It had been a long time since Ross spent any significant amount of time with his dad, Jack. Like everyone else, Ross was busy with work and kids, and he didn’t make it by to see his parents as often as he would have liked. More out of guilt than anything else, Ross canceled on several commitments he had made for Super Bowl parties this year so that he and his son could sit and watch the game with his dad. Ross told his mom, Judy, not to worry about fixing anything to eat; he was going to bring everything. It was going to be nice – three generations of Gellers together for the big game.
The afternoon did not go as Ross had expected. Throughout the visit, he noticed things about his dad that caused him a great deal of concern. Jack seemed to recognize Ross’s son, Ben, but he had obvious difficulty remembering his name. He told the same stories several times throughout the night without realizing it. He even seemed confused when trying to recall what teams were playing in the Super Bowl. His physical condition seemed worse than normal, too. Ross privately asked his mom how dad was doing, but she seemed to be in denial, arguing that nothing was wrong.
The next morning, Ross called his sister, Monika, to talk about Dad and what, if anything, they should do to protect their parents. They decided to push for two things. First, they wanted their mom to take Jack in for a doctor’s appointment and for an honest discussion of his condition. Second, they scheduled a consult with an Elder Law attorney to find out what steps their parents could take to make sure dad received the best care possible without pushing Judy into poverty. With the average monthly cost of a nursing home nearing $5,000, and with assisted living fees not far behind, they would need any assistance available if long-term care was in Jack’s future.
Ross’s parents agreed to take his advice. During the doctor’s visit, Jack agreed to schedule several follow up tests to help determine the cause of Jack’s memory issues and what, if anything, could help. The consult with the Elder Law attorney was enlightening. After hearing mom express her concerns to the attorney during the meeting, Ross came to realize that a lot of her denial about Dad’s condition probably came from fear. Judy talked about how she had friends who “lost their homes” to the state because their husbands had to go to the nursing home. She discussed her income situation and how Jack brought in the vast majority of the couple’s retirement money. Of course she worried about Jack’s health more than anything. But her financial situation–if Jack’s condition worsened to the point of needing long-term care–terrified her.
The information the attorney had for Judy was such a relief. The attorney told Judy that Medicaid was there to help if Jack needed a nursing home. The attorney explained the rules relating to Medicaid and home ownership. He clarified that the home was not a countable asset when it comes to Medicaid qualification, and he explained that there were steps they could take to protect the home. He also outlined the income protection Judy would benefit from under the Medicaid rules. With Medicaid, the general rule requires all of the income of the nursing home resident to go to the facility to contribute to the cost of care first, with certain limited deductions, then Medicaid pays the balance of the facility charges. That might have been what scared Judy the most, because her income consisted only of Social Security in the amount of $750 per month. However, when the income of the non-nursing home spouse is less than $1,839, that spouse is permitted under Medicaid rules to keep enough of the nursing home spouse’s income to reach that level. Judy would be permitted to keep almost $1,100 of Jack’s income before paying the facility to help her meet expenses around the house. Finally, the attorney reassured Judy that she would actually get to keep a significant amount of the couple’s financial resources as well – approximately half of whatever the couple has whenever Jack enters a facility.
Judy, Ross, and Monika were hopeful that, after all the tests were complete, the doctors would determine that Jack had many more healthy years in front of him before a nursing home would be necessary. But the family was able to sleep easier at night knowing that, if and when a nursing home was needed, Judy would still be taken care of.
