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HermanS Asked August 2018

Are there unbiased local experts?

My wife (and I) are responsible for her 83 year old bedridden father. He is very lucid, but needs near-24/7 care. Currently, we are paying caregivers (not associated with any agency) at home. Too expensive, so looking for the best place for him or maybe a live-in individual.


That's the situation, but the bigger picture is there is SO MUCH to know between Medicare, Medicaid, insurance, finances, healthcare, etc. It seems we need to just research, study, continue to learn in our spare time. All, while finding out the many mistakes we've made, and are likely still making. And, each "expert" we talk to here is employed by an entity or facility that profits if we decide to use their service.


Is there such a thing as an industry expert we can sit down with, and pay them to assess his situation, and give guidance who does not work for a facility. Similar to a financial advisor who doesn't work for a financial services company?

dkentz72 Aug 2018
#1 DO NOT USE ANYTHING THE STATE OFFERS "IF" YOUR FIL QUALIFIES!!!
There is a lot of bias by the State. The "help" they give is not worth a tinker's damn (really never understood that saying). All the State is doing is providing you with a loan AND you have to pay down all of FIL's assets first. Then when FIL passes, the State gets their money back...paid in full.

Have you contacted A Place For Mom? They will give you a list of agencies that have been vetted, in your area.
INTERVIEW every single one and go into detail. If FIL takes meds, in-home-care uses certified staff and they cannot touch, administer any medications. A family member will need to do this or you'll need to pay extra for an LPN/RN at their hourly (even if they're there for 5 minutes) rate.
Medicare, depending on what part FIL signed up for, will provide up to 30 hrs a week.
Tall with FIL doctor, these are generally the agencies that work in various ways with the State or their programs are run with the same guidelines.
Does FIL have medical policy he maybe paying for when he retired?
Just because an Attorney list(s) as Family law, Estate, Financial planning....may not really have the interest other than money for them.
Rresearch, research, research. Call the ABA for your State regarding how much the firm actually does in Family law etc. I found an attorney by researching on my own, whose practice is over 75% elder law, majority of that is elder abuse financially and physically. I asked the paralegal who helped me court wise, her opinion regarding this attorney. Answer: the best for me and well known for her tenacity.
You can also check the nurses registry for nurses who adultsit and may do light housekeeping too.
Get guardianship/conservator so any debt, including his care costs are paid from his estate. Keep record of any out of pocket as his Estate pays you too either by hour (have to clock in/out) or at the end of FIL's time that is down by receipt record.
The State should have a website explaining all of this and what has to be done by the guardian/conservator/personal representative/all the ins/outside required.
Hope this helps.

tornadojan Aug 2018
I think it is important to be hands-on yourself while accessing other resources (touring facilities, etc.). You are right - all of the resources - except for Area Agency on Aging - get a fee from the facility they recommend. That is how they make their money. Personally speaking I will not do that - I will do the legwork myself if necessary. A good elder law attorney can definitely assist and will have your best interests in mind - because you will be paying him or her. I also work in this area independently - with no affiliations. Best wishes.
HelperMom Aug 2018
Not to mention, the “advisors” can steer you in the wrong direction by recommending inappropriate facilities just because they are on their referral list. For example both of my parents are physically disabled, but I was directed to check out a place that had standard bath tubs and showers that you had to step over the tub’s edge to enter! Totally inappropriate for their needs and I wasted time driving to another town to visit them. Another one of their recommendations sounded fine and was absolutely appropriate, but required six years of private pay prior to transitioning to Medicaid. Again, not a good fit. I backed away after that and did my own research with the help of our local Area Agency on Aging. They know the real scoop on what’s available in your area and will let you know if a place has a poor reputation.

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Etheljr Aug 2018
Good question! I own such an agency myself and am also caregiver to my elderly parents. Two ideas:
Every county has an Area Agency on Aging. Google that name and you will find the one in your area.

I belong to the Aging Life Care Association aginglifecare.org. You can look up agencies by state. These agencies are run by geriatric care managers who can provide the guidance you need. Most of us offer free initial consultations. I don’t partner with any providers and most geriatric care managers don’t.

gdaughter Aug 2018
Yes. One option is a geriatric or elder care specialist and there is an association to which they may or may not belong and the official name is escaping me right now. You've identified the worst mistake of taking advice from those standing to benefit at the places you're considering. I would invest your research time in finding out who the best elder law attorney is who will want a full financial assessment to help make the best decisions here on out and get the essential papers re will, POA, health care issues tended to. You might want to connect with your local office on aging who might know who is better or worse. Be cautious. The first attorney we used was HIGHLY regarded in the community and professional opinion and turned out to be a total jerk. The 2nd attorney, who knew the first was wonderful and caught an immediate error in the first person's efforts so that it had to be, for one sentence, completely redone at our expense.
IF you opt to hire privately you may get advice from the attorney or from a CPA as far as doing paperwork. Make sure you do a criminal background check. If you have any valuables you may want to make sure they are locked and safe. It's too easy for those looking for something to have access after gaining your trust. Which isn't to say it couldn't be the best option. Very hard to find good in-home people and of course you will need more than one for one is likely to need time off as well and not be on call 24/7.

Catwinter Aug 2018
I would start with an elder care attorney.

Countrymouse Aug 2018
Independence is no guarantee of quality, you know. And just because a care group "profits" from their service, it doesn't mean it isn't a good service.

Maybe one way to start would be to make a short-list of facilities in your area and tour three to five of them. Ask if the tour could include a meet-and-greet with their in-house advisors, so you can get a feel for them and do some useful comparisons.

anonymous594015 Aug 2018
https://www.aginglifecare.org/

We hired an Aging Life Care Specialist (Geriatric Care Manager). The one we chose is a social worker with over 30 years of experience. Some of them we interviewed were RNs. Find someone who knows the services and homes in your area very well and pay them by the hour. You might only need to pay for a few hours to get the information you need.
I was overwhelmed when we first started to help our elderly relatives. There are too many rules. Our care specialist has saved us a ton of money, time and saved us from distress. I highly recommend hiring one.
Zdarov Aug 2018
Thank you so much for posting this statement and link! I’ve read answers saying that this exists - but now I could look it up and find names. There is an agency near me and I’m going to call them!
cwillie Aug 2018
An elder law attorney could help you navigate the murky waters of Medicaid and financial planning.

AdeleL Aug 2018
You might see if your local hospital has a Medical Social Worker you can meet with to discuss your Father's situation, what you are and are not eligible for, etc. That's what they are paid to do. They are paid for by the hospital and don't work on a commission, so that conflict of interest is gone. Also, your Father's doctor might be a good source for a name or two of a fee for service Social Worker.
A Geriatric Case Manager could be another good source to help with navigating the land mines. These folks can help with both the Medicare/Medicaid stuff as well as the medical issues you might be facing.
All my best to you and your family. It is a difficult journey you are on and the best gift you can give to your Father.

Grandma1954 Aug 2018
There are Geriatric Care Managers that can help navigate all that you are doing.
There are smaller group homes that might work,
There obviously are the Nursing homes, some nice, some not so much.
Is her Dad a Vet? If so have you looked into the VA and what is available through them? And if he has any conditions that would be considered a "service connected disability" that might make things easier for you as he would qualify for other programs. The one I used for my Husband was VIP it is a program designed to keep Veterans in their homes and I was "given a budget" to work with and I could hire caregivers and they would be paid through that budget. If I was not married to my Husband I could have been paid through tat budget as well for my caregiver services but spouses can not be paid. As a Daughter or a SIL you could get paid.

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