Long-term care as baffling as it is costly

When I visited my husband at the nursing home the other day, he was sitting in a wheelchair by the side of his bed, using both hands to hold a fold in his sweat pants.

What are you doing? I asked. “I’m pressing my pants,” he said. Why? “So they can be hung up in the closet.”

They don’t hang up sweat pants, I said, they fold them up and put them in a drawer. I tried to disengage his hands but he hung on fiercely until I managed to do it.

He does not have Alzheimer’s but obviously was hallucinating so when a nurse came in, I told her and she said, “Oh, he’s pulled out his oxygen tube. He needs oxygen.”

She restored the tube and also hooked up an apparatus he had to hold in his mouth for a daily breathing exercise.

The nurse and I began to discuss a story that was in the newspapers that morning about how for the first time, Washington state officials will seek liens against Medicaid patients’ estates to recover the cost of long-term care, even if they have deeded their homes to their relatives to avoid that. It’s a new law that went into effect June 30.

My husband is not on Medicaid. That’s for people who have no more than $2,000 in cash or other assets, besides a home and a car. Before the new law, oldsters on Medicaid could live in their homes on assisted living until death, and leave the home to someone. No more. Now the state can sell the home to recover the cost of long-term care of the individual.

If the individual is in a nursing home, all it takes is a doctor’s sworn assertion that he or she will never leave the nursing home and the state can go ahead and sell the patient’s home. The only way around this is for oldsters to give their homes away at least three years before applying for Medicaid.

This didn’t sound like too bad an idea to me because I'm what’s called a private payer, and when the state cuts back on the money it pays to nursing homes and the like for the care of Medicaid patients, you know who the operators turn to to make up the shortage. People like me.

That’s why the cost for my husband went from $181.75 a day to $194.47 a day for a two-bed room last Jan. 1.

When he isn’t on Medicare — which he can be under certain conditions for certain periods of time — I pay the home $6,028.57 for a 31-day month.My husband’s long-term care insurance reimburses me $100 a day, which still leaves me $2,928.57 a month to pay out of pocket, plus cost of medications and medical supplies, which can be horrendously high.

My husband’s nurse was not in agreement with me about the use of liens by the state to recover long-term health costs for Medicaid expenses because, she said, there are other costly expenses involved besides just room and board.

Now, if you anticipate yourself or some kin going to a nursing home in the near future, let me give you some advice. Get a bunch of manila folders or one of those alphabetized file folders, and keep every scrap of paper you receive or copy of what you send involving your case.

Keep separate folders for the home, hospitals, the drug company you or the home deal with, long-term care correspondence, ditto correspondence and notes on telephone conversations with doctors and other medical personnel, Medicare and supplemental insurance papers, all receipts.

Further, get a small journal for about $5 and write down all decisions made that are pertinent and all conversations about care, procedures, etc. Give dates. Don’t rely on anyone’s memory.

My husband, who had been listening to this nurse-spouse conversation, pulled out his breathing apparatus. “Do you have any money?” he asked. What do you need money for? I asked. “For this,” he said, pointing to the breathing tubes. It’s paid for, I said. “You take it,” he said. “It’s yours.”

He glared at me. He still thinks he’s being kept at the nursing home and not allowed to go home because I want it that way, rather than his doctor’s orders. Then he began pressing his sweat pants again by holding a fold in his hands.

I’ll be back Sunday, I said.

Adele Ferguson can be reached at P.O. Box 69, Hansville, WA, 98340.

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