Location, Ca$h, and Care

The United States of America is still one country. But if you are looking for financial help to pay for dementia care services, it may not seem that way. Each state determines its own spending policies for elder care programs and many states distribute funding in ways that make no obvious sense. Differences between states are often compounded by variations across rural and urban districts. One factor, however, seems to be true across all geographies: Benefits for dementia care improve in locations where elected officials are sensitive to the issue.

The financial policies of your county and municipality can have a big impact on the types of services you can afford to buy for your loved one. These policies are typically formulated as the state’s response to the Older Americans Act  which was passed in 1965 as a framework to provide community services that guarantee seniors’ access to a “retirement in health, honor, dignity — after years of contribution to the economy”. Each time this federal legislation is re-authorized, it is subjected to a national review with requests for community input. Once it is re-authorized, each state must then review its own policies and determine how it will comply with the updated federal legislation.

This state-by-state review can result in wide disparities between states with different economic conditions — and those that have a larger aging population. Pennsylvania, for example, provides better benefits for elders than those offered by some other states. This is partly due to the fact that Pennsylvania is home to Philadelphia, which has the highest proportion of senior citizens among the 10 largest cities in the United States. But the state also adds resources to programs for seniors through funding generated by the Pennsylvania Lottery to Benefit Older Pennsylvanians.

After the PA Department of Aging incorporates its funding recommendations into a plan for statewide implementation, each county of the state must review trends and needs of its residents and determine local spending priorities. But there are big regional differences in the amount of money available to spend on senior services. If you live in Pittsburgh or Philadelphia,  your region has more money to spend on senior services due to the “hold harmless” clause protecting the large number of seniors in these two urban areas. If you live in a rural part of the state, the budgets for caregiver support programs are much smaller and in some cases, seem very unfair.

What does all this mean for your family’s healthcare budget? Funding differences across geographic lines may provide another opportunity for joint family planning. If there is more than one person in your family who can provide care for your loved one with dementia, you may want to do some research on the kinds of programs and funding streams available to support care in each person’s municipality. Siblings may be living in counties with very different funding pools available to pay for adult day services, caregiver respite, prescription medications, and even elder transportation. You can use information about these programs to develop a long term plan for how you will pay for care over the course of the disease. Learning more today may help you plan better for tomorrow. And don’t forget to “remind”  elected officials to protect funding for programs and services that really help your family.



3 Responses to Location, Ca$h, and Care

  1. Thanks for the educational piece of writing. This information is spot on what I was hunting for. I’ve saved your blog!

    • Preparing for the Cost of Caring for Elder Loved Ones In the feature sengemt is this episode of the Senior Care Corner Podcast we discuss a number of those costs to help family caregivers plan. Knowing up front what costs you might face can help you plan for them but certainly doesn’t guarantee

      • I helped move my mom from a one berdoom independent apartment in a residential care facility to a studio apartment. Mom is running out of money and I quickly. No one really anticipated this. The good news is that she has remained independent longer than we thought. (Mom has Parkinsons and a long term care policy that will kick in when she needs assisted living.) The bad news is that she will probably run out of money before she needs the care. I am exhausted and living in a fog. My sister is helping her unpack and settle in this weekend. She flew in from CA leaving her husband and two young girls who start school on Monday. I don’t think she will get everything done with mom because mom will have to get rid of at least 50% more stuff to really make the small space work. I dread dealing with the left overs when she leaves. Mom has Parkinsons and needs more and more help. I thought I was in the thick of things 8 years ago when she was diagnosed and she moved from her condo. Now I realize that it is really just being for me. The last years of a move, multiple falls, emergency room visits, managing multiple medications well that is seeming easy now. I am not looking forward to the next stage. I am not looking forward to aging myself.

Leave a Reply