Personal expense allowance

When I first moved to a nursing home, a $40 monthly allowance was not much. However, with no way to get out of the facility to purchase anything, I had little use for money. I could buy things from the vending machines. But that is not something I would have done consistently. I got enough to eat. I had clothing to wear. Initially, the facility provided everything for me.

The resident personal expense allowance (PEA) began in 1980. Then, New York nursing home residents received $50 a month—and they still do today. Ohio residents get $30–$40 a month.

Smokers use their PEA to buy cigarettes. Some residents pay for activities, such as a monthly lunch out and "order in" meals once a week. Other residents buy health and beauty aids, snack foods, soft drinks and batteries.

Nursing homes are supposed to provide residents with food, housekeeping service, linens, toiletries and in-house activities. The facility does not provide hair conditioner, hair styling products or styling implements. Nor do they provide hair accessories such as headbands and ponytail holders, or skincare products and makeup. If residents want those items, they would need to use their PEA and the activities team will purchase those items during its weekly shopping trip.

At this facility the activity assistant is a licensed cosmetologist. She cuts the residents' hair at no charge because this facility has no "full-service" beauty salon on the premises.

George (pseudonym) said his PEA goes to his brother (guardian) each month. Though George did not say he needed anything, he asked if it was legal for his brother to get his monthly PEA. I said it probably is as long as his brother spends the allowance on George. He shared he would like control of the PEA so he could order out or buy snacks when he wants.

Since this is a behavioral facility, a phone is provided for resident use. Staff assists residents to make calls and monitors them. Residents are allowed to make two calls out a day—local or long-distance.

At my previous facility some ill residents or those with dementia used little of their PEA. The facility used their PEAs to purchase a bedspread, pillows, or other items for their rooms. Sometimes residents’ allowances were used to purchase fresh flowers for their rooms.

Some resident advocates are suggesting a PEA increase to $75 a month. I do, however, wonder how some residents would handle a larger PEA. Since residents are not required to budget their allowance, some will want to "blow it" as soon as it arrives.

I think residents should get vouchers for clothing and shoes. I think the PEA amount has been kept low to discourage corrupt individuals from mishandling or mismanaging resident funds.

I have witnessed residents who put their PEA in a drawer or pocket, only to have it go missing for whatever reason, leaving the resident upset and heartbroken.


Topics: Activities , Alzheimer's/Dementia , Executive Leadership , Medicare/Medicaid