Where will I go when I am unable to care for myself?

Those of us without children or a spouse who can become our advocate are all in the same bind, the best option to ensure at least minimal care is to find someone who agrees to fill that roll. I plan to name one or more of my nephews/niece but others have asked trusted younger professional colleagues, friends, someone from their faith community or even a professional guardian of their own choosing rather than one thrust on them by the courts.. I'm not expecting a hands on caregiver (although a little personal attention would be nice), just someone who can find an appropriate facility and manage my needs.

If you have the time to read all my drivel I have one more piece of info. to add to my findings. When I was in the ER recently I asked to see the Medical Social Worker to investigate the future possibilities for long term care. Well ........ when she arrived she had no suggestions at all and told me there really wasn't any help in this area. (I live in a fairly big town, pop. 21,000). Then .......... wait for it, she continued to tell me about a practice called 'patient dumping' whereby people are literally 'dumped' on the kerb in their hospital gowns if they have no family and are unable to pay! I even looked this up on Google and sure enough there was a story of a poor old Altzeimer's patient who was in fact dumped in such conditions in her gown and without shoes in 30 degree temps. When the police came they returned her to the same nursing home. Of course, this may be 'fake news' or an exception to the rule, but when you come to think of it these fascilities are all run as private businesses so are unwilling to keep people in beds for nothing. Why would they? They are not charities. Everything is about profit after all. As I say, 'wealth care' not 'health care'. There is often very little care involved.

I have had so many helpful replies to my post that I am very grateful indeed that people have taken so much time and trouble to reach out to me.

I should just like to clarify my position as I don't seem to have made myself clear. I am not so worried about getting care at home if I am marginally sick as there is various unskilled help available in my area for housekeeping, shopping etc. but the thing that really worries me, as I said above, is if I am really ill and totally unable to take care of myself in my own home.

I have high blood pressure and a family history of stroke for example, so this is something that weighs heavily upon me. If I should be so unlucky as to follow in my father and brother's footsteps, as far as I know I shall be left high and dry because of the Medicaid situation. They have a very low bar for eligibility, about $1100 a month, if I remember.

I am about to receive meals on wheels this coming Monday as it happens. This is a great boost in many ways but I have kidney disease so am not allowed this and that. But never mind, I am really grateful for this service, so shall just pick out the things I am allowed to eat.

Thanks again to everybody for their input. It is great to think there are people out there who take enough time out of their busy day to help others. I shall print this whole post out now and shall certainly follow up on all your suggestions.

Becky, thanks for writing. I keep reading about the AAA (sounds like insurance!) so maybe this is the answer. I hope so. I have been in touch with Health and Human Services and must say they were quite helpful but it was not guaranteed help by any means.

I am very lucky, apparently, that I am under the care of DADs which is the Department of Aging and Disability. They are responsible for sending out providers to do housework, shopping, laundry and cooking but, oh, my, what chaos. I have tried so many agencies I have lost count and have had a long string of women who arrive or not, (no phone call), late or early (never on time), wrong days even when I am out, then if they do arrive it hardly seems worth the effort. The last one was here for 2 hours and made the bed, washed the dishes, put the luandry from the washer into the dryer (said there wasn't time to fold it) and emptied the trash. After that she sat down and was about to stay put for the next half hour until I got her to mop the kitchen floor. She was so disgruntled about that I never saw her again. I begin to wonder if I am actually "too nice" as people do seem to take advantage of me. But then again that is in my nature and I can't imagine being a tyrant, and don't think that would get me anywhere either. Unfortunately, this is the sob story of agencies around here but, of course, my income doesn't stretch to private housekeepers.

Sorry for the moan. At least I have got that off my chest. I am coming to the conclusion that I am very lucky to get any help at all so I had best say nothing.

Thanks for replying to my post.

In the short term, please contact your local agency on aging and see what services may be available to help you continue in your home. Many communities offer personal care and housekeeping assistance 2-3 times a week. Meals on Wheels is a good program to consider because of the social interaction and the attention it brings from your senior community agencies. Our local sheriff department recently started a program where on request they will call a senior daily and send officers on a wellness check if the calls are unanswered.

Secondly, please consider joining a local church and some of its social circles. Members of these circles will provide a ride to meetings and often some shopping after a meeting. They won't provide direct care, but they will provide social contact and may do lots of small things that will help you continue living in your home. Our church recently started picking up online grocery orders (grocery pickup is a recently added service in our rural area) and delivering them to seniors in our community.

Consider looking for a senior apartment now as it can take several years for an apartment to become available. Once you are in the apartment, you can sell your manufactured home to fund a savings account that can be used to pay for personal or housekeeping help as needed. Just a little help can keep you in your apartment for a long time. When your savings are exhausted, you will most likely qualify for HUD section 8 where you pay 30% of your income for your housing (usually including utilities).

Medicare will pay for some home health care following a hospitalization or if you have a continuing medical condition that requires nursing support. Medicare pays for a CNA to check blood sugar, bathe and dress wounds/skin care for a diabetic aunt twice a week.

You need a living will or advanced directive - filed with your PCP and a copy easy for EMTs to find in your home. You also need to start looking for someone trustworthy to grant financial and medical POAs should you become mentally impaired. You may want to name co-POAs to reduce the opportunities for abuse of these powers.

Make an effort to remain as social as possible. If you cannot be out and about much anymore, use the time you are out and about to make contacts and follow-up with short phone calls later. The simple fact is that the more people you have contact with, the better quality of life you will have.

Oh good grief, I hear you. We are in the same situation. “Too rich” for Medicaid and too poor to pay our bills. I’m exploring the feasibility of a Medicaid Waiver right now. We would have to establish what’s called a Qualified Income Trust/Miller Trust. “Excess income” (that’s a joke) would be put in that account. I can use the money in there but only for my husband’s care. It’s a giant pain but if it saves us money, I’ll do it. The agent I spoke with said if he qualifies for that, he will basically receive all benefits supplied by Medicaid.
I started this research by contacting our local Medicaid office which is in with our Jobs and Family Services Agency. I’m not sure if this will work for us, but if it does it will be great.

Have you investigated low-income housing? You would pay a percentage of your income. If that’s feasible for you, find an apartment now. My mom had one in her city and it was wonderful. It was a Senior Housing apartment. But, she had to wait 3 years for an apartment to become available.

Call your Area Agency on Aging and talk to them about what might be available in your area. They can direct you to resources in the area.They should be able to tell you what would happen in your circumstances and what you would need to do to avert problems.