August 7, 2012: You Must Be This Sick to Ride This Ride

Sometimes, Mom likes to flip through my husband’s iPod. Fourteen demerits!

          My mother flunked another ALTCS exam.

          The Arizona Long-Term Care System (ALTCS) is the state’s version of Medicaid. ALTCS offers minimal financial support to people who don’t want to shove their old people into a nursing home. Every six months or so, I prevail upon them to give my parents another go. ALTCS’s answer is always the same: my parents have “too much money” and aren’t sick enough to be given any real assistance from them.

          The deal with ALTCS is that, once you’ve gone broke by “spending down” your life savings, you qualify for up to 20 hours a week of in-home care. Twenty hours. A week. And that’s only if you’re what they call “full-care,” which means you can’t walk or feed yourself or stand unassisted. People who are screwed up enough to qualify at all, but aren’t “full care,” can usually count on about 12 hours a week of paid in-home care. And any other services you may have been receiving from other government aide programs is automatically canceled once you go on ALTCS.

          In order to score even this paltry amount of “help,” an old lady with Alzheimer’s, like my mother, has to score 60 points or higher in an ALTCS assessment. Mom’s newest score is a 58.

          “But she’s incontinent!” I reminded Steve, the nice man from ALTCS who came to the house recently to interview my parents and find out if they’re infirm enough to get some paid help. “She wears disposable briefs and thinks Lyndon Johnson is doing a fine job in the White House!”

          “Yes,” he replied. “But she changes her briefs on her own, and she dresses herself and feeds herself and when I arrived she was playing Solitaire. That’s negative five points right there, just for the card game.”

          “She has dementia!” I countered, hoping for a couple extra points just for being adamant. “She had colon cancer a couple years ago! She can’t tell the difference between her underarm deodorant and an Airwick solid!”

          “Your father mentioned that he has a big family,” Steve said, hopefully. “Maybe you could get them to pitch in and help!”

          I stared at him for a really long time, but his head just refused to explode.

          “Look,” Steve finally said with a friendly smile, “it doesn’t really matter anyway, because at this point your parents still have too much money in the bank to qualify for services, even if they were more incapacitated.”

          “But if I spend all their money in order to get the teeny bit of help you provide, I won’t have any money to pay for help the rest of the time,” I reminded him—just as I’d done the last time he was here. “You realize I’ve been taking care of these people for five years, and as they get older and sicker, I’m going to need more help. Right? How am I going to pay for that? The extended care policy pays for one hour per day of in-home care—and that’s after we’ve paid for 90 consecutive days of full-time care!”

          “Well,” Steve said, as he stood to leave, “and now you know why so many old people end up in nursing homes.”

 Thing I Hate Today: Red tape

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5 Responses

  1. Have you spoke with Susan Sutton about this? She cared for her parents until they died (they died in their early 70s). She went through all sorts of insanity getting help and her dad did have to live in a home because he had had a major stroke and was immobile for the last 13 1/2 years of his life. Our system is insane and you are a saint (as is Todd) for doing what you’ve done for so long.

  2. be sure to post when you “figure out the system” as lots of us are in the same boat with caring for our elderly parents!

  3. i hope his head explodes next time.

  4. I’ve been through something similar in the past couple of years with my mom – I’ve thought too about creating something to help people navigate the system (contact me if you start that project and want help!) The problem is the system itself. Like health care, elder care is a “for-profit” business in this country and you either have to be very rich or very poor to participate. (And after the next election, the very poor may be eliminated from the equation as well.)

  5. Have you looked into a Miller Trust?

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