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My Mother-In-Law gets $2,300 a month and the cheapest place I found here in Sacramento, CA is $3,600. How do I offset that? Medicare? Medicaid?

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Your profile says Mom has Dementia. The word "Independent Living" when used here is usually a place that is part of a care community. The Community has different levels of care, Independent living, Assisted Living and Long-term Care. All exactly what they say.

Independent... the person must be able to care for themselves completely. Just like moving into an apartment. But, they are offered 3 meals a day, activities, transportation, socialization and entertainment.

Assisted living...the person needs some kind of assistance. With bathing, medication, they are disabled in some way. They too are offered 3 meals a day, activities, transportation, socialization and entertainment.

Both of the above are private pay. Sometimes States have waivers for AL but your Mom is passed that if she suffers from Dementia. She needs Memory Care and that is the most expensive of the 3.
So your option would be a nice Long-term facility that takes Medicaid. Your Moms SS will be used to offset her care with Medicaid paying their share. A very small % of her SS will go to a Personal Needs Acct for her personal needs. Your Social Service office should be able to give you info on how Medicaid works in ur State.

Medicare is a health insurance, it does not pay for any kind of housing. It pays for Rehab that is usually in a Care facility but thats limited to 100 days if needed. Medicaid is what MIL needs. Medicaid offers health insurance, in home care and long-term care are with different criteria.
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AZDaughterinLaw Feb 2023
Dementia doesn't automatically make a senior ineligible for independent living. They will screen and depending on the policy and level of dementia, she probably could live there. Independent facilities allow family to administer drugs or provide other care for ADL's. Some families chose to come in and take care of their LO needs or hire home care. That normally is o.k. with the facility as long as the resident is not deemed to be a risk to themselves or to others during the times that a family or outside caretaker is not with them. If they are, then the facility will have the right to give notice for them to find another facility that is more appropriate.

My MIL who had memory issues and a lower level of dementia and was living with her husband in independent living did great for 3 1/2 years in independent living. She was functional, able to do her ADL's, find her way around, was not anywhere close to wandering, and participated in the activities. I helped her with medication management and after her husband passed, we had the on site assisted living folks do that for an add on cost without having to move her. About a year after her husband passed, she had more incidents of memory loss and confusion although she never got to the point of wandering. She did pretty good for a year but the facility was giving us hints that they saw the fast decline and if they deemed she would be a danger to herself or others, they would give notice...but she had not gotten to that point. She had progressed to the moderate dementia stage at a fairly fast pace. We didn't want to take the chance we would have a short time frame to move her so we found and moved her to an AL that also had a memory care facility to move to when needed. If there were no memory care apartments when she needed it, they would be equipped in AL to care for her. Her doctor did not recommend Memory Care as long as she was as functional as she is. After visiting memory care, we realized that she wasn't quite there yet. Being locked up would have taken her spirit away.
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Independent living can be expensive. Keep in mind that she is going to have expenses beyond just the fees at the facility. She may need to pay for her cell phone, any activities, meals eaten elsewhere, miscellaneous groceries, etc.

Most facilities won't accept a resident if that resident can't find a way to pay. They don't ever want to admit people that they would need to evict. That would be a nightmare for everyone.

My mother's facility had all of her adult children sign a legal document to pledge a portion of the fees. Then we are all billed separately each month via ACH. I don't know how many children you MIL had, but it might be worth chipping in to keep her happy and occupied. I love my Mom, but I'm glad to pay $400 a month not to have her live in my house.
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CTTN55 Feb 2023
"My mother's facility had all of her adult children sign a legal document to pledge a portion of the fees. Then we are all billed separately each month via ACH. I don't know how many children you MIL had, but it might be worth chipping in to keep her happy and occupied. I love my Mom, but I'm glad to pay $400 a month not to have her live in my house."

That is interesting. How many adult children are there? My MIL has said she will be have to be carried out of her old 2-story house with no full bathroom downstairs, no potable water, steep no-longer-to-code stairs with things on them (she is mobility-impaired). But IF she had to move elsewhere (and couldn't move in with her favorite daughterchild, because she has stairs), I can see that favorite daughterchild expecting all the sibs (5 total) to chip in for Mama to live in a facility.

And I would balk at it, because Mama-in-law spent most of an unexpected inheritance on worldwide travel. I would say she should sell the decrepit farmhouse to fund the facility. But, oh, no...supposedly THAT will be inherited by her one unmarried daughter.
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The independent living facility doesn’t offer any assistance with ADLs or custodial care, right? We were looking at a couple of them in Santa Clara and what they provided was the apartment, on site dining, linen service, utilities, medical alert, and some activities and transportation. Residents could arrange their own caregivers if desired. Some had cars and parking was available.

With family support and some caregivers it can work OK in the early stages of dementia, but Medicaid doesn’t cover it because the person doesn’t need custodial care. In our case, when it stopped working, it was time for memory care. All was self pay from monthly income and the proceeds from the sale of the home.

Have you had your MIL’s needs assessed? Is she safe to live independently and come and go from the facility on her own? If she qualifies for Medicaid (Medi-Cal) medically and financially, then you can see what non-nursing-home options are available.

If she is still competent, make sure she has a good POA, so someone can handle her financial arrangements making only commitments on her behalf (not from their own money). If she has assets, seeking legal assistance with Medicaid would be a good idea.
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Go to your local DSHS / Welfare office and apply for subsidized housing in a building for seniors and disabled. Rent is based upon income. My friend in WA State receives $1019.00 from Soc. Sec. His rent for a studio apartment is $296 a month. The building he lives in has office staff, security, laundry rooms on each floor, a small restaurant, vending machines, and lots of nearby shopping. Good luck to you.
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Contact the local Area Agency on Aging. They steered me to the Medicaid waiver program. This was in Indiana. Each state is a little different.
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Medicare and Medicaid do not pay for Independent or Assisted Living. CA may have a program that assists. Check with social services in your county.
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No help here from medicare and medicaid. Might check into board and care. Some are lovely, family owned, with few residents and a very home like atmosphere. But there really isn't any help for seniors living on social security. Medicaid normally will not cover ALF. I hope others have some other ideas for you.
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AngieGuido74 Feb 2023
i wonder if a person had long term insurance, if that would help
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Please look into In Home care for your mother-in-law instead. There are programs that will help provide funding so she does not have to move into a facility. We have a program here called IRIS which will help pay for care givers (including family). They will also help cover expenses for things they need not covered by insurance. Every state does offer something similar.
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PeggySue2020 Feb 2023
You’re talking about a state other than California, which pays family caregivers about 200 a month provided the recipient is already on Medicaid. We have a program of about 2000 people, all Medicaid qualified and in snf, to move them to lower levels of care.
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guidetolife: State your query to your locality's COA (Council on Aging) who should have on staff a dedicated elder case worker and also a social worker. Start there.
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Medicare doesn't pay for assisted living. Pretty much, all they cover is X number of days for skilled nursing when you need rehab. Nothing long term/ongoing. Medicaid in most states only covers nursing home care (if there is medical necessity for that level of care). Most folks in assisted living facilities have money and are self pay. You can call some of the assisted living centers to ask if Medicaid covers AL in California. Some state counties have waiver programs (usually long wait list) that may assist with certain types of AL. The facilities should know or you could call the Medicaid office in the county where you are trying to locate a facility.

Does MIL have a house she can sell? That money could pay for her care until she runs out of money. Then she could apply for a Medicaid NH bed. If you do sell an asset, make sure you do so at Fair Market Value, keep the sales contract, deposit all of the proceeds into the bank and then keep a good check register to show how all the money was spent. If you give any away or sell house to someone below market value, you could be creating a penalty period where Medicaid will not pay anything. (That is because you can't give away assets to become eligible for state funded assistance)
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