Q. What do I look for in choosing a nursing home for my parent?
- Location is usually a factor for most families.
- Cleanliness of facility.
- Atmosphere: Are bright colors used, natural lighting, seasonal decorations?
- Personnel: Does there seem to be a good rapport between aides and residents (i.e., gentle persuasion and bantering)? What is the staff/resident ratio - are their enough staff to adequately care for the residents (including weekends and holidays)?
Q. Am I financially responsible for my parents?
No, you have no legal obligation to pay parents’ bills or for their care in a nursing home or other facility.
Q. What legal matters do I need to be aware of in dealing with my parents?
It is essential that older persons grant a Power of Attorney to a relative or lawyer, or close friend if there are no relatives. This should be done through an attorney. Power of Attorney gives financial powers to individual but individual with Power of Attorney cannot give healthcare decisions, this can be accomplished only through a Health Care Proxy.
Everyone over the age of 18 should have a Health Care Proxy. The Health Care Proxy is currently the only legal form in New York State for the designation of a patient’s wishes, when the patient is unable to speak for him/herself and/or has no hope of survival.
This document SHOULD CONTAIN A SPECIFIC STATEMENT CONCERNING THE PATIENT’S WISHES REGARDING ARTIFICIAL NUTRITION THROUGH A FEEDING TUBE AND HYDRATION THROUGH AN IV TUBE. This does not need to be done through a lawyer, nor does it need to be notarized in order to be legal.
Q. Who pays for nursing home care?
Nursing homes expect that the patient will pay for his/her own care. Only in very rare cases will Medicare pay for the nursing home and then, only partially for up to 100 days.
Medicaid will pay when the patient runs out of money. There are financial provisions made for a spouse remaining at home while the other is on Medicaid in the nursing home, so that the at-home spouse will not be impoverished.
Q. What alternative senior housing situations are available for Monroe County?
- Subsidized apartments for low income seniors. Most of these charge 30% of income as rent.
- Senior Retirement Apartments - These apartments have rents beginning at about $1,100–$3,400 per month.
- Adult Homes/Assisted Living - Meals, laundry, housekeeping services provided as well as activities. Costs range from $2,000–$3,500/month.
- Skilled Nursing Facilities with costs ranging from $9,000–$12,000/month.
For printed information on different types of housing situations,please call NY Connects at 585 325-2800; 9:00 a.m. until 4:00 p.m. (Monday through Friday).
Q. Will Medicaid take my home if my husband goes into the nursing home?
As long as the spouse continues to live in the homestead, Medicaid will not take the home.
Q. I have Medicare and my ex-employer provides a supplement. Do I need a Medigap policy?
Probably not. Check the coverage your supplement provides. Are there any areas you feel could be better covered by a Medigap or an HMO program? Compare the cost to you for both options. Beware! If you leave your ex-employer’s coverage you probably will not be allowed to re-enroll later.
Q. Where can I find prescription drug coverage?
This is not a Medicare benefit, however, some Medigaps and HMOs offer a degree of coverage. Also, many New Yorkers qualify for New York State’s Elderly Pharmaceutical Insurance Coverage (EPIC) program.
Q. I’ll be 65 in three months and just received a Medicare card. Part A will cost me nothing, but I’ll have to pay a premium for Part B. What will Part B do for me?
Part B covers a wide range of services and supplies, however, probably the most important coverage is the help with doctor bills. The medically necessary services of a Medicare certified doctor are covered no matter where you receive them within the United States, whether at home, in the doctor’s office, in a clinic, nursing home or hospital.
Q. I’m going to work beyond age 65 and my employer will continue providing health insurance. Should I accept Medicare Part B?
If there are 20 or more employees, your employer will have to offer you the same coverage provided to the under age 65 employees. If you take Medicare Part B, it will be the secondary payor and the residual benefit may not be worth the cost of Part B. It’s your decision. If you choose not to take Part B be sure to contact the Social Security Office as soon as you become aware that you will no longer be eligible for your employer’s coverage. If you wait until a later time to enroll in Part B you’ll be penalized a 10% increase in your Part B premium for every year you could have taken it and didn’t.
Q. My doctor submits claims to Medicare but does not send the balance to Blue Cross/Blue Shield for consideration. Can you help me?
Yes! We can help. The Monroe County Office for the Aging sponsors a program called Health Insurance, Information, Counseling and Assistance Program (HIICAP). HIICAP has trained volunteers who can assist with claims filing, initiating appeals, explaining coverage, assisting with comparisons of insurance options, and many other concerns related to HMOs, Medicare, Medigaps, Long Term Care Insurance, etc.
If you’d like to discuss any of the above questions, or have other questions related to seniors’ health insurance, call 585-244-8400 and ask to speak to someone about HIICAP.
For copies of a Health Care Proxy and instruction sheet, contact NY Connects at 585 325-2800 (Proxies only).
Q. I suspect an elderly person may be the victim of elder abuse. What should I do?
Get as much information as possible about the signs of elder abuse and compare this with the situation you are observing. Ask questions of the alleged victim, in a respectful, but direct manner. It is recommended, and may be necessary, to interview the older person privately, without the alleged perpetrator present.
Q. Where can I obtain information on elder abuse?
In New York State, contact your local Office for the Aging and/or Adult Protective Services. You can also find the listing in our website directory. In Monroe County, NY you can call Adult Protective Services at (585) 753-6532 between the hours of 8:00am -5:00pm Monday - Friday, after 5 and on weekends you may call: (585) 461-5698. You can also call NY Connects at 585-325-2800 Monday - Friday between 8:00am - 4:00pm. For other areas in the United States, call the Eldercare Locator at 1-800-677-1116.
Q. If an elderly person is being abused, what choices does he or she have?
Unless a court has determined that s/he is lacking in capacity to make his/her own decisions, the person has the same rights as any adult to make choices about his/her living situation. These choices can range from taking action against the abuser to doing nothing and allowing the situation to continue. When the victim chooses to stay in the abusive relationship, it is often the most difficult choice for the family, friends and service providers to understand. Counseling, in-home services, other living arrangements and adult day programs are some other options which might improve the situation and reduce the risk of further abuse.
Q. Can’t Adult Protective Services force a change in the situation?
Not if the victim has capacity and knows his/her options. Lack of capacity can only be determined by a medical evaluation and a ruling by the courts.
Adult Protective workers will interview the alleged victim and make an assessment of the situation. They will probably employ the least restrictive method of intervention to address the problem.
A medical evaluation to determine capacity should be as comprehensive as possible. Physical and cognitive abilities/disabilities should be evaluated, preferably by a doctor that has experience with older adults. The primary care physician may be willing to make a referral to a geriatric assessment clinic or a geriatric psychiatrist if cognitive (mental) functioning is suspected to be impaired. A written report of the findings should emphasize the level of incapacity or impaired judgment, and in which areas of functioning these impairments occur, e.g., ability to make financial decisions, live by themselves and understand health risks.
Q. What legal options exist for the victim?
There are several, depending on the circumstances and desire of the victim to choose one. In New York State, s/he may choose to get an Order of Protection judge will take into account the wishes of the victim when issuing an Order of Protection. This order may or may not include the expulsion of the perpetrator from the home. Another option, particularly in cases of physical abuse, is to call the police and have the perpetrator arrested under the state’s Domestic Violence Law. In cases of financial exploitation, there are several legal options available, such as guardianship, to stop the exploitation. Victims should contact their attorney, the local District Attorney’s Office or Adult Protective Services to see if criminal or civil charges can be pursued. If outside New York State, check with your local Adult Protective Services office.
Q. I know of an older woman who is being physically and financially abused. She doesn’t want her substance-addicted grandson to go to jail, so the police are not called. All she keeps saying is can’t you make him get help? What can I do?
Your options are limited. Even though you may want to act on an older person’s behalf, the victim must agree to take some action. You can call your local Office for the Aging or Adult Protective Services.
Your identity will be kept confidential. New York State’s Social Services Law 473-e provides this protection for those who call in a referral. However, the victim can get an order of protection (see previous question) and a determination will be made without incurring criminal sanctions. If the grandchild violates the order, he may go to jail for contempt of court.
Q. An elderly man has been caring for his wife for many years. I believe she has Alzheimer’s disease. He seems very stressed. Will he become abusive?
Not necessarily. Recent research is casting doubt on the long-held belief that the stress of care giving, by itself, will inevitably lead to abuse. Subjective factors such as a caregiver’s response to the situation, feelings of guilt, being constantly in demand or feeling out of control were more important. Of equal importance was the relationship between the caregiver and care receiver. If there has been a past history of poor relations, or the care receiver is perceived to be unappreciative or demanding, the risk for possible abuse increases (From The Mistreatment of Elderly People, London Sage Publications, 1993).