Q: My mother, living in a northern community, really needs some in-home help. She struggles with making meals, no longer drives, and has problems getting in the bathtub, among other things. Wouldn’t Medicare help her pay for some of these services — to keep her out of a nursing home? It would seem like money well spent in my mind. (From a daughter in Blue Mounds).
A: It does make sense that Medicare would cover some of the costs of services especially if it means keeping someone out of a nursing home; however, that is not the reality of the benefit.
Medicare covers only skilled services. That eliminates all of the things you listed above because normal daily activities are not skilled services. They are considered custodial care.
Medicare defines skilled care as “care that requires skilled staff or rehabilitation staff to manage, observe, and evaluate your condition.” This is the definition provided by the Center for Medicare and Medicaid Services. Examples of skilled care include intravenous injections and physical therapy.
Without knowing what county your mother lives in, it is hard to say what resources are available to her. Most of the counties in Wisconsin now have aging and disability resource centers (ADRC).
Since you live in Dane County, you could call the local ADRC at 608-240-7400 and ask them if there is a resource center in the county where your mother lives and for the contact phone number.
If the county of her residence does not have an ADRC, they may provide you with a contact number to begin the search for available resources.
If your mother has limited income, she may qualify for a program that can provide financial assistance to help individuals remain in their own home. If she exceeds the financial limits, she may think about hiring someone to assist her with the tasks she can no longer perform independently.
Another option is an adult day center. If there is one available in her area, she might like to attend a few days a week. There may be several options from which to choose.
The important thing is to keep talking to your mother. Let her know you are willing to help her gather information so she can make a good decision and get the assistance she needs. She is lucky to have a daughter like you.
Jean Mueller has been a registered nurse for over 30 years. Her experience includes working in home care settings, skilled nursing care, and training individuals to become certified nursing assistants. For the past 13 years she has worked in the Aging Services department of the Madison Diocese Catholic Charities.