Rhys
Incidentals [in-si-den-tlz] n—Minor expenses
“It’s called a spend down,” the hospital’s financial counselor says.
Mom fiddles with her magnetic bracelet.
“What’s a spend down?” I ask the counselor.
“Exactly what it sounds like. In order to qualify for the full benefits Medicaid offers, your mother must spend down her excess funds.”
“How am I supposed to live without any money?” Mom jumps in.
“Well, in order for Medicaid to cover your basics, such as housing, food, and medical expenses, you must not have the ability to do so yourself,” the counselor explains.
Mom stops twirling her bracelet. “That’s great that they will take care of the absolute necessities of life, but what about everything else?”
“You’ll be given a small stipend each month to cover incidentals.”
“How small?”
The counselor’s eyes twitch almost imperceptibly. “Forty-five dollars,” she says.
Mom gapes. “Forty-five dollars?”
The counselor nods. “I know it doesn’t sound like a lot—”
“It doesn’t sound like anything,” Mom interrupts. “After this spend down, I’d be broke. What if I can’t live like that? I’d be stuck.”
“I’m not saying it wouldn’t be an adjustment, but there are wonderful assisted-living facilities in Utah.”
“You can’t be serious?” Mom turns and searches my face. “In a home with old people? I’m too young to live in a place like that.”
I want to tell the financial counselor she’s crazy. That I will never ask my mother to spend all the savings she’s worked so hard to earn and then live in some old folks’ home, but I can’t do that. This was the answer I received: get Mom help. But how can I put her in a facility? I can’t abandon her like Dad did. My hands begin to sweat as my heart races. Eyes closed, I say a silent prayer, asking for clarity.
“I know it’s scary to think about living on so little,” the counselor says.
“You seem to know a lot.”
The counselor sits unfazed by Mom’s sarcasm.
“How would it work?” I ask. “The spend down?”
“It’s pretty simple. You’d use the rest of your mother’s savings to pay off all of her hospital bills and medications. Once the money is gone, you’ll qualify for extra help.” She pauses, but we don’t say anything, so she continues. “You don’t have to decide anything now, but I encourage you to think about it. Maybe tour a few homes and see what you think. You may be surprised.”
A lump forms in my throat as the counselor pushes a stack of glossy brochures across her desk to Mom and me. Mom doesn’t move to take them, so I do. On the cover are gray-haired people with big smiles. Mom has long brown hair and smooth skin. She’s right. She’s too young to live in a place like that. What if we can’t find a home where she’ll be happy?
Mom doesn’t say anything as I wheel her down to my truck. Or as I walk her into the house. Or when I help her get ready for bed. But as I lift her into bed, she starts to sniffle. “I’m scared, Rhys.”
“I know you are.” I don’t try to placate her fears. I’m afraid too. Everything is unknown. We could spend everything down and end up worse off than before. I cling to the feeling I had as I prayed. “I’m scared too, but we can’t keep doing this. You need to be safe. And you’re not here.”
She nods, dabbing at her eyes with the edge of her floral comforter. “It should be me caring for you.” She touches my face as I kneel at her bedside. “Not the other way around.” She’s silent for a moment. “If you feel this is the right thing to do, I’m okay with looking at some assisted-care homes.”
“I promise I won’t abandon you. We’ll find a place that feels right, okay?”
She pats my cheek. “You’re a good boy, Rhys.”
I tuck her in and then flip off the light as I leave her room.
* * *
A week after our appointment with the counselor, I’ve set up several different tours at assisted-living facilities, and we’re driving all over Utah Valley.
The first care center we visit is small. Two roommates in each room, a small living area, and an equally small kitchen. They call it cozy. I call it cramped. Having lived with Mom, I already know this won’t work. She likes personal space and values independence. We keep looking.
The second and third facilities are nice, but the average age of the clientele appears to be ninety. Mom is half that. Our search continues.
The next several places are too dirty, the staff unfriendly, or just not right.
It’s hard not to question the answer I received. This has to be the right decision though. I felt it. It’s right. I know it’s right.
Mom is exhausted. Getting in and out of the car only to see yet another no-go is wearing on her.
“Can you handle one more?” I ask as we pull into the driveway of a newer facility.
Mom looks out the window at the two-story building with a wraparound porch skirting the exterior—by far the nicest place we’ve seen so far. Mom nods, but I can tell even that takes effort. She needs food and rest. And so do I.
I’m not sure parking is allowed in the horseshoe driveway, but I see no sign posting otherwise, so I stop as close as I can to the front door.
An orderly appears at the door. He’s older than me but still young. “Can I help you with that?” he asks as I take Mom’s wheelchair out of the truck bed.
“Nah, I’ve got it.” I help Mom into the chair and then follow the orderly up the ramp.
“So what can I do for you folks today?” the man asks.
“We’re here for a tour,” I reply.
“Excellent. I’d be happy to show you around.”
The grounds are nice, and the building is a newer light-brick with white wood accents. Bright red flowers line the cement walkways. Inside there is an inviting fire with plush leather couches situated around it. A few women play cards at a round table, laughing. Our tour guide points out a bulletin board advertising the “clubs” offered to residents, special-guest lecturers, a driving service, and many other activities. Mom seems to perk at the idea of being able to have “wheels” again. But not half as much as when she finds out residents can have a plot to garden. For the next ten minutes, she talks about what she’d plant.
We’re shown sample rooms. And a resident who looks to be only a few years older than Mom is kind enough to let us see her room as well. It’s been painted yellow, and the woman’s personal pictures hang on the walls. It’s nice, not at all sterile like the other homes we’ve seen.
By the end of the tour, Mom has stars in her eyes. While the majority of the residents are over the age of eighty-five, a few are Mom’s age.
The man asks if we have any questions.
I do. Several. I open my mouth to ask one, but Mom beats me to it.
“How’s the food?”
The man smiles. “That’s a common question. Why don’t you let me treat you to dinner, and you can tell me?”
Before we even step inside the dining room, my mouth waters at the scent of garlic and butter. As soon as we sit at the table, a server takes our order. I select enchiladas, and Mom chooses vegetable stir-fry. Starved, we eat in record time.
The man continues to talk about the benefits of living here, and we feast on every word.
“So how’s the food?” he asks as we push our plates away.
Mom wipes her mouth with a cloth napkin. “The best meal I’ve had in years.”
He chuckles, not realizing Mom isn’t exaggerating. I’m a terrible cook, and the vegetables she burns can’t be considered a meal.
“How much does it cost to live in a place like this?” I ask.
“That depends,” the man says. “Variables such as view, roommate, and amount of care needed all influence the final cost, but packages start at $2,300 a month.”
Mom’s smile falters. That is triple what her current living situation costs. Triple.
“I know it sounds like a large number, but when you think about the services we offer and the lifestyle we provide our residents, it’s a bargain.” He sounds like a used-car salesman.
“I’m sure it is.” I push away from the table. “Listen, a financial counselor at the hospital recommended we tour here, but I think she was mistaken about our ability to afford a place like this.” The man listens politely as I try to back my way out of an embarrassing misunderstanding. “I appreciate your time, but—”
“Did this counselor explain Medicaid? Spending down?”
Mom shifts in her seat.
“She did,” I say. “But I’m not sure that’s something we’re comfortable with.”
“I know it can be scary, but our resident satisfaction rating is high, and in many cases, our residents are not only safer living here but also happier.” The man hands me his business card. “Tell you what. You guys talk it over, and if you have any questions about our facility or spending down or anything . . . I’m happy to help.” He stands, shakes our hands, and then excuses himself from the table.
Mom’s eyes flash to me, hopeful as he walks away. And in that moment, I know we’ve found the right place for Mom to call home. It will be scary, but we’ll spend down what’s left of the money by paying her hospital bills, and we’ll move her here. It feels right. She’ll be happy. And safe. Things are going to be okay.