topics, such as handling stress, dealing with legal issues, specific health-care tips and relationships with siblings. Useful resource lists are included."

 "It Shouldn't Be This Way: The Failure of Long-Term Care," By Robert L. Kane and Joan C. West
"This poignant book will provide insight to families struggling to deal with long-term illnesses and the challenges of placing loved ones in residential care facilities. Robert Kane is a physician and geriatrician, and thus his confusion and difficulty dealing with the long-term care system is particularly illuminating as he and his sister document their attempts to get the best care for their mother."

 "Caregiving at Home," By Dr. William Leahy (editor) and the editors of Hartman Publishing
"Caregiving at Home distinguishes itself from the many other books for family caregivers in its straightforward approach and practical advice on the hands-on care for people in a home setting. Written by a doctor, the book outlines more than 200 direct-care procedures that a caregiver may need to know in assisting a frail or ill relative, and includes tips on communicating with physicians, symptoms to watch for and other useful information."

    Bookmark   January 11, 2008 at 12:43PM
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Medicare DOES pay for some in home health help, in some circumstances. When my mother has had health issues, medicare not only had nurses coming to the home to take care of her medical care, but her health aids (bathing/cleaning help) were paid for as well. You have to ask the right questions, though, and have the right requests from the dr.

Social services at the hospital is a good place to start. You may also call one of the home nursing services in your area and find out from them, just what has to happen for your father's help to be paid for--they know, and will help you set things up properly. Yes, a nursing home--if he goes there directly, will probably be paid for. My aunt had appedicitis last year, and her rehab stay at an intermediate place was totally paid for.

A few other questions and suggestions. Does your dad have supplemental health insurance? He needs it if he doesn't. It's well worth the cost. We used AARP for my mom and aunt, and have been very satisfied with the coverage.

Also, if you exhaust all avenues for getting nurses into your home, you might start looking into volunteers. They won't be as well-trained, but even a few hours of someone else coming in a week will give your sister a break. Try the Alzheimer's Association--they've been helpful with my MIL, and it was a free service (although, it would be nice to remember them when you do your yearly charitable contributions).

Good luck--having been my mom's caregiver for over 12 years, and having the main responsibility for my aunt, I know what you're going through. Not an easy time of life, and unfortunately, we're all approaching it like explorers. No one really prepares or educates you for the experiences you'll have as a caregiver--you just don't know, until you get there, what you'll find.

    Bookmark   January 14, 2008 at 8:34AM
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Thank you all very much you have been not only helpful but very kind!

    Bookmark   January 15, 2008 at 8:46AM
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Nursing home comparison information is available free. Do not go to any website that asks you to pay for such information.

    Bookmark   May 29, 2010 at 2:35PM
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I talked to a lady who took care of her mother in the mother's home and was paid for it. Maybe you should talk to an SRS rep for more info. I agree you should check into care homes a bit more. Hospice and a care home will have to visit and evaluate him. When I was looking for a care home for my husband, I found the small towns surrounding our city have better care homes than our city did.

    Bookmark   May 30, 2010 at 3:06PM
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Yo vala55.........I've been doing this for my mom for 15 years for free. If such an I-get-paid-for-this option is available, I surely would be interested in learning about it. Can you say where to find info?

    Bookmark   May 31, 2010 at 7:20PM
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People who get paid generally qualify under low-income limits. It's possible, yes, but not a lot of people qualify, either the care recipients or the care-givers. Both must be very low income. Different states have similar programs, altho all are under financial stress because of severe budget cuts.

    Bookmark   May 31, 2010 at 7:29PM
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I live in Kansas. I was in a waiting room and discussing my sister who is caring for our Mom, when a lady spoke up and said she was being paid for giving her mom home health care. That's all I know. I would ask a doctor, the senior rights office in your state capitol. If you don't get any results ask SRS. I didn't pay to much attention because being a care giver is no longer in my future. I hope!

I don't know the correct name for seniors rights office. Google your states offices, it should be listed.

    Bookmark   June 1, 2010 at 1:39PM
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Me again....I do know in our state you can charge your Mom for her care, mileage, time you spent with her, etc.. You need a confirmation in your state. Keep a journal of your hours and mileage.

    Bookmark   June 1, 2010 at 1:46PM
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"Keep a journal of your hours.........."

At least that part would be easy...24/7/365!

She put up with me for 18+ years. I reckon I can handle it.

    Bookmark   June 1, 2010 at 3:58PM
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"I spoke with his doctor to see if MEDICARE can provide a nurse or aid a few hour at least Monday to Friday..his secretry made calls for us and the Medicare case worker said "NO" he is not entitled for us to hire PRIVATELY...there is NO money for this just a few thousand he has set aside for burial. My father is a WWII vetrean with 2 Purple Hearts and the Veteran Association denied care in the home too...."

Carolyn (barker_tx) had a good suggestion: talk to the social services person at the hospital. A friend of mine had to take her partner to the hospital. He was also a veteran with limited resources (80yrs). The social services person suggested they choose hospice in the home. He passed away while he was still in the hospital, but during this time my friend learned that as a US Military veteran he was eligible for a free burial with full military honors.

I noticed this thread was started in Jan 2008. Hopefully the OP was able to resolve her situation to everyone's satisfaction.

Links that might be useful:

Vets Helping Vets hospice unveiled for Mercer County

    Bookmark   June 7, 2010 at 8:51AM
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You need to prepay for the funeral now. If a person goes to a care home first, I don't think SRS will allow it then. I choose a very inexpensive funeral home for taking care of our final arrangements. No high pressure sales pitches on anything. It cost $800 to cremate my husband, that included the urn, I had to pay $125. to open the grave for the urn. I prepaid mine at a $600. cost. Funerals there run around $1,400 dollars. There are 3 funeral homes in our city like that. I think what most places charge is outrageous.

    Bookmark   June 7, 2010 at 7:04PM
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Call your Area Agency on Aging. There is such a thing as "Attendant Care". In my state, if you qualify, you can obtain in home care for no cost. Waivers are available that can fund the services.

You can also call your local Center for Independent Living to get information about such services and what's available in your area. You can find your local center by visiting

I hope you are able to find some help.

    Bookmark   June 21, 2010 at 1:14PM
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