Florida Options for Providing ElderCare in 2009

For many of our readers who may not be up to date with Florida's options for Elder Care, the following material may provide adult children some alternative sources to begin the process of looking at fees and benefits available when it becomes necessary to provide a higher level of care.

Caregivers:  Be careful when asked to give certain prescribed pharmaceutical drugs.  Some drugs may require 24 hour/day supervision because they put your loved one at risk for falls. Care may be provided in a nursing home, assisted living, or at home with a 24 hour a day caregiver.  24 hour/day caregiving may be provided  with a live-in caregiver costing approximately $170/day.  When a parent is at risk of falling, new agitation presents, is prone to elopement, or makes suicidal threats this elder may require 2 (12hour/day) caregivers costing $375/day.  If hiring a live-in, you must provide 2 hours off during the day to leave the home, take a meal, run errands, or simply take a rest in another room.  The live-in must also be given 8 hours of uninterrupted sleep at night.  That should help you determine your decision between hiring a live-in or providing two (12-hour) caregivers.  Long-term insurance policies are sold because of the high cost of caring for the elderly.  In lieu of that, Reverse Mortgages may offset the cost of caregiving.  To do that your parent's home must be in their name.  Work with someone who has a great deal of experience in Reverse Mortgages. 

Guardianship:  Your parent still has rights to live in his/her home versus living in a facility even if you may not want this option.  However, you may pursue Emergency Temporary Guardianship through the courts.  To do so, you will need to petition the court for guardianship.  If adjudicated incompetent by a court, this action will remove a parent's rights giving the person named as guardian the right to act for the individual.  Probate Law is very strict.  Some Judges don't favor restricting the rights of an individual.  This is also a very costly process since you will not only need to get an attorney for your position, but will have to pay for an attorney to defend your parent's rights.  Until then, your parent's rights remain intact.  Get an elder law attorney familiar with Probate Law for more information.  Go online to:  http://www.NAELA.org

Aid and Attendance is a veteran’s benefit that can pay a parent approximately $ 1000/month towards ALF expenses if your dad or mom was a Veteran.  The process takes about 6 month but once approved, it is retroactive and pays your surviving parent direct benefits.  

Medicaid Waiver programs:  If a parent's only source of income is social security, he/she may be eligible for the Medicaid Waiver Program.  A licensed nurse may be sent to the home to do medications management, and an aide may be sent to help with showering/bathing (perhaps 1 – 2 hours daily).  Some Florida assisted living facilities accept the Medicaid waiver program in their facilities.

Adult Family Care Facilities: In South Florida there are private homes in residential communities that take in elderly  individuals.  If  2 or more individuals reside in a home, an ALF license is required by the State of Florida.  If only one individual will reside, no licensing is required.  I have visited some of these homes run by nurses and they are lovely, clean, have good meals, and send residents out to day centers for activities.  

Board and Care:  I have met individuals who own their own homes and have occasionally taken in residents for care in the person's own home.  These resident's may stay in the home until the resident's passing. Some homes have been in a position of trust by some very prominent long-distance adult children and charge fees of $5000 a month. The fee is generally all-inclusive. Make sure you check references and that the home owner has a health background.

Long Term Care:  Placement in a nursing home as a private paying resident may cost $8000/month or more in South Florida.  You may pay down your assets until a Medicaid application is processed or assets are transferred to the community spouse through an elder law attorney. The Medicaid application requires completion of Form 3008.  There are two criteria for admission to a nursing home:  medical, and financial for the sake of Medicaid applications.  Contact the offices oft A Good Daughter Elder Care Management for a checklist of documents needed should you wish to pursue this avenue. 

Always remember when discussing options with a loved one to be compassionate and careful in languaging with the elder loved one.  Be careful not to create unnecessary confrontation or agitation when dealing with a parent who just doesn't wish to be moved from his home.  Be mindful of your parent's feelings and their rights as individuals for one day you may find yourself in very similar circumstances.  

For more information on any of these options please contact olga@agooddaughter.com.  All comments are welcome.