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Stay at Home Solutions blogs on topics such as aging in place, universal design, adaptive equipment, home modifications, accessibility, durable medical equipment, legislation, and caregiving.

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How to Pay for Home Modifications or Repairs
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Pexels

Hello, my dearest friends! Let’s talk about the biggest hurdle to overcome when you’re thinking about home modifications or repairs to your home: money.

Many people I talk to say, “I don’t know if I can afford you.” I completely understand the dilemma. You want to make changes in your home, but your bank account isn’t too sure you can handle that. You know home modifications can help you stay safe and independent in your comfortable abode.

You’re right, home modifications are a key ingredient to keeping yourself OUT of a nursing home. But paying for them can be tricky!

I am a firm believer in thinking you don’t need to spend a ton of money to make your home safer! Unfortunately, I do run into certain problems that require more extensive home modifications as part of the solution. A common example of this predicament is when people need to use a wheelchair or power wheelchair and they cannot fit through the bathroom door.

The truth is that home modifications are an investment for you and your lifestyle. And like any investment, you need to buckle down and think about your options before making a decision.

An investment in knowledge pays the best interest.

-Benjamin Franklin

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Pexels

To help you make the best financial decision, I created a page devoted to financial resources on my website. This page is specific to the Kansas City area; although a lot of resources pertain to residents statewide in Missouri and Kansas.

My biggest passion is to help you live at home for a lifetime. I am a huge advocate of looking into every possibility for people to remain at home if that is their wish. Click here to see how happy Mrs. B is with her home modifications!

My zest + the power of research = Home Modification Financial Resource

I am excited to have this resource available for you because it can be confusing to figure out what financial supports exist! If you want to learn more about a particular resource, just click on the link highlighted in red. Or you can contact me to answer your questions!

I covered financial supports like: Medicaid, grants, loans, tax credits, long term care insurance, life insurance loans, resources for veterans, and Kansas City area community organizations. The focus is on financial assistance for home modifications. Please note that home modifications include home repair, household items, and equipment in addition to structural changes to the home, like building a ramp.

People ask me often if Medicare will pay for home modifications. The answer is “No”. Medicare will help pay for medical equipment with a doctor’s order, like a hospital bed. You have to pay a twenty percent copay for the medical equipment.

As of right now, there is legislation for the Medicare Advantage plans to cover simple home modifications in 2019, like grab bars and shower chairs. If it goes into effect, many people will benefit from simple fixes to their bathroom or main entryway at home.

If this legislation passes, please ask an occupational therapist on where the best placement is for grab bars in your home!!! Occupational therapists have the medical training to look at your overall needs compared to a contractor or handyman’s skills to install your equipment. Your home modifications will go smoothly if you have a team that includes an occupational therapist and a contractor!

The worst anecdote that comes to mind is of a woman, Betty, I met in a nursing home. (Names have been changed.) Betty started to notice how difficult it was to step out of the tub shower in her bathroom. She felt like her foot slipped on the floor of the tub while she picked up her other foot to step over the ledge. Betty would reach out her strong left hand to hold on to anything to steady herself. She knew it wasn’t safe to hold onto the jiggly towel rack, but she didn’t have any other choice.

Betty didn’t want to fall, especially in the bathroom! So she called a handyman to come over and put in a grab bar to feel more steady. She paid the handyman with her own funds and no financial support. With the grab bar in place, Betty felt more comfortable with taking a shower again.

Maybe Betty could’ve benefited from this? Photo by Pexels

Maybe Betty could’ve benefited from this? Photo by Pexels

When Betty was stepping out of the shower, she felt her foot slip again. She quickly reached across her body for the grab bar with her strong left hand, but it wasn’t enough. Betty slipped and fell over the tub ledge onto the bathroom floor and broke her hip.

It’s awful when home modifications, like putting in grab bars, doesn’t work out well for people like Betty. The effort and money she put in to install the grab bar to provide her safety did not turn out as planned. If she had an occupational therapist on her team, her money would not have been wasted. An occupational therapist would have helped Betty create a solution customized to her needs.

Don’t be like Betty. Be informed about making the best financial investment for you and your home! Look through this list of financial resources for home modifications. Find an occupational therapist to help you in deciding what home modifications are going to be right for you! Talk to friends and family about contractors they have hired in the past. Read this article on how to find the right contractor.

In the story above, Betty tried to prevent getting injured in her bathroom. She did a great job being proactive and recognizing she needed help. But Betty didn’t realize she needed an occupational therapist to look at the big picture for her tub shower.

I am happy to assist you in creating a team that is committed to help you stay at home! Planning home modifications in advance is much better than needing them right after an injury or illness. You need to do it before you need it!

If you know of a financial resource for home modifications that I did not list, please contact me! I would love to add it!

Preparing for the Costs of Long-Term Care: Tips for Seniors
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Foreword:

The goal of Stay at Home Solutions is to do everything in our power to help you make changes in your home in order for you to live safely and independently for as long as you would like. However, the reality is sometimes “the best-laid plans of mice and men often go awry”, meaning that you can make as many changes as you would like to your home, but you may need 24 hour personal care that your family cannot help you with.

None of us like to think that we could end up in that situation. Since we are practical people, we like to share additional information on what else you can do to prepare yourself. Luckily, we found someone who enjoys helping people do the same.

Hazel Bridges is the creator of AgingWellness.org, a website that aims to provide health and wellness resources for aging seniors. She’s a breast cancer survivor and challenges herself and others to live life to the fullest. Hazel contributed the information below for you to make the best decisions for you!


Preparing for the Costs

of Long-Term Care: Tips for Seniors

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It’s important to plan for your long-term care needs even if you don't end up needing it. You can never be sure if an unexpected illness or accident will suddenly change your ability to care for yourself. Though Medicare is valuable to seniors, it provides little coverage for the extensive costs of long-term care. The best thing you can do is prepare for the possibility of long-term care while you’re still able to make important decisions and look into your funding options.

Know What Types of Costs to Expect:

There are three main options for long-term senior care: nursing homes, assisted living facilities, and in-home care. According to A Place for Mom, a private room in an assisted living center costs about $90 per day while a private room in a nursing home costs $205 per day for the more intensive levels of care. In-home care costs anywhere from $112 to $192 per day, depending on the amount of time that care is required. If you have family members that can step in and help out, you can cut out some of the costs of in-home care. If you’re looking for the most affordable facility options, consider a care center in a non-urban area rather than one in the city.

Understand What Medicare and Medicaid Cover:

Long-term care services include assistance with daily living tasks such as dressing, cleaning and eating. Although Medicare can help seniors out with their required medical services, it does not cover any other aspects of long-term care. For example, Medicare covers doctor's visits, prescription drugs and hospital stays. It may also pay for a portion of the costs for short-term care in a certified nursing facility following a hospital admission, which can be helpful if you just need to recover from an accidental injury. Other than this, the program does not help with personal or long-term care services.

Unlike Medicare, Medicaid can help you cover some of the costs of long-term care, but only if you are low-income with few assets. Medicaid does pay for long-term care services in nursing homes and at home. However, states have different eligibility requirements and differ according to which services they cover.

Consider Funding Long-Term Care Yourself:

Of course, you are welcome to self-fund your long-term care if you have the means. This is a great way to avoid paying expensive premiums for insurance and have the flexibility to put your money exactly where you need it. However, this is difficult to do unless you have substantial savings built up or assets that can be liquidated. Selling your home can be a viable option if both you and your partner are moving out of the house. Before you sell, make sure you're up to date on the current home sale trends in your area. For example, homes in Smithville, Missouri have sold for an average of $215,000 in the last month.

Know About Your Insurance Options:

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According to Mariner Wealth Advisors, there are two main types of long-term care insurance. These are the stand-alone policy and life insurance with an accelerated death benefit rider. Stand-alone long-term care insurance covers the expenses that aren’t taken care of by either Medicare or Medicaid. This includes assisted living, nursing homes, and at-home care. However, if you don’t end up needing care, you don’t get any benefits from the insurance. On the other hand, a death benefit rider on a life insurance policy allows you to receive benefits if you end up needing care while any unused benefits will be paid to your beneficiaries. This type of policy is more flexible but tends to have higher premiums.

Many Americans' greatest fear about aging is requiring long-term care and not being able to pay for it. This is no surprise since costs can get as high as $100,000 to $250,000. Although government programs can be valuable to seniors requiring medical services, it's important that you make alternate plans to pay for possible long-term care needs in your future.


Afterword:

Although planning long-term care has its benefits, this can be a difficult topic to discuss between family members. No one enjoys thinking about the possibility of needing long-term care in the future. It’s easy to put this topic on the back burner.

Some tips to make long-term care planning easier include:

  1. Reflecting on what you want if you needed long-term care

  2. Identifying family and social supports

  3. Organizing information you gather to help you make sense of everything

In my experience, families who do talk about long-term care planning do not appear as stressed or frantic when their loved one needs it. They know what to do, where to go, and how it’s being funded. Peace of mind comes with planning your long-term care needs. It’s a lot of work, but consider the process as a gift to you and your family!

Stair Lifts Costs

[This article was initially published on the blog August 15, 2017. I checked current payment options for residents of Missouri and Kansas.]

I recently encountered a client who was unable to walk up the stairs in her home to access her bedroom and bathroom. Unfortunately, my client has no bathroom on the main level of the house. My client has the following options: 1) Use a bedside commode and portable shower in the living room. 2) Install a stair lift or inclined wheelchair lift to access the second floor. The client opted to remain in a facility until gaining more independence with her ability to care for herself.

A stair lift or elevator is a viable choice for people who want to remain living in their home. However, lifts can cost thousands of dollars and can be difficult for most people to pay up front. For adults 65 years and older, Medicare will only pay a small sum if the stair lift has an elevated seat. People eligible for Medicaid will find coverage varies by state and may not cover the entire cost of the installation. Read my blog post, "Payment Options for Home Modifications" to learn more about Missouri Medicaid.

Lastly, the Veteran's Administration will pay for a stair lift or inclined wheelchair lift for a veteran who is a wheelchair user with a service connected disability. This will occur after a home visit and functional skills assessment by an occupational therapist. 

It is important to note that I always recommend using a company who specializes in lifts and elevators, such as KC Lift, in able to assure you purchase the most appropriate and safe lift for your needs. If you purchase a lift off of the internet, you do not have the guarantee the lift is properly installed.

If you were unable to move on your own, would you be able to live in your home? Please contact me on Facebook (@stayathomesolutionskc) or email me to let me know what your options would be!

What Happened?

On December 20th, Congress passed the Tax Cuts and Jobs Act of 2017 which will create a deficit of $1.5 trillion in the next ten years. Unfortunately, legislators will cut spending from social welfare programs, such as Medicare and Medicaid, which will hurt older adults and people with disabilities. These cuts will drastically affect these populations in reducing affordability and accessibility of health care services.

Organizations, such as AARP, wrote a letter to congress to share their concerns and disapproval. AARP mentioned although the medical expense deduction is still intact the new tax legislation lowered it from 10% to 7.5%. Almost three-quarters of tax filers who claim the medical expense deduction are over the age of 50 and have at least one chronic condition.

On a personal note when I work in rehabilitation facilities, patients balk at the $157.50 co-payment they need to pay on day 21 of their stay. The co-payment amount will increase to $167.50 daily co-payment in 2018. Patients end up discharging home too soon resulting in medical complications or injury. With the great possibility Medicare will undergo spending cuts, this co-payment could possibly rise even higher. I am not convinced members of congress considered the potential harm this legislation will cause to older adults and their families.

Attention Medicare Users!

Please consider commenting on the 2019 Medicare policy and technical changes through January 16, 2018. The Administration for Community Living shared the rule would impact the following:

"-Revise the Medicare Advantage program (Part C) regulations and Prescription Drug Benefit program (Part D) regulations to implement certain provisions of the Comprehensive Addiction and Recovery Act (CARA) and the 21st Century Cures Act;

- improve program quality, accessibility, and affordability;

- improve the CMS customer experience;

- address program integrity policies related to payments based on prescriber, provider and supplier status in Medicare Advantage, Medicare cost plan, Medicare Part D and the PACE (Programs of All-Inclusive Care for the Elderly) programs;

- provide a proposed update to the official Medicare Part D electronic prescribing standards; and

- clarify program requirements and certain technical changes regarding treatment of Medicare Part A and Part B appeal rights related to premiums adjustments."

If you use Medicare or know someone who uses Medicare benefits, share you thoughts and experience with the Centers of Medicare and Medicaid Services in order for policymakers to gain insight into the changes needed to improve healthcare and prescription services. If you are unhappy with your healthcare, take ownership!

Paying for Stair Lifts

I recently encountered a client who is unable to walk up the stairs in her home to access her bedroom and bathroom. Unfortunately, my client has no bathroom on the main level of the house. My client has the following options: 1) Use a bedside commode and portable shower in the living room. 2) Install a stair lift or inclined wheelchair lift to access the second floor.

Lifts can cost thousands of dollars and can be difficult for most people to pay upfront. For adults 65 years and older, Medicare will only pay a small sum if the stair lift has an elevated seat. People eligible for Medicaid will find coverage varies by state and may not cover the entire cost of the installation. Read my blog post, "Payment Options for Home Modifications" to learn more about Missouri Medicaid.

Lastly, the Veteran's Administration will pay for a stair lift or inclined wheelchair lift for a veteran who is a wheelchair user with a service connected disability. This will occur after a home visit and functional skills assessment. 

When I work with people who suddenly become unable to move in their home, it causes me to reflect on my own home environment. Would I be able to enter my home if I became injured? Would I be able to carry groceries into my home or get in and out of my shower? I encourage you to put yourself in my client's shoes. What would you do to perform daily activities in your current home environment?

Payment Options for Home Modifications

The cost of a home modification can be expensive to many individuals. Keep in mind that you are investing in yourself through a home modification to remain in your home compared to living in a nursing facility. In Missouri, the average cost per day in a nursing home is $153 with a yearly total of $56,000.

Paying for Senior Care has valuable information on financial resources at your disposal when considering a home modification. The state of Missouri has limited waivers and loans for low-income residents. Other financial options to consider are veteran's benefits and long term care insurance benefits.