Hi
I’m a care taker of an elderly guy who has no family whatsoever. I’ve been caring for him 7 years. He’s running out of money and currently in a senior living apartment. He pays pretty high rent and we haven’t spoken to the management yet. He wants to see what options he has.
What are his options? Who can I contact? He has Kaiser Medicare but can change it to state Medicare or Medicaid. He is 80 and lives in California. I want to put him in nice nursing home or facility. I just have no info. Can I be his guardian and make decisions on his behalf? He wants that because he doesn’t want to be left alone and have the state make decisions for him.
Thank you.
Welcome to the forum.
You have asked questions that are rather complicated. I will hit the highlights.
His insurance will only pay for medical care, not housing unless he is financially and medically in need and qualifies for California Medicaid which is called Medi-Cal.
Both of these criteria must be met. He must need skilled medical care 24/7 and must have exhausted almost all his income. It is a lengthy and complicated procedure.
Senior subsidized housing usually requires being on an extensive wait list as there are many more who need housing than there is housing available. It is harder in some parts of the state than others. If he has health issues that require a NH he may be able to be placed sooner.
Since he wants you to be his guardian, you need to truly understand what that means. It is not easy or simple and requires going to court and having a judge assign you. It is expensive and requires a great deal of paperwork on your part.
If he is competent to make his own decisions at this time, he can assign you as his Medical and Financial POA (power of attorney) and should be sufficient to help him get signed up for any services available to him.
A couple of things you can do to get him started is to look for his county Area Agency on Aging. Each county has an office. See what services they have available and what guidance they can give you. Do not put this off. If he is already running out of funds he has no time to waste.
Here is a link to the State of Ca. Area Agency on Aging.
https://www.aging.ca.gov/Find_Services_in_My_County/
Good luck with helping him and let us know how it goes.
- Request to be Durable PoA so that the authority becomes active "on the roll" and not requiring 1 or more medical diagnosis of incapacity. This is because if your client develops dementia, stubbornness and irrationality can make getting him to the doctor way more challenging. Make sure to get his cognition tested every 6 months so that it is in his medical records. This will be important if he ever decides to rewrite the PoA and assign it to someone who is a scammer.
- Make sure any facility he goes to has a continuum of care (from IL, AL, MC, LTC and hospice services).
- Make sure the facility accepts Medicaid recipients.
- Learn as much about aging and dementia as possible, since the signs can appear very slowly and be unrecognizable from general "stubbornness" or "forgetfulness' or negativity.
- Get his hearing tested and if he needs hearing aids I strongly recommend he get them and use them before it is too late. Caregiving is already challenging without having to shout at seniors, who never think there's anything wrong with their hearing. It's exhausting. Even if you have to put them in for him, or he only uses 1, it's better than none. Being deaf is very isolating and can lead to depression.
- If you become his FPoA you need to know the Medicaid rules and keep meticulous records so that you don't do any transactions that would delay or disqualify him. Keep a written contract every year outlining your employment parameters. If he pays you in cash...this is its own issue and topic. Every state has its own rules that govern whether a carergiver is ever a contract employee. If he's paying you in cash, then he's not paying into YOUR social security for your OWN senior years like an actual agency or employer would be. Do you get vacations and sick days? Who will cover for you when this happens? Lots to think about.
- If he promises you assets as a form of compensation, make sure they are in a legally created Will before agreeing to it.
I wish you all the best on this journey!
I'm not sure what's available in CA but if he is still with it, maybe he could go into government subsidized housing. My MIL used to live in one and she paid what she could afford. They look at what you spend on meds, give you X amount for food and such and then what's left is what you pay in rent. She only paid about $200 since she literally had nothing but her SS check.
Does he need nursing care? If so, might be time for a nursing home that accepts Medicaid.
Good luck.
If you are a hired caretaker you better check with a lawyer before you do anything. You getting POA or guardianship may be seen as exploiting an elder. Seven years is a long time to be caring for the same client. I realize that you have become family to him and he trusts you. You may be the perfect person to take on this responsibility but its a BIG responsibility. You may think he has no relatives but they seem to come out of the woodwork when they think there is something in it for them.
You both need to talk an elder lawyer to understand what is involved. Guardianship is very expensive. The cost should come out of his pocket. The Courts get involved and a Judge makes the assignment. You are then required to keep the State aware of how his money is spent ect. And even if no family, he should have a Will stipulating where his assets go.
I don't think it matters what type of Medicare he is on because it has nothing to do with receiving Medicaid. Medicare is a federal program you only get if you have paid into it. Medicaid is a State program partially subsidized by the Federal Government. With Medicaid each State has the ability to set their own criteria.
With POA financial and Medical you can make decisions for him. And I would make that immediate. This way you won't need a Doctors diagnosis of incompentcy later on. Guardianship usually comes into the picture when the person is incompetent to make informed decisions or there is a problem with the POA and someone applies for Guardiandship to override a POA because the principle, because of incompetency, cannot revolk the POA and assign a new one.
Again, I think you best bet would be to see an elder lawyer. He can advise you concerning POA vs guardianship and Medicaid. Not all lawyers are versed in Medicaid but Elder lawyers should be.
Good luck and update us. We all learn from each others experiences.