He has no close relatives - parents are deceased, no brothers or sisters, no children, married and divorced 4 times. He asked me several years ago to look after him and I am now his legal guardian. Unfortunately, he made no financial provision for this and he only has SS and small pension totaling $1800/month after his health insurance. Obviously, this isn't near enough to pay for care but he can't live at home alone any more - it's just no safe for him. He's a veteran but unfortunately doesn't qualify for VA Aid and Attendance (he missed Vietnam by a year) and I certainly can't afford to subsidize his care for $1000 to $2,000+ per month, I've got my own parents and retirement to worry about. From what I'e been able to tell, his income is to high for any sort of state (NC) assistance and he won't qualify for Medicaid until he needs "skilled nursing care". The problem is this gap between him not being able to live alone safely and needing skilled nursing care. So this is my question - is my only solution to let him remain in his home until something "bad" happens to him, which would require him to go to a nursing home.? Or what if I resign my guardianship, there are no other nearby relatives (and I live an hour away btw) and let the county deal with it? If he's a ward of the county will they have to pay for his care? I'm just not sure what to do right now but the financial resources just don't exist for me to pay for the care my cousin needs. I'm at a total loss as to what to do right now.
Filing for any insurances or programs is a maze for most of us , so knowing some of the steps involved is helpful.
Good luck gathering help for your elderly cousin.
In my state, if the monthly income is over and above the limit, the person must "spend down" the excess amount each month. For example, if the limit is 1800 and the income is 2000, when $3000 of in-home care is provided then the person must pay $200 and the program pays $2800. It is kind of like a deductible. Unfortunately I can't easily find the information about this in NC. I hope that your county Social Services department can supply this information.
My mother in law has dementia, but does not need skilled nursing care. She walks, dresses herself, feeds herself, reads books (the same one) but has dementia. They had to move her from her Assisted Living unit into the locked dementia unit for her safety. She kept leaving to ”go home” and was out in traffic. If she did not wander, and get mad if someone tried to stop her (the alerts, alarms, etc. didn't stop her from getting out - she is tricky!).
Now she is in the locked dementia/memory unit. No one in her unit of 20 patients needs the skilled medical care that the patients in the regular nursing home unit need. Only 2 of the 20 are in wheel chairs. No one is dragging oxygen around with them, and all of them feed themselves and mostly dress themselves. No one stays in bed. They are very active!
We have applied for Medicaid, and she will qualify. The skilled nursing care requirement is not required for dementia. She has roughly $2000 a month income, but the nursing home costs so much more, that that income is not an issue for low income Medicaid requirements. We are in Maryland.
http://www.alz.org/national/documents/medicaideligibilityissues.pdf
You need a medical evaluation and then get on the waiting list for a nursing home. This waiting for a dementia unit bed can take awhile. These people are generally not physically ill (COPD, heart), they just have dementia and cannot live alone. And emergency placements can bump you down the list, too.
www.Medicaid.gov
Your State Medical Assistance office is the best source for information about how to qualify for Medicaid in your state and to find out if your cousin qualifies for long-term care services.
Since he has limited income perhaps having some retired lady stay with him most of the day would guard against him injuring himself. He should be able to get meal on wheels which would eliminate some of his need to cook anything.
I would check again with the veterans agencies to see if he can get help on anything. If they have free adult medical day care sites they may keep him in a safe program during his waking hours. You need someone to supervise him (bathing etc), clean the house, get his meds and food in each week.
Unfortunately our system presumes the family will do the lions share of the care. However, he is lacking in these areas and we don't provide for people aging on their own.
Good luck.