Jerry Cohen, CareGiver

Interviewed with Janet Morris, Attorney, Bet Tzedeck Legal Services, Los Angeles

Janet Morris & Jerry Cohen

Interviewer: How does it make you feel? When you've worked your whole life, and you have to spend down your income? Can you talk about that?

Jerry: Well, I'm not angry, but I'm very disappointed that there's such inequity regarding the criteria of what is and what isn't regarding my income. Why can't I get assistance from MediCal? If I meet those figures, and what is better for a patient than to be in our own home environment? Nothing better than that.

Janet: People have a better quality of life when they are living at home rather than at the nursing home. And they can get personalized attention at home. But, unfortunately the way the system works, there's an incentive towards institutionalization. So that the same criteria, financial criteria, that's used, if you could qualify for care in a nursing home, you can't qualify for care at home. So you can't get any benefits living at home, being cared for at home, but you can get complete benefits if you live in a nursing home. And I think that really has to be addressed on a national level.

Interviewer: How do we address it?

Janet: Well, I think they just have to include caregiving at home in the benefits eligible for Medicaid. And that would extend to coverage for all the medical expenses, as well as home care. Right now, in order to qualify for home care at home you have to be extremely low income, basically poverty level. You can only have $3,000 in assets as a couple and $1,100 in income. Anything over that you're not qualified for MediCal.

Interviewer: How does this kind of myopic, short-sighted policy get a toehold and stay there? Because this has been going on for years

Janet: The policy was that we weren't going to impoverish spouses. So that's how it all started. So in order to keep the well spouse with a little nest egg we decided to extend the benefit to keep the well spouse at home when the sick spouse went into the nursing home. And I think, though, people who were caregivers at home just got sort of forgotten. And now, I think people are getting older, they're getting sicker, there's more caregiving going on so it's an issue that has to be addressed now, again. And I do think that there needs to be legislation to cover people at home as well as in the nursing home, as well as in assisted living. Any place where they need care, the same criteria should apply.

Jerry: When you consider the patient being at home with a caregiver, there's a one on one. Give and take. I recall my life, having been in an in-patient rehab center where there were not professional nurses, but there were aides. One aide has to take care of about thirteen patients. You can't accept that, that's unacceptable. That's not caregiving. My wife's left limb, her arm and shoulder, are paralyzed and there is a medical term, there's a 'sublexation' of the shoulder, and, where the shoulder is out of the socket. And while she was in the rehab center she was literally being abused by the "caregiver" by schlepping her arm. And that, you just can't compare. It just doesn't make any sense. Any rational person can realize a home environment with a caregiver plus the spouse, to me is just the best.

Next: The meaning of CareGiving ...