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My father is a 104 World War II vet. SInce he came to live with us in September, 2014, he has had congestive heart failure and a stroke. He needs a lots more help now with activities of daily living. He can walk using a walker as long as someone walks with him, and can feed himself, but needs help with most other things. He doesn't have dementia or Alzheimer's, thank goodness. The VA has only given my father 10 hours of caregiving per week, which isn't nearly enough. I am having his doctor fill out a new VA form 21-2680. Since this is a new application, is there a case number that I need to put on, which it asks for? My father does get 30 hours a week from Medicaid also, but my husband and I work fulltime on our business at our house and could use more hours in the afternoon for a caregiver to look after my father. My father refuses to go to adult daycare. Private pay for caregivers starts at $15.00 in our area of Virginia, and my father has no savings left. There are no other relatives to help care for him.

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Ramiller, thanks for the information about the fast tracking and for your kind wishes. My dad's initial application when he first came to live with us was fast tracked, so hopefully this one will be fast tracked also. Hug to you also.
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Wow, that is just amazing. He sounds like quite a man. One thing I was told by my VA rep was that any who applied who was over 91 would have their application fast tracked. My moms application was approved in 3 months. I do hope you get the help you need. Hug to all of you.
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Ferris, thanks for your lovely comments and so sorry your husband has dementia. I am very fortunate that my father was 45 when I was born, so I am only 59 and am in good condition and can take care of him, with my husband's help. My dad already does get Aids and Attendance, but we want to have the amount increased because his physical condition isn't as good as it was a year and a half ago. I was told on the phone that it would take three to six months to process a new application. My father watches tv and sleeps part of the day, but he also does his exercises every day and goes to physical therapy twice a week.
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I meant to say "genes", since you have more than one! Ferris (too early in the a.m.)
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God love him for living to 104! The VA Aid and Attendance is primarily based on income, and I believe he will die before he gets any funds from that resource. Having said that, enlist the aid of the local VA chapter counselor to start the process, and when approved the payment is retroactive back to the date of application. Again, it has been my experience with A&A that income is really the criteria, and since he doesn't have dementia (which is rare at this age), he must have great gene to still be alive. Put a rush on it, but if you work in your home at your business, you are available to help him if he needs help. I suspect he is sleeping in the afternoon. I don't know how old you are, but he might outlive you given what condition you say he is in, and do as he wishes with his care. Again, thank him for his service, and tell him my husband also served in WWII, Korea, and Vietnam, but has dementia.
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luvdawgs, I'm in New York State (not NYC, where things may be different) and I got such a runaround, such differing stories. Someone told me Medicaid would pay for home health care, and then the Visiting Nurses said Medicaid was phasing home health care out. There were different criteria for different things, it was all very complicated. By the time my mother needed full-time care she was placed in a nursing home and that is paid for by Medicaid, Medicare, her social security and pension. We had to spend down anyway in order for her to get Medicaid. I understand they would cover things like crutches and eye exams, but we needed full time caregivers, and they only offered a few hours a month 'respite' care. And the day care a few days a week.
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Lassie, what state do you live in, if you don't mind my asking. I am surprised they won't pay for home care in your state because it would cost them a lot less to pay for homecare than it does for them to pay for a nursing home. It doesn't make financial sense to me. That's terrible that you had to pay and use up your mother's money for private care.
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Debdaughter, my dad received the 10 hours a week of care in addition to getting the VA pension money. He didn't start getting the money or the care until he after he fell and broke his pelvic bone, which after he had three months of rehab moved into our house in Sept. 2014 and we applied for the A&A care and VA pension for him. He lived by himself and took care of himself before that until he was 103 and had the fall. My father was seen in the VA clinic when he first came down here, but it is an all day trip and difficult because of his age for him and for us to spend the six hours taking him there and home, going through security, seeing the dr. there, etc., so we decided to have my dad see a local doctor. We do not live far enough away from the clinic for the VA to pay a local doctor though. We could take him to the VA doctor if we wanted to though.
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luvdawgs, my dad got around the same SS as yours and he got at least twice as much A&A as your dad - that's the part I'm not understanding - I'm guessing you're saying it's just paying for 10 hrs. a week, because you are paying for that yourself with the A&A money, right? not that those hours are in addition, which he should be able to get as well; at least my dad did. Were you already paying for that much before? It was our VA rep who told us about the caregiver agreement that allowed us to get what we did; with us, he was in the clinic where dad was being seen; your dad is being seen medically at a VA clinic, isn't he?
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Well, I am flabbergasted. Medicaid doesn't pay for SQUAT in this state, they are phasing out home care altogether. I think I was told they would pay for a couple of hours of 'respite care' a MONTH. And I think they would pay for the adult day care a couple of times a week. The only thing Medicaid does pay for is part of the nursing home cost. I had to pay out of pocket (using up my mother's money) for caregivers at $25 an hour, and at $100 a day, and it certainly wasn't enough!
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Great question! If I could add some further clarification.

If the plan of care by the physician and the care team calculates a stated need for more care hours and if your State authorizes that amount, the short answer is yes, you can have more than 30 hours per week for just one client. Our State mandates a review every 62 days but you can request a review if health changes warrant the screening.

Side note: When there are multiple clients, the incidentals of care cannot be duplicated. The ADLs determine the number of units; the IADLs - instrumental activities of daily living (cooking, driving, managing medicine). The ADLS are essential - caring for and moving the body such as walking, dressing, eating, and hygiene (toileting, bathing).
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ladylee1115, my father is already getting AIDE and ATTENDANCE from the VA, but only 10 hours a week. He was in better physical condition when he first started living with us in September, 2014. He has since had 2 TIA's, congestive heart failure, and a stroke, so he had a new reassessment done by his doctor and I am going to reapply for AIDE and ATTENDANCE to try to get MORE money so that we can pay for additional caregiver hours in our home so we have time for respite, to work on our business, and time for ourselves. Thanks We already have BOTH Aide and Attendance AND Medicaid caregiving hours, but need more. I am glad to know that my father will get priority, since he is a WWII vet. Thanks for your reply. :)
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Make sure you have a VA rep help you with the application. Your Father should be eligible for AIDE and ATTENDANCE if he meets Assisted living or Nursing Home Level of Care,
The aide and attendance money can be used to hire private caregivers to give you respite in addition to the hours Medicaid gives you.
The fact that he is getting the Medicaid in home assistance means the he has already met the Nursing Home Level of Care and he should get A+A promptly.
Each County in the US has a Veterans Service Office. look them up, they are the door to the program and will assist you in getting the medical records and expediting the process. WWll Vets get priority. You can have both programs and will not lose any benefits.

Good luck.....
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I applaud you for caring for dad at home as you are. Hope the best for you all during the rest of his journey.
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Yes I agree. The whole system needs to be reworked. The cost to family caregivers in lost wages, future benefits for themselves like social security are just now starting to be talked about in the community. Its to late for a lot of caregivers who gave up work years ago to care for someone only to find now their own ss took a big hit because of it. My hope is that through much talk we can bring light to the whole broken system.
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The nurse who does the assessments for my father's medicaid hours already assesses him every year and because of his health, says he is only eligible for the 30 hours of care paid for by Medicaid. If he could do even fewer things for himself or if we worked outside of the house, then my father would qualify for more hours. You would think they would take into consideration that it would cost Medicaid a lot more to pay for my father if he were staying in a nursing home than they have to pay for caregivers in my home. Also, it doesn't make sense that they will pay more if my husband and I worked outside of the home instead of working on our business in our own home. It still takes time to do our work regardless of where we are doing it from.
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They already have medicaid paying for 30 hours of care do you think they will pay for more? Asking for my own future reference
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You are on the right track asking questions.

In our state, I would recommend that you contact the local ADRC office for Medicaid guidance. Medicaid will pay for home care in order to save the high cost of assisted living. Additionally, there are provisions for relatives to be trained and paid (all eligibility standards must be met). Your local county ADRC can guide you as to the specifics as to when VA is applicable, when Medicare and when/if Medicaid your family might be Medicaid eligible.
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I'll check my VA and military newsletter archives and get back to you with links or whatever information I can find.
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GardenArtist, I've heard about those activities but didn't know where to find out about activities honoring older veterans. You are correct that an event like that would help get my father some attention. I will have to look up military newsletters online and try to find out more. Thanks for the idea! Wolflover451, I am very fortunate that my father has no major issues, knock on wood. Hopefully it will stay that way. My father's mother (my grandmother) lived to almost 101 but had fallen and broken her hip. I guess good genes run in the family. :)
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A bit off topic, but perhaps of interest and another source...

Have you checked out any of the activities honoring older veterans? I'm not suggesting that he request one of the honor flights to D.C., but I've read in a military newsletter I get that older veterans have been honored, including at the White House.

An event like that would get your father some attention, which might help the VA accelerate processing of his re-application.
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God bless him and you that he is 104 and doesn't have any memory issues and can still use a walker with some assistance. I would definitely ask to fill out another form and request more hours. IF he can get aid and still basically can do feeding, etc., and IF you are having no other major issues if you can keep him home that would be great. however if things worsen then you need to do what is in his best interest for the care he would require.
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ThereIsNoTry, do not worry...there is NO way we are going to let my father go to a nursing home. He has all his faculties and he loves living in our home. We wouldn't have it any other way. When my father was at rehab, I saw how some of the patients were treated in the nursing homes. My father says he wouldn't still be alive now if he had to live in a nursing home. He is here in my house for the remainder of his life.
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If your Dad would ENJOY being around others during his wake hours, then living elsewhere might work. But if he has all his faculties, for god sakes, do what he wishes, and know how wonderful that is. Let me be where he wants, he is worth the effort. Dealing with things in a care home that may go on while he is unprotected from "caring" strangers might be more work/heartache than shuffling afternoon duties between yourselves. You know it, I can tell!
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My father received 10 hours per week of caregiver support from the VA and we were told that was the maximum that was available through them. Additional care had to be provided through another source and, for him, at his cost. I actually got tremendous support for this issue (others, not so much) by calling the VA hospital and speaking with someone directly. Once I was able to build a connection (albeit through the phone) with someone, I always asked for the same person. I agree with the others who said 40 hours a week is a lot and if you need more, a residential facility may be more appropriate -- as hard as that would be. Good luck!
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Does anyone know where to more information on aid and attendence and the forms I need to fill out. Thanks
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Luvdawgs you are already at the cutoff limit. You get 6 hrs a day and the agency probably bills $30per hour or $180 a day. Since Virginia pays that much to a nursing home, if you ask for more, the case manager will recommend placement to save expense. Follow the link to Virginia reimbursement rates for 2016
http://www.dmas.virginia.gov/Content_atchs/pr/Copy%20of%20Price-Based%20Reimb%20Rates-07%2001%202015-06%2030%202016%20WEB%20Final%20updated.pdf
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No, his income is very low. He gets $798/mo from the VA and about $1,000/mo. from social security. The cost of living in Northern Virginia is very high as well.
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He only gets $798/mo.? is his income fairly high? my dad got more than that
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Gladimhere, yes, you can get both Medicaid and Veterans' benefits. My dad has been doing so since he arrived here. Thanks for all of your tips and help, everyone. My dad has someone from 10 am to 1 pm to help get him ready and feed him breakfast in the morning and someone from 6 to 9 pm to feed him dinner and help put him to bed. We were hoping the VA would find that my dad needs more pension amount (currently they pay $798/month) to help pay for a caregiver in the afternoon, because my husband and I can take care of things easily when my father is sleeping, as we have a child monitor and my father can just call us if he needs anything or has any problem. He usually just sleeps at night. He does not need to be in a nursing home. Thanks again, everyone!
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