Aging veterans, as many other seniors, wish to age in place, in their own homes, where they feel comfortable. While aging in place is a growing trend, aging usually brings a natural decline in mobility and energy along with weaker bones and muscles.
Aging in place has its own benefits but home health care can help many seniors live at home for a long time. The following questions can help to determine whether a person is capable of aging in place.
- Does your senior loved one remember to take medications at the right times, as prescribed?
- Is s/he able to cook and eat balanced meals?
- Does s/he have difficulty navigating stairs?
- Can s/he bathe, groom, and do their laundry by themselves?
- Can s/he still drive? If not, does s/he have access to an alternate method of transportation for doctor visits, grocery shopping, etc.?
- Does s/he continue to socialize?
- Is his/her home clean and in good working order?
- Does s/he remember to pay bills on time, and regularly check their mail?
If your answer to some of the above questions is “no”, it doesn’t necessarily mean aging in place is not the right choice. In fact, aging Veterans and surviving spouses could be eligible for VA benefits to help pay for home care and assistance with these types of tasks.
While home care offers many benefits to our aging heroes, the cost and funding needs to be considered and it is important to know the difference between non-medical home care and home health care services.
Non-medical home care vs. Home health care
Non-medical home care, or simply Home Care, includes help with activities of daily living (ADLs) or instrumental activities of daily living (IADLs).
ADLs: bathing, dressing, feeding, toileting, ambulating, and transferring
IADLs: companionship, transportation, household management and communication, meal preparation, and medication reminders
Home health care is provided by a skilled health care professional and includes services relating to an injury or life event, such as a surgery. It may include wound care, injections, or monitoring the patient’s health at home.
Home Care Funding
Many Americans believe that Medicare will cover the costs for home care. While this federal program covers these services, the coverage lasts no longer than approximately 100 days.
Many seniors require ongoing home care assistance. The most common long-term home care funding solutions fall into two categories
- government assistance
- existing assets
Aging at home can become easier for seniors who have access to assistance with ADLs and IADLs. Yet, the most important question for many Veterans is how to pay for these services. Here is a look at the options.
Medicaid is a state and federal program that provides coverage for those with very low incomes. Each state offers a Medicaid State Plan – “Regular Medicaid.” Medicaid Waivers (or Home and Community Based Services or HCBS Waivers or 1915 Waivers) are available to eligible seniors.
Each state’s Aging Services Division provides seniors, who need home care, with home and community-based services. State-funded chore workers can help with non-medical home care services, such as delivering meals, household chores, and providing transportation. Check your state’s Department of Social Services for more information.
• VA Pension with Aid and Attendance
For eligible wartime Veterans with limited income, the US Department of Veterans Affairs offers pension funds to pay for home care. These funds can be added to other funding resources eligible veterans.
Wartime Veterans who need help with ADLs may be eligible for the Pension with Aid and Attendance benefit. These funds can be used to pay for the cost of services, such as navigating steps, dressing and undressing, basic hygiene, meal preparation, and transportation. Veterans, surviving spouses of Veterans, and dependent children of deceased Veterans can apply for VA pension funds.
Remember that the Pension with Aid and Attendance benefit is different from VA Housebound Pension.
Many families don’t qualify for assistance through the government for home care. In such cases, the best option may be to use existing assets to pay for home care. There are several possible options.
• Life insurance policy conversions
Seniors may sell their life insurance policy to a third party in exchange for home care services. These conversions are also referred to as a Long-Term Care Benefit Plan, a Medicaid Life Settlement, or Life Care Funding.
• Long-term care insurance
Long-term care insurance can also be used to cover the cost of home care services. But if you don’t already have long-term care insurance, buying it at an advanced age may not be cost effective, due to the high premiums.
• Private Pay
Many Americans put money away for their retirement years or a “nest egg”. This fund can be used to help older seniors age in place.
• Reverse mortgage
A reverse mortgage is a cash loan that can be taken against your home’s equity. The Home Equity Conversion Mortgage (HECM), is relevant to aging seniors who want to pay for home care. This reverse mortgage is insured by the United States Federal Government.