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    Care Taking

    Are you prepared to pay for your parents’ long term care?

    fressYour mom or dad may have decided to move to an assisted living residence or a nursing home if they need comprehensive long term care. The cost of this care can range from $5000-10,00 per month depending on their location and the extent of care. Unfortunately at some point they may run out of money to pay for these services. At that time they will need to apply for Medicaid, a program jointly funded by their state and the federal government, to pay for their nursing home care.

    In order to apply for Medicaid they must select a facility that is Medicaid approved. They must also meet the severe limitations on income and assets established by Medicaid. Medicaid funding has become a major budgetary issue for many states over the last few years, with states, on average, spending 16.8% of state general funds on the program. If the federal match expenditure is also counted, the program, on average, takes up 22% of each state’s budget.

    As baby boomers retire at the rate of 10,000 per day dependence on Medicaid is very likely to increase. At some point states may no longer be able to fund these increases. They may be required to implement the filial responsibility laws. These laws could hold children legally responsible for the long term care expenses of their parents. They are on the books in 30 states but have rarely been implemented.

    But recently the State of Pennsylvania enforced it filial support laws and found a defendant responsible for his mother’s long term care bill from a skilled nursing facility for $93,000. Other states may follow suit if their budgets get tighter.

    What does this mean for you and your family? This possibility makes it increasingly important that you have a conversation with your parents about their plans for long term care. You need to ask them three basic questions.

    1. If either one of them needs long term care do they plan to stay in their home?
    2. If either one of them is incapacitated who do they expect to be the caregiver?
    3. If they need long term care services how will they pare for this care?

    If initially your parents respond that this is really none of your business, you should tactfully answer that it may become your business. You can cite the case in Pennsylvania as an example.

    Your conversation with your parents may uncover their plans to stay at home if they need care. In that case they need to look carefully at their home to see if it safe for a physically limited person. You may learn that they expect your spouse to be their primary caregiver. This opens up a whole new area of conversation. You also may find that they have significant assets to provide their care or they have long term care insurance.

    You will not know the answers to these questions if you are afraid to engage them in this critical conversation. It all starts with three words… “Can we talk?

    It Takes a Village to Serve Elders

    Many seniors want to do everything they can to stay in their homes as they get older. But often they need help to handle various responsibilities including getting to medical appointments, shopping, socializing with friends, preparing meals, and managing things around the house.

    They usually have two choices to get these services. First they can rely on family members to help them. This is often difficult if their children are working or are not in the immediate area. Second they can hire aides to come to the home. But this can be very expensive. Aides often cost $20 an hour or more and many seniors just can’t afford them.

    But a new alternative is emerging. It is a volunteer nonprofit organization created by a community to allow neighbors to help other neighbors. Each senior pays a fee to become part of the network. Fees vary by community and services offered . They range from $175 to $900 a year. Community members volunteer to provide most of the services. Discounted fees are available to people with lower incomes.

    Beacon Hill in Boston was probably one of the first neighborhoods to offer such a program. Beacon Hill Village was founded in 2001.

    A group of friends in the neighborhood started to talk. What if they banded together and created a network of like-minded people who were aging, but who knew they didn’t want to go to a nursing home? They could help one another when they needed it, recommend plumbers and doctors and home-care aides to each other, and schedule social events so no one would be isolated at home. The network would mean they wouldn’t have to be a burden to their children, and they wouldn’t have to go to a nursing home, either.

    Services offered to members include:

    • Referrals to discounted, vetted providers for everything from dog walkers to plumbers
    • A volunteer to assist you in your home or around town
    • Geriatric care management for you or your family members anywhere in the US
    • Rides home from a medical procedure that are required by the hospital/doctor
    • Personalized grocery shopping—we will drive you or deliver groceries to your home
    • Discounts to all providers: Electricians, plumbers, organizers, personal trainers, massage therapists, home care specialists

    A similar program was started on Cape Cod in 2011. It is called Nauset Neighbors that states “One call does it all”. It is staffed by 320 volunteers and serves over 260 seniors in the lower Cape. Volunteers provide transportation, light home maintenance, technical support, and other support tasks

    There are now eight open villages in Massachusetts. Each village is unique to its area and resources.  Nauset Neighbors is part of the Village to Village Network which now is composed of 190 open villages with another 185 in development around the country.

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    Reprinted from Bob Mauterstock’s The Gift of Communication Blog. Subscribe at http://www.GiftofCommunication.com  and receive Bob’s Family Meeting Checklist Guide.