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Does anyone have experience with using VA A&A for in-home care 24/7? Did you have to do the legwork for establishing the care? Was it successful?

You don't get enough money for Aid and Attendance to pay for 24/7 care.

"The 2025 Veterans Aid and Attendance Benefit rates are: A Veteran may qualify for as much as $2,358 per month."

A surviving spouse gets even less. You need to talk to your local county VA office to see what the Vet or surviving spouse is entitled to.

When a person needs 24/7 care, it may be time to place them. Couples should see an elder lawyer to split assets. If no assets, then Medicaid will help pay for the persons care.
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Reply to JoAnn29
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In all my years here I have never heard of in-home care 24/7 provided by the VA?

If such exists I would love to know that?
Will be following your post and am wishing you good luck.
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Reply to AlvaDeer
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There are other programs the VA has. My Husband was on a program called VIP (He was not classified as having a Service Connected Disability)> He was assessed and a dollar amount was assigned and with that dollar amount I could pay for caregivers and I also had to pick at least 2 other categories tat would help keep him at home. (I chose lawn service and house cleaning since the lawn service was just summer and the house cleaning I could do 2 times a month I had more $$ for caregivers)
The Up/ Down side to caregivers is I had to hire privately but all the background checks were done and a company was in charge of payment and doing all the taxes. I had to submit time sheets weekly.
The VIP program for me was a lifesaver. So please check to see if there are other programs in addition to A&A that will help out.
And there is a program that will make renovations / modifications to the home so that they can remain in place.

There is also another program that I heard about
The VA has Medical Foster Homes.
People that are trained have Veterans move into their home and those trained caregivers take care of the Veteran.
When I heard about the programs is sounded like a great alternative to a facility since the care is provided in a home
I am in Illinois the information I have is for the coordinator
john.zidek@va.gog.

If this is of interest you can get some info as there are several YouTube videos about the program.
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Reply to Grandma1954
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AlvaDeer Feb 14, 2025
Great info!
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The only time we used Aid and Attendance for in home care for my FIL was a bath aid that came 3 times a week. And once for a week of respite -for which I think he qualified (sorry this is a vague memory and also would have happened over 5 years ago and much has changed with respite care since then) for perhaps 9-15 hours a week of in home care - and the rest was paid out of his pocket. He required care 24 hours a day for the week we were gone - so that cost to him was not insignificant.

Now, I will say -because he had a service related injury that was responsible for some % of his disability - we got incredibly lucky in his placement for SNF. He had a 70% SRD rating and we had placed him at a VA Home within an hour of his home. Initially, because he did not have the rating in place yet, he paid private out of pocket (but frankly, even that was discounted in comparison to other SNF rates). But once he had his rating - he was moved to a shared room and the VA covered his entire payment.

It is my understanding that home skilled care is limited as far as Aid and Attendance. Honestly before he needed 24/7 care - the VA had helped him to the point of it being ridiculous - to help him stay in his home.

Garage elevators for his scooter, his scooter, a chair lift, more than 25 professionally installed grab bars, a bariatric hospital bed and multiple mattresses, a magnification reader, OT ensured that his computer was set to the best usage options - huge font and size, enlarged keyboard, special monitors, special home phones, special clocks, at one point they even offered him a VR set up - but they could never get it to work with his home internet set up. Right before he had to transition to SNF (my SIL and her DH lived with him) the VA installed the most amazing grab bar I have ever seen - it was custom created for his needs and his bathroom. He never even got to use it. The provided him with glasses, shoes, walkers, wheelchairs, chair assists, magnifying lamps, cpap, most of his medications.

To be honest, he never really knew what it was like for a lot of seniors who can barely get what they need and it costs them an arm and a leg.

Your best option is to sit down or have a meeting with them and talk about options. I doubt 24/7 in home is an option at all. But there may be respite, and there may be residential care options depending on SRD.
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Reply to BlueEyedGirl94
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Vancil47 Feb 15, 2025
Stop with so many acronyms. At least the first time you use it, say what the program is or what you're referring to.
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First, Alva, as noted in other posts, A&A is a stipend that can be used to provide ALL types of care including facility care and home care hours. What it is NOT is a VA supplied 24/7 care program. While knowing that little, I'm stumped on how A&A has been used in real life examples. AC to the rescue again.

So...onward as time is not slowing down.

Thanks, thanks, and more thanks. All this is good information to help fill in the holes and various puzzle pieces. Each answer has given a tidbit to help.

A&A has been applied for and is in limbo re: decisions. As my parents were both in the service during the war -- where they married -- the decision(s) is/are prolonged as the VA works out her unique application situation. While the local VBO handles applications, they are not "case managers" so they currently have no more to do until the review is completed. Meanwhile her current home health company recommends her to bump from the max available to full 24/7 and her health care providers agree.

To even complicate it more, she is SSA 100% disability -- not yet disability rated in the VA system though. Medicaid won't approve/deny the Medicaid application until VA has completed the VA A&A plus disability determination. She is kind of in "limbo land".

Placing Mom might be the easier part because she does not (yet) have dementia with the Parkinson's. Paying and timing are whole different conundrums :-)!

Thanks again. All the responses have been very helpful.
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Reply to MyNameIsTrouble
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Aid and Attendance offers money for those who qualify to hire their own caregivers or to pay a family member for care.

Look on the veterans website and you will find the documents you will need to fill out to apply for aid and attendance. As you can appreciate, this will take documentation of vet service, marriage license if for the spouse, doctors signature that the claimant needs care, financial information, etc.

You can find many links online. Make sure it is a .gov link (not a .com link) such as the one attached. You can find help in filling out the paperwork at your local VA office if you need it. They are sometimes located in or near your county courthouse.

I attended a meeting in an ALF years ago where a company gave a talk on the benefits of A&A and for a fee helped with the paperwork. You shouldn’t have to pay a fee as the VA will assist. You do have to gather the documentation, discharge, marriage, income, outgo, doctors signature and parents signature.

Good luck on stretching the amount of money paid by A&A to provide 24/7 care. But it will help.

Medicaid in a skilled nursing facility is usually what is required when the family can’t provide 24/7 care and the health condition and financial impoverishment must be addressed.

https://www.va.gov/find-forms/about-form-21-2680/
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Reply to 97yroldmom
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We are going through that right now and as all red tape is, it's a tedious and frustrating process. I had to fill out the documents and furnish copies of my husband's DD214. Fortunately I knew exactly where that document was. If you don't have that it will add considerably to your leg work. Once I filled out the documents and sent it along with the DD214 to the Veteran's Affairs office it just came t to a stop. I finally found a good advocate just last week (I began working on this the week between Christmas & New Years). He immediately reapplied for me and is in the process of trying to get us help with 9 other programs. The best way to find a good VA advocate in your location is to contact the Area Agency on Aging. They are a very good liason between caregivers and the VA as well as other government programs. I wish you success on this and pray God guides you to the right person to help you.
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Reply to Ctcart
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A A is a fixed stipend for hired care or to partially help with payments in a facility. If you need 24 hour care than perhaps it is time for a VA nursing home
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Reply to MACinCT
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Aid and attendance is a monthly payment they send to help with costs of care. You need to find the caregivers. It is a lengthy and labor intense process but can be worth it. We had to prove the need for help was related to his service connected disability. We enlisted help of a VA rep and are getting farther through the process.
We also receive homemaker/pca care. It isn’t many hours of help but still so very helpful. We contacted his assigned social worker through the health care side of things to start that process.
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Reply to Kquirk1
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Kquirk1 Feb 15, 2025
Also, they are low on funds for the last few years and we have been seeing less and less covered and fewer hours and more requirements for approval. It will not be a cover all but a small help to take edge off of care.
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I have been working with the VA for nearly 14 years now getting my mother the Widows Pension Plan and A&A. It is a very long tedious process. You need to have all of your T's crossed and I's dotted. One example they kept asking for the death cert for my father and we kept sending it. Then they closed the case. Then I got ahold of everything and looked at the death cert--somebody put a sticker over cause of death and VA did not accept it. And that was just the beginning. My mother lives in FL and I live in PA which has made it even more difficult. The local veteran's affairs office might be able to help. Mine is in the courthouse. Once you submit an application, you need to watch for a letter. The letter will ask for more information and you have to decipher what it is they want and get it to them right away. Good luck! You have to constantly keep after this to be successful. And also understand the income limits and guidelines.
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