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I am a caregiver for my grandfather and I have POA. The elder firm I am speaking with is telling me to apply for Medicaid benefits for my grandfather. He is a veteran with VA benefits (not aid and attendance) he has Medicare A&B. Recently I was notified that he is a candidate for hospice. He has advanced prostate cancer. My question is why would I apply for Medicaid when hospice will take over at this point? The law firm is advising me to get a PCA and spend down his savings to 2000K so he will qualify for Medicaid. I would like to hold onto his money for additional care if necessary. Please help with any thoughts. Thank you in advance for any words of wisdom.

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Hospice will not provide 24/7 care and any custodial care aka room and board provided by nursing home or other facility is not included in hospice benefit. You will get equipment provided by hospice for comfort care, but not 24/7 caregivers. Is he staying at home?
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Check this out:

www.va.gov/GERIATRICS/Guide/LongTermCare/Homemaker_and_Home_Health

Thanks to a few other posters here, I discovered this benefit. I don't know all the details, and you'd probably have to contact the VA to find out how much support you would have at home, but it's worth exploring.

At this point, I'm still sorting out what we can get through the VA. Navigating through its programs can be like going through a maze.

One program I discovered, again through help from other posters, is considered part of the basic VA health care benefits; the only qualification is really an assessment of what the veteran needs.

I contacted a local VA service organization and was advised that the Veteran's PCP at the VA would be the individual scripting for the service.

So I would instead of considering Medicaid, first contact your GF's VA Team and learn more. You might also ask about a home visit given his condition.

I think I'd also explore the VA hospice program. I don't have a link, but I recall seeing reference to it as I was navigating one of the sites.

And I'd consider consulting with another law firm, just to be sure you're getting a good representation of your options. (I imagine this particular law firm recommending Medicaid is going to charge you for handing the application?)
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I agree with GardenArtist. First check what additional VA benefits he may be entitled to.

If he goes on hospice now, you will in effect be spending down his assets for his care. He will need someone there 24/7. Most of what he will need in equipment hospice will provide (bed, bedside commode, wheelchair, etc) and there will be no med costs. If the cost of a PCA (or more than one -- are you able to be with him at night and part of the day?) and other expenses brings his assets down to $2,000 and he still needs care, then you can bring in Medicaid. I guess this is sort of what the lawyer said. Spend the money you need to spend on grandpa's care. If he is going to run out of money, apply for Medicaid when he gets near $2,000 left.

Is there a pre-paid end-of-life plan, for burial or cremation and a service/celebration if that is desired? If not, that is the first thing you should spend his money on. If he is eligible for hospice, that may be needed within the year. Don't spend all his resources without considering that.
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If GP has other medical needs other than his prostate cancer hospice will not cover any costs associated with that. For example if he is also diabetic they won't provide the medications he needs for that.
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Hospice will not transfer him to a hospice facility until he is in the active stage of dying (maybe last week or so). Until then, he will need to pay for his own care until his assets are below $2k, and he qualifies for Medicaid.
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Veronica, this is a bit off-topic for this thread -- we don't even know if GP has diabetes -- but hospice does cover the drugs and supplies for comfort and symptom relief. That is all any diabetic treatment is. Nobody is saying it will cure diabetes, just, hopefully, minimize symptoms and complications. But I don't have experience with that on hospice. Was that your experience?

I do know that on hospice they recommend a more relaxed approach to diabetes. Lows can be more a problem than highs, short term, and people on hospice are looking at short term. Even early in his dementia my husband's doctor took a more relaxed approach with his diabetes. He stopped testing himself and she did the a1C about every 3 months.
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My FIL, was recently on Hospice in our home and until he passed away last month. He was Non-insulin dependent Diabetic, but on tablets.
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Jeannie I was using Diabetes as an example only. Hospice will in my experience cover costs for admitting diagnosis but if other diseases cause unpleasant symptoms such as nausea from renal failure when the patient was admitted with heart failure the nausia will be treated as that will be part of the comfort care Hospice provides.
Every hospice is different in how they interpret the rules and it all goes back to the money and what the hospice can afford and the attitude of the Nursing supervisor and the Medical Director.
I agree that a more relaxed attitude is taken to existing diseases and only essential medications are encourages. Again for example in the last few weeks of life there is no need to continue with anti osteoporosis drugs.
Hospice will not prevent a patient from seeking other treatment with or without discharge from Hospice.
The patient or their caregiver is always in charge and hospice is there to direct them in the best choices.
In my case I would present the choices to the patient and family then assist them in whatever choice they made.
It is a very flexible system and different people will agree with one choice but in others feel they have been failed. Someone with COPD might want to be treated in the hospital and i could arrange that but the following morning the Nursing Director might decide the admission could not be paid for and the patient would be discharged for the duration of the admission but once discharged from the hospital be re admitted to hospice. Costs for hospital would then be billed to medicare or whatever insurance the patient had. For younger people who are still working many insurances also have a hospice benefit.
Hope this makes sense.
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Thank you every one for the info. I just enrolled my GF into hospice today. They are bringing in the hospital bed, commode, wheel chair, oxygen, and shower chair. The nurse advised me he would be fully covered under Medicare and that they will be responsible for all his existing med's. I was surprised to see he qualified for Hospice under three diagnoses- Prostate cancer, Dementia, and CHF. I also have an appointment with the VA social worker this week. She called to tell me they offer a program where they work with Hospice and will send a caregiver/nurse/aid to the home on the days Hospice nurses don't come. This was also a free benefit from the VA. I will keep you up to date as this all progresses but it was definitely worth looking into VA. Hopefully he will not need Medicaid with Hospice and VA. Thank you all again for your helpful links and comments.
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Mishey - how is it going? Out of curiosity, between hospice care and VA care, how many hours per visit & # of days would you say someone other then you or family is there for gF oversight?
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Update: the VA link I provided is no longer good.
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