What should happen to old people w/o money?

[Sum Dum Gai]

very dark sense of humor

Hey! What the hell is that supposed to mean???

[Works4me]

Sorry Dark - did not to mean to imply that dark is a bad thing!

ETA - but then again, it is not necessarily a good thing ... never mind.

[NastyWoman]

Per TD's instructions I am thinking outside the box for those who are old and destitute: with your last money go to a state that does not have the death penalty; buy or bring a gun; kill someone in public, drop your gun and raise your hands high; shout "I did it and would do it again; and let the state take care of you for the rest of your life -> a roof over your head, three squares and medical care provided courtesy of the tax payer.

[Deleted]

to pay for it can't they sell blood? sell a kidney? or something else?

[findingdeadbeats]

Joss- there was a story a few months back about a guy who needed medical care. He went into a bank, demanded they give him $1 and told everyone that he would not hurt them, he just needed to go to jail to have a place to sleep and get the medical care he needed. It already happens in this country. Sad. Very sad.

www.deathandtaxesmag.com/107130/man-robs-bank-for-1-to-receive-prison-healthcare/

[TheOtherMe]

I have been a volunteer representative payee for a woman who passed away in January. She was on Medicaid. She was allowed to have $2K in assets. Her income was social security and a pension. All except for $50 went to the nursing home each month.

Since she died early in January, there was a refund from the nursing home. There was also money that I didn't know about in her trust fund (spending money) at the nursing home. The pension paid one last payment. Everything is in the bank account waiting for the state to request the money. It's a little over $2K at present after the refunds.

I just received her final bill. Her hospice bill was over $4,000. There are a lot of pain meds on the bill at $250 each. Total bill is over $10K and it says she owes zero.

I can see why facilities complain about receiving payment. She passed away on January 5. It appears she was receiving hospice care in December. I received the bill this week--it's May.

[TheOtherMe]

For myself, I hope euthanasia is legal in my state or I will have to move to Oregon as I do not qualify for long term care insurance.

[Works4me]

If you require long term care (LTC) and do not have the funds to provide for it, Medicaid will cover your care to be provided in a skilled nursing facility. A SNF is what we think of as a nursing home and is different from an assisted living facility or a board and care home. The main difference is the need for medical care not just help with ADL's (Activities of Daily Living) such as dressing, brushing your teeth, cooking etc. Assisted living can help give you your medications and bathe you etc but you do need to be fairly mobile. Board and care is a lower level of care, mainly providing meals and lite housekeeping.

LTC Medicare is different than standard Medicare and there is not a hard income limit of $2000 per month. However as stated above there is an asset limit fof $2000 per person. All income minus about $50 per month for personal needs is expected to go to the SNF and then Medicaid will pick up the difference. There are complicated spousal impovershment laws which exist to allow the healthy spoue to remain home with adequate income and assets, ie to prevent spousal impoversment. These vary from state to state and it can be necessary to repay the state following the death of both spouses.

The basic premise of our welfare laws is this: one's income and assets are expected to provide for one's own care and needs. When someone is unable to, ie you outlive your assets, then welfare ie Medicaid will step in. Preservation of assets for the heirs is a touchy matter and you are best advised by your own attorney.

[Works4me]

TheOtherMe - that is so wonderful that you were willing to help someone as their Rep Payee - kudos to you!

[Deleted]

crone, you forgot the posts from months ago already? you commit a crime and go to prison. there are more amenities in prison than a nursing home!

[findingdeadbeats]

Which shows that we as a nation value our criminals more than our old people.

[Works4me]

Shasta - ain't that the truth!!!
I have so often said the only crime my clients are guilty of is growing old.
BTW - read what you wrote above and you presented one of the best descriptions of Medi/Medi differences I have ever seen. I would love to say that I cannot believe what the hospital did to you with your husband but it happens all the time, despite the fact that it is illegal, immoral and unethical. If you can survive that you can do anything! I can't wait to see where you go from here!

[marvholly]

I live in IL. About a year ago we were going thru this for my Dad-he'll be 94 this summer and he had physically declined to the point he was/is in a wheelchair FT.

MOST of the asst living places I checked into (private & charity/religous)explained that he needed enough assets to pay the bills for a reasonable amount of time (generally 1 year). Then together they & we (brother has POA) would apply for Medicaid. He would NOT be shipped to one of us or put out on the street.

For us it turned out to be better for my Dad to stay in his senior apt. w/a FT caretaker. The cost is within $500/month of assisted living for his needed care level and I do not remember which way. i do see it is getting harder for his caretaker to physically move Dad himself. Not sure what the next step might be or if/when something will be needed.

I do know Dad is not happy since my mom passed away in 2004. Brother(has POA-legal & medical) & I agree he is to be let go if anything happens. I also suspect brother is picking up a number of Dad's bills himself-some I KNOW (Rx co-pays) and some just suspect (physical therapy has been ongoing WAAAY more than covered by Medicare). He is a top professional and I have been unemployed for 2 years.

If there is no family/POA then there is a state(county?) legal guardianship program for dementia, etc situations via the court system.

[Deleted]

Why does euthanasia have to be "legal"? You can off yourself anytime you want to whether it is "legal" or not. I don't get it.

[973beachbum]

May 12, 2012 10:09:14 GMT -5 @shooby said:

Why does euthanasia have to be "legal"? You can off yourself anytime you want to whether it is "legal" or not. I don't get it.

I don't want to speak for others but I think they are afraid that by the time the need it they will not be capable of doing it themselves anymore.

Personally I don't fear dying. I fear living like DH's mother. She had a stroke 5 years ago. She hasn't been able to walk, talk or go to the bathroom by herself since and we have no clue what she is or isn't capable of thinking anymore. She is 70 this year. She could live for years like this too.

[Deleted]

Yes. That is a terrible situation. But, i think we need to look more at Advanced Directives and Living Wills. If i were incapicated, i do NOT want a feeding tube or any of that. Letting someone die naturally and not intervening with a bunch of tubes and medications is different that active euthanasia. Everyone should be required to have and fill out and Advance directive and living will so that it is clear.

[TheOtherMe]

May 11, 2012 22:13:15 GMT -5 Works4me said:

TheOtherMe - that is so wonderful that you were willing to help someone as their Rep Payee - kudos to you!

Thank you. I had two clients at the time and now have a new client. She worries that she will not receive the same care should she need to go on Title 19. She worries about every cent she spends and she is spending more than she brings in every month.

My other client has schizophrenia and is very sad. I never know what I am going to be dealing with when I visit her. She thinks I have lost $1 million of her money.

[TheOtherMe]

May 12, 2012 10:19:18 GMT -5 973beachbum said:

May 12, 2012 10:09:14 GMT -5 @shooby said:

Why does euthanasia have to be "legal"? You can off yourself anytime you want to whether it is "legal" or not. I don't get it.

I don't want to speak for others but I think they are afraid that by the time the need it they will not be capable of doing it themselves anymore.

Personally I don't fear dying. I fear living like DH's mother. She had a stroke 5 years ago. She hasn't been able to walk, talk or go to the bathroom by herself since and we have no clue what she is or isn't capable of thinking anymore. She is 70 this year. She could live for years like this too.

This is my fear.

I also fear living like your DH's mother. I do not want to live like that.

After visiting nursing homes as a volunteer rep payee, I just hope I have no mind should I need to go there. Those people seem to not be so agitated and upset that they are living in a nursing home.

[The J]

May 12, 2012 10:09:14 GMT -5 @shooby said:

Why does euthanasia have to be "legal"? You can off yourself anytime you want to whether it is "legal" or not. I don't get it.

Because it's much more pleasant to have an overloaded morphine drip?

[Deleted]

Well, i don't disagree. My mom is in exactly the position neither her nor i would have wished upon her. She has a living will, advance directives and all of that. But everything happened so fast and now she will spend the rest of her days in Assisted Living. I wish that wasn't the case. However, she had some periods of distress and being very uncomfortable and he Doctor did medicate for her comfort. And, Doctors can and do that as well. On one hand, I believe this is God's way of making the inevitable easier for me, not her. And, in some ways, it is a blessing for my kids to at least have their grandma around to give them a hug. But, yet, it is a very nagging discomfort of seeing her in that position. Sometimes i just don't know.

[findingdeadbeats]

May 11, 2012 22:29:35 GMT -5 Works4me said:

Shasta - ain't that the truth!!!
I have so often said the only crime my clients are guilty of is growing old.
BTW - read what you wrote above and you presented one of the best descriptions of Medi/Medi differences I have ever seen. I would love to say that I cannot believe what the hospital did to you with your husband but it happens all the time, despite the fact that it is illegal, immoral and unethical. If you can survive that you can do anything! I can't wait to see where you go from here!

Thank you.

I literally stood in the ER on the phone arguing with the county social worker about the fact that since I was married, I was therefore responsible for doing care I did not in any way feel like it was possible or reasonable for us to try and do at home. And, I couldn't afford to pay someone to do it, and where was I supposed to find this magical caregiver here in the woods with no notice?

In my case, his massive seizure the following morning, before I had to call for the fire department's help to get him out of bed as was the suggestion.... brought him back to the hospital where he belonged.

Got back to the ER the following morning and the SAME doctor was still there. (Small hospital, only one MD on in the ER for 12 hour shifts... lucky us.)

I called down to the nephrologist's answering service, on a Sunday morning, and begged the girl who answered the phone to call the doctor on-call for me. I was fortunate that she agreed, and I was able to talk to the doctor who immediately said he would agree to a transfer. But, I had to call a second time because the ER doctor REFUSED to call the nephrologist to transfer because "people have seizures every day" and I was told not to " my problem in his ER." I had to have the nephrologist call the ER and demand a transfer. I am still very fortunate that the helpful doctor in the group was on-call that day.

When I got to the ER that second day the doctor told me he didn't appreciate my attitude the night before. I told him I didn't appreciate that he was being a complete asshole just because he was too lazy to do his job. I have a LOT of respect for doctors - NONE for this one.

My case with APS was "unfounded" and dropped. The social worker with APS told me is was common for this ER doctor, as most of their referrals come from him. What a jerk.

The next time DH was in the hospital, which was next to the last time in his life, I found the social worker the first day he was there and we started talking about his care and the fact that we were just not able to do it at that point at home.

How do you do home dialysis, which is dangerous, on someone who can't help? I had never inserted needles, DH did his own. When his pressure dropped from taking off too much fluid, I needed him to tell me he felt weird, before passing out. It was a very complicated thing, not just like he had the flu and I was lazy or something...

The social worker said this is something they hear daily in her job. People get too sick for 24/7 at home care, but the nearest Medicaid beds, especially for overweight dialysis patients, were nearly impossible to find. Unlike the ER, however, they were not going to just ambulance him back home. They agreed that wasn't a good option and were looking for placement for him in a SNF in some state, in case he didn't recover.

Ultimately, my in-laws finally stepped up (for the one and only time) and took DH for 2 weeks so that he could get better down in their area with no stairs, a local dialysis center, etc.....

He recovered enough to come home and about two months later got a fatal MRSA infection from one of three medical procedures he had done on his dialysis access that wasn't working.

The hospital agreed to keep him until he died because the doctor's opinion was that wasn't going to be long. He literally drove the car himself one day and five days later was dead. It's amazing an infection can do that, and there were no drugs to stop it once it gets into your heart valves.