No long-term care? No nest egg? Medicaid can help

I grew up in the Arizona desert which is, among other things, rattlesnake country. The purpose of the rattle, in addition to its appealingly rhythmic cadence, a warning, so I’m rattling before I strike: I’m setting out to talk about nursing home care; specifically paying for it.

The reason I’m setting out to do this is because, lately, a lot of you have been asking about it, so let’s just do it, and I’m going to begin with my standard definition of a caregiver: A “caregiver” is somebody who is taking care of somebody who needs to be taken care of, whether they like it or not — think, “long-term care.”

Sometimes, the caregiver just can’t continue to do it anymore. There are a million good reasons why that might be true, one of the most common being advancing dementia (e.g. Alzheimer’s, etc), but there are lots of them — It doesn’t really matter, you are where you are, and the time has come — whether you like it or not.

So, now, you’re having to consider nursing home care — TIME OUT: I am specifically talking about nursing homes, not assisted living facilities or retirement communities or continuing care communities or adult family homes — nursing homes, OK?

I know how emotionally difficult this can be for all concerned, and if you are the caregiver, thank you for hanging in there for as long as you did. You changed a life; now let go of the guilt and change your own.

And have “Thank You” tattooed on your heart.

But you’re “there:” You’ve got to place your person into a nursing home; obviously, there are all kinds of things to think about, like location, reputation, quality of care, the staff, the food, etc. ad infinitum, but one of the things that’s bound to come up on the list is money, because nursing home care is pricey.

If you and/or “care receiver” and/or family have substantial financial assets (good for you), then make your decisions based on quality of care and geographic convenience, and remember that you did your best.

If someone bought a “Long-Term Care” policy several decades ago and has been cheerfully paying the premiums each month since the Hoover administration, then find it and read it; then read it again. TIME OUT: If you do have a long-term care policy, whether you think you need it right now or not, find it — then, put it someplace where you (or somebody who isn’t you) could actually find it again. People lose these things all the time, because they never needed to care where they were; remember, everything really is alright, as long as it is.

IF you have one of these, it might pay for some or all of the nursing home care for “X” amount of time; in fact, it might pay for some in-home care, which might change the game; either way, find it, read it, then read it again.

NO LTC policy? OK, here’s what often happens: “Care receiver” (“Dad”) has enough assets to pay for nursing home care for a while (Note: A few years ago, $7,000/month was a workable average, with any specific facility being a little more or a little less — I sincerely doubt that it’s gone down); hopefully, you or someone “close” has a “Durable Power of Attorney” in place (particularly important in the “dementia scenario”), and can move Dad’s income and assets around in order to do what needs to be done.

So, a facility is selected and Dad moves in and you’re paying the nursing home “X” dollars per month. Breathe a sigh of relief, because you deserve it, but don’t think for a moment that you’ve stopped being a “caregiver because you haven’t — Yes, I do get it.

Time goes by and everybody kind of settles into their new places and roles and (hopefully), everything is going reasonably well, most of the time, when it hits you: “Oh, my Gosh! He’s going to run out of money! Now what?”

First of all, here’s what’s NOT going to help: Medicare. Yes, Medicare does pay for some nursing home care if you’ve been in the hospital and were actually “admitted” and you’re in the facility for rehab and blah blah blah, but on a long-term often permanent basis? Nope, not Medicare, so you’re going to have to think about — And deal with! — MediCAID.

Let’s back up: Dad’s income and liquid financial assets will be gone soon (Note: Do NOT wait until they’ll be gone next week. Start thinking about this at least two months ahead of “broke!”), no LTC policy and the family can’t just whimsically cough-up upwards of 7K every month, right? OK, then it’s “Medicaid time,” so try to relax, grab a friendly beverage and Don’t panic.

We can do this.

Mark Harvey is the director of Information and Assistance for Olympic Area Agency on Aging. He can be reached at or 532-0520 in Aberdeen, (360) 942-2177 in Raymond or (360) 642-3634. FACEBOOK: Olympic Area Agency on Aging-Information & Assistance.