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?
Enroll her in Medicaid or Medi-cal. Do the application for eligibility. Call the assistance center for resources and options. If you run out of money for Board and care and can't afford it (private pay) Then you need to consider "shared cost". My mom has dementia and will be moving from a Board and care memory care to a Skilled Nursing facility. They will claim her Social Security monthly payment as her "shared cost". You need to moved quickly, do the work, and contact the Medi-cal or Medicaid call center. You will have to do all the research and enrollment in moving her to a Medicaid shared cost facility. Then make the transaction on shared cost. Medicaid does not case manage this. They just process your claims and change of information. I have been through the house sale, power of attorney, finance control, and private pay facilities. Money is winding down. Need to take this step. Very sad. All these wavier programs have a waiting list of 6 to 9 months or more. Good luck. If you can afford to wait. At $5000.00 a month, this is costly with no guarantee. So sad, I wish I could provide a better situation. I am just like you.
Hi, you can work on getting an HCBS Waiver. It's a combo of state and Medicaid help and covers assisted living and memory care. Get on a waiting list asap, as it can be months, sometimes longer to get in a place that has some Medicaid beds. Here is info: Go in to your local Agency On Aging if you need help with any of the following or for anything. First ask for an Options counselor.Often they even have volunteers who can help with legal questions or who help you at home. Ask about Certified Medicaid planners. Also you can check with the Alzheimer's Assoc.
https://www.dementiacarecentral.com/medicaid/assisted-living-waivers An HCBS Waiver is a way to get an LO into assisted living or memory care at no cost if the LO's money can be spent down or put into a Qualified Income Trust or similar Medicaid-approved trust. It's paid by the state and Medicaid both.
https://www.dementiacarecentral.com/medicaid/assisted-living-waivers These are for a.l. or memory care.
be sure to check into Miller Trusts (also called Qualified Income Trusts) if your loved one is spent down (no assets left besides a couple of thousand dollars)…But still has too much income per month. I believe many states will allow you to set aside up to 4K or so of extra income, in order to get into Medicaid. For example, a person makes 5k per month but needs to make $2,800 or so per month to qualify for Medicaid. Thus, you set aside $2,200 per month into the Miller trust (see an attorney to set it up) and then all of the trust will one day go to the center, I believe upon death. In the meantime, the center receives their remaining monthly income of $2,800 because they are now utilizing Medicaid.
We unfortunately are in the same place. Mom makes too much because of a survivor annuity, social security and mineral rights royalties. We have had to take a loan from her life insurance leaving only a small amount under 2k. Opened a funeral trust that is the only thing protected from medicaid. Every dime of the loan has to be accounted for with receipts. She previously took out Home equity loan of 75% of her home value. Overdraft line of credit is nearly maxed at 3k. She cannot give away assets. She cannot refuse royalties. Medicaid will not cover her per every test the aging office. At 7k to 12k a month before medication how the heck is anyone supposed to afford care. Are you supposed to spend yourself into poverty before you retire in order to have old age covered? Find the loophole and scam it or be honest and get screwed.
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.
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,
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!
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.
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.
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.
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.
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
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.
Go in to your local Agency On Aging if you need help with any of the following or for anything. First ask for an Options counselor.Often they even have volunteers who can help with legal questions or who help you at home. Ask about Certified Medicaid planners. Also you can check with the Alzheimer's Assoc.
https://www.dementiacarecentral.com/medicaid/assisted-living-waivers
An HCBS Waiver is a way to get an LO into assisted living or memory care at no cost if the LO's money can be spent down or put into a Qualified Income Trust or similar Medicaid-approved trust. It's paid by the state and Medicaid both.
https://www.dementiacarecentral.com/medicaid/assisted-living-waivers
These are for a.l. or memory care.
https://www.eldercareresourceplanning.org/medicaid-benefits/hcbs-waivers/
https://www.nolo.com/legal-encyclopedia/safe-ways-spend-down-your-assets-qualify-medicaid.html
https://www.medicaidplanningassistance.org/getting-paid-as-caregiver/
be sure to check into Miller Trusts (also called Qualified Income Trusts) if your loved one is spent down (no assets left besides a couple of thousand dollars)…But still has too much income per month. I believe many states will allow you to set aside up to 4K or so of extra income, in order to get into Medicaid. For example, a person makes 5k per month but needs to make $2,800 or so per month to qualify for Medicaid. Thus, you set aside $2,200 per month into the Miller trust (see an attorney to set it up) and then all of the trust will one day go to the center, I believe upon death. In the meantime, the center receives their remaining monthly income of $2,800 because they are now utilizing Medicaid.
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.
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!
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.
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.