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We are about to bring my 90 year old father home from a nursing facility. He can't use his hands due to severe arthritis. He can only partially bear his own weight. He can't move himself in bed. We know about the MedicAid spend down requirement, but we are trying to weigh the advantages/disadvantages of nursing home care verses caring for him at home. Once he qualifies for MedicAid, how much is he allowed to pay us for room and board? Is there a separate $ amount made available for me as his caregiver? Anything else we should know?

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Oh, I just noticed you had asked about you being paid. Sorry, majority of grown children are not paid for taking care of their parents, unless the parent can afford to pay from their own retirement fund.

Now, some States do have "Cash and Counseling" but the pay would be minimum wage and only part-time. If your State does offer payment, that's good, but don't be disappointed when you feel like you are working 90 hours a week but being paid for 20 hours.
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NMDadCare, to figure out how much care your Dad would need, stay at the nursing home for 48 hours to watch to see what the Staff needs to do. You'd be surprised at all the work involved, and remember the Staff works 8 hours [or 12 hours] and a new shift comes in already rested to do the work. And if a Staff member is on vacation or out ill, there is always someone to fill in. Who would fill in for you at home? Something to think about.

If you bring Dad home, you would need to set up his room like that of a nursing home. The bed should not be up next to a wall as it takes two people to help from both sides of the bed.

You would need to purchase a hospital bed that rises up and down. The reason for this is that when the bed is in the fully up position, it makes it easier for you and another family member to turn your Dad since he can't turn himself. It's easier on your back, so you won't hurt yourself. Also, with the bed fully up, it's more helpful for lifting your Dad out of bed into a wheelchair.... if he is able to walk, then the bed has to be in a position that is easier for him to exit the bed. Now if your Dad is prone to falling out of bed, the bed has to be at it's lowest point, plus you would need "fall mats" on both sides of the bed.

And as Babalou had written above, you would need to purchase a special air mattress and machine. If your Dad isn't very mobile, and is uncomfortable sitting in a wheelchair, the best thing is a Geri Recliner, but those recliners are very expensive.

What about doctor appointments? How would you get Dad to said doctors? Would you need to hire special transport? At the nursing home, the home has their own doctors who come in to visit the patient.

And what if you have Dad at home for awhile and find it was a mistake, you might find the nursing home Dad had been residing doesn't have an open bed. You would need to find another nursing home.
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You say you know about the Medicaid spend down requirement; one of the best ways to spend down is on care. If he has resources, can you private pay at the facility he's in, or another one for a certain time period and then have him continue as a Medicaid patient? You'll have a wider choice of facilities that way.

If he can't move himself in bed, he's going to need to be turned every 2 hours or so, even during the night. He'll need a special air mattress that inflates and deflates so as not to cause bedsores.

A caregiving contract should be done by a lawyer, to make sure that it complies with Medicaid requirements, if you are determined to bring him home.
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You should really consult a local certified Eldercare attorney about this. Medicaid is administered by each state differently and you need someone familiar with the local laws to advise you intelligently.

Why are you bringing him home? It really sounds as though he needs 24/7 care.
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