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AmyStack Asked February 2022

How do you navigate the assisted living/home care world?

My Dad is almost 75. He went on a ski trip to Jackson, WY and had an accident. He broke his neck. The did 2 surgeries and he is a rehab in Salt Lake City for a few more weeks. My Mom died 2 years ago. So it's me and my brother to help him. My brother is some help, but not a lot so this will fall on me to deal with. We live in Colorado. I am 2 hours from Dad and my brother is three and a half.

I have a cousin who is a paraplegic. He lived on his own for years with Personal Care Attendants (PCAs). I am hoping my Dad can do the same thing. He lives on a fly fishing stream and I'd like for him to go back home.

Sounds like they will move to him to another facility soon. There is one close to his house that I am going to visit next week. Guess if they can accommodate him he will probably go there. The insurance situation is scary too since they will only pay for rehab for about 100 days.

I am new to all this and it's not a lot of fun. I haven't been taking great care of myself the last few weeks (this happened on Ja 18th) either. And haven't done anything much fun since then (although people, including him, have told me to).

Guess just hoping for some advice from those in a similar situation.

AmyStack Feb 2022
Thank you for the answers. I am Power of Attorney in his Will but don't know if we need to have him sign stuff over to me now. I have been dealing with his bills a little so far. The insurance/medical stuff gives me anxiety. We got a bill from the Ambulance which I haven't seen yet. Probably should look into talking to the financial people where he is so we don't get too many surprises.

Agreed, it's his life and his decisions. I almost bought him and cel phone to land line phone splitter then decided to ask first. Also just found out Alexa might be very helpful when he goes home. Assuming he is OK with it and he gets home.

Fortunately he does have savings so we should be able to fund his recovery/help in the house.....assuming the covid shortages of these type of people doesn't cause too many problems.

And yes. I don't think any of us really want me to move in with him and become his primary caregiver.
Geaton777 Feb 2022
AmyStack, Power of Attorney is the assigned authority to act in that person's best interests while they are still alive. The moment a person passes away that authority ends immediately. Then the Executor of the Last Will (also assigned by the LO) is responsible for taking care of expressed wishes, paying off debts, bringing things financially to a close, distributing assets as directed in the Will, etc. The Executor of a Will has no authority to manage or make financial or medical decisions for the LO while they are alive. They are 2 completely separate functions and authorities, even though sometimes they are the same person.
JoAnn29 Feb 2022
Just need to say, secondary insurance does not always pick up the 50% that Medicare doesn't. It may pay partially or not at all. It all depends on the insurance Dad has. That 50% can ad up if a person is in the whole 100 days. It's been over 5 yrs but my Mom paid $150 a day after the 20 days. If she had been in rehab the whole 100 days it would have cost her 12k. I would speak to the finance department in the facility. They should be able to tell u what is being paid and not being paid. I was given paperwork that spelled that all out for me.

Assisted livings do not do the type of care you are talking about. They help with daily ADLs. They are residences. They don't do physical therapy. That gets called in at the expense of the resident. They are private pay. Some residents can come and go.

Lets say Dad does his 100 days in Rehab. Medicare stops paying. He needs more care, so Skilled Nursing is suggested. SN is private pay. If the person is low income with no assets, Medicaid can be applied for.

It does not hurt to look ahead but you need to be prepared for the worst. What you and Dad may want may not be what he needs. Time will tell.

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Geaton777 Feb 2022
My best advice to you is to have tempered expectations.

"He lives on a fly fishing stream and I'd like for him to go back home."

This is getting way ahead of things. You need to see how he progresses in rehab. If he is 75 and was skiing, I'm guessing he's pretty athletic which is definitely in his favor, but as we age, recovery is harder and longer. Watch for signs of depression, UTIs (from being catheterized), brain fog from anesthesia (if he had surgery for his injury), etc.

Like BarbBrooklyn suggested, it is critical that his legal protections are in place and someone is able to manage his financial affairs and help him make medical decisions. If he doesn't have a PoA this needs to happen. Facilities often have notaries on staff so if you can get the paperwork to him (and assuming he can sign it or approve it in some way) then he doesn't have to travel to an attorney's office. The documents can be downloaded from websites like Legalzoom.com or Rocketlawyer.com. FYI this requires transparency with your brother so he knows what's going on. If you accept being the manager of his affairs, you must insist on being his DPoA.

Also, no one can "assume" another person into being a life-time caregiver to another person, even if it is your parent. You do not have to accept this position by default, for any reason (your brother lives slightly farther away than you? Nonsense.)

Again, you will just have to wait and see how his recovery goes. Make sure your brother understands that you are not necessarily the default caregiver. I wish you much wisdom and clarity during your dad's recovery.
AmyStack Feb 2022
Thanks for the websites. His mind is fine so probably we don't need me to officially be the DPoA now. It's just the communication since he is in Salt Lake City and I am in Colorado and he can't really use a phone or computer yet. Taxes should be all sorts of fun.
BarbBrooklyn Feb 2022
Welcome, Amy.

First off, remember that your dad's life is HIS resposibility, first and foremost. His choices, his money. I get that you are worried about his future, but if he is competent, he should be driving the bus.

Medicare pays for 100 days (first 20 at 100%, next 80 at 80%--his supplement should pick up the difference) but only if progress can be documented. "We're discharging your dad tomorrow" is frequently heard. Those discharges can be appealed.

Talk with him and find out if anyone has been given Power of Attorney. That would be useful so that you can keep his bill payments up to date if he isn't able to.

What do he and his doctors tell you about his prognosis? Is he paralyzed?

Get a clear view of his finances. Does he have long term care insurance? Does he have the funds to employ PSW's around the clock indefinitely?

Is his home wheelchair and handicap accessible?

Come back with any questions or vents!
BarbBrooklyn Feb 2022
Correction; after 20 days at 100%, Medicare will pay 50% of the days up until the 100 day mark,

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