Frequently, there is the need to explain to someone that the possibility of returning to their previous living environment is not an appropriate option. The usual response is resistance to anything other than what has been the most independent living. The conversation requires empathy, understanding, and professional knowledge. Delivery of less-than-good news also needs to be considered with the ability to educate someone who sees themselves as losing control. Generally, when someone has time to process the information and reasoning behind such a recommendation, they can see in order to keep their highest level of control, they need to be realistic.
When someone has experienced an incident that has brought them to an inpatient rehabilitation facility with the expected outcome less than ideal to return home, as a patient it is frequently assumed that insurance will cover any increase in ongoing need or care. Medicare will cover, up to a point, when you need skilled care with a high probability of returning to your previous level of function. It is possible though, that your previous level of function what not sufficient to sustain living at that level, causing your decline. With education, reason, and the willingness to live in the environment that allows you the most independence, the question remains, who will pay for this increased care?
Medicare does not cover the cost of the care that would be required for you to meet your daily needs. When it comes to maintenance or custodial care, it is the responsibility of the person who requires the care, or their guardian if applicable. Long-term care insurance will assist with cost and this will depend on your coverage plan. Long-term care insurance is on and above healthcare insurance and can be quite expensive, as long-term care is expensive. The more services you need, the higher the monthly cost. Chances are, where you are rehabilitating is the most expensive as they have registered nurses and multiple nurses aides on staff 24 hours a day in addition to daily in-house therapy services. The monthly costs can be upward of $8,000 and more per month with you receiving 3 meals per day, laundry, medications, etc. It is possible to continue rehabilitation under a different source, if you have it, to continue to increase your independence.
Other options to consider are adult foster care and assisted living care. These types of facilities do not always have the same requirements for staffing as a skilled nursing facility. For instance, in Michigan, they can have direct care workers work as daily living aids. Direct care workers do not need training and continued education certifications to maintain their credentials but should be cleared with background checks. Adult foster care and assisted living care can be found for as low as $2,000 per month but keep in mind, how elaborate you desire will come at a cost. Each facility will have guidelines to address if they are able to meet your particular needs, so it is important to continue to interview multiple facilities. Don't judge a facility by appearance. An extremely well-maintained facility may be within your budget.
Maybe you have the means to privately pay for help in your home. If you do not need 24-hour care, this may be an option that will not require a large dollar every month. It is possible to have someone come in for a few hours, several times a week for much less than $8,000 per month. Please don't get me wrong, agencies can be expensive and you should assess the amount of care you require and the amount of care you can afford.
Lastly, I want to touch on a touchy subject, your current home. Your home can still be your best asset and help offset your housing needs. If you live alone, this is an opportunity to put your home to work for you. I have seen family members place their aged ones in less-than-ideal living environments due to the desire to maintain as much money as possible. Greed can be very debilitating. If your health prevents you from returning to your home, you should be able to use that money to live your days as comfortably as you are able. Possibly your spouse may be better suited to an apartment relieving the burden of yard work or a long drive to the store.
Whatever strategy you decide on, make sure you have explored all your options. Make sure when you settle, you settled on the place that's right for you. If at any time, you need someone to bounce ideas, get ideas, or just an outside objective perspective on your situation, please feel free to reach out and contact our research team at Hidden Earth Wellness Company.
If you need a place to start in order to increase your probability of control of your living environment, look for my book coming to Amazon in early 2023, The Skilled Nursing Home Trap & How to Avoid It by Lucy Arnold, COTA/L.
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