Are there guidelines about what ways are appropriate for me to use my father's Medicaid respite care?

My husband and I take care of my father 24/7. The previous caregiving company let us use the hours to take time off for ourselves for whatever we wanted for a few hours, up to the annual limit of 480 hours. The new caregiving company says the respite hours have to be used just for medical emergencies or if we are out of town for more than one day. This is all in Virginia.

Medicaid

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Oh, and they do give my father a small check each week, but we have to use most of it to pay the Medicaid "co-pay" that Medicaid in Virginia charges my father, which amounts to about 1/4 of his income. We do have someone working on trying to get my father more VA hours.

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My father does get Aid and Attendance from the VA, but they only give us 10 hours a week, since he was not disabled in the war.

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Does your father get Aid and Attendance pension from the VA? If he's eligible for Medicaid he should be eligible for that! That could help give you money to hire a caregiver. See a VA benefits counselor right away and get a letter of intent filed. It can take 3 months to a year to get started, but when it starts you get pay retroactive to the date of the letter of intent. He doesn't have be service-connected or retired to be eligible, it's based on financial and physical need.

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My father needs someone around 24/7 in case he needs something. I called the Medicaid in Virginia, and they have their own regulations about what respite care means. My father needs assistance when ambulating, being transferred or toileting. His decreased mobility started two years ago, when he fell and broke his pelvic bone and had rehab for three months. Last year, he had congestive heart failure and a stroke. He had physical therapy and his muscles are very strong, considering he just turned 105, but he still cannot walk without assistance and when he goes to medical appointments or at night when he is weaker, he needs to be pushed in his wheel chair. He lived by himself in his own apartment and took care of himself until he was 103, when the pelvic fracture occurred. He is determined to keep trying and did not ask for assistance before that happened. He is also a World War 2 vet, but the VA will only give him 10 hours a week because he was not disabled during the war.

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Does your father actually need 24/7 care because of his stroke, or just someone to be around in case he needs something? I'm curious about the answer to this as well. Do states make their own regulations about what respite care is, or is that up to the particular agency/insurance?

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Respite care should be exactly that, respite for the caregiver:

"res·pite [ˈrespət, rēˈspīt] NOUN a short period of rest or relief from something difficult or unpleasant:"

What your new agency is describing I would consider crisis care, something different altogether. Is this change coming from the agency or from your insurance provider? I would think that as long as it can be paid for respite breaks can be as often and as varied as the caregiver needs/desires.

Are there guidelines about what ways are appropriate for me to use my father's Medicaid respite care?

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