Home Health Care for Elderly Parent

[MichaelB]

Good. This is difficult to say but you must put your needs first. By that I mean you need a very subtle, mental shift where whatever you do for him is done to make your life easier and not the other way around.

An example might be scheduling his meals around your time instead of his or hiring someone to do something you could easily do, but need "me time". It may sound selfish, but in the long run you're serving him better by minimizing your possible burnout, fatigue, resentment etc. YOU must come first. Been there (still there).

The importance of this cannot be understated. The person managing the care of another has to be fit, both physically and emotionally, or they will end unable to care for another or themselves.

 

[pacergal]

I am sorry to hear this. Has your father had an X-ray and evaluation of his knee to make sure there is no hidden fracture/injury from the fall also?
If he refuses to put any weight down due to pain, and movement is necessary for his recovery, he will need 24-7 care and possibly lift assisting devices as mentioned by earlier poster. Without movement/frequent respiratory care/ he may easily develop pneumonia. Rehab/Nursing home care may be best.
This will be difficult, but not impossible to take care of at home. May or may not be less expensive, depending on services. You would definitely need hospital bed with overhead triangle pull that he can use to help lift himself, wheelchair, bedside commode/bedpans (if he can not do one leg weighted transfer). Home OT/PT/health aide/home nurse visits.

My heart goes out to you, fractured hips/pelvis are a frequent downfall of the elderly. Your Dad will need much care to stay on top of things and get healthy again.

Contacting a Social Worker at the hospital may give you some helpful advice, referral.

Best Wishes to you and your Dad.
If you do tackle this at home, make sure you and your family take some time for yourselves to rest and recover. Respite care is vey important.

 

[garyt]

I am sorry to hear this. Has your father had an X-ray and evaluation of his knee to make sure there is no hidden fracture/injury from the fall also?
If he refuses to put any weight down due to pain, and movement is necessary for his recovery, he will need 24-7 care and possibly lift assisting devices as mentioned by earlier poster. Without movement/frequent respiratory care/ he may easily develop pneumonia. Rehab/Nursing home care may be best.
This will be difficult, but not impossible to take care of at home. May or may not be less expensive, depending on services. You would definitely need hospital bed with overhead triangle pull that he can use to help lift himself, wheelchair, bedside commode/bedpans (if he can not do one leg weighted transfer). Home OT/PT/health aide/home nurse visits.

My heart goes out to you, fractured hips/pelvis are a frequent downfall of the elderly. Your Dad will need much care to stay on top of things and get healthy again.

Contacting a Social Worker at the hospital may give you some helpful advice, referral.

Best Wishes to you and your Dad.
If you do tackle this at home, make sure you and your family take some time for yourselves to rest and recover. Respite care is vey important.

Yes, he had xrays and they see no fracture. I wonder about a ligament tear? It's so hard to talk to anybody. I know he had a CATscan on his head but not sure anywhere else.

 

[marko]

Yes, he had xrays and they see no fracture. I wonder about a ligament tear? It's so hard to talk to anybody. I know he had a CATscan on his head but not sure anywhere else.

From years experience, I learned that you have to assert yourself big time. Squeaky wheel. I'm not normally confrontational, but I quickly found out that unless you adopt an alter personality and become a PITA, you'll get nowhere. You don't have to be nasty, just demanding and insistent in a calm nice manner.

I once walked in on a nurse talking to another about me: "...oh $#%#@, if his brother sees this there'll be hell to pay!..."

 

[MichaelB]

From years experience, I learned that you have to assert yourself big time. Squeaky wheel. I'm not normally confrontational, but I quickly found out that unless you adopt an alter personality and become a PITA, you'll get nowhere. You don't have to be nasty, just demanding and insistent in a calm nice manner.

I once walked in on a nurse talking to another about me: "...oh $#%#@, if his brother sees this there'll be hell to pay!..."

+1

 

[joesxm3]

At the nursing home I overheard the nurse say "with Joe everything is an emergency."

I tried to be at hospital or rehab as much as possible and stayed extra to catch the doctor at rounds. With stepdad once I was out of service for surgery and then with covid he started going down hill. Probably coincidence but I wonder.

 

[garyt]

Anybody know does Medicare cover in home nurse visits? Would they pay to have an aide come in twice a day for an hour? What about supplies? Diapers etc? Any agencies where I could talk to someone about these things?
Just brainstorming.

 

[aja8888]

Anybody know does Medicare cover in home nurse visits? Would they pay to have an aide come in twice a day for an hour? What about supplies? Diapers etc? Any agencies where I could talk to someone about these things?
Just brainstorming.

You can call Medicare and ask them. Or you can look in the annual "Medicare and you" book sent out to members yearly. Here's the benefit coverage under traditional Medicare:

Home health services

Home health is a wide range of health care services that you can get in your home for an illness or injury.

www.medicare.gov

 

[joesxm3]

In our case Medicare only paid for a limited number of visiting nurse visits.

In my state there is a program that pays for caring for someone at home instead of nursing home. You can pay aides or pay yourself. But it is hard not get into and I never tried to apply.

If your town has a social worker or a senior center they may know. Also the elder law attorney I visited seemed to know about the programs.

 

[marko]

Anybody know does Medicare cover in home nurse visits? Would they pay to have an aide come in twice a day for an hour? What about supplies? Diapers etc? Any agencies where I could talk to someone about these things?
Just brainstorming.

AFAIK, Medicare is limited in what they pay for. As noted earlier, find your local Elder Services who can provide a lot of support and services and, at least here, is income based. A low income individual could still get a lot of freebies through them including VNA and PCAs.

Commodes, bed rails, urinals, wheelchairs and walkers are relatively inexpensive I've found; you might get the whole kit for under $200.

 

[aja8888]

READ the Medicare booklet everyone gets first. If you have a SUPPLEMENTAL policy, READ that too in relation to what they will cover beyond Medicare (maybe they will, or won't). Anyone you ask will require you to READ the published benefit package.

Or just CALL MEDICARE and ask them.

Pretty straight forward and I have been on Medicare for 16 years and have dealt with home health care several times during that period.

Note, if you are on a Medicare Advantage policy, which is benefits covered by the INSURANCE CARRIER (not Medicare), READ that policy to see what your benefit is.

 

[RetiredHappy]

Anybody know does Medicare cover in home nurse visits? Would they pay to have an aide come in twice a day for an hour? What about supplies? Diapers etc? Any agencies where I could talk to someone about these things?
Just brainstorming.

Some Medicare Advantage plans started to provide limited home care aide visits after Center of Medicare and Medicaid approved these plans to provide these visits a couple of years ago. Generally, in your father case, it is best to start with contacting elder care social services and Medicaid for help.

 

[zippy2020]

Many people do not realize that if you break costs down into a per-hour basis, Skilled Care Nursing facilities (aka nursing homes, convalescent facilities, as well as Memory Care), home healthcare costs are actually higher than facility costs.

Over 5 years ago, Medicare reported that home healthcare costs were seeing the biggest cost increases of any other healthcare segment in their annual surveys. That has and probably will, continue.

 

[harllee]

Many people do not realize that if you break costs down into a per-hour basis, Skilled Care Nursing facilities (aka nursing homes, convalescent facilities, as well as Memory Care), home healthcare costs are actually higher than facility costs.

Over 5 years ago, Medicare reported that home healthcare costs were seeing the biggest cost increases of any other healthcare segment in their annual surveys. That has and probably will, continue.

Very true. For my mother, it would have cost $30,000 per month for 24 hour home health care, but "only" $10,000 per month in skilled nursing.

 

[MrsHaloFIRE]

im sorry to hear this. Payroll for unskilled care you recruit train manage yourself runs about $20 an hour where I am. But these kind of folks cancel alot, lack reliable transportation, come after working a night shift etc etc. So you end up running your own mgmt company trying to keep them on staff, finding replacements, and doing it yourself. Youre running a long term care facility. You still have to meal plan, shop, manage supplies, mail, utilities, prescription retrieving and changing, bed sore prevention and mgmt. Tranportation to appts. Its a hot mess and not for anyone with any kind of outside distraction namely their own life, their own health, and their own fitness/nutrition.

 

[socaldonnan]

If your father is a veteran, you might want to consider checking into Veterans Aid and Attendance benefit.

 

[marko]

Very true. For my mother, it would have cost $30,000 per month for 24 hour home health care, but "only" $10,000 per month in skilled nursing.

True. People needing 24 hour care are likely better off in a SNF.

However a lot of people don't require 24 hour attention. While considered "SNF/Nursing Home eligible", my brother is able to live at home with three different people providing assistance a few hours at different times of the day. His total cost is under $50k a year.

In his case, at a SNF he'd be paying for a lot of services he doesn't need. I've seen paid PCAs sitting there reading a book (or napping) while their patient has been sound asleep all afternoon.

Somewhere along my/his journey someone told me that nursing homes cater to those of moderate means while the wealthy tend toward home care until things reach final stages.

 

[philly62]

I went through this with my parents.

I did not get home care but rented a not so great hospital bed for $100 or $200 a month never used.

The unskilled home care I investigated was about $30/hr.

Both were in a nursing home first on Medicare then medicaid. My mom was not too bad off and I went 3x a day to walk her. The nurses said that doing that saved her and I rescued her to my house when covid hit.

My stepdad turned out much worse. He started deconditioning the first week in the hospital and got worse in the nursing home. He was assist by two so I could not walk him and he went downhill really fast. The nursing home staff may mean well but they are spread thin and can't give a lot of good care.

I hate to be a downer, but if you can't get the therapy, Movement and exercise going quickly there is a good chance he will decondition past the point of no return.

We had PT and OT from visiting nurse but that was only two or three times a week and their goal is to teach you what to do and cut you loose.

Also home care will need stuff like toilet rails, commode, walker, wheel chair. It can me a really big job for someone that has mobility issues. I could not handle it once they were not able to move by themse!ves.

Good luck. I will add you to my prayer li

 

[Mpl172]

My 100 year old Dad fell and broke his hip last week. He had surgery and that went well but his knee (which was bone on bone before the fall) is killing him and he's refusing to do therapy because it hurts too much.
So it looks like his only option is a nursing home. But he freaked out the first night when he went to a rehab place and was alone for the night. (We've been sleeping at the hospital with him) to keep him calm.
So I was thinking of bringing him home, getting a hospital bed and trying home care. Anybody have any idea what that costs? I know it's dependent on the level and hours of care. I was thinking of moving in with him so I'd be there at night. I'd need coverage for when I or my sister can't be there. Assuming he doesn't do any therapy he'd be bed bound.
He has no real savings and income is about $2500 a month so self pay at a facility is not an option. He'd have to go the Medicaid route.
Any info/help/suggestions appreciated. If any of this makes no sense it's because I'm sleep deprived and half delirious. Thanks

Was he in the military? There is a special va pension if he served in WW2. Dad just passed at 97 but I got him the pension Thru va of $2300 a month.

 

[LadyIJ]

My 100 year old Dad fell and broke his hip last week. He had surgery and that went well but his knee (which was bone on bone before the fall) is killing him and he's refusing to do therapy because it hurts too much.
So it looks like his only option is a nursing home. But he freaked out the first night when he went to a rehab place and was alone for the night. (We've been sleeping at the hospital with him) to keep him calm.
So I was thinking of bringing him home, getting a hospital bed and trying home care. Anybody have any idea what that costs? I know it's dependent on the level and hours of care. I was thinking of moving in with him so I'd be there at night. I'd need coverage for when I or my sister can't be there. Assuming he doesn't do any therapy he'd be bed bound.
He has no real savings and income is about $2500 a month so self pay at a facility is not an option. He'd have to go the Medicaid route.
Any info/help/suggestions appreciated. If any of this makes no sense it's because I'm sleep deprived and half delirious. Thanks

It’s difficult- been there before and again. No one understands how bad. It’s heartbreaking for your loved one, but detrimental to your health. I would most likely move him in with me and use the $2500 for care which should buy about 15 to 30 a week care. The range would be from using an agency to finding someone privately that takes cash. If you feel you need to be with your dad at night maybe you could use those hours during the day to run errands and sleep/rest. I was lucky to find a wonderful woman for my mom through a local Facebook page. A personal referral from a woman who used her until her mom passed away - not saying I found a caregiver directly on Facebook. I didn’t put my information out there to be bombarded but searched the word “caregiver” in local suburbs’ Facebook pages which I joined for that reason and a woman said her mom passed away but has a marvelous caregiver who was looking for work.
The plus side of agencies which are costlier is there reserves.
Even if you have to pay a portion, you need to take care of yourself as well while assuring your dad is cared for.
Prayers and hugs.

 

[FlaMariner]

I'd suggest you go to several local senior "independent" living centers. Speak to the folks at the front desk, or in the "restaurant" area.

Agree with this ^

This worked for MIL. The front desk of the "independent" living center maintains a list of folks who are available for home assistance. We found a fantastic lady who works half days 3x a week and is also able to take her to doctor appointments and the grocery....and the ice cream place!

 

[Lstansbury]

My mother, age 93 with Alzheimers and heart failure (pretty much bed bound) is in a continuing retirement community (CCRC). Until a few months ago she was in independent living with caregivers (CNAs) 6 hours per day, $33 an hour during the week, about $50 an hour on weekends. When she fell and ended up in hospital her doctor said she needed round the clock care so we decided to move her to skilled nursing in the CCRC. Around the clock care at home would have been unaffordable. The skilled nursing facility is $10,000 per month and this is in a low cost of living area. Thankfully she has long term care insurance that pays around $5000 per month for a couple of years (but it is been almost impossible to get them to pay, I finally had to hire a lawyer). The skilled nursing facility in the CCRC is excellent but they do not accept Medicaid.

Thank you for this detailed an answer. Would you mind sharing what company was so difficult regarding payment of LTC benefits? If it is Unum or Mass Mutual, I may need to prepare my daughter with this info.