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I keep my dad at home with a 24/7 home health aid. For the most part she is excellent. She is in charge of his care and maintenance and I pay all the bills not covered by medicare and mediacid. This includes her salary.

I visit my dad every other day and always find a stack of mail, many of which are bills or if not, mail dealing with my dad's care and maintenance. It never fails.

Lately when I visit my dad and the aid goes grocery shopping, using the food stamp card, she returns with a separate bill for household supplies etc...this amount is rising steadily, to the point that I had to give her money that I was planning to use for my dinner at a local diner. Instead I had to go home and eat a frozen dinner. Yeah I know...no big deal...but it pissed me off even though I checked the bill and saw what she spent that money on. I think she could do better than that..

Maybe I should consider putting my dad into a facility. I just feel put upon everytime I visit him.I feel like I'm being set upon by wolves.

Is it just me?

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RICK:

I'm from the Bronx, and that Medicaid card is a source of temptation for many people. Health aides are no exception; and this one needs some supervision.

That card is your Dad's American Express to quality food and pocket change. Make a photocopy of the card to track the expenses by phone, paying particular attention to cash transactions.

When you visit, check if there's enough nutritious food around. As for household supplies, you can buy those yourself at those .99 cent stores. Go through each and every bill.

I suspect she's getting too comfortable.
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Dear Jeanne...thanks for the link...very helpful
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I'm very sorry to here that. Bummer. Have you looked at this website that lists NY nursing homes that accept Medicaid by area or by zip code? It also includes ratings and a summary of complaints. http://nursinghomes.nyhealth.gov
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Most down here in NYC don't
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I suppose it varies by region, but there are plenty of NHs that accept Medicaid. Depending on the source, the percentage of NH residents on Medicaid is estimated to be between 47% and 70%. With all the Medicaid residents there are obviously nursing homes that accept Medicaid!

Generally the nursing home website indicates whether they accept Medicaid, or you can find out with a single email or phone all. I don't know what it is like in your particular area but around here NHs that accept Medicaid are plentiful.
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To clarify my own question. My undersgtanding is that nursing facilities that accept medicaid are few and far between.

My investigation of costs between home health care and an assisted living facility is that when you add in the 'hidden costs' of the facility it becomes more expensive than staying at home because part of the cost of the home health aid is paid for by medicaid.
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If you want advice you came to the right place -- you'll get all kinds, and you'll just have to sift through it and pick out what applies best.

You pay all bills -- out of your own pocket? Since Dad is on Medicaid then I know he does not have assets. Does he have a monthly income? I assume that all income goes to this own care, and then you are paying the rest. Is that correct? Are there siblings who could contribute financially?

I am glad to hear that your dad has food stamps. I sounds like you are really making an effort to stretch his money. I wonder if you are taking full advantage of his Medicaid. I know that in my state it will not cover 24/7 in-home care, because at that point a facility will be more cost-effective. But Medicaid does cover more limited in-home care and also things like homemaking. If your father was assessed and determined to qualify for 25 hours a week of aid, and your health aid qualifies or could take some steps to qualify, then that much of her salary could be covered by Medicaid. Medicaid does not pay for waxed paper and dish soap, but they will cover incontinence supplies if that applies. Getting meals on wheels might reduce grocery costs, though obviously the aide still needs a lunch.

You are not responsible for your father's financial needs. That you are covering his needs is extremely generous and loving. But it is terrifcly expensive to maintain two households and to pay for in-home care. If you were rich this would be less of a problem, but it doesn't sound like that is the case. It sounds like you have to scrimp to make this work. You also need to be thinking of your own old age and putting money aside for that.

If you very much want to keep Dad at home, see if you can get more benefits (that he is genuinely in need of and entitled to) from Medicaid. You might be able to reduce expenses a little by buying staples such as toilet paper at warehouses in bulk or in large quantities on sale. But I suspect that would be a small savings. Every bit helps, but you need more than a little bit, it seems.

A facility would be paid entirely by Medicaid and let you off the hook financially. You might want to brighten his life some by paying for extras he couldn't afford on the allowance Medicaid specifies. And certainly you would continue to visit him every other day or more. And be his advocate to see that he is getting excellent care. You'd be off the hook financially, but still have duties as his son.

I don't know how your father feels about living with the caregiver and how hard it would be for him to leave his house. Many many elders do enjoy the chance to socialize in a care center and to participate in activities, once they settle in.

Facts are facts. Father does not have enough money to live on his own. He is already qualified for a program that will pay his way in a facility. Subsidizing his living on his own is a financial hardship for you and is making you feel set upon by wolves.

Hmmm .... where to you think this is leading? If you were reading this as an outsider, what advice would you be giving?

If you do decide to consider a facility and if Dad owns his home, see an Elder Law attorney first. See if they is some way you can be paid back for all of your expenses out of the sale of the home when Dad dies, rather than Medicare recovering their expenses first. I sure don't know if/how this is possible, but it would be worth spending a little more and getting professional advice. (Or did you do this when he qualified for Medicaid?)

If Dad does not own a house then there probably isn't much to take care of before you consider a move.

It is certainly not just you. With people living so much longer than previous generations did, many elders are in a position of not being able to support themselves in their old age, especially if they have medical needs, as so many have. So their adult children are in a quandary. They know that they will likely also live a very long life. How can they prepare for their own old age and also financially support their parents? I don't know if it is comforting to know you have company, but you certainly do!
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When my mother became unable to live alone, I placed her in and Assisted Living facility. The cost of a 24/7 caregiver would be almost three times the cost of Assisted Living and I would have to pay all of those extra expenses that you are facing. Even though my mom would much rather be at home, it just wasn't financially feasible for us. If you dad qualifies for medicaid and needs around the clock nursing care, I would begin looking at Nursing Homes that accept medicaid. Most assisted living facilities are private pay and may or may not be an option for you. Good luck and God bless.
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