Alzheimer's and health care

My husband is 68 years old. He has Alzheimer's, now at the moderate to severe stage. He has medicare parts A and B, and Cigna Health Insurance. Neither of these cover home care, custodial care, or assisted living care. Medicare will cover skilled care for up to 20 days, and then a co-payment until 100 days, then they pay nothing. That is skilled care only.

I cannot afford private pay at a facility nor in my home. Home companion care is about $2000 a month. A facility is between $3000 and $4000 a month. We live in Indiana. We both receive social security, but I'm not medicare eligible yet. I work as a substitute teacher, and my income is minimal. I do not work through the summer. So, here are my options:

1. Try to find someone who will stay with my husband for a very minimal amount of money a week.
2. Quit my job and stay home with him.

The disease is very unpredictable. I could stay home with him, and the next day he could get much worse and have to be hospitalized. I would be without a job to return to.

With universal health care I, and millions of others, would not be facing this horrible situation. I have a job and may have to quit to stay with him. This is unfair and unjust. Plus, if he does end up in a facility, they take everything he has. They would also retain his pension, which is also part of my living. It's not right. There is something very wrong with our health care system that people would end up like this.

reply to post by aero56

Hey aero56, I am sorry to hear your story and it appears your situation is one of numerous that falls thru the "qualification" cracks. I hope you have a family member or a friend to help you watch him, or maybe you could find some line of work that enables you to work from home. I would start applying for any/every kind of assistance there is too.
I believe we have some very knowledgeable medical people here and this may have gotten more specified replies in the medical issues board. Maybe do another thread posing a similar question.
Best wishes and I hope you find some answers.

spec

reply to post by aero56
Sorry to hear about your husband, it's a tough, sad situation. I went through a similar situation with my husband who came down with alzheimers in his fifties, it took us all by surprise and broke our hearts.

A question for you:

Did your husband serve in any branch of the military, the Reserves, the Natl. Guard ever? If so the VA does cover home care. The coverage varies from state to state. Texas VA sends a home care person over for 3 hours a day, Indiana may differ.

A couple of tips:

Home Depot sells a door/window alarm for fourteen dollars, runs on batteries, no need to plug in. Just stick it on the door and every time he wants to wander when your back is turned you can count on the alarm to let you know.

There are also bed alarms that wake you when he gets out of bed in the middle of the night. The kind I used had a long cord with an alligator clip that you attach to his pajamas. The cord is attached by magnets to the base which is on the nightstand. Whenever he gets out of bed the magnet is pulled off of the base and the alarm goes off. These are more expensive (forty to seventy dollars) and are carried by medical suppliers.

Most importantly, don't forget to take care of yourself, for both of your sakes, 'cause if you get rundown you won't be able to care for him. I hope someone in your family can help give you some off time.

Take care, u2u me anytime,

STM

Note: As for the national healthcare coverage, I don't expect it to cover any more than it does now. If ya'lls income is low enough he may qualify for Medicaid. It covers many things that medicare doesn't.



[edit on 7/25/2010 by seentoomuch]

I see someone beat me to it, I to was going to ask if your husband has served in the military.

Otherwise, I see you mentioned medicare plans, have you applied for medicaid? It usually picks up what medicaid doesn't, that's how it has with my spouses disability.

My grandma in law has medicare and medicaid and she received a home helper when she broke her hip. This person would would help with housework, cooking, go to the pharmacy, take her to doctors appointments. She was not a medical a professional, however if all you need at this point is someone to watch over him and maybe call 911 if need be, it could be short term option for you while you work.

I did a clinical in an alzheimer's unit, and you really have to search for a good one, and home care is ALWAYS best if possible, at least in my opinion. Granted their basic needs were met, but it was very heartbreaking for me. The place I was at often had family come in and help with feedings and care, and thank God for that. I do not think it was necessarily anyone specifically who was at fault, but simply not enough workers to care for all the patients and therefore they did not have the time to really care of the patient.

reply to post by aero56


I can empathise with your situation. I have done some Dementia training, and it is a truly horrible disease to live for both the person who is living with the dementia and that person’s carer. I live in the UK where we have “universal” health care, yet it is still common for people in your situation to give up work to care for their spouse, from talking to these courageous people it is both immensely rewarding vocation and an emotionally draining one.

I wish you and your husband the very best of luck.

This is exactly the job I want. I want to help someone in your situation, care for their elderly loved one at minimal cost. It would be great if you could find someone to do this for you. Unfortunately, it's hard to find someone to trust, who will not hurt your loved one, or rip you off blind.

I have a grandparent who started out with a mild dementia and needed a little help for a few hours a day. We did a lot of research. Companies who provide this service cost an arm and a leg and most people must pay out of pocket.
Self-employed people cost considerably less, but there are horror stories of abuse, taking advantage of, and or ripping the elderly off. But, that can happen with anyone you chose, whether you chose in home care or a home.

It makes it hard for honest, caring people like me to be able to help these folks out.

I wish you all the best. If you do find someone to help, please install hidden camera's so you know what is going on.



[edit on 25-7-2010 by virraszto]

I do not know if you have seen this in your search so I'll post them anyway (just in case).

Medicare itself will pay for home care if he meets their guidelines for skilled need. What this means if he has a need for physical therapy, occupational therapy, speech therapy, or intermittent skilled nursing AND your doctor writes a prescription for it, medicare will cover with home care.

Here is a link to Medicares website with all their definitions and and requirements. It is in the Medicare and Home healthcare booklet, I don't know if you have that one.

This one is from alzinfo.org and it has a brief description of how people pay for homecare using the insurance options you have listed as available.

I am assuming with a moderate to severe stage you should have no problem getting his doctor to write the prescription, which is what seems to be the most important in getting medicare to pay out.

Originally posted by aero56
1. Try to find someone who will stay with my husband for a very minimal amount of money a week.

Hire a Mexican.

Thanks to all of you for your kind and resourceful comments. I appreciate them very much.