Question (by e-mail): Since my mother, now 71, was diagnosed with Alzheimer’s two years ago, she has steadily declined. At first, my father was able to take care of her with part-time help from me; however, as time passed, she became too much for him to handle. And when he suffered a stroke and then a fatal heart attack, Mom’s care became my total responsibility.
With my husband’s agreement, I stopped work and moved her in with us; but I soon found that I could not meet her needs, especially when she became aggressive and, on occasion, physically abusive to me and my teen-age son. We never knew what was going to set her off, and it got to the point that the stress was causing problems in my marriage and with my son who could not bring friends to our home. Even medication did not help.
So my husband and I decided to try to find a suitable place for her to stay, and have continued to strike out. This is why I am writing you. Even though Mom receives nearly $3,500 each month from Social Security and my father’s pension, and has a home valued at $125,000 and investments of $85,000, she has been denied admission to two nursing homes and three residential care facilities because she "did not meet their patient profile." I have her power of attorney. I have learned that Medicare will pay nothing for her care. And even if she had no money, we are told that because she does not need "nursing care," Medicaid would not provide for her. It seems that people like her are slipping through the cracks. We as a family are having a very difficult time coping, and we know that she is miserable. With all we read about care for the elderly, why do we find ourselves in this situation and what can we do?
Answer: Today’s health care system -- which is driven to a large extent by cost containment and a need to make profits -- is not prepared to deal with the nearly four million Americans with Alzheimer’s disease and other forms of dementia. And with estimates of nearly four times that number by 2050, the future does not look bright unless there is a paradigm shift in the way care is provided.
Even though nursing homes were designed to care primarily for people with chronic, long-term medical problems of the body -- not the mind, about two-thirds of the residents in these facilities suffer from some form of dementia. And a large percentage of these residents are difficult and expensive to care for. It’s common sense that an immobile stroke victim is less time consuming and less expensive to care for than an aggressive Alzheimer’s patient. Therefore, by "not meeting their patient profile," the facilities you have contacted are telling you that they are not interested in providing care for another Alzheimer’s patient.
Your mother needs custodial care which is not provided by Medicare; however, in some areas of the country, specially staffed and designed assisted living facilities – which provide a lesser level of care than nursing homes – are cropping up to meet the needs of this growing population segment. Depending on where you live, the rates for these facilities are less than skilled nursing homes, but more than regular assisted living facilities. And in some states, Medicaid may assist those who can not afford these services.
We suggest that you contact your local Alzheimer’s Association, an elder law attorney in your area, or a geriatric care manager who can help you determine your options in your community.
Jan Collins is an award-winning writer and editor. Jan Warner is a matrimonial, tax, and elder law attorney.
Send questions by email to janwarner@nextsteps.net or by mail to P.O.Box 11704, Columbia, South Carolina 29211.
