No room at the home

While the challenges of caring for the frail elderly hit all socioeconomic strata, without question they are more acute among families of low-income seniors. The solutions are often stopgap and patched together by family, friends and government programs.

Carilion has a significant number of patients — a dozen in Roanoke Memorial Hospital alone — who board in the hospitals because “we can’t find a place for them to be discharged to and they don’t have insurance,” said Dr. Mark Werner, Carilion Clinic’s chief medical officer.

“Without adequate funding, low-income people languish without access to assisted living and skilled nursing.”

Such was nearly the case with 70-year-old Annie Jones, who had made a career out of caring for old folks, working as an in-home aide for five decades. “There were days when she literally worked 22 hours,” said her granddaughter, Stephanie Coles, 36.

Even at 69, Jones still labored full-time “because all she had was Social Security. She was still working to live, to eat, to help take care of our family.”

It fell to Coles to be the primary caregiver as her grandmother slid into dementia: First, there was the car accident — Jones had found herself on the wrong side of the highway, panicked and hit another car.Meals on Wheels volunteer Sandra Sweeney (left) comforts Leola Williams. (Click image to enlarge)

Then came the call from Jones’ Bedford retirement complex: Your grandma set the stove on fire. Within hours, the landlord taped an eviction notice to her door.

Jones wasn’t sick enough to qualify for skilled-nursing care, likely funded by Medicaid, and she didn’t want to live with Coles in Roanoke — claiming in her confusion that “Stephy stole my money and went to Washington state and brought my pocketbook back dirty.”

For the next 24 hours, Coles and a Bedford social worker searched frantically for an assisted-living center that would accept her grandmother as a Medicaid Auxiliary Grant-funded patient. They found a nice facility in Bedford, but it cost $2,000 a month and accepted only private-pay patients. They located one in Roanoke with a few Medicaid-designated beds, but the waiting list was two years long.

After calling facilities from Danville to Christiansburg, they found exactly one bed available: in a shared room at North Roanoke Assisted Living.

Coles works two jobs to help pay what Medicaid can’t cover: her grandmother’s phone bill, hygiene incidentals and life insurance policies. Most Sundays, the two of them go Goodwill-shopping and out to lunch. Money’s too tight for both to eat out, so Coles waits and eats at home at home instead.

“Sometimes we’ll go to Wal-mart on Sundays and she’ll see something she likes and looks at me sheepishly, like she doesn’t know if she can get it.”

She can, and does, whether Coles has the money to spare or not. “It’s like when I was little I did that to her, so you know, I owe her this much.”