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Mom's dementia is getting worse. We will not be able to care for her much longer as we cannot be with her 24/7 and I worry about her safety when she is alone. We cannot afford to put her in a home, nor can she. What options do we have?

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My mom was just admitted into a home. Her dementia had gotten so bad and so quick. My brother and I couldn’t care for her anymore. She was using knives and scissors to break out and when she did she would wander and the police had to get involved. She even hopped on a bus, fell, and bruised her face on one of her wandering walks. Luckily someone called the police and because of the bruises already on her face they took her to the hospital. From there, we refused for them to discharge her. We told them that she is a danger to herself and there is no one to care for her. Social worker from the hospital jumped in and they looked for a nursing home for her. Previous to this, I was calling SSI, calling NHs, but just endless runarounds. POA wasn’t recognized in the government offices therefore they wouldn’t talk to me without her. This is the quickest way into a NH via hospital. They will use Medicare first then Medicaid will then kick in. Best of luck to you. It’s so hard to go through this.
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mstrbill Apr 29, 2024
Thank you for sharing. This in my experience is the best way to get placement. When you try to do it on your own it’s very difficult.
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area of aging in your county. or if she goes to a hospital do not accept her home, it is easier to place in a nursing home straight from hospital then from a private home. medicare will pay for 1st 100 days and then she will qualify for medicade providing she dosent own any assests,
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geddyupgo May 1, 2024
I think you meant to say that on the placement by the hospital, Medicare (traditional) will pay fully for day 1-20 of needed skilled nursing and.or rehab (provided she is willing and able to participate). After day 20, if skilled nursing or rehab is still needed Medicare will pay 80% until day 100 with the additional 20% being paid by the patient or their supplemental insurance. Advantage programs operate differently and OP would need to read the contract or call the programs customer service.

During the skilled nursing/rehab stay, the patient is evaluated for appropriate discharge (this is where, as has been pointed out, the OP tells them she can not provide care and a discharge to home is unsafe. May have to say it repeatedly!) and that patient needs long term care (LTC). OP should discuss with a certified elder care attorney who is familiar with Medicaid in her state but I can guarantee OP will need LO's birth certificate, marriage and divorce papers, rent mortgage receipts, (deeds of all property owned) bank statements --- all going back about 5 years so she should start working on that immediately. In NJ you need to spend down to $2000. but each state is a bit different.

The Medicaid app process is not that bad........... it's the hunting for the documents they require that is exhausting!
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Application to Medicaid.
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Nursing home on Medicaid is the option. You can try to accomplish this by yourself, but it may be time consuming and difficult. You have to apply her for LTC Medicaid through your State's social services portal online or you can call them. Then you need to visit nursing homes in your area to see which ones you like best and to see if they have open Medicaid beds and will accept Medicaid pending. You'll also need Dr's recommendation that she needs nursing home care (she needs to medically qualify, she will if she cannot perform ADL's on her own). If you don't have success, and can't find an open bed, contact a state social worker (APS) and let them know the situation, and that your mother is in a dangerous situation. Remember, it is not your fault. If you have to work to pay the bills, then you have to work and can't be with your mother, and hiring in home help is not possible financially. This is not about neglect, it is about getting help for your mother. The social worker will help and should be able to find safe placement for her.
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Whatever assets mom has are burned through, then her SS is used along with Medicaid to pay for her care. Start the application process as soon as possible. Our family was blessed by a very knowledgeable business manager at my mom’s nursing home who expertly walked us through the entire process at not charge. Not everywhere has such a person. Don’t assume that by using Medicaid her care will be less, we didn’t find that to be true my mom
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BurntCaregiver Apr 25, 2024
@Daughter1930

A nursing home resident always needs an advocate keeping that staff and administration on their toes. Never trust a facility on good faith that they'll take good care of your LO. Not even the high-end places, but especially the Medicaid ones. If you keep them on their toes, your person will get decent care.
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Yes, she can be put into a home. The facility will take her monthly income and it's not enough to pay the monthly bill. She will go on Medicaid and they will pay the difference.

If she has unprotected assets like real estate, bank accounts, or insurance policies these will have to be liquidated and will go towards cash-paying her in a care facility until they run out. Then Medicaid kicks in.
So she can go into managed care.
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Get mom qualified for Medicaid. Then, look for skilled nursing facilities that accept Medicaid.
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The Area Office on Aging was a great help for navigating the initial Medicaid application. A nurse manager from the office was able to communicate with the state office and help avoid some snags specific to my mother's situation. Also, the insurance (an advantage plan) case worker was extremely helpful. These folks would know the state-specific rules that are easy to miss.
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Sell her house and spend down assets.
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I just went through the search for mom's care. It is insane expensive $7,000 - $9,000. A month and I question if the do interact with patients. I didn't want mom just lying in a bed with little sunlight and a little TV.
I did check if she qualified for Medicaid, but nope. I did add the AARP insurance for caregiver needs and options on hospital beds, etc. The addition to her Part A and PART B. was at no extra cost. If the doctor(PCP) approves the needed care the United Healthcare AARP plan pays for overnight and daily care I think it was 40 hours a week. Maybe you could make a plan for hours that would allow you to work and live with the hours they can support. We managed around the hours they can arrange. The insurance pays for the care costs. Anyway, it's helpful having someone who can move her to avoid bedsores, etc.
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