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The Elder Angel Network Blog:

Caring for Our Aging Loved Ones

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 Please Don't Wait!

June 20, 20234 min read

“What do we do? We found her in bad shape. We don't know her insurance or anything! Does she have a POA?! ” - My Good Friend on the phone.....

Please - don't wait for the emergency!

I had just come home from work and was relaxing for a few minutes before making dinner, when my phone rang. Her boyfriend's mom was found in a puddle of urine. Couldn't even get herself to the bathroom. And, she hadn't told anyone. Thankfully, she hadn't been there for days and days.

No one in the family knew her personal affairs. They knew nothing about what to do next. Was there a POA? Does she have Medicare or an Advantage Plan? Where is her purse? She couldn't answer much of anything, but they finally found her purse and some mail that helped them determine her insurance coverage. They got her to the hospital.

Don't Wait to know your Loved Ones Affairs!

With that said, here are 8 next steps for this family:

1. Does she have Medicare or an Advantage Plan?

 Medicare has some rules that Advantage Plans do not have and vice versa. Many seniors don't even understand that they've sub-contracted away their Medicare if they have an Advantage Plan. It will help you to know these answers asap.

2. Will she need "Skilled Services" after the hospital stay?

The medical world has a term for the services needed in a Skilled Nursing Facility that are not considered "custodial care". Skilled Services are covered by Medicare/Advantage. Custodial services usually are not.

3. While she's in the hospital, they'll need to choose a Skilled Nursing Facility.

The patient/family always has a choice, but the trust is that the hospital do a lot of the coordination (assuming Skilled Services are needed). Please note that there usually is very little warning that the patient is about to be moved. When/if the hospital gives a list to look at facilities, do not delay.

4. Determine her Primary Doctor and make a connection.

A lot of medical documentation is needed if she needs permanent placement in a Senior Living Facility. Start the communication now!

5. Check into financial and bank information and security.

Unless she's 'with it' mentally, it's probably time to partner with her on her Personal Business. Do not assume that she'll regain all of her mental capacity - and even if she does this is potentially a turning point in her independence. It's probably time for the family to start helping her.

6. Start looking into Medicaid in your state.

As previously stated, "custodial" care is usually not covered by Medicare and it is quite expensive, depending upon the level of care needed. Be prepared to start collecting a LOT of information for the Medicaid application.

If you're not sure about Medicaid eligibility, and/or think you may need Estate Planning, now is the time to start looking for an attorney. Please keep in mind that many states have a 5-year lookback at financial information. Also, she will need to give her Social Security and other income to the Senior Living Facility. This will be her Sliding Scale Rent and then Medicaid pays the rest.

7. Look into her home life, belongings and pets.

It may be time to start scaling down her life. Or have to scale it down more. Make a plan for her belongings, home, and be sure to remember a plan for the pet(s).

8. Try to determine what the next 3, 6 & 12 months hold for her.

Emergencies can sometimes determine the future - or sometimes they're just a Wake Up Call. Unfortunately, they don't come with a label telling you which one it is. Work with everyone involved to see what the prognosis is physically, mentally, and logistically (can she handle things anymore). As with many things in life: "Plan for the worst and hope for the best". And, always reassure her! This is far worse for her than for you, but that's easy to forget. Remind her that you want to be a Partner with her, not take away her independence and abandon her.

For help with this and similar information, Join my Support Group and read the Information Guide. It's an encyclopedia of information. Or, if you want 1-on-1 help - please contact me directly for a quote.

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Our senior citizens often live far from family and frequently have difficulty functioning on their own.  It only takes a moment for a medical event to send this situation spiraling out of control.   Even for someone in excellent health, navigating the important health care decisions, the paperwork, and the process can be overwhelming. My many years of experience as part of an administrative team in nursing homes have shown me where seniors and their families struggle with the complexities of a system that baffles everyone!  

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