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realtime Asked November 2014

Will my Mom lose her Veterans Aid and Attendance Benefit if she leaves assisted living, and instead lives at her home with a caregiver?

She's in wonderful shape for 94 and longs to live at home. She, my brother and I think we have found a way to make that happen for her. She receives about $550 a month from the VAA program as the widow of a WWII vet, which is a nice cushion to her pension and social security. Will she lose that entirely? Or will they just recalculate the benefit based on different costs?

EXPERT Ralph Robbins Nov 2014
VA Aid and Attendance Pension is a needs based benefit. If she has already qualified and is receiving benefits, any changes in expenses or income must be reported.

She has already met the asset test and we can presume that her income is relatively steady with only COLA increases.

The award, however, is actually granted based on income relative to expenses. To receive the maximum award for a surviving spouse (assuming here that she is not the veteran), which for 2014 is $1,130 per month, her net income for VA (IVAP) purposes must be $0.

To arrive at IVAP, start with gross income and subtract unreimbursed medical expenses which can include payments for medically related insurance premiums such as those for a Medicare supplement and Medicare Part D plans, ongoing out-of-pocket co-pays, ongoing services and supplies (such as those for incontinence), and the cost of care - whether it be home care or room and board and cost of care in an assisted living facility. If IVAP is $0, a full award will be granted.

The fact is, if her care at home is more expensive than in AL, her award might go up.

I applaud you for making the effort to grant your mother's desires. Caring for loved ones at home can absolutely work - even in complicated cases. For many there is indeed no place like home. Good luck!

pamstegma Nov 2014
There would be a recalculation of income vs expenses and my guess is she would lose the benefit. At home care is ordered by an MD, and $550 a month would get you very little, where an ALF has people to help her 24/7. Sounds like a bad idea and a very risky move.
She "longs to go home" but home is not a place, it is a time 50 years ago when she was much healthier and active. For her to think she would be fine at home is extremely delusional. She has forgotten that someone else does the cooking the cleaning the laundry and the meds. Keep her safe where she is.

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pamstegma Dec 2014
Pam156, You mom probably still needs the home aides that she has, so I don't see why she would lose A&A. Once on Hospice, you have Hospice MD's and Nurses and possibly some changes in meds, but Hospice is all Medicare paid.

BarbBrooklyn Nov 2014
Does she have any signs of dementia? Very iften, folks with dementia long to go home. By that, they seem to mean that they want to be young, strong, competent, again. We hear a lot of stories here about elders who ARE home and refuse to believe that is where they are. Proceed with caution.

I assume at AL, she's got easy access to a doctor and an RN when she needs it. Are you going to take her to doctor's appointments or rely on the in home caregiver to do that? Is this person going to live-in? Make sure that you've thoroughly vetted her so you don't end up trying to evict her. How will your mom react to loss of socialization and activities? Do you have podiatry services lined up? I'm sorry that I haven't answered your question about A&a.

Badabbot Nov 2014
Iam 100 percent disabled vetereran getting aid and attendance question is my wife has dementia and is starting to forget to take her meds and is getting more confused is she also eligible for aid and attendance

Pamela156 Dec 2014
my mom has alzheimer's and lives with my sister, and receives the maximum VA benefits. It is time now to have hospice come in, so will she lose her VA award of 1,130.00 per month?

Pamela156 Dec 2014
Hi, Thank you for your reply about my mom . I pay caregivers to take care of her, so I will need them even with hospice? I do not know how any of this works and not sure if the time is right for hospice. My mom is 89 and her symptoms started in 2010. She has rapidly declined, needs total care, and now keeps food in her mouth and sometimes will not swallow it. So she eats only soft food, because her teeth of course are not in. (She started taking them out) Sometimes she can't stand or walk with aide, and other times the complete opposite. She is in good health other wise, BP great with meds, preventative antibiotic for UTI, and Namenda. She watches TV and occasionally laughs. One aide says she thinks mom is nearing the end, and the another aide says she is not that bad. So mom has good and bad days. I communicate with her doctor and tell her what the caregiver aides say. Sometimes they can get her into the shower, but most of time bedside bathing. She is always in the living room and we try to keep her mind working by talking to her, and she responds, but most of the time doesn't make since. She remembered her birth year and day a few days ago. So confused and any advice is greatly appreciated. Thank you

Buddy57 Jul 2016
Do caregivers have to pay taxes on their income from aid and attendance???

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