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I am not a caregiver.


I am a 71 year old woman who is suddenly getting many issues and medical diagnoses, including stage 3b kidney disease and bursitis of the knee and hip which is giving me a lot of pain when mobile. I also have bipolar disorder, but can manage this with the local clinic's help at the moment.


The problem is that I have no family whatsoever in this country and I can't expect to rely on friends should any of these problems worsen and leave me unable to take care of myself. At present, I am very lucky to have free services from the local Department for Aging and Disability but this is not reliable with regard to non-skilled workers who either turn up or they don't, and I don't see myself being able to rely on them for any skilled nursing care in the future. I have tried a lot of different agencies, but they only pay minimum wage so cannot keep their staff.


My income is small, $20,400 p.a. at present (depending on the exchange rate seeing as one of my pensions comes from my work in England). I have Medicare parts, A,B,C and D and have taken care of other services like Medic Alert and future Meals on Wheels. However, I understand that Medicaid will not pay for any long-term care because my income is 'too high' according to them, but when I look into private facilities, my income is far too low. I have very little savings and am having to dip into them quite often these days to pay for various emergencies. I seem to fall into the gap.


I am researching all this for the future when I may indeed be more incapacitated and unable to care for myself. If you can give me any help with this I would be very grateful.


Sally

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You need to see a qualified Eldercare attorney. If your income is too high for Medicaid, an instrument called a Miller trust can be set up in some states.

You are so wise to plan ahead! Welcome!!
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Do you speak any Spanish? If not, never too old to learn. Was paying some $12,000 a month for companion care for my wife and she was losing her English--we married and had lived in the U S for some 45 years. Could not find dependable companion care that spoke Spanish and were not constantly changing. That added greatly to her anxiety. Her large family live in Ecuador so I uprooted us and relocated to Ecuador. She can see and be seen by her family and we have round the clock companion/nursing care plus a full time cook and housekeeper, and for all of them I pay only about 1/6 as much as was paying in the U S. Something to think about and there is a growing number of Americans retiring to Ecuador for all the things that retired senior types need. Good medical facilities, good beautiful weather year around and the Ecuadorian people are some of the nicest on Earth.
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L
Leighone Aug 2018
How do I get my mom and I there? She’s 96! Longevity is in her blood! But she has dementia and the facility I we can’t pay. She’s been to Ecuador long time ago! Better there than here
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There is independent senior living housing in my state (NY) and also in New Jersey. It is not assisted living but it does offer a community of seniors who look in on each other. The two I investigated were close by to medical providers and had transportation to grocery stores and doctor appointments. Your income will not be a problem. You are charged on a sliding scale. There were waiting lists for these places so you are wise to get started looking around early. Ask a social worker at the Department of Aging if anything like that is available in your area.
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Wow! Good for you to be planning ahead!
i agree with Marcia above- in my state (Pa) there are 55+ retirement communities with transportation, elevator buildings, excellent amenities, and doctor offices across the street. The residents all look after each other. This might be a great place to start, and if your needs arise, you can apply through the corporation for the aging for a financial and needs assessment for Home personal care assistance.
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You make as much as my Mom did and I had no problem getting her Medicaid. I figure you make about 1700 a month. Depending on the state, I think you are below the amount most states allow. Call Medicaid and see if you can apply for their homecare services,
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Your income is roughly twice mine. What prevents me from getting assistance is my savings. I'm thankful I planned ahead and should the time come when I have exhausted my savings, I will gladly accept Government Assistance.

I don't know if your income is too high - but I'm thinking that your savings are probably still too high for assistance, anything over $2000.00 is considered too much money.

I was advised that Medicaid will assist you in approved spending-down to become eligible for assistance.

Asking questions is the best First Step you can take.
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There are Medical Advocates you can hire, there are Senior Advocates you can hire. Either of these will work with you to ensure that your wishes are followed as well as addressing concerns that you have.
You can and probably should consult an Eldercare Attorney that can help set up the papers that you need to also ensure that your wishes are followed.
You should also look at a P.O.L.S.T. this is a document that is more detailed than an DNR it will give medical personnel the information you wish to convey if you can not articulate for yourself. (either at the moment or permanently)
Another thought..decide at what point you will no longer get treatment for your kidney disease. You would at that point probably qualify for Hospice and would get great service from them. There are other conditions that would be considered "life limiting" and may qualify you for Hospice. It does not have to be a diagnosis of 6 months or less in all cases.
Low income senior housing is a possibility and if you are working with a Social Worker try to get them to advocate for you.
Great that you are looking ahead.
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Sally
We too had to "spend down" "mom's money (savings").  But we needed to do it correctly as you will need to look into this carefully.  It is hard but here are a few areas we took care of.  We Pre-paid for her funeral expenses, that way you are in control of your burial and how it is paid for.  Most funeral homes will set up an irrevocable policy that can be used at their funeral home or at any other home you choose.  Other things are "daily living" type home renovations.  We installed a a shower and had the tub removed so she didn't have the trouble climbing in and out to bathe.  Also Paid for lawyer for her updated will.  These are legitimate type expenses.  As you a  trying to plan ahead some remember getting Medicaid takes many months and your savings need top help you through those months too.  If you have a good Church home I  would suggest speaking with your pastor and get their thoughts too.  I spoke with mine at Bible Fellowship Church
Blessing to you all (Sally and anyone who looks to these areas)  This is hard as we are going through it now
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I have not contacted them personally, but there is a website for the Patient Advocate Foundation, www.patientadvocate.org, that might be able to provide you with some information or more resources. I remember when I had a parent in the hospital there was a patient advocate associated with the hospital that knew a lot about local resources, and also had some awareness of the difference in different levels of services between states. I had occasion to contact the local Dept for Aging and they were never any help at all, so I am glad they at least have been some help to you. At stage 3b, you are a long way from dialysis, but since you are a planner, you might be able to talk to someone associated with the local dialysis center who might connect with you local resources, or be able to talk to other kidney patients.
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When you apply for Medicaid, you will have to do a "spend down" of your funds. Depending upon what is allowed for countable assests where you reside, that sum is what will get you qualified for Medicaid, as long as you spend down CORRECTLY and in addition PROVIDE THE 5 YEAR LOOKBACK OF BANK RECORDS. For my late uncle in the state of Massachusetts, he was allowed to own $2,000 in countable assests in order to be Medicaid eligible, as well as producing the 5 year lookback. What are correct spend down items? Think pre-paid funeral for one.
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