Refuel #14

🔥 Refuel | Issue #14
A Newsletter from Faith + Gasoline
📅 Subject: “Is It Time for a Nursing Home?” – A Guide to the Levels of Care

🛠️ Welcome to Refuel

Hey fam,

One of the hardest questions a caregiver will ever face is this:

“Can they still live at home?”

And when the answer starts to shift toward no, it’s unsettling.
You might feel guilt. Shame. I landed on confusion. If the answer is no, it just creates more questions.

You might worry about what your parent will say… or what your siblings will think. My main issue was how would we afford to pay for care?

And many people will say that it’s safer at home for your loved ones and they will receive the best care with you. And you have to decide if that’s an option for you and your family.

This issue is about making the right call, not the easy one.
Let’s talk about the levels of care, what Medicare and Medicaid actually cover, and when hospice enters the conversation.

🔥 This Week’s Theme: Keeping Them Safe May Not Mean Keeping Them Happy

📖 Verse of the Week:
“There is a time for everything, and a season for every activity under the heavens.” – Ecclesiastes 3:1

There is a time to fight.
A time to rest.
A time to care.
And yes—a time to ask for help.

🚗 Story from the Road: The Falling

My mom had Alzheimer’s, and I tried to keep her at home as long as I could.
But eventually, she couldn’t walk safely. She forgot how to use the bathroom. She was falling. And eventually hit her head and had to go into hospice. We did hospice at home for the entire year of 2024.
There is a lot of ground before you get to hospice - which offers support but not much in terms of help. You still will need another caregiver to take a shift, especially if you have to work. I hung in there but let’s be honest, I wasn’t trained for this level of care. I had to learn quickly.
And you too will have to figure out what is available to you and what you can afford.

🔍 What Are the Levels of Care?
Let’s break it down:

🏠 Independent Living

• Seniors live alone or in retirement communities.

• No hands-on care needed, just lifestyle support.

• Medicare/Medicaid? ❌ Not covered. Private pay only.

🧹 Assisted Living

• Help with meals, meds, bathing, dressing.

• NOT medical care.

• Often not covered by Medicare. Medicaid may help if the facility accepts it. You have to ASK.

🏥 Skilled Nursing Facility (Nursing Home)

• 24/7 medical care. Nurses on staff.

• Think: IVs, wound care, rehab, chronic illness management.

• Medicare: ✅ Pays short-term (up to 100 days after 3-day hospital stay).

• Medicaid: ✅ Pays long-term care if your loved one qualifies (income/assets matter).

🩺 Home Health Care

• Medical support at home (nurse visits, PT, OT, etc.).

• Medicare: ✅ Covers with doctor’s orders if patient is homebound. Our caregiver was $29.95 an hour with a 4 hour minimum. Ouch.

🕊️ Hospice Care

• For terminal illness when curative treatment stops.

• Focus on comfort, not curing.

• Provided in home, facility, or hospice centers.

• Medicare: ✅ Fully covers hospice care. (Don’t expect this to be a 24 hour helper in the home with you - they do take calls 24 hours but this is mostly on you and whoever you hire or have to help you. This includes the active dying part of it…)

📌 Bottom Line:
It’s not one-size-fits-all. And it’s not shameful to choose more care when your loved one needs it. But be mindful of how to pay for it. It’s EXPENSIVE. And everyone you know will have advice but they won’t show up to take a shift or send you any money. Just make the best decision for your loved one(s) and that’s all anyone can ask.

⛽ Quick Refuel: 5 Signs It May Be Time for a Higher Level of Care

✅ 1. Frequent falls or ER visits.
Safety is a daily concern, and you're on high alert. The patient cannot be left alone at any time. That was my 2024.

✅ 2. Medication mistakes or refusal.
They’re missing doses, doubling up, or fighting you. I had to grind her meds up in her food. Will share more on my tools of the trade later.

✅ 3. Aggression, confusion, wandering.
Especially with dementia—it can become dangerous. My mom bit, hit, kicked and screamed.

✅ 4. You’re burned out or physically ill.
Your health matters. You can’t pour from an empty cup. You have to decide if you can do it! Only you can answer that question.

✅ 5. They need medical supervision you can’t provide.
Feeding tubes, bed sores, catheters—this is where skilled care comes in.

📌 Takeaway: The goal is better care, not more control.

🛤️ Faith in Motion: A Simple Prayer

"God,
Help me release the fear of what others will think.
Help me make decisions from love, not guilt.
Show me the right timing, the right place, and the right words.
Let this next step bring more peace, not more pain.
Amen."

📌 Next Steps

💬 Let’s Connect:
Have you had to place a loved one in a facility?
Share your story—we’re building a resource guide for others walking this road.

🧠 Tip:
Call your state’s Area Agency on Aging to speak with a care coordinator or social worker for free placement support.

💸 Curious about Medicaid eligibility or how to protect family assets?
Look up “Elder Law Attorneys + Your Zip Code”—many offer consultations but they’re worth it. I avoided those conversations too long.

🔥🔥New store: https://refuel.printify.me/

Get a head start on your own health with Function ⬇️⬇️⬇️⬇️

📢 Know someone struggling with this decision? Forward them this issue with love. It may be the answer they’ve been praying for.

💙💙 Community is the new currency 💙💙

You’re not abandoning them.
You’re just choosing care over collapse.
That’s what real love does.

Make a plan✅✅✅

Go be great. 🚀💙
Love you.

With faith & fuel,
Judith A. Culp
Founder, Faith + Gasoli