Monthly Archives: January 2014

Primer on Medicaid (Nursing Home)

Medicaid for Long Term Care | Jim Schuster, CELA from National Elder Law Foundation on Vimeo.

IN this little video Jim explains the basics of Medicaid including spend down to $2,000. He also covers excluded assets, such as a home and car. Perhaps the most important point is the very important topic of the protection of financial security for the at-home spouse. By most important I (Jim) mean that the spousal allowance is too little known and too many “community” spouses experience needless financial harm.
Hope you enjoy.
p.s. we have much more in-depth info on our website. Just look around and call anytime – (248) 356-3500.

The Paradox of Aging. Elder Parent and Children fight: for the Parent’s Independence

This post is the first part of a series on the children of aging parents: Dad is aging and starting to need regular help.

Let’s first state some general propositions:

      *It is a truth of aging, sooner or later every person needs assistance with daily life. And, almost every elder approaches that dependence the same way they have met other challenges in life.

*Every Elder wants to maintain independence

*Every child of an elder wants their parent to be as strong, vital and independent as they were when they were younger.

And so parent and child battle each other for the same goal: the elder parent’s independence.

Consider a typical scenario: (We’ll use “dad” where the problems could easily be with “mom.”) A daughter notices that Dad is not as sharp as he used to be.  He is not the careful dresser he was. He always seems to wear the same thing.  The home is not in its usual state of tidiness. She notices a pile of papers with past due bills on the kitchen table. There is a doctor’s appointment reminder buried in the pile. Dad may have missed a doctor’s appointment.

When the daughter approaches Dad offers quick excuses and daughter jumps in to help out. The house is cleaned up, the bills are paid or a new doctor’s appointment is made. Dad thanks her and says he’ll let her know when he needs help again.

Dad doesn’t tell daughter that he is bothered by these problems.  His life seems to be just a little bit out of control. In his eyes he manages well, all day long, but some little things just slip through the cracks.  So he forgets something.  Who doesn’t?   He approaches this challenge in the same way he has every one in his life. He tries just a little bit harder.

Hard as Dad tries things continue to happen.  He has a place set aside for the bills, but somehow the electric bill got moved.  Daughter found it buried in pile of newspapers.  He drove to his next doctor’s appointment, but backed into a light pole on the way out.  Minor, but noticeable damage. Not worth reporting to the insurance company and since the car is nine years old, no need to fix it. Then she presented one of the prescriptions he picked up a week ago.  It was still full.  “You aren’t taking your medications dad.”  He assured her that he was busy when he got home that day and put in the bathroom cabinet and just forgot about it.  He could see that she was worried. “Nothing to worry about.  I just forgot it. I’m going to take them every day now” he assured her.  But he didn’t tell her he was a bit worried too. That never happened before.

Daughter and the other children start thinking that Dad shouldn’t live alone.  And, maybe he shouldn’t drive anymore.  They need to talk to him. They agree they should all talk to him at his house. They arrange to be there Sunday.

Dad is a bit surprised that all his children want to come over on Sunday.  It’s not a holiday.  Then he figures out what’s up.  He suspects that they think that just because he is old he needs to move to an old folks home. Phooey on that!  He can handle everything!  They just don’t want to help him out every now and then!  The ingrates. He didn’t think his own flesh and blood would turn on him like that.  Well, he decides he’ll hear them out, and if they don’t give him respect he’ll throw them out!

Sunday comes and everybody is on edge.  The oldest son and Daughter lead the group of the four. They lay out their concerns and Dad agrees that the things they point out are problems and that he did not have those problems before.  He assures them that he now knows he needs to pay attention and try a little harder.  He is doing that and he is doing fine.  No problems.

The children are frustrated.  For every problem they point out Dad has an excuse or says he has taken care of it. Yet, things keep happening.

Then Daughter asks “Dad, what are you going to have for dinner?”  He replies “I thought you were going to take me out, but I’ll fix something.”  Then Daughter says “I looked in the frigerator and it is almost empty.  And you have 20 cans of tuna in the cupboard and not much else.  Look at you, you look gaunt.  You have lost weight.  You are not eating right!

She then presents some papers for him to sign. She says an attorney prepared them.  He looks them over and then throws them down on the table and storms off.   After a minute he comes back and tells them to leave.

They do and talk outside the house.  What do they do next?

In our next posts we will cover some of the common problems growing out of this scenario. And, we’ll look at solutions and strategies to avoid them in the first place.

Jim Schuster