Japanese dive bombers couldn't stop the Navy radioman in 1941, but Parkinson's disease is catching up with him nearly 69 years later.
But while the degenerative disorder threatens his life, the cost of long-term care threatens to unravel the realization of his dream -- shared by many aging Americans -- of financial security.
The 87-year-old veteran and his wife, Millie, have lived frugally and managed to put away some savings, which are now being drained by the $7,000-a-month cost of his stay at the Spokane Veterans Home.
Sinnott, confined to a wheelchair, went to live at the nursing home about three weeks ago, his son Larry said. Millie could no longer help him into his wheelchair or lift him after a fall.
Sinnott's daughter, Dianne McNeal, says the care her father is receiving at the state-run facility is exceptional, but the country could do a better job of providing for its veterans.
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"It's not fair to him and a lot of American veterans," McNeal said. "He was promised he would be taken care of for life."
Because Sinnott's medical condition is not connected to his military service, he is not entitled to long-term medical care benefits from the U.S. Department of Veterans Affairs.
Like the vast majority of Americans, he does not have long-term care insurance that would pay a portion of his care in a nursing facility.
Legislation championed by the late Sen. Edward Kennedy and recently signed by President Barack Obama could provide relief for families like the Sinnotts in the future.
The Community Living Assistance Services and Supports Act will provide an opportunity for Americans 18 and older to pay into a long-term government insurance program.
"It will be a big help in terms of changing the experiences of older Americans," said Susan Reinhard, senior vice president for the AARP Public Policy Institute.
But the CLASS Act has come too late for Millie Sinnott.
The act does not become effective until 2011 and experts say it is unlikely to be made available before 2013. Participants then must pay into the voluntary program for five years before they are eligible to receive benefits, so it will be 2018 before anybody can make use of the CLASS Act for long-term care.
A study by the U.S. Department of Health and Human Services found that people who reach age 65 have a 40 percent chance of entering a nursing home. Yet fewer than 9 million Americans have long-term care insurance, according to the American Association for Long-Term Care Insurance.
Medicare, the federal insurance for the aged or disabled, pays only for medically necessary skilled nursing care and only under certain conditions. It does not pay for custodial care to assist with daily activities such as dressing or bathing.
Medicaid, the state and federal insurance for the poor, does pay when the state determines a patient qualifies for assistance. Sinnott is currently paying about $231 a day for care at the Spokane Veterans Home. Medicaid would pay about $174 a day.
Eventually Sinnott will qualify for Medicaid, but only after he and his wife "spend down" their savings.
Federal law allows for spousal impoverishment protections intended to ensure that the spouses of those residing in nursing facilities can live out their lives "with independence and dignity," according to the Centers for Medicare and Medicaid Services.
When a couple applies for Medicaid, the couple's resources are combined to determine eligibility. Their home, household goods, car and burial funds are not included in this assessment.
One half of the combined total is the "spousal share," which is used to determine whether the spouse residing in a nursing facility meets the resource standard for Medicaid determined by each state.
A "protected resource amount" is subtracted from the couple's combined resources for the spouse who is living at home. So the government cannot take all of Millie Sinnott's assets. It has to leave her a monthly allowance.
What the Sinnotts are experiencing is very common, said Reinhard, of the AARP Public Policy Institute.
Once you've reached age 85, there is a high probability of needing long-term care, and it's expensive, Reinhard said.
"Most people spend down within five or six months," she said. "These are middle-class people who have worked hard, raised children and contributed to the country."
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Distributed by McClatchy-Tribune Information Services.
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The CLASS Act will not be an option for those who are already disabled (and unable to work) or those who are retired and do not want to work. The law requires that in order to qualify for benefits, one must pay premiums for 5 years AND must be working for at least 3 of those 5 years.
ReplyDeleteThe CLASS Act's $50 per day "average benefit" will only cover a small portion of the $75,000+ per year most Americans pay for in-home care. Most people who want to protect their savings will still need to purchase long-term care insurance to supplement the CLASS Act benefit.
One of the biggest problems we face is that most Americans still think that Medicare or their medical insurance covers the cost of long term care.
The CLASS Act addresses this problem by making a very clear statement: You have to pay for your own long term care. You either have to pay for your own long term care by using your savings, the $50 per day CLASS Act benefit, long term care insurance, or a combination of these.
Most of the ten million Americans who own long term care insurance, own it because they've seen friends or family have to spend down their assets before qualifying for Medicaid. The CLASS Act will help alert the rest of the country to the fact that they need to financially plan for their future long term care needs.
Scott A. Olson
www.LTCInsuranceShopper.com