<prompt> Human: My husband and I are trying to work through the ins and out of long term care for his father who is 82 - with dementia.His mother is 13 years younger and is taking care of him full time.Their house is paid off and they are currently living on social security.She is getting overwhelmed with his care - but she is scared to death of putting him into a VA facility and having the facility take all of her money that she needs to live. She wants to sell their small home if he moves into the VA because it is too much for her to take care of on her own but she is also scared if she sells the home then the facility will take all of that money too.I have no idea what to tell her and the websites are full of - it depends paragraphs.Shes in New Hampshire. She is 69. He is 82. They barely have an income. In a perfect world She would sell her house - we would sell our house. He and I would buy a bigger house baby on the way and build her an inlaw apartment so we could keep her close by. But it looks like no matter what we do she is going to lose any money that she gains from selling their small house.Advice? Suggestions? My head is spinning from all the stuff Im reading. Thanks for all the advice - getting a lawyer we will figure out how to pay him - looking into all the websites supplied. There is a lot to look into but Im going to sort through it tonight so we dont overwhelm Mom tomorrow night. Questions to ask:1 What are our options for care for dad? Costs involved with VA facility?2 What can we do to ensure mom and dad are taken care of - whether that means a facility for dad and or an inlaw apartment for mum?3 If we sell her house how do we handle the money so that mum has something to live on?and Im sure a million other questions.Take my advice - if you have older parents and they dont have insurance with long term care attached - GET IT NOW. If I knew 15 years ago what I know now I would have pushed her harder to get this stuff set way back then.  <response>: ok. I aint a lawyer, this advice is only for educational purposes:ask many questions, you get many answers.good advice all around. I bill out of NY with long term care in the home. 1 if you can afford one. an elder law attorney. 2 mom should not sell the house. 3 VA - you will have to call. Sorry not my area. There is mentioned a state NH Veterans Home earlier. Is it close to home so she can visit? 4 The federal look back period on assets is 60 months 5 years for transfer of assets to other persons. 5 Whole life is an asset. Burial plot and pre-paid services are not an asset. Things like stocks, bonds, money-market - are assets. 6 Personal possessions are ... not my expertise. But usually are not included. ie dont show a caseworker your house full of gold bars. 7 Cars are assets. it helps if the primary car is not in the name of the patient, ie 5 year look back. sorry :- 8 I would recommend speaking to an actual caseworker that comes out to the house to do enrollment, they will be your first best contact. 9 There was mention of the spousal assets. Yes she can stay in the home, yes she can have savings and assets up to a certain federally mandated level 117K or so, it keeps going up every year a little bit. She may need to surrender part of the monthly social security check based on income levels of combined spouses. 10 realize that spenddownoveragesurplus that is paid in a couple of hundred a month, and an aide comes out 12 hours a day, you get back thousands of dollars worth of services per month. ... New Hampshire Medicaid here! and dont forget your county level Department of Social Services Office of the Aging Apply online at NH Easy! third button the right for Medicaid. Medicaid Eligibility! for general items on eligibility.A confusing page with numbers about incomes for you here! How to apply page here! the long formal page of course. try the NH Easy first. ---And now for the practical.Breathe, you will land on your feet and so shall she. Dad will be ok.Personal Care Aide - personal care attendant, personal care in the home I want to stay in my home but I need help or relief. Home and community based care for the elderly - this is a loaded ball of wax of words, but usually includes a form of Personal Care mixed in.Private duty nursing - usually shift work by a nurse in a patient home, long hours and ongoing. Not Dad. Adult medical day care - dad goes to day care for adults who cant take care of themselves. this is usually a couple of days a week, includes a form of transportation. It helps if he is able to move about for the most part helps immensely, and would be in a community setting while be stimulated mentally hopefully. A couple hours a day relief for mom.Home health - I interpret this as Health Homes in NY. A Health Home is a care management service model whereby all of an individuals caregivers communicate with one another so that all of a patients needs are addressed in a comprehensive manner. This is done primarily through a care manager who oversees and provides access to all of the services an individual needs to assure that they receive everything necessary to stay healthy, out of the emergency room and out of the hospital. Health records are shared among providers so that services are not duplicated or neglected. Health Home services are provided through a network of organizations providers, health plans and community-based organizations. When all the services are considered collectively they become a virtual Health Home.health home in ny! please ask your case worker for more information. This is probably not for dad.Medicaid Eligible patients usually will qualify for some time of MEDICALLY PRESCRIBED Home Care, as determined by a medical professional ie your doctor. Must be medically necessary, and prescribed. ok dad qualifies. Depending on state: Care can be accomplished in a number of different ways. Full institutionalization if needed. ie full Nursing Home, hopefully with good Dementia Care. Personal Care in the home. Usually through a state licensed agency, some are Certified Home Health Agencies CHHA, some are Long Term Home Health Care Programs LTHHCP. Some states have Non-Medicare agencies licensed by the state that can provide only Medicaid services for home. Programs: I believe Dad is Dual Eligible. Medicare and Medicaid eligible by the sound of all things. This helps a lot. A CHHA or a LTHHCP program can pick him up for Medicare nursing visits and bill Medicaid for the Personal Care Aide. LTHHCP, I know as a nursing home without walls, and some states are trying push or revamp health care for some of these items. what to look for: -Personal care aide in the home through a CHHA or LTHHCP. -Consumer Directed Personal Care , you are the employer - hirer and fire the aide, and need a state licensed agency to play payroll agency to back the insurances needed disability and work comp. Hire your neighbor to help out and get paid. -Nursing Home Transition and Diversion Waiver Program sorry NY terms - NH Community Passport Program ??? I just dont know ask your caseworker. A service coordinator meets as part of a team, to get what patient needs to be able to live at home with federal dollars in waiver program, DME, extra doctor visits, mental health provider, home and community based services some personal care aide -New Hampshires Choices For Independence Waiver - can be found here.! sorry you will need to do the foot work here. also here for more reading.! If you were in NY I would also say that, depending on state, you may need to have dad enrolled in a Medicaid Managed Care Organization to receive more than 120 days of continuous home care. Managed Long Term Care, Medicaid Advantage Plan Plus, or a Medicare Advantage Plan for Dual Eligibiles. Do Not Forget to call the VA as well.Also - If someone had say Medicare, was paying for a supplemental medical care union benefits that pay deductibles or something like AARP Medicare Supplement Plan to fill in all the little gaps, these month payments can be used as part of the overagespenddownsurplus in New York by person. The state wants to bill medicare, then bill AARP, then anyone else who can pay like Long Term Care insurance, and then Medicaid is the payor of last resort. sorry my brain is fried. edit: i Kan spel and eddit just like anione else. :- 