Payment Options — Knowing that there are specialized care options for individuals with dementia is helpful. Since custodial care, by definition, does not need to be provided by a skilled professional, most insurance, including Medicare, will not pay for such care. This becomes quite a quandary for many individuals. For those with financial resources, they can pay privately for the type of care that is necessary. But what happens when the financial resources have been exhausted? How do those individuals without financial means obtain the necessary care? There are some options.

One option is long-term care insurance. Long-term care insurance policies are not standardized like Medicare supplement insurance. These policies can cover a wide continuum of care and must be purchased prior to the onset of a chronic illness.

There are a large variety of companies selling policies with multiple combinations of benefits and coverage. Therefore, when shopping for long-term care insurance policies, it is imperative that:

• You have thoroughly thought about the type of care that you may desire in the future
• It is fully understood what is being purchased and what the policy will and will not cover. For example, some policies will only cover nursing home care while others will cover home health care and assisted living care as well. In addition, some policies may often cover care for a specified amount of time (such as 3-5 years) and then the policy will expire.

Another option is seeking assistance from state insurance programs such as Medicaid. Many state insurance programs will cover custodial care in nursing facilities as well as some care in the home and adult family homes. Eligibility for these programs and what types of care they will cover varies between states. To determine eligibility guidelines and the type of care that is covered, contact your local social services office, Area Agency on Aging.

It is wise to speak with an elder law attorney or a financial planner to plan for the future and to determine which options are the most feasible. It is important to know and understand the financial situation so that resources can be managed and budgeted over an extended period of time.

How to Determine the Most Appropriate Care Options – The decision-making processes are often times left to the caregiver. The chosen options must meet the care needs of your loved one, but they must meet your needs as well. Although you want the individual that you are caring for to be as independent as possible, they must be safe and secure. You may want to ask yourself the following questions when faced with a decision:

• What type of services and assistance do you, the caregiver, need? What types of services will provide you with the most efficient, affordable and necessary assistance?
• What types of assistance and care does the individual you are caring for need? Some areas in which an individual may need assistance with are:
  • assistance with financial management and banking needs
  • bathing
  • dressing
  • health maintenance such as taking medications as prescribed
  • housekeeping
  • meal preparation
  • mobility
  • supervision
  • toileting
  • transportation
• Do you have a clear understanding about the individual’s physical, emotional and cognitive strengths and limitations?
• Do you understand the individual’s preferences regarding the type of care they would like to receive?
• Are you able to respect their preferences even if they are in conflict with yours as long as the individual will remain safe and have their needs met?
• Do you have a good understanding of the individual’s financial situation and the type of care and services they can reasonable afford?
• Is the individual involved as much as possible with the decision making process? Are all individuals that may be impacted by the decision involved in the process?
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• Call 408-854-1883 , motherhealth@gmail.com for flexible payment options for your parents with AD or PD in the bayarea.
• Sometimes, family members can take turns with 2-3 caregivers from our agency to provide 24/7 care for homebound seniors.