can a senior citizen stay at home too long

One of our roles at New Jersey Elder Law Center is to provide solutions to our clients that will allow them to take advantage of all options available to them.  Sometimes correct advice is counter-intuitive and causes family members to rethink their strategies. One such instance is when family members stand by as their loved one declines at home amidst a promise that they would never “put” them in a facility.

Before I begin, let it be known that I am a proponent of aging wherever it is deemed appropriate under the circumstances.  With experienced guidance, a senior can spend her remaining years at home in a safe and comfortable manner. But I am also a firm believer that families dealing with age-related decline must understand the ramifications of their various housing choices and plan accordingly.  Homecare is great until one begins to run out of money.

First, let’s discuss the word “put”.  It conjures up images of sending one off to jail or to a psychiatric ward a la “One Flew Over the Cuckoo’s Nest”.  We prefer to use softer words, such as “place”, “move”, or “relocate”. Likewise, the words “facility” and “old age home” have negative connotations.  We prefer “community”. The problem with old word choices is that they are derived from ancient experiences which, for the most part, are no longer applicable – especially when one considers the progress our country has made in operating and licensing assisted living facilities and nursing homes.

In New Jersey, most assisted living facilities accept Medicaid.  This is wonderful because it allows residents to continue receiving care in a safe, home-like environment even after they run out of money.  However, it’s not that simple and it creates a lot of confusion during a time when families are under stress. In short, don’t wait until your loved one runs out of money at home to pursue alternative options.  I’ll explain below.

Under state law, those assisted living communities that accept Medicaid must reserve 10% of their beds for Medicaid residents.  This creates a supply/demand issue. As residents run out of money the demand for Medicaid slots inevitably exceeds the supply. Therefore, there is often a waiting list for these coveted slots.  To make it fair for those residents who have been paying privately, most communities enforce a 2-3 year private pay requirement. This means that in order to qualify for Medicaid in assisted living, one must first move in with at least two years of funds.  Otherwise, the senior risks eviction for non-payment. Moreover, once the senior has paid for two years she must then add her name to the Medicaid bed waiting list. Waiting lists can be as long as one year. One must be prepared for these pitfalls and plan accordingly.

When a family waits for their loved one to run out of money prior to moving to assisted living, they risk squandering the opportunity to place their loved one in a better community that would have enhanced her final years.  Unfortunately, in these cases the families that promised their loved one she would never leave home are often forced to place her in a nursing home that accepts immediate Medicaid. This is a far cry from the promised plan of aging at home.

At New Jersey Elder Law Center we understand Medicaid and its interplay with assisted living and nursing home care. New Jersey Elder Law Center provides programs to guide families through the entire long-term care process – whether that is receiving care at home, in assisted living, or in a nursing home.

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