Warren and Mary Webb never planned on spending their last years
like this. At 74, Warren was still working as the only hand engraver
in a Bethesda, Maryland, trophy shop, and playing golf three days
a week. But, in a span of four months, Warren's life took a dramatic
turn. He suffered two major strokes that eventually left him paralyzed
on one side, unable to sit up, walk, or control his bladder.
Mary, who is 20 years younger, had never wanted to put Warren
in a nursing home. But after months of caring for her husband
while holding down two jobs, she felt she had little choice. Although
the state was picking up Warren's monthly $361 tab for his blood
pressure medicine, Warren's Medicare policy did not cover the
home care services he needed, including diapers and daily living
Struggling to Provide Care Alone
Mary works as a physical education teacher at a private religious
school; she also works three days a week as a day care provider.
She depended on Warren's salary. Warren had no pension. He does
receive a $669 monthly Social Security check. With him no longer
working, she can barely pay the bills and cover the $900 monthly
mortgage on their condominium. Mary struggled to pay out of pocket
the $6 to $10 an hour charge for Warren's home care help that
was often unreliable. But it was becoming harder for her to keep
Warren at home.
A county official told her it could be months or years before
she'd get public assistance because other people were ahead of
Warren. Sometimes the caregivers didn't show up and Mary had to
call in sick to her job. When Warren had to go to the bathroom,
Mary called on her neighbor, a nurse, to help her lift his body
out of the bed or wheelchair. As Warren became weaker and more
dependent, it became increasingly difficult for Mary to cope.
"I did my very best to keep him at home," she says. "I did everything:
I tried friends, caregivers . . . it just was not working out.
I was at rock bottom, physically, mentally, socially, and financially."
But finding a nursing home hasn't been easy, and navigating the
financial route to pay for that care has been exhausting. "I would
go for tours [of the nursing homes]. . . I would cry and they
would pray with me and say, 'You're not the only one.'" Many homes
never called Mary back and most said there were no beds available.
Ironically, if Warren had been admitted to the hospital for at
least 72 hours, Medicare would have allowed her to place Warren
immediately in a nursing home and would have picked up the charges
for a limited period of time. One day Warren fell out of the wheelchair
and Mary considered calling 911, but Warren's doctor discouraged
A Financial Dilemma
She has finally placed him in a facility near her home, but Warren
has yet to qualify for Medicaid, which covers long-term nursing
care. The price tag is $150 a day or over $54,000 a year. Mary
is in the process of trying to get Warren onto Medicaid but it
won't be easy. If Warren qualifies, the state will likely take
the $669 monthly Social Security check Mary relies on to help
pay her mortgage.
Warren, who can still speak, wants to come home, and is angry
at Mary for putting him in a nursing home. He's dropped 30 pounds
since his illness and he no longer can feed himself. Although
Mary desperately misses her husband, she says without financial
help she can't care for him at home. In nine months of care at
home, she spent more than $7,000 on caregiving and diapers.
If Medicaid agrees to pay for a full-time home caregiver and pick
up the cost of his medicine and diapers, Mary says it would be
possible to bring him home. But she worries that if the home care
situation doesn't work out she would lose a nursing home bed and
have to retrace her steps to get Warren qualified for assistance
again. It took her eight weeks to get her first appointment with
Medicaid. The state has already stopped picking up Warren's blood
pressure medicine but he's getting it through the nursing home.
A Long Road
In 34 years of marriage, Mary says she and Warren never discussed
end-of-life issues. She knows that this could be a long road.
Warren's parents lived until age 90. "This could go on for years,"
After she leaves work, Mary visits Warren every night at the
nursing home. The hardest part is leaving him there. When she
gets home, Mary eats dinner alone with her cat. She looks around
her apartment at the pictures of her dapper husband, who was so
active only eight months ago. Mary fears she'll go bankrupt unless
she gets help. "I don't know what's going to happen to us," she
says. "It's like a numb feeling. You just can't believe this is
happening to you."