Monday, October 4, 2010

Placed My Father In a Nursing Home This Weekend

My sister, for the past few months, has been trying to get my father approved for Medicaid Long Term Care to help pay for my dad's Adult Daycare costs. At the time she initiated the process, my father was deemed "too healthy" and has "too much income" to qualify for Medicaid.

With respect to his income, I finally filed my parents' Ch. 7 bankruptcy petition on 9/30/10. This will free up my parents' income for their own care, rather than paying back overwhelming credit card debts. My sister and I also set up a "Miller" Trust" to get past the Medicaid income requirement. In a nutshell, my dad's entire monthly income will go into the Trust, with my sister acting as Trustee. My sister is required to disburse my father's income for various approved expenses: my dad's personal needs, spousal support to my mother and reimbursement to Medicaid. At the end of every month, my father's monthly income will need to be spent completely for all approved expenses. Anything left over, gets handed over to Medicaid.

With respect to his health, my father appears to have lost all will to live. He won't eat and spends most of his days and nights just sleeping. He can barely remain standing or sitting upright for a minute before he has to lie down. He was approved for hospice care, which will be paid by Medicare. My father will probably undergo a second-round of health evaluation by a Medicaid nurse to see whether he now qualifies. (He undoubtedly will qualify now.)

My family concluded that my dad is now beyond my sister's or my mother's ability to properly care for him. My dad doesn't make his care-giving any easier with his disrespectful attitude towards my mother and my sister. (On the flip side, when standing in his shoes, I wouldn't want my last days being at the mercy of people I hated either.) No matter how you looked at it, we all felt that placing him in a nursing home was the best option.

My sister and my mother went to look at various Medicaid-approved nursing homes. What they found were shocking. All of the commercial facilities that resemble mini-hospitals were "private pay"-only facilities that charged upwards of $5000/month-$7000/month. When my sister mentioned "Medicaid," these private-pay facilities hung up on her.

All of the Medicaid-approved facilities were run by private individuals out of single-family homes. I had the opportunity to inspect two facilities - one was a depressing home with a wall-eyed "nurse" dressed in sweats and a dirty t-shirt. The room was dark and dingy and the carpeting looked stained and dusty. I didn't even bother to inspect the bathrooms.

The second home was a bright, clean home with the proprietor's licenses prominently displayed in the lobby. The nurses at this home wore medical scrubs and looked very professional. The bathrooms were handicap-accessible and clean. The second home charged $2,500/month for a small, private bedroom. My sister and my mother both agreed that this second facility was the best out of all they've inspected. There was an immediate vacancy on 9/27. My sister and I debated whether we should wait until my father was approved for Medicaid or whether we should place him immediately and pay out-of-pocket in the interim.

We concluded that the bigger risk was to wait for Medicaid approval and the nursing home would no longer have a vacancy. We sucked it up, paid $2,500 for the first month and placed my dad in the facility this past Saturday. My dad didn't argue, fight or resist the transfer. The nurses gave him a cup of Ensure blended with some ice cream (the only thing he will consume) and he went to sleep. We visited him again yesterday morning and the only thing he complained about was that his internet wasn't working. When we fixed his internet, he promptly went back to sleep.

Watching my father wither away makes me wonder - - is there any reason to keep someone alive who is clearly terminally ill and no longer has the will to live?