Why Is A 108-Year-Old Resorting To GoFundMe To Pay For Home Care?

[appalachiablue]

- Longtime activist Judith Bernstein of Chatham, Mass. has started a GoFundMe campaign to raise money and help her stay in her home.
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By Ross Barkan, The Guardian, July 7, 2021. - Excerpts, Ed.

- The predicament of Juliet Bernstein is just one more example of how America’s byzantine healthcare system fails so many. -

A 108-year-old woman named Juliet Bernstein recently launched a GoFundMe to pay for around-the-clock home care that she could otherwise not afford. A retired schoolteacher who is physically frail but mentally sharp, Bernstein, who was born before the first world war, hopes to remain in the modest Massachusetts home where she retired, receiving help to cook, clean and bathe. “I saw it was being done for someone whose child was very sick,” Bernstein, a longtime civic activist, told the Boston Globe.

“So I said, ‘I’m not going to go to a nursing home. I’m remaining here.’” Bernstein has raised more than $100,000 so far, an impressive figure that still may be spent down quickly, given the realities of the American healthcare system. Bernstein’s home care is not eligible for Medicare or Medicaid assistance. She cannot afford private insurance for long-term help, living on her modest pension and social security.

While it’s heartwarming that the GoFundMe has been able to raise cash for her home care, her predicament is just one more example of how America’s byzantine patchwork of public and private for-profit healthcare options fail so many people, particularly the elderly and the vulnerable. Even if Bernstein decides to move to a nursing home, Medicare will pay for only a limited stay with such care. Medicaid provides nursing home coverage if a person’s assets do not exceed $2,000, excluding a home, car and personal belongings. Since she has a pension along with social security, Bernstein does not meet that threshold.

She wants to avoid the fate of many seniors who spend down their assets to qualify for long-term care under Medicaid. That would mean bleeding out her savings, selling her home and becoming effectively destitute. To receive mostly free healthcare in America, that is the decision many elderly and ill people must make.. Other advanced democracies already guarantee healthcare to everyone. America is the tragic laggard. Instead of single-payer healthcare or a national health service, we have been forced to endure an expensive, predatory privatized system with a fractured safety net for the elderly and the extremely poor...

More,
https://www.theguardian.com/commentisfree/2021/jul/07/juliet-bernstein-108-year-old-gofundme-home-care-america-healthcare
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Chatham activist Juliet Bernstein, 107, starts GoFundMe to stay in her home, Cape Cod Times, June 16, 2021,
https://www.capecodtimes.com/story/news/2021/06/16/chatham-activist-juliet-bernstein-107-starts-gofundme-stay-home-mercy-otis-warren-council-on-aging/7598918002/

.. Bernstein is a well-known figure in Chatham and on Cape Cod. She served in the League of Women Voters of Lower Cape Cod and in the ’80s was actively involved in the Cape Cod Chapter of the Fellowship of Reconciliation, an international peace group created during World War I.

[MFM008]

1. because unless i remember

correctly Medicare pays for 100 days of treatment.
If you need more you have to go into hospice, i think this is what we did with my mom.
Had to move her from home to home to home
and she was a veteran, but the VA wouldn't pick the big stuff up because she was not a veteran or a foreign war like my dad was.
The US had to be at war for her to qualify for her own benefits and she was in in during a 2 year gap year period of
no active conflict..............its all very very confusing and A LOT of paper work with various agencies.
Otherwise we would have to have put our house up as a lien for her to get medicaid.
None of us wanted to do that.

[DURHAM D]

2. I believe that Medicare only pays for 100 days if she is

recovering from a hospital stay of 3 days or more. Otherwise zip as far as I know. How would she qualify for hospice? She seems okay?

[appalachiablue]

3. A terrible, complex system. Tx for sharing.

Glad your mother had family to help her with this during difficult times.

[littlemissmartypants]

6. IIRC, Medicare pays for 100 days of medically necessary Skilled

Nursing Facility treatment plus room and board. What she is hoping to fund is regular activities of daily living support which is not considered medically necessary.

She is seeking, it appears, is what some call a sitter or aide. The responsibilities may include food prep, laundry, shopping, light housekeeping, transportation to medical appointments and so on. They may also help with bathing and dressing, transfers from bed to chair, or from the toilet to a standing position, or bed to bath or toilet if the client has physical limitations.

It's possible that Medicaid could pay for some of these things but she would have to liquidate her wealth to qualify for Medicaid and she seems to be unwilling to do that. None of these things are covered by Medicare and are totally out of pocket for those in need unless you have had a qualifying hospital stay that can help you return to your former state of health, aka attending rehab.

Once you complete rehab you are expected to return to home unless you need additional care at which point you will be expected to pay out of pocket or if you have a supplemental health insurance policy that pays for what Medicare and Medicaid won't cover.

[pnwmom]

19. Medicaid in MA lets you keep equity in your home up to $900K.

If her home is in excess of that, she could consider a reverse mortgage to fund her care.

[littlemissmartypants]

21. I hope things work out for her whatever options she has.

It's both a privilege and a shame that this is what choice she has. We should do better taking care of our elders.
❤

[pnwmom]

22. I don't think it's really a shame that single people with million dollar homes

might have to use some of their equity at the end of their lives.

[littlemissmartypants]

23. They are fortunate to have that option, unfortunately many others don't. nt

[pnwmom]

24. Right. That's why I think The Guardian could have found a better example.

Also, the reporter is conflating the issue of National Healthcare with the issue of supporting oneself in aging, with greater need for assistance in living.

[littlemissmartypants]

25. Well, at least she got free publicity for her GFM. nt

[pnwmom]

26. I just read more. Her SON helped her set up the Gofundme. She wants to be able

to leave the house to her adult children.

Do you think taxpayers are supposed to take care of the living costs of people who own home equity of more than $906K, so their children can inherit them?

“There are people who have even less than what I have,” Bernstein said. “I’m not complaining, but I felt that I wanted to leave something for my children. I have the house. I want to keep the house for them.”

[littlemissmartypants]

27. She should set up a trust. Problem solved. It makes small difference what I think

Taxpayers are supposed to do. Of course, her son helped her with the GFM. It's all the rage with the youngsters. Creative wealth management with what looks like a granny grift. What could go wrong?

[Elessar Zappa]

28. This taxpayer

wouldn’t mind paying so elderly people can keep and pass on their homes. I would have no problem whatsoever.

[pnwmom]

29. That would be unfair to taxpayers who don't own homes.

Medicaid lets you continue to live in your home till you die, even if you've spent all the value in it -- and that's good.

But I don't think Medicaid should also be a backdoor way of creating a sheltered asset for someone's adult children.

[abqtommy]

4. I wish Juliet all the success that she so richly deserves.

[appalachiablue]

5. Well said, wishing this special lady the best.

[Hoyt]

7. Unfortunately, neither Medicare or Medicaid is going to cover home care 24/7.

She might qualify for some intermittent care, but not around the clock. She can probably qualify for nursing home care when most of her money is gone, but that’s not appealing.

Don’t think that is going to change anytime soon, no matter which Party is in control.

[choie]

8. I've mentioned that I assist older adults in applying

for benefits in NYC. In NY State, you can have up to $15,900 in assets and still be eligible for Medicaid Long Term Care. That doesn't count a house or a car. I did some research on Massachusetts and the maximum assets level is indeed $2,000 (not including a house or car). I am shocked that MA's level is so low, but it appears to be the case. So much for progressive Massachusetts.

[JustAnotherGen]

14. Thank you for this

My mom is in Western NY (Rochester area) - it was a bear dealing with Medicare after her Covid Hospital Stay. She's beyond that asset level - but I wondered during that situation . . .

What does a senior do if they don't have kids to step in and help financially and/or physically?

[Grasswire2]

9. Interesting

I wonder how my brother-in-law's visiting health aide was compensated. I thought it was Medicare. Perhaps it is a facet of an Advantage Plan. He had someone come to help with bathing and mobility issues, and someone else to do physical therapy to get him walking again. For a few months. He's 88, I think. Still living at home with wife and daughter in their paid-for house.

[pnwmom]

10. You can qualify for Medicaid if you have few assets and your Social Security payment

and pension are inadequate. And the Medicaid payment can go to either a nursing home or to at-home care.

[Grasswire2]

17. yes, but that's not the case here.

The home is paid for, in a nice suburb. Cars, antiques, furniture. Life insurance, burial plots, the whole shebang. I have to assume that a Medicare Advantage plan compensated the caregiver.

[pnwmom]

18. She could reduce her equity in the home, if it's over the $906,000 limit, by getting a reverse

mortgage. And she could use that money to pay for her care till she runs out.

Medicaid isn't set up so people with million dollar homes can hang onto all their assets no matter how long they live or how much care they need. I think The UK's Guardian could have found a better example of the US system not working.

[Hoyt]

15. Medicare will cover some intermittent care, but it doesn't go on forever. It helps people try to

stay at home, rather than a facility. It's the around-the-clock care that I don't think they cover, if they do it's not long.

Worse, home care is having problems finding care givers right now. Don't know if it's home health agencies/companies not willing to pay enough, or the government payment to agency is too low. Probably some of both.

[pnwmom]

11. Medicaid does pay for in-home care in all 50 states.

It can be used to help many seniors remain at home.

This part of the article is misleading:

Medicaid provides nursing home coverage if a person’s assets do not exceed $2,000, excluding a home, car and personal belongings.

Since she has a pension along with social security, Bernstein does not meet that threshold. She wants to avoid the fate of many seniors who spend down their assets to qualify for long-term care under Medicaid. That would mean bleeding out her savings, selling her home and becoming effectively destitute.

No one should be deterred from applying for Medicaid for nursing care, either in home or in a nursing home, because of the article. The problem appears to be that she doesn't want to spend down her other assets. And Massachusetts doesn't include your personal home among the assets, as long as you're living in it, so even her home isn't necessarily the problem, unless her "equity interest" in it is over $906K. If it is, she could get a reverse mortgage for the balance, and spend that down on her care, and then qualify for Medicaid.

https://www.medicaidplanningassistance.org/in-home-care/

https://www.medicaidplanningassistance.org/medicaid-eligibility-massachusetts/

What Defines “Assets”
Countable assets include cash, stocks, bonds, investments, IRAs, credit union, savings, and checking accounts, and real estate in which one does not reside. However, for the purposes of Medicaid eligibility, there are many assets that are considered exempt (non-countable). Exemptions include personal belongings, household furnishings, an automobile, irrevocable burial trusts, and one’s primary home (given specific circumstances are met). For the home to be exempt, the Medicaid applicant must either live in it or have “intent” to live in it, and his / her home equity interest must be no greater than $906,000 (in 2021). (Equity interest is not the same as the home’s value. Instead, it is the value of the home in which the Medicaid applicant owns). The home is also exempt, regardless of where the applicant resides or the applicant’s equity interest in the home, if a non-applicant spouse resides there.

[RainCaster]

12. Because too much of eldercare was written by the GOP

I only wish all those bastards would have to experience it for themselves.

[StClone]

13. Ah, the call for "public service" has raised my hackles for years

Big money's aim is to pay no taxes as they state "if you want it you pay for it" shift of the burden onto those of lesser income. Ever notice how for years, things which should be taken care of at a societal level are unfunded, or left undeveloped, and then there are calls for YOU to donate time, money, or expertise to ease the burden of people in need?

I have donated time and money and feel good in my efforts. But there are too many homeless, too many damaged vets, too many poor kids needing mentors for me and my colleagues to secure through volunteering. I am getting old, tired, and cynical now. We are a society where we kill wolves for fun, die to make the Libs cry, and attack what keeps us healthy (environment, vaccines, education, and gun control). Public service, I am all in but where is the end?

[JustAnotherGen]

16. If they taxed SS beyond 137,500

We could afford to do more for her - we could give a lot of Seniors the care they need to remain independent.

[pnwmom]

20. Medicaid in MA would let her keep her home equity, up to a value of $906K,

and still qualify.