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I'm kinda at my wits end here. My grandmother is in a NH and we are in the midst of the Medicaid qualification process. Sometime back in the middle of July, I received a call from the NH saying that t ...Read More

I'm kinda at my wits end here. My grandmother is in a NH and we are in the midst of the Medicaid qualification process. Sometime back in the middle of July, I received a call from the NH saying that the 100 days of Medicare coverage had passed and since Medicaid had not yet been approved, we needed to turn over my grandmother's soc sec. When I explained that we were continuing to pay her bills as we did before she ended up in the NH with her soc sec, this included her taxes, utilities for her home and credit cards. The first thing out of their mouth was "she's not allowed to have a house". Clearly I'm aware of this and explained we were in the process of getting the house on the market for sale (considering the market, we weren't expecting this to be a quick sale. They really didn't want to hear any of that, but that was the reality of the situation and I had nothing to hide So what we were told was to start paying x dollars the next month and then deal with months owed later. I had no knowledge there were months owed as with all that was going on, I must have missed the expectation to pay out of pocket which wasn't the case when my grandfather ended up at that same NH and his Medicaid qualification took 6 months. So I've since been paying the NH their payment of a little over $1000.00 a month, paying my grandmother's health insurance and paying the utilities on the house; the credit card bills kinda fell out of priority and I cannot afford to pay them myself as I have my own household to maintain/sustain. Fast forward to the beginning of this month, without notification, the NH apparently had her soc sec payments diverted directly to them, We called them this afternoon and this woman had the gall to say my grandmother's soc soc had been MISAPPROPRIATED!! My boyfriend warned this woman that unless you know exactly what it is you are accusing someone of, you should chose your words wisely. When told that they now have to take on the responsibility of paying her health insurance they immediately told us they weren't paying it for this month, they'll pay it next month. I'm annoyed and now they've pretty much placed the burden of my grandmother's household expenses that were previously paid by her soc sec $ on ME!!! I'm so sick of hearing them start a single sentence that begins with "usually the family pays....." we are not a family of "means" with extra $ to spare. Thankfully my grandmother is not remotely cognizant of what's going on as she would be so incredibly heartbroken to find out about all of this craziness and the monetary impacts on me. She has always said that she didn't want to be a burden. Its definitely my cross to bear as I would do whatever I could for her. I have a younger brother and an older brother and neither feel remotely "on the hook" to help out. I go to the NH every week to visit and I take care of my grandmother's laundry, I've been paying her bills and whatnot and now I'm in the process of clearing out her house and putting it on the market. I'm annoyed and stressed out by this entire process again. Getting my grandfather qualified for Medicaid was also challenging cause once again, it all fell on my shoulders. I just want to make sure my grandmother remains comfortable and gets the best care possible but GOOD GRIEF, I'm so annoyed at how the NH has handled this situation and the accusation they made today. It really doesn't pay to get to the point where you need to use the Medicaid system and it certainly doesn't pay to be anything above indigent if you or your loved ones need to qualify.

Thanks for the detailed info igloo572!! In my grandmother's case, with her now being completely bedridden and on a feeding tube with advanced alzheimer's, there's absolutely no expectation that she w ...Read More

Thanks for the detailed info igloo572!! In my grandmother's case, with her now being completely bedridden and on a feeding tube with advanced alzheimer's, there's absolutely no expectation that she will ever return to her home and there's no one else living there (my mom and grandfather used to live there but passed away in 2008 and 2009 respectively). And like you've mentioned, all assets; home and properties have been transferred into the Trust but yes, its the 5-year lookback thats the problem as we are only about 2.5, max of 3 years in at this point so that pretty much negates any possible exclusion of any of her remaining assets. At this point, where we were continuing to pay her bills (she does have a few credit cards as well as utilities, and her health insurance) with her social security, a few months ago, we were advised by the NH that we had to turn over her social security to cover her expenses (room & board). When I explained that she had other bills and such to pay including those associated with her home until it got sold (utilities and property taxes), I got the usual schpeel about she's not permitted to own a home and there are no exclusions. I explained that I clearly was aware of what she was and wasn't permitted to own but seriously I'm not sure if they expected that the day it was determined that she could not return home, we were miraculously able to close on the sale of her house, which is a major headache in this market as everyone knows. But I have been using her social security to pay her room and board at the NH and her health insurance and everything else is being paid with whatever monies she had/has in her account which are dwindling quickly to the point where I'm going to have to contact her attorny to discuss her options regarding these financial obligations that soon she will not have monies to cover and I have my own obligations and cannot possibly cover her bills and mine.

When my grandfather was being qualified, assets such as cars and property were able to remain with the living spouse and everything had to be transferred out of his name and into my grandmother's. No ...Read More

When my grandfather was being qualified, assets such as cars and property were able to remain with the living spouse and everything had to be transferred out of his name and into my grandmother's. Now that we are trying to get my grandmother qualified, we were told that she is not permitted to own a home AND qualify for Medicaid (and there are no exceptions) so we must sell the house as well as any other properties in her name. Not sure if it makes a huge difference, but we are in New Jersey.

After my grandfather passed away, at which point my grandmother was a year or so into being diagnosed with Alz/Dementia, we met with her attorney to move everything out of her name and into a Trust which would provide some level of "protection" of her assets after 5 years or so (the infamous "5-year lookback".) Unfortunately, her condition worsened long before reaching the 5-year mark so its the same as if she still owned everything. Also, apparently not every Trust will protect ones assets so if anyone is considering moving theirs or a loved ones assets into a Trust, definitely make sure your attorney is aware of the laws for whatever state you or your loved one reside in.

I don't know where your caregiver is from; an independent or from an agency but you might want to consider looking into Comfort Keepers. A co-worker in Floriday recommended them to me I've used them ...Read More

I don't know where your caregiver is from; an independent or from an agency but you might want to consider looking into Comfort Keepers. A co-worker in Floriday recommended them to me I've used them in the past and they were "reasonable" and have a rate table they use based on the total hours you need a caregiver; the more hours you need them, the lower the hourly rate. I know when I used them this summer (in NJ) they also had a 3 hour minimum shift.

Not sure if that helps but in general home care is expensive. I definitely recall doing the math for what I would have LIKED to have put in place for my grandmother and realizing I didn't have (nor does she have) an extra $4000.00 a month to spend on homecare.

My grandmother has Alzheimer's disease (diagnosed a little over 2 years ago) and during her most recent check-up with her Neurologist, he informed us that she is in the moderate to severe classificati ...Read More

My grandmother has Alzheimer's disease (diagnosed a little over 2 years ago) and during her most recent check-up with her Neurologist, he informed us that she is in the moderate to severe classification. She is an otherwise quite healthy 87 year old who absolutely LOVES to walk so she definitely gets around pretty good for her age. She is not at the point where she doesn't know who folks are but she can no longer dress or bathe herself properly and she requires that someone is with her constantly. The biggest challenge at the moment is toileting. She is quite cognizant of when she needs to go, however, she doesn't always go into the bathroom to do it. It's not so much that she waits until the last minute; it's a matter of her simply not going into the bathroom. She has relieved herself in the hallway of her home, in a living room chair at my brother's home and most recently in a kitchen chair in her kitchen. The first time we were made aware that she was relieving herself in places other than the bathroom, we immediately purchased the pull-up Depends for her. The problem with that is because she is cognizant of when she has to go, she pulls them down and proceeds to do her "business" and when she is done, she simply pulls them up. She is not the least incontinent so the Depends proved to be pretty useless in this endeavor. And of course with the Alzheimer's she totally denies having done anything wrong even when the evidence is quite apparent. We are beside ourselves trying to figure out ways to deter her from toileting in places where she is not supposed to. Any ideas/suggestions/recommendations would be greatly appreciated.

Loaded question!!! There are situations where siblings don’t want to be bothered with an elderly parent who is being cared for by another sibling and there are situations where the siblings do want t ...Read More

Loaded question!!! There are situations where siblings don’t want to be bothered with an elderly parent who is being cared for by another sibling and there are situations where the siblings do want to be bothered. I think that in the instance where the sibling wants to be bothered, then that is a step in the “right direction” that may open the door to them potentially offering to help out more. If this really just boils down to an issue between the siblings, totally unrelated to the parent then, I feel the siblings need to set aside their differences for the sake of allowing the visit with the parent.

I agree with you anne123!! Patience is so very critical!! Before he passed away, my grandmother completely lacked patience with my grandfather, she didn't understand why he behaved the way he did, sh ...Read More

I agree with you anne123!! Patience is so very critical!! Before he passed away, my grandmother completely lacked patience with my grandfather, she didn't understand why he behaved the way he did, she couldn't believe that he had an illness that was cause of him acting the way he did so she pretty much refused to "deal" with him other than to make sure he took medication, bathed, was appropriately clothed and ate his meals. My boyfriend and I would come to the house and he would immediately say "Hey Buddy!" to my bf (and "Hey Squirt!" to me) and my bf would sit there for hours talking to him, and most importantly LISTENING to whatever my grandfather had on his mind that particular day. He enjoyed having his "man's talk" time. In general, instead of dismissing some of the "odd" things he would say, I would simply respond that I wasn't aware of that or I didn't know about that and he would then explain whatever it was to me LOL!!! But he got great joy out of still being heard, still being engaged in conversation and definitely he enjoyed giving us all a great laugh with some of his silly little sayings. When he got to the point where he needed to go to a nursing home, there were times when he wouldn't let the attendants bath or dress him, so it was again, his "buddy", my bf to the rescue to do these things for him. My grandmother at some point realized that my grandfather wasn't putting on an act and at that point, she said she "felt sorry" for him. I told her not to feel sorry for him because at the point, he was surrounded by others like him and they all seemed to get along and understand each other. I know that might sound odd but he even used to sit with another lady and they would simply hold hands and chit chat about whatever; I'm not sure either really knew or understood what the other was saying. My bf would visit with him at least twice a week, he would bring his newspaper and was always greeted with the same "Hey Buddy!" and sometimes my grandfather would talk and sometimes he would sit busily figgeting with this lap activity thing while my bf read the newspaper. I feel this was a very special time for him; time for the boys to hang out. So discovering "new" ways to interact with your loved one will help instill trust. Just being there can also make a world of difference, the very presence of people that we know love and care for us has a way of making us feel "good" and I believe that in the midst of dementia that type of feeling good remains awaiting to be stimulated.

Long-term care insurance is a must!!! OMG!! My grandparent's generation knew NOTHING of this. As far as they were concerned, having a life insurance policy to handle burial costs, a Will to divvy up ...Read More

Long-term care insurance is a must!!! OMG!! My grandparent's generation knew NOTHING of this. As far as they were concerned, having a life insurance policy to handle burial costs, a Will to divvy up whatever they owned and collecting social security would cover them in their senior years which is soooooo painfully not the case.

Also, the more and more I think about it, I can't help but feel that once you get to a certain age, major assets, specifically property/real estate should be moved into a Trust or some other "untouchable" medium. If I knew 10-15 years ago, what I know now, I would have advised my grand-parents to move their home into a Trust when they were in their early 70's. Certainly the (NJ) Medicaid 5 yr look-back (recently someone mentioned it used to be a 2 yr look-back) would not have been a concern making in-home care a more feasible option initially.

I’m in NJ. When we were going through the process of getting my grandfather qualified for Medicaid, we had to provide bank statements, credit card statements, life insurance policies, property tax bi ...Read More

I’m in NJ. When we were going through the process of getting my grandfather qualified for Medicaid, we had to provide bank statements, credit card statements, life insurance policies, property tax bills, etc. They went through these documents, the bank statements particularly with a fine-toothed comb and whenever they were not able to clearly determine what a particular transaction amount was for, we were asked to provide details of what that transaction was for. This included having to provide copies of receipts for purchases, copies or images of checks, etc. You should be prepared to provide all bank statements showing the beginning balance of 120k thru to the depletion of the account, proof of rent payments, bill payments, grocery store receipts, pharmacy receipts, any type of receipts that you have to account for the spending of these monies. The use of online banking proved to be invaluable to us in this case because using debit cards for purchases are automatically detailed as well as online bill pay transactions. We also learned that outstanding credit card balances also count when it comes to spend-down, so if your mom has any outstanding credit card balances, definitely provide those details and have copies of the statements ready to present if requested.

Listing the required level of detail on the Medicaid form itself may be impossible. I created a spreadsheet that allowed me to keep track of the details Medicaid requested and the corresponding information that I was able to provide. To be honest, you may not have a receipt for every single penny spent but the bottom line is they will request specific details do make sure the monies have definitely been spent and not simply stashed away somewhere or invested. If some of these monies were used for your own personal use, you should be prepared to provide receipts and/or statements. I know that in order to do a number of things for my grandparents, I had to transfer monies to my personal bank account simply because I did not have a debit card for their account. In this case, I actually provided copies of my own bank statements and receipts to show proof of the offsetting transactions.

If you don’t initially provide the level of detail that Medicaid requires, don’t worry ‘cause they will let you know. So if it’s a matter of getting the process started by simply providing the most high-level summary details, then go for it. They will not hesitate to ask you for more information if they need it.

It was a very tiresome and tedious process and I feel really bad for anyone who does not have someone to handle all of the minutia involved in the Medicaid qualification process. Certainly by the time they need these services, our elderly loved ones are in no ways capable of doing this on their own.

I wish you best of luck and patience.

So sorry that your mom is suffering from this awful illness. I am not an expert by any means but always trying to help out by sharing things that I've learned along the way in dealing with the need f ...Read More

So sorry that your mom is suffering from this awful illness. I am not an expert by any means but always trying to help out by sharing things that I've learned along the way in dealing with the need for elder care for both of my grandparents who suffered/suffer from moderate to severe Alzheimer's. I've read about something called an Elder Guardian that may be the answer here whereby the courts can appoint someone as a Guardian to make decisions and such. Try finding out more about Elder Guardianship for your particular state as the procedures do vary from state to state. If you have access to a lawyer, definitely share the details of your mom's condition with them along with the fact that there is no POA in place and that someone needs to be able to make vital decisions on your mom's behalf going forward. Give that a try; Elder Guardianship.
Hope that helps.

In NJ, for Medicaid qualification they start with requiring 6 months worth of financial transaction data from date of filing backwards. If she withdraws the application now what could be the potentia ...Read More

In NJ, for Medicaid qualification they start with requiring 6 months worth of financial transaction data from date of filing backwards. If she withdraws the application now what could be the potential impact on when she should refile as once the 100 days of Medicare coverage ends how soon can they start billing you if you don't have an active application in the Medicaid queue? Generally speaking of course, as I also guess this can vary from state to state.

What MICROVIEW mentioned is very much aligned with how Medicaid qualification works here in the state of NJ. When my grandfather needed to go into a LTC facility and to qualify for Medicaid, because ...Read More

What MICROVIEW mentioned is very much aligned with how Medicaid qualification works here in the state of NJ. When my grandfather needed to go into a LTC facility and to qualify for Medicaid, because both his and my grandmother's names were on the deed so the house was "protected" and not factored into the parameters for his qualification . But in order for him to qualify, all of their assets as a whole had to be reduced. It was an excruciating process. My grandfather passed away 2 months after qualifying for Medicaid (took a total of 6 months of checking and verifying every single penny spent on their bank statements). My grandmother was diagnosed with Alzheimers shortly after my grandfather was placed in the LTC facility; July 2008 and as of last week is in the moderate to severe classification and seemingly on a fast decline. We had moved the house into a Trust never imagining she would decline this quickly and thought she would definitely clear the 5 year look back when it came time for her to need LTC and Medicaid. I am now preparing to meet with her attorney to see what our options are as she will need LTC a lot sooner than expected and cannot afford pay out of pocket and will not qualify for Medicaid unless we can sell this house in a market where no one is buying.

My story is similar but in this case it is telling a parent with severe dementia that his only child has passed away. My grand-father’s dementia had him all over the day with regards to what he perce ...Read More

My story is similar but in this case it is telling a parent with severe dementia that his only child has passed away. My grand-father’s dementia had him all over the day with regards to what he perceived as reality. He clearly didn’t remember members of his own family; living in the house were he, my grand-mother and mother. In the Fall of 2008, my mom was diagnosed with Pancreatic Cancer and after a really hard fight against this awful disease she was put on home hospice in mid-February 2008 and passed away within a matter of a few days later at the age of 62. Within the few hours that passed as the hospice caretaker returned to the house and we awaited someone from the funeral home to arrive, we were all seated in the room with my mom’s body and my grand-father was totally oblivious to what was going on; he was rambling on about this and that, laughing and joking as usual. He was unaffected by the somber mood that everyone else was in and complete unaware that his only daughter had passed away and was lying in the bed within 4 ft of where he was sitting. He did not attend the funeral, a family friend stayed with him while we attended services and repast. A few months later, he had what I refer to as a “moment of clarity” and out of the blue asked my grand-mother “Where is Joan?”. My grand-mother didn’t really know what to say so she tried explaining the best was she could and at some point he understood and said “Are you telling me that Joan is dead?”. My grandmother told him “Yes” and explained that she had fought a hard battle against a nasty disease and was no longer in pain or suffering. My grandmother said my grand-father cried his eyes out for a short while, she gave him some water to help calm him and when he had calmed down the “moment” was gone he was back in his own world again. I am actually thankful for that “moment” as my grandmother had a chance to see a glimpse of the loving, gentle and sensitive man she had married 50+ years prior. I am thankful that he remembered his only child/daughter and had the chance to mourn her even if only for a moment.

Solid recommendation by "TheFixer"! I've researched these and there are many options out there including a few that will alert a caregiver via Phone, e-mail or Text Message if a scheduled dose has no ...Read More

Solid recommendation by "TheFixer"! I've researched these and there are many options out there including a few that will alert a caregiver via Phone, e-mail or Text Message if a scheduled dose has not been taken. Price points vary across the different options so definitely take the time to do your research. If I may, here are a few links to get you started:
http://www.epill.com/medsmartplus.html and http://www.forgettingthepill.com.

You should get her to a Neurologist as soon as you can for testing and diagnosis. I feel that Alzheimers/Dementia can be similar amongst individuals as well as completely different. The constant rep ...Read More

You should get her to a Neurologist as soon as you can for testing and diagnosis. I feel that Alzheimers/Dementia can be similar amongst individuals as well as completely different. The constant repeating is something that my grandfather did all the time in the early/mid stages of his dementia but my grandmother doesn't do this nearly as often as he did. My grandfather suffered from what I've recently learned as "sun downer's syndrome" and completely came alive at night when he should have been sound asleep. My grandmother, thankfully, sleeps through the night and only gets up once to use the bathroom and then back to bed she goes. No need to guess on this. You are better off getting an official diagnosis and potential treatment started. All the best.

The Medicaid qualification process in NJ is BRUTAL!!! My mom passed away in Feb 2008 and even before then, my grandfather’s Alzheimer’s had advanced to the point where he really needed to be in a nur ...Read More

The Medicaid qualification process in NJ is BRUTAL!!! My mom passed away in Feb 2008 and even before then, my grandfather’s Alzheimer’s had advanced to the point where he really needed to be in a nursing home. My boyfriend and I started the process of getting him qualified for Medicaid in July 2008 and it wasn’t until December 2008 that he was finally and officially qualified and subsequently passed away Feb 2009. The amount of financial information and the level of details required for every financial transaction on my grandparent’s bank statements (6 months worth) was simply beyond overwhelming. I know for a fact that had they needed to go through this process on their own, it would have been IMPOSSIBLE for them to collect all the details that we were required to submit. In short, we had to provide detailed financial information dating back a minimum of 6 months prior to submission of the Medicaid forms. Because my grandmother’s name was on the house, the house was immediately removed from the equation but ultimately, we had to remove my grandfather’s name from everything and move things soley into her name. Now my grandmother at age 87, diagnosed with Alzheimer’s in July 2008 is starting to deteriorate in health we are dreading having to go through this entire process again considering because the house is/was in her name (I will loop back on this shortly) we will definitely have to sell the house in order to pay for her care. The deal is this in NJ, when applying for Medicaid there is a 5 year “look back” whereby they can evaluate the asset level, so if she sold her house in 2010 but needed to go on Medicaid in 2012, she will not qualify as they will still see this as an asset and require that she leverage the proceeds from the home sale for her health expenses. At the strong recommendation of my grandmother’s attorney, we have moved all of her assets; home and properties into a Trust. After 5 years, she will be free and clear of any Medicaid related financial scrutiny and/or liquidation requirements in order to qualify. In a nutshell, in NJ, our seniors must be indigent in order to qualify for Medicaid OR get beyond this 5 year mark on having moved and/or sold their assets. The only way around this, for the lack of a better term, is advanced planning to move all major assets out of the senior’s name as well as “spend down” cash levels in order to fall within the maximums allowed by Medicaid. I really wish I knew then what I know now as I along with my mom would have encouraged my grandparents to move their assets into a Trust when they were in their mid to late 70’s. I have advised all of my friends and colleagues who have parents and grandparents who are getting up their in age to start planning for Medicaid “protections” NOW so that when these services are needed the effort to qualify will be minimal. While moving and/or selling assets is one thing, the spend down process is another as Medicaid requires PROOF of how monies are spent; they want to see receipts and/or credit card statements, moving money into another account simply won’t cut it because as long as there is chance for the monies to be reunited with the senior, Medicaid will move to require additional spend down or simply disqualify them for benefits. To anyone who is in the process of getting their loved ones qualified, I wish you only the best of luck. Its not an easy process and the more detail oriented you are, the smoother the process will go; hang onto grocery receipts, bank statements, ATM receipts and anything else that can provide a trail for how your loved one’s monies are spent ‘cause it will be these documents that we take for granted (and crumble up in our purses and wallets) that will prove vital in the qualification process later. Folks who are able to do so, on-line banking will provide for an automatic accounting of transaction. Another thing is using those ATM machines that provide you with a photocopy of checks when you deposit them. Dedicate a box or drawer just for these documents so you’ll have them when you really need them and believe me, you’ll need them when you least expect to need them. All the best.

I wish I had an answer for you and I'm hopeful that someone will answer. I've had a similar situation when my grandmother had to spend a few weeks in a Nursing Home for rehab and antibiotic therapy, ...Read More

I wish I had an answer for you and I'm hopeful that someone will answer. I've had a similar situation when my grandmother had to spend a few weeks in a Nursing Home for rehab and antibiotic therapy, they lost my grand-mother's eyeglasses. She was in the facility for about a week and when I went for a visit I noticed the eyeglasses she had on where not hers. The nurses/aids didn't seem too concerned about finding them even when I pointed out that if she is wearing these glasses then surely there is another patient walking around with her glasses. I gave the glasses she had as they were very strong tri-focal glasses and I preferred to have her go without than to wear glasses that were not prescribed for her. A week of so later when she was released, I went to pick her up and she had those same glasses on again. I reminded them nurses/aids again that these were not her glasses, but I would let her wear them home and I would return them when I got her a new pair. The Nursing Home, never offered to pay a single penny to replace her glasses. $500.00 later, she had a new pair of glasses. Similarly, during a subsequent but brief hospital stay, the nurses in the hospital lost track of her hearing aid! I was furious because they take an inventory of everything a patient has; glasses, dentures, hearing aid, etc, yet could really care less when these inventoried items go missing. Thankfully 2 or 3 days after her release, I got a call informing me that one of the night nurses had found it. But the point is, this is a $2000.00 hearing aid that the hospital just pretty much excused themselves of any responsibility of even though they had inventoried it when she was admitted. Its quite sad and pathetic. My grandmother wears dentures too so this is another item of concern for me when she goes to the hospital. I've told her that if she has to go to the hospital, I'm going to have to take her hearing aid away from her for the duration of her stay, which is sad because her hearing is not good, but that's the only "protection" against nurses and aids that really are not attentive and/or really don't care. I really hope your mom's dentures are found. You may suggest that they pay attention to other patients who may suddenly complain of problems with their teeth as they could potentially have your mom's dentures.