She's in wonderful shape for 94 and longs to live at home. She, my brother and I think we have found a way to make that happen for her. She receives about $550 a month from the VAA program as the widow of a WWII vet, which is a nice cushion to her pension and social security. Will she lose that entirely? Or will they just recalculate the benefit based on different costs?
I assume at AL, she's got easy access to a doctor and an RN when she needs it. Are you going to take her to doctor's appointments or rely on the in home caregiver to do that? Is this person going to live-in? Make sure that you've thoroughly vetted her so you don't end up trying to evict her. How will your mom react to loss of socialization and activities? Do you have podiatry services lined up? I'm sorry that I haven't answered your question about A&a.
She "longs to go home" but home is not a place, it is a time 50 years ago when she was much healthier and active. For her to think she would be fine at home is extremely delusional. She has forgotten that someone else does the cooking the cleaning the laundry and the meds. Keep her safe where she is.
She has already met the asset test and we can presume that her income is relatively steady with only COLA increases.
The award, however, is actually granted based on income relative to expenses. To receive the maximum award for a surviving spouse (assuming here that she is not the veteran), which for 2014 is $1,130 per month, her net income for VA (IVAP) purposes must be $0.
To arrive at IVAP, start with gross income and subtract unreimbursed medical expenses which can include payments for medically related insurance premiums such as those for a Medicare supplement and Medicare Part D plans, ongoing out-of-pocket co-pays, ongoing services and supplies (such as those for incontinence), and the cost of care - whether it be home care or room and board and cost of care in an assisted living facility. If IVAP is $0, a full award will be granted.
The fact is, if her care at home is more expensive than in AL, her award might go up.
I applaud you for making the effort to grant your mother's desires. Caring for loved ones at home can absolutely work - even in complicated cases. For many there is indeed no place like home. Good luck!
If you were receiving Improved Pension Aid and Attendance as opposed to Special Monthly Compensation Aid and Attendance then her unreimbursed medical expenses for care could be deducted from household gross income to arrive at a higher Pension A&A benefit but that does not work with compensation as it is based purely on your rating, not your income and expenses.