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My uncle from the accounts that I am hearing from other members of the family, may be giving up as he has multiple issues.He has my aunt as a power of attorney over his monthly disability? check.Yet, she hasn't made arrangements for his care so that he can be comfortable.I hear he gets left in urine, as he cant get out of bed most times and doesn't eat much.I dont understand why his primary physician hasn't ordered hospice for him or at least a nurse to come check on him.Several weeks ago,he lit a cigarette while on oxygen and  burned his nose badly and he wouldnt go to the doctor.There are no other family members to help really,as I also am not able to help.But i want to try to at least try to get him some help if possible.What can I do to help him to get care at his home?Any info would be appreciated.
He is not well off financially but does have medicaid or medicare.
I dont want his situation to be like this.Someone needs to step in and help the helpless.But I dont know what to do.
Thank you.

Answer
Ross,
I am sorry to hear of the challenges that your uncle is having.  I do think this situation is not uncommon.  There are many family members that are trying to care for the aging population remotely.  Many family members of seniors live away and have to utilize the help of professionals and those that live near their loved one.  With that being said, I feel there is great hope for you to be able to help.
Here are a few things to consider that may open the door to getting your uncle the help he needs.  The first thing to do would be to engage your aunt.  I see you mentioned she has power of attorney over his finances.  Is it possible to call her and appeal to her to take responsibility for arranging care for your uncle?  She may not realize that she must now assume the responsibility for coordinating care for your uncle.  She may either be overwhelmed with the situation or thinking that others (for example your uncle's doctor) would take the lead on this.  If you or another family member who is close to her, talks with her to tell her she must start doing this and appeals to her about the urgent need to get this arranged, this may be the key.  She may not realize what avenues to take or how to start to arrange help.  If she is resistant to taking on this responsibility, or due to emotional or cognitive problems, is unable to, then I suggest a family member start to make the calls for them.   

One thing of note is that your aunt may be financial power of attorney but not medical power of attorney.  She may have both, but there is also a good chance that she does not.  If not, this may be an open door for another family member to get the medical power of attorney to oversee his medical decisions.  However, frank conversations with her and assistance with making the calls and the numerous follow up calls may be the answer.  

Here is some additional information that may help you.  Your uncle's doctor is key to getting hospice care.  Only under certain circumstances (specific diagnosis) would your uncle be eligible for hospice.  Someone needs to call his doctor to request hospice services.  The doctor will let you know if he qualifies based on his diagnosis.  If he does not, you may request to discuss with the doctor any changes in your uncle's condition.  Once the doctor writes an order for hospice care, the hospice service will come out and set up the services that he needs.  You or another family member can request to be on the list to be called regarding his care.  In this way, you can further help with the care coordination remotely.

If hospice is not ordered by the doctor, you have some additional options for caregivers to come into the home.  
First you should rule out any possibility that your uncle does not have Long Term Care insurance.  This would have been a policy that he and your aunt paid for every month, through his employer or on their own, much like a life insurance policy.  Long Term Care policies are designed to pay for this type of care.  Your aunt should know if he had this type of policy. This would be your best avenue to get the care immediately for your uncle.  
Another avenue for care is through Medicaid. This is usually a long and tedious process to begin this service.  There is at least a one year waiting period for most applicants and in some states it is even longer.  You will may have to enlist the help of others while waiting for this Medicaid benefit to begin.  
The third option is through the Veterans Administration.  If your uncle was a war time veteran, he may be eligible for the Aid and Attendant program.  This, like the Medicaid program is a long application process.  However, both of these options are good for helping to fund his care in the long term.  But as mentioned, you will need a solution while waiting for the programs to take effect.  
The fourth option is to pay for the service out of pocket.  Your aunt may have the funds to pay for some help and many times family members will pool their resources to help with this care.  There are many, many private pay services available to help.  These can be found on the internet as senior care services, non-medical care for seniors, or home care for seniors.  

A good approach may be to divide up the responsibilities and tackle them this way.  Your aunt may agree to contact the doctor to try to get hospice going, while another family member may call all the home care services to get their prices and the details of their services. You may wish to start calling the local Medicaid office to start the application process.  
Since you mentioned that your uncle is not well off, here is a quick note about the funding for these services.  Medicare will cover the cost of hospice care at 100%.  Hospice additionally covers many of the supplies needed, bed pads, oxygen, disposable personal care supplies and medications.  Without Hospice, Medicare does not cover these things and as you know only a portion of medication costs.  Medicaid covers the cost of sending a person to the home to help with personal care, bathing, dressing, etc., usually through a community waiver program mentioned above.  Veterans Administration covers the cost of sending someone to the home only through the Aid and Attendance program.  Private Pay services is 100% paid for by the individual or his family - this service is not paid for partially by insurance, etc.

I hope that some of this information is helpful to you and your family.  Your efforts are so necessary and important to your uncle at this time.  I wish you the best in engaging your aunt in arranging this care with your help.  Please do not hesitate to contact me back if you have any further questions at ginelle_leblanc@ymail.com

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Ginelle LeBlanc, CSA

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I can answer questions regarding home care solutions for seniors, in home care scheduling and care giver solutions, funding sources for home care, how to find a quality Care Giver, what questions to ask when interviewing a caregiver for home care, how to solve home care problems. All things related to caring for a senior at home, and the caregivers taking care of a senior. Additionally for those who own a home care business, I can help answer questions regarding the start up and operations of a home care business for seniors.

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I am a Certified Senior Advisor (CSA) accreditied to help seniors and thier families to find the best solutions for their needs. I owned and operated a Home Care service for Seniors for 6 years and was able to help nearly 1,000 families find the best caregiver match for their parents, or senior loved one. I have supervised a staff of caregivers providing care in private homes, assisted living facilities, hospitals and nursing homes. I continued in the Senior Care/Home Care Industry as Regional Director of Training for Comfort Keepers providing training and operational support to 10 offices in the Gulf South Region. I now have 12 years in this field. I now own and operate my own Senior Care Consulting business, GL Consulting, LLC (www.GLconsultingLLC.com)

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Graduated from Southeastern Louisiana University, Hammond, Louisiana. I am a CSA (Certified Senior Advisor).

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