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What to do after the holiday visit with aging parents

What to do after the holiday visit with aging parents

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visiting aging parents

Did you visit your aging parents during the holidays? You may have noticed some changes that worry you. Especially if you live a distance away and don’t visit regularly. Begin forming a plan now to avoid crisis-driven decisions in the future.

Perhaps you noticed your parent isn’t keeping up with household chores. Mail is stacking up on the kitchen table.  Maybe mom’s lost weight, seems moody, or is wobbly on her feet. You may wonder why your dad isn’t having coffee with his cronies – is he getting isolated?

So, you talk to your siblings. They aren’t concerned and the situation doesn’t seem urgent. You don’t want to be an alarmist but… you still worry.

Should you do nothing and wait until the next holiday visit to re-assess? No. Unless you like making critical decisions in a crisis.

Here are 5 things to do now after the holiday visit: 

1.

Assess the gaps you’re worried about. (bills, upkeep, meals, isolation, driving) 

2.

Begin a conversation with your parent.

“According to recently conducted research, 70 percent of family conversations about aging issues don't occur until they are prompted by a health crisis or other emergency. This can increase the likelihood of family disputes.”

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    3.

    Begin gathering copies of Legal & Financial Documents.

    You’ll need them at some point anyway. Do it now when you’re not rushed and under pressure.

    • Durable Power of Attorney for Health Care
    • Durable Power of Attorney for Finances
    • Advanced Directives (end of life wishes)
    • POLST (Do Not Intubate, Do Not Resuscitate Form)
    • The Will or Trust (or at least know where it’s located and/or who their attorney is)
    • Military Discharge papers (if they’re a Veteran or spouse of a deceased Veteran)
    4.

    Start a file or notebook and begin gathering information on resources in your or your parent’s area:

    • Home Care agencies
    • Independent Retirement & Assisted Living communities
    • Meal or Food Delivery services
    • Bill paying services
    • Transportation services
    5.

    ​Contact a local referral agent.

    • Get help finding resources in your area.
    • Learn about the different senior housing options if needed in the future.
    • Discuss the financial pros and cons of different options.
    Find Referral Agent Near You

    Finally

    Your parents will continue getting older. You never know if or when an emergency health crisis may occur. Be prepared by following these steps. Avoid making rushed or uninformed decisions.

    Recent Posts

    Be Smart About the Costs of Moving Mom In With You

    Be Smart About the Costs of Moving Mom In With You

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    As our parents age and become frail, we start looking at different care options. If you or your sibling is thinking of moving mom in with you, carefully consider the costs. Know what you’re getting yourself into.  

    Most adult children are usually motivated by a deep love for their parent. They’re committed to providing the best. They feel no one can do a better job of caring than family.

    While you may agree with that sentiment, be sure to examine your motives. Before making any commitment, start by answering your ‘why’.

    Is it a philosophical belief that ‘family takes care of their own’? Or do you hate seeing all mom’s assets spent on a facility? Or do you feel obligated because of promises made long ago? Or do you feel guilty and want to live up to your parent’s expectations?

    Whatever your reasons, clearly define them. They’ll help you create healthy boundaries and expectations of your own.

    After you’re clear about your ‘why’, consider the impact of multi-generational living on your finances, relationships, and personal space.

    Financial Costs

    People often under-estimate the financial costs of caring for a parent. And expenses go up as they age. These costs include possible income loss, remodeling, and hired care.

    Potential income loss

    People often under-estimate the financial costs of caring for a parent. And expenses go up as they age. These costs include possible income loss, remodeling, and hired care.

    Studies show that:

    • 33% of working women decreased work hours
    • 29% passed up a job promotion, training or assignment
    • 22% took a leave of absence
    • 20% switched from full-time to part-time employment
    • 16% quit their jobs
    • 13% retired early

    Considering that, think about whether someone will have to quit work when mom or dad moves in. Can your family afford the reduced income plus the increased costs of food and utilities? Will you parent contribute to the household expenses?

    Potential remodeling costs

    First assess your home for safety, accessibility, and logistics. You may decide to expand your home, remodel a bathroom, build ramps, or build a separate “granny pod”.

    Do your research on estimated costs. Can you afford it? Will it increase the value of the property?

    Will your parent contribute financially to the remodel? If so, what reimbursement will they get if you sell the home? And if something unexpectedly happens to your parent, will you reimburse their estate?

    Potential care costs

    Your mom might move in with you while she’s still cognizant, ambulatory, and continent. But as she ages, her abilities will likely change. If you’ve never been a caregiver, you’ll be surprised by how hard it is.

    Family caregivers often don’t realize how stressful care giving is. It’s a 24 x 7 job. You’re constantly taking on new care tasks – ones you’re not trained for. They often report feeling exhausted and depressed. Caregivers report finding it difficult to maintain a healthy balance in their lives.

    Family caregivers underestimate how much support they’ll need. And for many, it’s hard to ask for help. They often put unrealistic expectations on themselves. They try meeting every need and be the ‘perfect’ child.

    Respite breaks are essential for a caregiver’s well-being. So ask yourself, ‘Who else can help with increasing care demands’? Family, siblings, relatives?

    Can you or your parent afford hired in-home caregivers? If not, are there other family members who can chip in?

    Get a realistic picture of what it means to be a caregiver.

    • Read personal stories from caregivers.
    • Watch how-to videos on YouTube. Things like how to safely transfer someone, give showers, and help with incontinence.

    Relationship Costs

    Moving a parent in with you is a family decision. Even if you’ll do most of the work, everyone must be on-board. Many marriages have split over the change in duties, roles, and relationship dynamics.

    Siblings and extended family

    This includes having a conversation with siblings and other extended family. It’s an emotional time. You’re acknowledging your parent is aging and needs help. And you won’t be able to do it alone. Find out who’s willing to help and how.

    Additionally, prepare for sibling disagreement. Past roles and relationships can come into conflict. Your motives will be questioned. Make sure everyone’s viewpoint is heard.

    Try to keep the discussion focused on the well-being of your parent. And expect everyone to have different ideas about how to best meet those needs.

    A word of advice: consider hiring an elder mediator, social worker, or elder advisor to act as a guide.

    Your relationship with your parent

    Similarly, consider the relationship you’ve historically had with your parent. Has it been easy going or fraught with tension? Has your dad been controlling? Or your mom been a complainer? Have you felt they’re impossible to please?

    If that’s the case, it probably won’t change. In fact, living with your parent as an adult will likely bring up a lot of emotional baggage from the past.

    When 3 generations or more live under one roof

    What’s more, if children still live at home, they may need extra attention. Especially if they’re asked to give up their room for grandma. And what about if you have a blended family? Will your stepchildren cope?

    Living under one roof won’t be like in the TV series, The Waltons. Consider your parent’s attitude about kids. There’s a big generation gap between acceptable lifestyles. Your dad or mom might voice strong opinions; which likely won’t go over well. Are you ready to act as peacekeeper?

    Factor in illness or dementia

    And your kids will need help understanding what’s happening if your parent has an illness or dementia. Irregular behavior by a grandparent may scare or embarrass your children.

    Let your kids know that they are not the cause of their grandparent’s possible anger, weeping, or fear.

    Seek out books and videos from the library. Read them together and discuss the questions that come up. Talk about ways they can deal with the situation.

    Your parent's social needs with peers

    While we’re discussing relationships, think about how living with you will affect your parent’s friendships. Will their friends feel comfortable visiting? Will you take your parent to the senior center or church groups for socialization?

    Finally, think about if your parent will get lonely and isolated if you’re still working outside the home. Plan ways they can keep up the activities they enjoy.

    Costs on Your Space, Time, & Routine

    For most of us, our home is our refuge. It’s where we relax and turn off the world. When your parent moves in, you may feel your space invaded. Your home is no longer your home.

    Most likely you’ll find your schedule and time now revolves around someone else’s needs. You’ll cook differently. You’ll find a corner of your mind is always listening in case mom needs something.

    Interruptions

    For instance, if you work from home, anticipate interruptions. A knock on the door. The intercom beeping. Dad has a question or needs help in the bathroom.

    Similarly, if you and your spouse are watching a movie how will you feel about your parent joining you or interrupting you?

    Privacy and personal space

    Your parent doesn’t need to know everything that’s going on in your personal life. Set boundaries and expectations. This is a role reversal and you may feel uneasy doing it. But this is the time to work it out or readjust your thinking.

    While you are your mother’s daughter (or son) you’ve both evolved over time. You may not share the same opinions, standards, politics, values, or belief systems now. Agree to disagree. Steer clear of criticism and judgement.

    In Summary

    Without a doubt, moving your parent in with you (or your moving in with them) can bring about a closeness you never had before. It’s an opportunity to put love into action.

    On the other hand, it’s not for everyone.

    Carefully think about why you want to be their primary caregiver. There’s no guilt if you don’t choose this path in order to love and care for them.

    Then factor the financial, relationship, and personal space costs.

    Leave a comment below to let us know how this article helped you.

    We have a library full of great information to help you navigate the aging process. Be sure to check out these other articles too.

    Need a Senior Advisor to help guide your decisions?








    5 Ways assisted livings prevent dehydration in elderly residents

    5 Ways assisted livings prevent dehydration in elderly residents

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    Dehydration in the elderly is a serious health risk. It’s a common cause of hospitalization. Especially during the hot summer months.


    As a precaution, most senior living communities have a Hydration Program. Of course, some do a better job than others.


    That's why it's important to understand the risk factors, signs of dehydration, and prevention strategies. Then you can assess the program in your loved one's assisted living.

    Why are elderly more prone to dehydration?

    Assisted living providers understand the risk factors for older adults of becoming dehydrated.  You can partner with your mom’s community when you too know what’s involved.

    Diminished thirst

    As we age our sense of thirst diminishes and we don’t recognize we need fluids. So older adults get severely dehydrated before they even realize they’re thirsty. 

    Mobility

    Frail elders may find it difficult getting out of chairs and recliners. Getting a drink of water doesn’t seem worth the effort.

    Overactive bladder and incontinence

    Liquid in, liquid out. Many older adults avoid fluids because of incontinence worries. They get tired of frequent and urgent bathroom trips.

    Misdiagnosed and undiagnosed

    Many early signs of dehydration are easily confused with other medical and natural conditions. Things like dry mouth, fatigue, dizziness, and muscle cramps.

    Too many diuretics

    Many older adults avoid water and drink a lot of coffee instead. While coffee, tea, and soda are okay in moderation, they shouldn’t be the only fluids consumed.

    Medications

    Older adults often take several medications. Some of these meds act as diuretics. They may also cause increased sweating leading to dehydration.

    Decreased kidney function

    Aging bodies have aging kidneys that are less able to conserve fluids.

    Illness

    Vomiting and/or diarrhea can quickly cause dehydration in the elderly.

    What are the signs of dehydration in a elderly?

    Caregivers are trained to watch for the following signs of dehydration – especially during hot weather. Collaborate with your dad’s caregivers in keeping him safe by also recognizing the signs.

    • Confusion
    • Low energy
    • Difficulty walking
    • Dizziness or headaches
    • Dry mouth
    • Sunken eyes
    • Inability to sweat or produce tears
    • Rapid heart rate
    • Low blood pressure
    • Low urine output
    • Constipation

    You can also check an elderly person’s skin for turgor (plumpness of the skin cells). Pull up on the skin on the back of the hand for a few seconds. If it doesn’t return to normal almost immediately, they’re dehydrated.


    If you notice these signs in your loved one, call the nurse right away. He or she can assess if your elder should go to the hospital.

    What are Hydration Programs in assisted living?

    elderly couple drink beverage

    Most assisted living facilities start a Hydration Program during hot weather streaks. These programs prevent dehydration by surrounding residents with opportunities to drink fluids. Here’s what Hydration Programs could include:

    Caregiver training

    Caregivers should get frequent reminders about symptoms of dehydration. And daily review residents at greater risk – such as loners and those with dementia.

    Resident Education

    Seniors themselves need education about their risk of dehydration. They should be encouraged to drink, even when they don’t feel thirsty. Urge them to keep several water bottles around: by the bed, easy chair, or dining table. Kick off a Hydration Program with special branded water bottles.

    Body weight monitoring

    Elders can lose 2-4 pounds of water weight when they’re dehydrated. Daily weight monitoring is critical for folks with renal failure and cardiac issues.

    Mealtime choices

    Staff should routinely serve water and juices at every meal. Along with encouragement and reminders. Soups should regularly be on the menu. Also, meals should include a wide variety of fresh fruits and vegetables.

    Social hours

    Activity directors can include popsicles, fruit infused water, and fresh melons at all social gatherings. They can place water stations throughout the building. Especially in areas where residents naturally gather. Meanwhile, encourage your loved one to attend events.

    How can you partner with your parent's assisted living?

    young woman visits with elderly lady

    In case you're rating the Hydration Program at your parent's facility, a high score would include all the above. But keep in mind, your parent’s facility might not need all the above. Every community is different – every mix of residents is different.

    Over all, what do you think? Is your facility doing a great job? Wonderful! Be sure to compliment the staff and say, “Thank you.”

    On the other hand, could the program use a little boost?

    First, encourage your own loved one. Make sure they have plenty of water bottles.

    Second, talk to the administrator and ask about their program. They may be doing things you don’t see. Check the Activities Calendar.

    Third, ask how you can best help. Perhaps you could volunteer to join the social hours and help serve refreshments.

    In conclusion

    Keeping our elders healthy and safe is a team effort. It takes collaboration of family advocates and their loved one's assisted living.

    The best outcome for your elderly family member is to know about dehydration. Especially the added risks for elderly. Know the signs of dehydration and some prevention strategies. 

    Leave a comment below. Tell us how you partner with your assisted living community.

    Wondering about Assisted Living in your area? 

    Contact  An  OSRAA  Referral  Agent

    You might also be interested in these articles:

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    What is Assisted Living?

    What is Assisted Living?

    By 8 Comments

    seniors playing bingo

    Is assisted living right for you or your parent? Yes…or maybe No.

    Yes! Because today’s assisted living isn’t like the dreaded “old-folks home” of yesteryear.

    And No! Because not every assisted living matches you, your needs, or preferences. They all seem to offer the same things. 

    Look below the surface and compare the details. This article looks “under the hood” of assisted living. What it is and what it isn't.

    Here are the 5 basics that professional referral agents know. You should know them too.

    1. Assisted Living is a social model – not medical

    You often hear assisted living described as the “alternative to a nursing home.” This is only somewhat true. Assisted livings are not medical facilities.

    Assisted living is more like independent retirement. Both offer a “hotel-style” of living. But, assisted living facilities hire in-house staff to provide hands-on help with daily living.

    Think of assisted living as a bridge. They span the gap between independent living and nursing homes where complex medical care is provided.

    Older adults choose assisted living when they want independence but have help available if needed. These residents can direct their own care, value autonomy, and like having choices.

    2. Each facility is licensed by the State

    Assisted living facilities are licensed by the State Department of Human Services. They’re inspected every two years for compliance with Rules and Regulations.

    Inspection reports are public information. Every community must keep their report in a binder, on-site, and easily accessible.

    If you’re a consumer, don’t be shy. Ask to see it.

    In between inspections, any complaints of abuse or neglect are inspected within 24 hours. You can check Complaint Records online.

    3. Floor to ceiling care

    Imagine a building. There’s the floor and the ceiling. Some buildings have low ceilings and some have tall ceilings.

    In assisted living, the State sets the minimum requirements of care. That’s the floor or foundation. But each facility sets its own ceiling of care.

    State-mandated basic services include:

    • 3 meals + snacks per day
    • Private apartments with full ADA accessible bathrooms and basic kitchenette
    • Care assistance with bathing, dressing, personal hygiene, transfers, mobility, toileting, transportation arrangements, medication management, etc.
    • 24-hour awake staff
    • A social and activities program that meets life engagement needs of all residents

    Each facility determines how much care they’re able or willing to provide.

    ​

    Examples:

    Example 1 - Community “A” will assist or guide residents with transfers from bed to walker, if no lifting is needed. Community “B” will assist with transfers when 2 caregivers are needed, lifting is required, or a mechanical device is necessary.


    Example 2 - Community “A” will pass oral medications on a regular schedule. They’ll also provide regular diabetic glucose testing and give regular injections. But, they’ll require residents use pre-measured insulin pens. Community “B” will provide full sliding scale diabetic injection care.​

    Also, a community’s “ceiling” can fluctuate. Fluctuations are based on overall acuity of care at any given time.

    For instance, a community that typically provides sliding scale diabetic care, may decline any new diabetic applicants. The nurse or administrator may decide there’re too many current residents needing a lot of care. They want to ensure their ability to meet the needs of residents.

    Please note: the State restricts many medical care tasks in assisted living. These care tasks require licensed nursing. Residents in assisted living must be medically stable with predictable care.
      

    4. Staffing ratios are not mandated by the State

    The State sets minimum requirements for care, but it doesn’t mandate staffing ratios (as of this writing). Each assisted living community is expected to staff according to the total acuity of care in the building.

    Oregon does not require caregivers be licensed CNAs.  Front line caregivers or personal attendants must pass criminal background checks. And facilities must provide on-the-job training and regular ongoing education related to aging.

    Please note:  residents share 1 caregiver with 13-20 other residents. The average staff to resident ratio is 1:15 (hopefully).

    5. Culture

    Every assisted living community has its own “culture” or personality. The mix of residents, their backgrounds and interests, the current administrator, and team determine the culture.

    Before moving your parent to an assisted living, visit several times. Meet the staff, residents, and resident families. Attend events and social gatherings.

    Consumer-Driven Services
    Assisted living services continue to evolve. Many communities strive to meet today’s consumer expectations of choice, amenities, and aesthetics. Flexible dining and expanded menus are examples.

    But don’t be fooled. Lovely surroundings, fancy amenities, and extra services don’t always equate to five-star care.

    Consumer-Driven Services

    Assisted living services continue to evolve. Many communities strive to meet today’s consumer expectations of choice, amenities, and aesthetics. Flexible dining and expanded menus are examples.

    But don’t be fooled. Lovely surroundings, fancy amenities, and extra services don’t always equate to five-star care.Each facility determines how much care they’re able or willing to provide.

    Find the right assisted living, work with a local referral agent

    Professional referral agents have experience and insider knowledge. They network and build relationships.  Referral agents know a community’s history, staff turnover, compliance, and culture.  Agents preview and pre-qualify  communities. They’ve done the research, so you can relax.

    Home Health or Home Care?

    Home Health or Home Care?

    By 9 Comments

    Understand the Differences And Plan With Confidence!

     

    Ed’s mom, Ethel, is having major surgery. The family’s wondering about how to help when she gets back home. It’s confusing. Ed’s brother Stan thinks mom’s health insurance will pay for Home Health and they’ll do all the care. Ed’s pretty sure that’s not right.

    Ed is correct. Home Health will not provide the full care Ethel will need. But Stan’s almost right too because home health is covered by medical health insurance. But home health does not provide day to day care.

    Let’s clear up the confusion.

    Home Health

    Home health care services are prescribed by a doctor after a hospital admission or inpatient rehabilitation stay. Medicare covers home health services for a limited amount of time or visits. Services are brought to the patient at home; wherever home is. It’s intended for short-term recovery.

    Licensed health professionals follow up with a patient at home and provide services like nurse oversight, social work visits, speech therapy, physical or occupational therapy, wound care, and medication or injection monitoring. Sometimes home health services will include a bath assistant.

    Home health care helps patients make a full recovery and it’s assumed they’ll return to normal activities.

    When Ethel comes home after her surgery and skilled rehabilitation, she’ll have home health follow up. But her stamina will be poor; she’ll tire easily. Ethel will need someone to help with the activities of daily living such as shopping, cooking, housekeeping, laundry and, transportation. She might also need a little support with dressing, bathing and, medication reminders.

    Ethel’s family plan to help out. But they work full time so they’ll hire an in-home care caregiver.

    In-Home Care

    Seniors and their families can hire professional in-home caregivers in a variety of ways.

    Caregivers are available through:

    • Home Care Agencies
    • Caregiver Registries and Referral Services
    • Independent caregivers

    Click here for a comprehensive overview about getting in-home care.

    Carefully review the pros and cons of each.

    In-home care services range from light supportive care and companionship to full nursing services. In-home care agencies are licensed by levels of care they can provide.

    In-home care services are usually paid out-of-pocket. Some long-term care insurance policies have an in-home care benefit. Medicaid may also cover some in-home care for low-income seniors.

    If you’re paying out-of-pocket, no doctor’s orders are needed. If you’re accessing in-home care through a long-term care insurance policy, there may be required physician forms.

    Costs for in-home care range, on average, from $15/hour to $37/hour. If complex medical care is needed, prices will be higher.

    Most in-home care agencies have minimum service contracts. Most will require a 2-5 hour, per day, minimum for 3 days per week.

    A Safe Plan

    After a lot of discussions, Ethel’s family put together a safe and appropriate plan for her return home. They decided to share time and tasks. They’re each taking turns spending the night and staying over on weekends. Stan, who runs his own company, can’t commit to staying with mom. Instead, he’s contributing financially towards the cost of hiring a caregiver from an in-home care agency.

    The agency has a trained and experienced caregiver who’ll come for eight hours on Mondays, Wednesdays and, Fridays to help Ethel.

    Everyone hopes Ethel will regain her strength and get back to normal. If that doesn’t happen, Ethel and her family will consider other living options. It might be more cost effective financially, emotionally and socially for Ethel to move to a senior living community.

    When it’s time, Ed will call a Senior Referral Agency. He knows he can trust the recommendations of an Oregon Senior Referral Agency Association member.

    For more information, referrals and help making senior living decisions,

    call

    OSRAA (503) 305-3878

     

     

    What’s the Difference Between Medicare and Medicaid for Older Adults?

    What’s the Difference Between Medicare and Medicaid for Older Adults?

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    When it comes to the differences between Medicare and Medicaid, there is much confusion surrounding the two.  We break down who qualifies for each program, what services are covered and the qualifying steps needed to get started.

    [Video] Medicare and Medicaid Coverage

    What is Medicare?

    Medicare is a Federal health insurance program. It provides health care for people over 65 years who’ve paid into the program. Seniors enroll in the program. Medicare health care coverage is available regardless of income. But the insurance is not free.

    Seniors pay a monthly premium for Medicare insurance. Medicare covers most medical bills. These include: doctor’s appointments, hospital stays, rehab services, some treatments and specific equipment. Besides monthly premiums, patients pay a deductible when using services.

    The federal government sets all rules, regulations and standards for Medicare. Medicare is also available for younger disabled people and dialysis patients.

    There are several parts to Medicare insurance. Medicare Part A covers up to 100 days in a “skilled nursing” facility per incident of illness. Strict guidelines determine qualifying for a skilled rehabilitation stay.

    A three-day admission to a hospital is one of the requirements. The first 20 days are covered. Days 21 through 100, have an out-of-pocket copayment per day. A weekly evaluation determines a patient’s progress. Medicare will continue paying its part if the patient meets progress standards. Patients rarely get their full 100 days of rehab care – whether they’re fully recovered or not.

    Medicare DOES NOT pay for long term-term care. Medicare only covers a short stay in rehab following a three day hospital admission.

    What is Medicaid?

    Medicaid is a low-income assistance program. It’s jointly funded by Federal and State taxes. Medicaid provides health care coverage for very low-income people – not just older adults. Some people can have both Medicare and Medicaid for health care coverage. Medicaid helps pay for premiums, deductibles, medications and services for those who can’t afford to pay.

    Medicaid is jointly administered by states and the federal government. Medicaid eligibility requirements vary from state to state. People eligible for Medicaid coverage must meet strict income and asset guidelines.

    Medicaid Coverage of Long-Term Care

    The most significant difference between Medicare and Medicaid is coverage for long-term care. Medicaid covers long-term care. These care settings include:

    • nursing home care,
    • assisted living,
    • residential care,
    • adult care homes,
    • memory care and
    • some in-home care.

    People must apply for Medicaid assistance. To qualify, applicants must meet low-income standards, have limited assets AND have significant daily care needs.

    Income and Assets for Medicaid Eligibility 

    In Oregon, a single person can make up to $2,205 per month (in 2017) in gross income to qualify for Medicaid. Asset requirements are usually limited at $2,000.00

    Applicants cannot give away or “gift” their property or assets. There is a 5-year look-back law. The application process requires proof of income. Medicaid workers search for any hidden or undeclared income. The Medicaid application requires bank records, bills of sale and financial documents.

    To understand acceptable ways to “spend-down” assets, consult an Elder-law attorney. Pre-plan long before applying for Medicaid.

    Care Needs 

    Part of the application process for Medicaid includes a care needs assessment. A Medicaid worker collects medical history, diagnosis’ and documentation. Applicants must prove they need help with daily activities of living (ADLs). Assistance with the following are evaluated:

    • medication management,
    • meal preparation,
    • dressing,
    • bathing,
    • ambulation,
    • transfers and
    • toileting assistance.

    Each ADL is scored based on the amount of help needed. The combined total determines a person’s level of care. The care level determines the monthly reimbursement a care home or nursing home receives. This level of care is for Medicaid purposes. Don’t confuse it with other levels of care many communities talk about.

    Medicaid continues covering long-term care if a senior continues qualifying for care. Yet, Medicaid eligibility rules change frequently. Income and care levels are forever in a state of flux.

    Also, significant numbers of care facilities do not have contracts with the State. They do not accept Medicaid payments.

    Accessing Medicaid takes significant pre-planning. We highly recommend contacting an Elder-law attorney.