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  • Requirements to leave nursing home?

    I have an 80 yo relative who is in a nursing home. He suffered from a few mini strokes and has mild Parkinsons disease. He is unable to walk, get dressed or go to the bathroom by himself. He simply hates the place, so I was wondering if it would be possible for us to get him out of there and back home. Could we assemble the necessary caregivers, and what kind of costs would there be?

  • #2
    Niceguy, your post would probably get more responses in the caregivers Forum. This is a tough situation because the person needs 24/7 care. I have known a couple people who used private adult foster homes for elderly relatives. You might look into that.
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    • #3
      you should consult an occupational therapist.

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      • #4
        Originally posted by Niceguy View Post
        I have an 80 yo relative who is in a nursing home. He suffered from a few mini strokes and has mild Parkinsons disease. He is unable to walk, get dressed or go to the bathroom by himself. He simply hates the place, so I was wondering if it would be possible for us to get him out of there and back home. Could we assemble the necessary caregivers, and what kind of costs would there be?
        Would he be living with you? Would you be providing the needed care and 24/7 supervision he needs? Is your home accessible? I assume he is in a nursing home because he cannot provide his own needs and requires supervision. Who is paying for his nursing home care? Medicare is probably not paying. Is he on Medicaid? How does he qualify? Is he private pay from his savings?

        Medicare does not pay for non-skilled home care services such as ADL assistance (bathing, dressing, transfers, feeding, etc.) and has very limited if any coverage for home care bowel or bladder management except for what is classified skilled care, such as changing an indwelling catheter. This would mean that if you or other family members cannot or would not be providing his care, you and your relative would need to private pay to hire caregivers. This would be cheaper but a little more intensive for management if they were private hires (not from a home health agency).

        I would recommend sitting down with the social worker and head nurse of the nursing home and getting a full understanding of what his care needs are, and then looking at what the costs would be, and where the money would come from to bring him into your home. He cannot be kept involuntarily in a nursing home, but it is also important to be sure that safe care can be actually provided for him outside of an institutional setting.

        (KLD)
        The SCI-Nurses are advanced practice nurses specializing in SCI/D care. They are available to answer questions, provide education, and make suggestions which you should always discuss with your physician/primary health care provider before implementing. Medical diagnosis is not provided, nor do the SCI-Nurses provide nursing or medical care through their responses on the CareCure forums.

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        • #5
          Originally posted by SCI-Nurse View Post
          Would he be living with you? Would you be providing the needed care and 24/7 supervision he needs? Is your home accessible? I assume he is in a nursing home because he cannot provide his own needs and requires supervision. Who is paying for his nursing home care? Medicare is probably not paying. Is he on Medicaid? How does he qualify? Is he private pay from his savings?

          Medicare does not pay for non-skilled home care services such as ADL assistance (bathing, dressing, transfers, feeding, etc.) and has very limited if any coverage for home care bowel or bladder management except for what is classified skilled care, such as changing an indwelling catheter. This would mean that if you or other family members cannot or would not be providing his care, you and your relative would need to private pay to hire caregivers. This would be cheaper but a little more intensive for management if they were private hires (not from a home health agency).

          I would recommend sitting down with the social worker and head nurse of the nursing home and getting a full understanding of what his care needs are, and then looking at what the costs would be, and where the money would come from to bring him into your home. He cannot be kept involuntarily in a nursing home, but it is also important to be sure that safe care can be actually provided for him outside of an institutional setting.

          (KLD)
          Thanks. We could give him some care but the rest would need to be provided by help. He is paying around $15K a month out of pocket to the nursing home, but he may qualify for Medicaid when his funds run out. Sounds like it would be less expensive to keep him in the nursing home when he gets onto full Medicaid, than to bring him home?

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          • #6
            How much longer will he be able to pay $15K/month? That money would last lot longer to pay for in home aides to help care for him (if living with family). He could always go back to the nursing home on Medicaid when his person funds run out (if they do). Even a live-in PCA rarely makes more than $2200-3000/month.

            (KLD)
            The SCI-Nurses are advanced practice nurses specializing in SCI/D care. They are available to answer questions, provide education, and make suggestions which you should always discuss with your physician/primary health care provider before implementing. Medical diagnosis is not provided, nor do the SCI-Nurses provide nursing or medical care through their responses on the CareCure forums.

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            • #7
              wow, i saw 15k and about lost it...but waited for KLD to respond. my dad had parkinsons. we paid no where near that.

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              • #8
                Have you contacted the Medicaid office in your town about other options for home care, if and when he runs out of funds. Sounds like he could do so much better at home paying for round the clock care. What state do you live in? You may wish to look into the Medicaid Waiver programs. Every state has a version of this (or so I am told). If he qualifies, he will be able to get a lot more services than he could ever get through Medicare alone. Some provide up to 40 hours a week of private duty nursing or home care, some even more. They are designed to get people out of nursing homes, and save money for the state. They can help pay for ramps in the house and other transition services from nursing home to home. Really important resource in your state. Hope this helps. Good luck.

                http://www.state.in.us/fssa/ompp/2549.htm
                http://www.unlockthewaitinglists.com...iverManual.pdf

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                • #9
                  Most state waiver programs are having cut backs in funding and have waiting lists of up to 2 years. If he is paying 15K a month, his assets are either substantial or they will be depleted quickly. For a Medicaid waiver his assets must be less than $2,000 if he is single.

                  KLD has suggested the best option IMO, let him self pay for much less and stay at home. Even if he rented an accessible apartment , it would still be substantially less money than what he is paying now.

                  Quality of Life is important----too often it gets forgotten.

                  I wish you success in your plans.

                  Please note: http://www.unlockthewaitinglists.com...iverManual.pdf is a document specific for Georgia and is for individuals with developmental disabilities.
                  Every day I wake up is a good one

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                  • #10
                    my dad ended up in nh. he was private pay. nothing like 15k.

                    last nh was ok, but if i had it to do over again, i would have brought him home. at the time, i was fairly newly injured, new mom and overwhelmed. he died alone in that nh, with no warning.

                    he told me he was not living, don't cry, etc. etc. but....i was wrong. i wish i had brought him home.

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                    • #11
                      Cass, I am so sorry. That i so sad. NH can be such sad places to live.

                      NG,If you can bring him home, get information on all the resources, even if they are not right now, they may be right in the future. In regard to the Medicaid Waiver, my friend was approved in less than three months. I think it varies by state and by individual circumstance. It may take time for a spend-down and may not be right now because need to be accepted to Medicaid with a $2000.00 asset limit. The Medicaid waiver links are simply an example from a state, but you may be able to acquire this information online in a search under Medicaid for your state. There is a listing somewhere online which lists all states, but I could not find it. Good luck. It is nice to try to give him a chance to be home.

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