I am a caregiver for my grandfather and I have POA. The elder firm I am speaking with is telling me to apply for Medicaid benefits for my grandfather. He is a veteran with VA benefits (not aid and attendance) he has Medicare A&B. Recently I was notified that he is a candidate for hospice. He has advanced prostate cancer. My question is why would I apply for Medicaid when hospice will take over at this point? The law firm is advising me to get a PCA and spend down his savings to 2000K so he will qualify for Medicaid. I would like to hold onto his money for additional care if necessary. Please help with any thoughts. Thank you in advance for any words of wisdom.
Every hospice is different in how they interpret the rules and it all goes back to the money and what the hospice can afford and the attitude of the Nursing supervisor and the Medical Director.
I agree that a more relaxed attitude is taken to existing diseases and only essential medications are encourages. Again for example in the last few weeks of life there is no need to continue with anti osteoporosis drugs.
Hospice will not prevent a patient from seeking other treatment with or without discharge from Hospice.
The patient or their caregiver is always in charge and hospice is there to direct them in the best choices.
In my case I would present the choices to the patient and family then assist them in whatever choice they made.
It is a very flexible system and different people will agree with one choice but in others feel they have been failed. Someone with COPD might want to be treated in the hospital and i could arrange that but the following morning the Nursing Director might decide the admission could not be paid for and the patient would be discharged for the duration of the admission but once discharged from the hospital be re admitted to hospice. Costs for hospital would then be billed to medicare or whatever insurance the patient had. For younger people who are still working many insurances also have a hospice benefit.
Hope this makes sense.
I do know that on hospice they recommend a more relaxed approach to diabetes. Lows can be more a problem than highs, short term, and people on hospice are looking at short term. Even early in his dementia my husband's doctor took a more relaxed approach with his diabetes. He stopped testing himself and she did the a1C about every 3 months.
If he goes on hospice now, you will in effect be spending down his assets for his care. He will need someone there 24/7. Most of what he will need in equipment hospice will provide (bed, bedside commode, wheelchair, etc) and there will be no med costs. If the cost of a PCA (or more than one -- are you able to be with him at night and part of the day?) and other expenses brings his assets down to $2,000 and he still needs care, then you can bring in Medicaid. I guess this is sort of what the lawyer said. Spend the money you need to spend on grandpa's care. If he is going to run out of money, apply for Medicaid when he gets near $2,000 left.
Is there a pre-paid end-of-life plan, for burial or cremation and a service/celebration if that is desired? If not, that is the first thing you should spend his money on. If he is eligible for hospice, that may be needed within the year. Don't spend all his resources without considering that.
www.va.gov/GERIATRICS/Guide/LongTermCare/Homemaker_and_Home_Health
Thanks to a few other posters here, I discovered this benefit. I don't know all the details, and you'd probably have to contact the VA to find out how much support you would have at home, but it's worth exploring.
At this point, I'm still sorting out what we can get through the VA. Navigating through its programs can be like going through a maze.
One program I discovered, again through help from other posters, is considered part of the basic VA health care benefits; the only qualification is really an assessment of what the veteran needs.
I contacted a local VA service organization and was advised that the Veteran's PCP at the VA would be the individual scripting for the service.
So I would instead of considering Medicaid, first contact your GF's VA Team and learn more. You might also ask about a home visit given his condition.
I think I'd also explore the VA hospice program. I don't have a link, but I recall seeing reference to it as I was navigating one of the sites.
And I'd consider consulting with another law firm, just to be sure you're getting a good representation of your options. (I imagine this particular law firm recommending Medicaid is going to charge you for handing the application?)