by Star Jameson, Hamilton
Recently there have been two important articles about the care of elders and inevitably their caregivers in Montana. In the past few years I have needed to access care for my husband. I had two huge concerns on my plate: his daily needs and negotiating a system that regularly fails our citizens. I am a retired social worker who dealt with Medicaid regularly in various capacities. I am assertive and I know how to push for answers. How many times I have cried for those caring for their beloveds who don’t have the skills or knowledge to get their financial and daily living needs met.
I’m not a researcher, but let me share a few numbers. Nationally 1:5 of us will experience dementia and will require a caregiver for an unknown number of years. Therefore another 1:5 of us will be deeply, if not extremely affected by arranging for care, or providing care directly. Having attended a support group for caregivers for over five years, I witnessed so many who arrive in the state to care for mom or dad who believed they’d be here a few months to settle their parent into a skilled nursing facility (SNF) and return to their home. Then they discovered average cost for a month in a SNF is $7000. Some folks with long term care insurance found it didn’t cover the costs. Other caregivers, wanting their family member to remain at home, suffer debilitating physical and emotional distress after a few years. Obviously Medicaid must underwrite some if not all of the costs.
While I found the workers in the Medicaid system extremely friendly and helpful, I also discovered that the left hand often didn’t know what the right hand was doing. I received months of enormous bills from DPHHS after my husband entered care. I’d call the Helpline in a panic and was told I could ignore them. Then there were the “spenddown” bills of over $2000/month that rolled in. Told to ignore them.
So in addition to increasing Medicaid reimbursement (across all medical services would be appreciated), I’d like that system to streamline. Between qualifying for Medicaid and finding a SNF, I was tracking daily for a year and a half before a placement opened.
The Bitterroot Star printed a moving letter January 4th about these issues signed by nineteen County Commissioners in the state calling for increased reimbursement which stated that 10% of skilled nursing facilities have closed since January 2022. Ravalli County Commissioners were not signed onto that letter, even though we have had significant closures locally. Given the elders in this community I cannot fathom why they wouldn’t support the aging.
Finally, my concern focuses on those with dementia, but hundreds more in the valley are suffering from COPD, ALS, Multiple Sclerosis, severe heart conditions, crippling arthritis, other mental illnesses, and the list goes on. Families are doing what they can to keep their beloveds at home, then there comes a time when placement is the only answer. This state needs money for employee wages, money for day-to-day expenses and building improvements for skilled nursing facilities, and we need it now.