WHILE MANY FAMILIES find it difficult and stressful to discuss their finances and financial management strategies, these discussions are extremely important - and helpful - in the context of planning for potential care needs. Long-term care services are expensive. It is important to know your income resources, assets, and all sources of financial support. It is also important to maximize your resources through tax benefits, trusts, asset protection, and Medicaid spend-down, if appropriate. Starting these discussions early provides time to do a financial assessment and strategize ways to maximize insurances, protect assets, and pursue eligibility for benefits and entitlements.
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| Plan Of Care For Multiple Sclerosis |
Developing a Plan
IF THE TIME does come when a family member with MS requires additional assistance and services, the next step is for the family to sit down together to develop a detailed plan of care. The plan should address all the needs that must be met and identify the family and community resources that could be put in place to address those needs.
The goal of most families is to keep their loved one at home and in the community for as long as possible, regardless of his or her physical status. Fortunately, in recent years, we have seen increasing government interest in supporting and funding home- and community-based services. There is finally an acknowledgement within the health and social service system that access to home health care, homemaker services, adult day programs, and respite care is imperative if families are to care for loved ones with chronic disease and disability at home.
There is no question, however, that the time can come when safety issues in the home, or the chronic care needs of the family member with MS can exceed family resources, and a residential option will need to be explored. For individuals who continue to be capable of self-management and who have the financial resources, assisted living is certainly one alternative. In addition to providing housing in a semi-independent setting, most assisted living facilities also provide supportive services (e.g., meals, emergency assistance, and some personal care). However, if clinical and medical needs exceed what either home or assisted residential care can provide, then it becomes a priority to find a skilled nursing facility that is equipped to address the unique and complex needs of a person with MS.
It is important for families to be aware of the continuum of options and to be able to evaluate the appropriateness of these services and settings for the person with MS. This is particularly challenging since many of these programs primarily serve the frail elderly, not younger people with MS and other adult-onset disability. Therefore, services need to be reviewed, not only in terms of availability and quality of care, but in terms of whether they can provide appropriate services for a younger, non-elderly population.
There are numerous questions that need to be asked by families as they explore and engage a network of services and support. Meeting a person's needs at home raises questions such as the following:
- What kind of help is required? Are we talking about companionship, home upkeep, or personal hands-on care? Obviously, the level of skill needed for each of these services varies, and if one is purchasing any of these services from community agencies, the cost will vary as well. If a person only needs someone to run errands and vacuum the house, there is no need to be paying for a certified nurses aide.
- When is the help needed? Is it concentrated in the morning, in the evening, or throughout the day? Are there safety concerns that would require someone to be available at all times?
- How much help can family members and friends provide? How reliable can they be? What other demands are they dealing with in their lives? Can they do the tasks that are needed? Who will coordinate the schedule and the care? Can neighbors help? Are there church or fraternal organization volunteers that can help?
- If the decision is made to seek services from community agencies such as healthcare agencies, adult day programs, transportation services, or meals-on-wheels, who will make the contacts? Who will look into eligibility for subsidized services? If the family must pay, how will payment be arranged? Who will pay for what?
- If the decision is made to hire help privately, who will interview applicants? Where will the interviews take place? Who will check references? How will payment be arranged?Who will train a new employee? Who will learn about wage and benefit regulations?
- Who will explore options for home modifications, durable medical equipment, and technological devices that will optimize independence and necessitate less hands-on care?
To find out more, you can check out Plan Of Care For Multiple Sclerosis.