When a parent needs care, the hope is always that the aging parent can remain in place in the home and receive care for their medical needs in the primary residence. If payment for this home health care is an issue, then Medicaid planning to get state assistance may be the next step
All Medicaid state plans pay for in home care for personal care (called Home and Community Based Services (HCBS), through Medicaid waiver programs), but before the Medicaid application is filed, oftentimes planning comes first. The first step is to determine whether or not the aging parent physically qualifies to receive personal care assistance. Are any of the basic activities of daily living or instrumental activities of daily living (ADLs) compromised. Does the parent need assistance with meal preparation, or grooming, or bathing; do they have compromised mobility, etc.? Is memory care or Alzheimer’s Disease part of the equation? Do they need home health aides to assist with these functions? As part of the initial case management with Medicaid, these assessments will be made to determine physical need.
The next step is to determine what if any payment sources (income and assets) are available to pay for the care, i.e. investments, long term care insurance, bank accounts, etc. Also, the family should determine if any gifts had been made in the previous five years with the look back period to ensure that the family is not within a Medicaid penalty period. If the family has sufficient funds to currently pay for care, but not for a lengthy period, then Medicaid planning becomes vitally important. Are there any strategic moves that can be made to hasten Medicaid eligibility to get assets under the asset limit? Perhaps home modifications to make the home more parent friendly, given their current limitations.
Once a Medicaid application is imminent, the next step is to determine what type of care will be sought. Will the paid caregiver be provided by a home health agency? Will adult day care or adult foster care be part of the equation to provide the personal care services? Is this long term, or just for respite care? Will the child seek to pursue self directed care and privately pay for a friend or family caregivers to provide the paid care? Such structured family caregiving is an option under Consumer Directed Medicaid home care programs. Family caregivers can be employed under the Medicaid program and paid for by Medicaid.
If a parent does not need (or not yet need) a nursing home level of care, and has options to remain in the home, Medicaid planning, an entitlement program for those in need, is available to pay for care. QMC regularly provides assistance in this area, a qualified elder law attorney can assist. Free options for information may exist through your area agency on aging. Help is available.
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