Let me start with I love my mother dearly and would do anything for her. She had a heart attack a few years ago which left her with no short term memory and the need for a lot of medication including insulin. My husband and I took her in to live with us for about 1 year and a half but it took a toll on my mental and physical health, our marriage, and relationship with my children. Luckily she had enough money at the time to move into a very nice assisted living with a hired private caregiver. She lived there for almost 3 years. Now her money is out and she is back living with me. She cannot be left alone. I have looked into Medicaid funded facilities but would not dream of putting her in the places in my area. I don't know what to do. I feel stuck and hopeless for my family, me, and my mother. Any suggestions would be most appreciated!
you will most likely not find a place that is covered and to your liking. But the alternative is finding yourself back where you were a few years ago.
Sorry if this feels like a lecture and its really hindsight but before Mom ran out of money did you not start looking for LTC. The easiest way to get into a nice LTC facility that takes Medicaid is to private pay for a few months. This gives you time to apply for Medicaid and have it start when Mom runs out of money. IMO if you had to hire a private caregiver, Mom should not have been in an AL.
Did you ask the AL if they except Medicaid after a resident has paid privately for a certain length of time? In my State Medicaid will pay if the resident has paid privately for at least 2 yrs.
Make an appt with Medicaid and see what your options are. My State allows you to apply and then within 90 days spend down any assets, get them the info needed and find a place for the recipient. Lets say your Mom is Okd for Medicaid for Sept 1st. Sept 1st is the day you move Mom to the place you picked out for her.
Your Moms application should be easy. She has no home or assets at this point. Hopefully, her monthly income is below the cap set by your state. But that may be worked around with a Miller or Qualified Income Trust, which should to be drawn up by an elder lawyer.
What is the right answer you'd like to hear, honestly??? There aren't a ton of options here!!
It didn't work once, it won't work now.
Look for a nice, well rated SNF for mom. They do exist. You just have to look harder. #Truth
Have you visited them? Looked them up online? Checked the ratings done by state or federal agencies?
I was told one Tuesday morning that my mother was to be discharged THAT AFTERNOON, and I had absolutely no idea what to do.
There were two places near my home, one that was “in town”, so difficult parking, and one that was a couple miles in the opposite direction, but rather dark and dreary looking.
She would be heading there for her Medicare rehab, so mostly on a coin flip I chose the 2nd option, where I was sure I could park.
She was placed in a 3 bed room (horrors), and I was there every day. The physical therapist was AMAZING, and the shabby chic began to win me over.
But when her 45 or so days were completed, I chose to bring her home. “Home” became my private Hell on earth.
I couldn’t move an inch without her attempting to follow me, yell for me, scream for me. I was a prisoner in my home, sleeping on the floor next to her bed every night, for fear she’d attempt to get out of bed and fall.
After 9 months, I was attempting to get her ready for bed one night, and she slipped off the mattress toward the floor. I knew that I had to place her.
As luck would have it, the residence where she’d done her rehab, the shabby, homely but meticulous place I had originally thought would just be a “steppingstone” had a bed open, and I took her there.
Kind faces remembered and greeted her, and I suddenly had a shot at taking back my life. And best of all, a brand new building was in the works, and she moved into a brand new room there, just 6 months later.
I visited every day, and she lived in her new”home” (it was) for the 5 best years of her life as a widow.
Moral? Don’t reject any idea, not even the strangest or farthest out, unless you can MAKE some time, even a little, to explore it as it is.
It MIGHT turn out that you had made a guess about one of the Medicaid places that wasn’t really accurate. It might not. But just consider…..
I will try to be more open minded but I do worry so much about her.
I used a company called Carepatrol to help me find a place for both my in laws and my mom… maybe there is a franchise in your area. If not Google care placement specialist..try to find someone local or an independent…
These companies know what is available, cost , services, matches your needs , finances, arranges tours, .. They are paid by the facility , not you… I placed my mom with her first AL this way, an independent..when I moved her by me, it was the franchise…invaluable service…
You say that having Mom with you took a toll on your marriage, your mental health and your physical health as well as your relationship with your children, who--assuming they are young and need to be with you--are your first responsibility.
Not everything has a good "fix". Not everything has an answer that everyone can be happy with.
Heart attacks don't cause mental damage as described unless there was a good deal more going on? Some permanent damage do to a cardiac incident that left Mom with oxygenation, or some other event? I am guessing that it the reason Mom had to live in ALF with a hired private caregiver also? But whatever the reason there is now no money and no place to give.
I hope others have the answer that is escaping me, but I cannot imagine one. I understand that you love your Mom, but your Mom has had her life. It is not a good reason to sacrifice all your relationships and your mental and physical health to her. I hope that you will seek the counseling of a good therapist to work your way toward an answer you can live with. My heart goes out to your good intentions; I wish you so much luck.
Let's give one another some Hope...
Look at your situation as you just need to find "one" place for your mother.
I'm sure that will happen. The problem is Medicaid is different throughout the country. And, yes, others have written once they see "Medicaid" your options are limited. It's like travelling steerage class as opposed to the Queen Mary 2.
We all love our mother's and want them to have the best quality of life. But the bottom line is--everything comes down to $$$.
Just to let you know I don't know of too many people, at least in my social circle who can afford these high end assisted livings and/or the long term insurance which starts out affordable then the premiums increase and you're priced out of the market. So play the hand you are dealt with, take action like you are now on this forum and have Faith girl!
A few suggestions:
*Was your father a Veteran? Look into Aid & Attendance
*Can your mother's PCP (primary care doc) write orders for homecare
*Can you get paid as a Caregiver (some States allow this)
*I also agree A Place for Mom is supposed to be helpful
*Little Sisters of the Poor or any Catholic related Nursing Home
*Depending upon your mother's mobility, a day (4) hour once a week
Respite program (medical model)
*Call your local State Representative and/or Senator, they have a lot of
resources and tell them you will vote for them. Even better during an election
year as they promise you the world for a vote.
*Contact the "Nurse Manager" at your Mom's primary care doc. They know more than the docs.
*Meet with an Elder Attorney for a "free consultation"
*Meet with a Social Worker
The more heads on this the better. A lot of these places you can do a virtual tour online. Oftentimes in life you have to make that 9th phone call. Perseverance is the prices of success. I spent the last 9 months on the phone, emails, letter, receipts to finally get reimbursed for a piece of medical equipment that my mother needed. Grievance Dept. Appeal Dept. you name it. The check for 80% just arrived. Have you seen the salaries of these big insurance executives. I kept at it.
You are in my prayers and you are a wonderful daughter to reach out like you are. You love your mother and bottom line is none of us want our mother in a crap box. Let's be frank. You will find what you need in life! You go Girl!
Amen...
Thank you again so very much for your support!
Ireland on the thread is right. Really everything comes down to the money. Beggars can't be choosers as the saying goes. It's terrible and wrong because Medicaid shells out enough per month for everyone on it to at least live in a decent facility that is clean, has competent help, and offers decent food. Profits first though.
You say your mother cannot be left alone because she has no short-term memory. Would she not be better off in a memory care facility?
If your mother is on Medicare and Medicaid is her secondary insurance, they will pay for some hours of homecare if her doctor writes an order for it. At least that would give you a bit of a break. Medicare also pays for a certain number of respite care days per year in a facility. I made the arrangements for a respite stay because I needed to take a vacation. If I remember correctly Medicare paid for five or six days in the NH. The family was not going to care for my client themselves and the other aides couldn't make up my full-time hours because they had other clients. They left her in the NH for the three weeks I was in Israel and paid for it out of her money. They didn't want to have to get another caregiver to come for the three weeks I was out. The cost was about what they were paying for us to care for her at home.
It's a start. Talk to Medicare about homecare and to her doctor about writing the order for it.
You may have to place her if she has dementia. You, your kids, and your husband have to be put before your mother's care needs.
Even if she is placed in the kind of facility Medicaid pays for. You can still do for her and help with her care in the facility. Please think about it and talk it over with your husband. Good luck.
Another thought just came...what about if you look at facilities in your area that have the following: Again, this all depends on where you live. There are some facilities that have the following all in one--short-term rehab, long-term rehab, day respite, nursing home and hospice. Many newer facilities especially in the warmer more affordable States are building "stages".
For example, my mother is living with me in a modified apartment. She had the VNA here, a 10-day short-term rehab stint that got her back on her feet along with an Up Walker Lite ($500) and I now have her enrolled in one morning a week (4) hour "medical model" that has Speech and Physical Therapy. Continental Breakfast and Hot lunch are included. Some of the people are out of it others are talkative. But Mom has found her tribe and has her "lunch table" just like high school. They provide transportation but I drop her off and pick her up due to in case she has to go to the bathroom. I don't want her to feel pressured on the bus. She may not speak and ask the bus driver to pull over because she gets embarrassed.
These day programs, the better one's are like getting Mom into Harvard. There are so few slots. But now that the Pandemic is under control there may be some openings. Keep everything local, convenient in your town. Again, every State is different.
This same place also has Homecare nursing visitation, Assisted Living (for the rich $$$, we are not in that social circle) Memory Care and Nursing Home. The place my grandmother lived at (I was her caregiver too, she passed when I was in Grad School--my dad died before her and he was an only child, so I was "elected" by my siblings) had the same aforementioned and added Hospice. Basically this is the final resting place with different levels of care.
A plan could be if it's not already water over the dam should you keep Mom on Medicare get her into a good place when her $$$ runs out then she will have to go on Medicaid but hopefully if you found a good facility she could remain. I know you said your mom's $$$ ran out but it seems like a step is missing somewhere??? I would speak to an Elder Attorney and then call your local State Representative and/or Parish Clergy. People like to help and no one is exempt.
There is an answer you just have to configure different scenarios like I did. I had to move my mother from a 2nd floor to a first floor, walk-in shower. I work at night from home. The portal with the doctors is a great convenience. I run this place with military precision and pray a lot too!
Amen Sister...go out and have a nice big piece of strawberry shortcake for Memorial Day with lots of whipped cream!
1 - Placement into a skilled nursing care facility (since she needs a nurse to give her medications). Apply for Medicaid. Get a placement near home. Visit often.
2 - Enlist more help so you do not get burnt out again. Ask family, friends, members of faith community, and paid help (sitters and home health aides) to lighten your caregiving load. Ideally, you should have enough help to have a few hours "off" daily and more weekly/monthly from caregiving to nurture yourself, your marriage and your other relationships. If you can not find enough help, then choice number 1 is the option to go with.
If someone could just realize this and create an affordable facility that is in between these fancy assisted living places and nursing homes that would be great! I guarantee, there is no reason getting basic decent care and a decent place to live should cost about $6000 or more a month!