Wednesday, June 3, 2015

The Economics Of The Aging Process

Aging isn’t easy. The desire to live at home independently is natural and a human right.  But as one’s physical ability to perform daily household chores diminishes and circumstances change, it’s good to be aware of all the home care services available that might be of help. Many times, personal decisions to seek home care services are made suddenly or after an emergency. The drastic changes can make the adjustment more difficult and painful. The choices to receive home care services are always a personal and unique one.
Home Care is generally categorized by services such as Personal Care, Homemaker Services, Chore Worker Services and Consumer Directed Services. Personal Care Services are medically oriented tasks provided as an alternative to nursing facility care, that are designed to meet the maintenance needs of individuals with chronic health conditions. Homemaker services are generally when household tasks are provided. Chore services are short-term, intermittent tasks necessary to maintain a clean, sanitary and safe home environment. Consumer-Directed Services (CDS) provide assistance with personal care, homemaker and chore services. The services are rendered by a family member or a caregiver hired by the individual needing the care through the Medicaid Home and Community Based programs. Many times these services are provided for the entire course of the individuals remaining days of life.
Long term care costs are expensive. Some average costs for long-term care in the United States (in 2010) were:
  • $87,600 annually for a private room in a nursing home
  • $3,293 per month for care in an assisted living facility (for a one-bedroom unit)
  • $21 per hour for a home health aide or attendant
  • $19 per hour for homemaker services
  • $67 per day for services in an adult day health care center
However, advanced financial planning helps ensure that you are able to live out your health care wishes the way you want them.  Most forms of private insurance do not cover non-medical custodial services or personal care services. If they do cover long-term care services, it is typically only for skilled, short-term, medically necessary care.  However, Medicaid and Veterans Administration Aid and Attendance Pensionwill cover personal care and non-medical custodial services such as light housekeeping or meal preparation.
To be eligible for Medicaid you must meet certain requirements, including having income and assets that do not exceed the income levels. The person must be permanently and totally disabled, or is 65 years of age or older, or is 18 years of age or older and is determined by law to be blind (vision less than 5/200). The income and asset limits vary state to state. In Missouri, the person must have a net income less than $827 per month for an individual or $1115 for a couple. If monthly income exceeds this amount, the participant may become eligible when their incurred medical expenses exceed their monthly income. There are many different eligibility groups in the Medicaid program; each one has its own set of requirements. An individual may apply for medical assistance at the Family Support Division (FSD) in the county which the person resides. At Home Care will also aide in the application completion process prior to submission to the FSD office.
The Aid and Attendance Pension program provides cash to eligible veterans and with disabilities and their surviving spouses to purchase personal care assistance and homemaker services. The cash is a supplement of up to $25,440 to the eligible veteran’s pension benefits. To be eligible for Aid and Attendance Pension, the Veteran or Surviving Spouse of a veteran who served 90 days or more on active duty, with at least one day of service during a period of war must have had an honorable discharge. The applicant must have a medical condition not related to military service requiring assistance with activities of daily living. There are also income and assets requirements.
As an individual seeks to obtain more information about home care or long term care, thoughts of choosing the home provider should not be taken lightly. A look at the individual’s culture, family structure, the families’ ability to provide the care themselves and the expectations of the provider must be addressed when making a choice. While the conversation about seeking additional help may not be easy, it is better to have this discussion sooner than later. If the opportunity allows, one should to bring the discussion of long term care before the individual needing care has reached the level of incapacity.  Many people have a fear of the unknown. A caregiver in the home may be also viewed by many as intrusive. However, a reduction of feelings of loneliness can provide a sense of safety. The fear tends to subside when one truly understands that the home care can help an elderly person remain in their own home versus a nursing home. If there are questions about the home care, hearing feedback from an unbiased third party such as At Home Care can help a loved one realize the additional care is needed. Just remember to respect your loved one’s need for independence and involve them in all of their health care decisions.

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