Wednesday, January 31, 2024

In-Home Care for the Seriously Ill - You May Qualify for More Help Than You Think

 The husband of a friend of mine died a few months ago. He was only on hospice for two days before he died.  Although they had paid for long-term care insurance for years, he did not take advantage of it during the months before he died, despite the fact that his death was not a total surprise.  He had metastatic melanoma, failing kidneys and COPD. He could only leave the home with assistance. He was often in pain. Unfortunately, during those last few months they did not hire a caregiver for him and his wife provided all his care, right up until he went into the hospital for the final time and then was brought home on hospice for the last two days of his life.  When the wife finally hired a caregiver, her husband died two days later.  They barely took advantage of the long-time care insurance they had paid for.

Since then, my friend and I have had several discussions about what she wished she had done differently. Number one on her list was that she wished she had gotten more help and more care for her husband at home in the months before he died.  Doing that might not have helped him live longer, but it might have made his quality of life better.

Of course, not everyone has a long-term care policy.  However, everyone deserves to have help in the final months of life, and every caregiver deserves to have some relief from taking care of everything alone. There are many ways you can get more help during the final months or years of your life.

Where to Find the Help You Need

You might qualify for Medicaid - Medicaid is the largest payer for nursing home care in the U.S. and, in many cases, they will also pay for an ill person to get part-time care at home, as needed.  You can find out if you qualify in your state by contacting your local Social Services or Medicare office.   You may be surprised at how much assistance they can give you, especially if you are on both Medicare and Medicaid at the same time.  

Ask your doctor about home healthcare, home palliative care, or home hospice - Even if you do not qualify for Medicaid, these other programs will allow you to have occasional visits from a home nurse and/or physical therapist, combined with video visits with your doctors.  For people who are dealing with debilitating chronic health conditions, it can make life much easier if you can avoid as many difficult trips to the doctor's office as possible.  

If you are initially turned down, do not be afraid to appeal.  My husband, who has kidney and heart failure, qualifies for home healthcare and gets many of his services at home.  Nurses and physical therapists come to work with him at home, give him shots, check his medications, and take his blood pressure and other vitals.  Most of his doctor visits are video visits.  It is a huge relief to me to not have to take him to the doctor's office for an in-person visit very often.

Arrange for meal and grocery deliveries at home - There are now many companies, in addition to Meals on Wheels, which can deliver nutritious meals to you several times a week. Our neighbors who receive Meals on Wheels also have the additional benefit of having someone who checks on them to make sure they are OK.

You can also order your groceries online.  Most large grocery chains offer that service. One of my favorite grocery delivery services is Amazon Fresh (Ad), which my husband and I have used since the beginning of the Covid pandemic.  I especially like the fact that they deliver heavy items right to my door, including groceries such as milk, bottles of juice, cases of sparkling water, soda, and laundry detergent. They also bring the bulky items like paper towels and toilet tissue.  As my husband's primary caregiver, having groceries delivered makes my life much easier.  I order from them about once every two to three weeks.  In between, I stop at the store just to pick up fresh fruits and vegetables, and anything I want on the spur of the moment.

Contact your local Senior Center for information about medical transportation and other services - Senior Centers are a wealth of information.  They can put you in touch with Meals on Wheels, medical transportation, and a variety of programs which will make it easier for you to remain at home, even if you are fighting a serious illness such as cancer or heart failure.  They also offer opportunities to socialize, which can be important to your mental and physical health.

If you have a long-term care policy, use it when you become eligible - You may qualify for your long-term care insurance policy, especially if your life expectancy has become short and your health has declined to the point that you are falling often, need help with showering and personal hygiene, and/or you have difficulty transferring from your bed to your walker or chair.  When this happens, you should initiate a claim on your long-term care policy.  Dementia can also qualify you, as well as being put on palliative care or hospice. You've been paying for this policy, so do not hesitate to use it when you are nearing the end of your life.

All the above programs make life easier for people during their final years.  Make sure you take advantage of any programs you qualify for.  Even getting just a little extra help can make a huge difference in the quality of your life.

Do as much shopping from home as possible - In addition to groceries, you can shop online at sites like Amazon (Ad), Etsy, WalMart, and many drug store chains for cleaning supplies, personal hygiene products, clothing, gifts for your friends and family, or other products you might need.  This is an especially easy way to send gifts to your adult children and grandchildren.  Try to avoid as many stressful shopping trips as possible, unless you have someone to help you.  If you are ill yourself, or a caregiver for someone else, try to delegate routine chores as much as possible, so you do not have to handle everything for yourself. 

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