I need to make a decision fast

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A couple of days ago mom was diagnosed with dementia and while at the Drs office she fell and broke her femur/hip bone. She had emergency surgery and is still in the hospital. SHocking to us all she is now having sundown syndrom. She must have been hiding most of this very well. She will be going to rehab. Her insurance will stop in 20 days.........she falls between a gap. She is still in the process of a divorce and so there for her assets are tied up, because of that she will not qualify for medicaid. Thats problem #1. Problem #2 is that in the mornings she is kind of like herself and pleads not to go to a nursing home but by afternoon she is WOW a different person. I dont know what to do, I dont know if I should hire a stranger to come into our home to care for her and hope that they take care of her or let her live iwth strangers and plead and cry all day. UGH this is so hard, we have limited resources here and when I ask other family members for their opinion everyone says "I dont know". I am an only child I have POA. Any insight?

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Hello,
I know the sundown syndrome is devastating but you said it came as a surprise to you after the fall. Here are some questions for the hospital, the social workers and the nursing staff.....
1. What medications does your mother take?
2. What was her baseline before the fall?
3. How long has you mom been in the hospital? Is she isolated?
4. Did your mom have any kind of anesthesia? I know from seeing my father in law experience significant sun-downing and memory impairment. The first time he had surgery it took several months for him to gain back most of his origional congitive functions. This past time he was under anesthesia for a broken hip and he's slowly gaining back what he did have. Unfortunately, we have no way of telling how much he will remember, since his dementia had progressed significantly.

Finally, music, and fidget toys help a lot. They seem to calm and stimulate thought and memories.

Good luck, keep us posted.
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There are never any guarantees, as everyone truly is different. But one thing about hospitalization and elders is that delerium can factor in and make the dementia worse. The hospital atmosphere is so bad for them. Some recover totally and some don't.

As for elder attorneys and estate attorneys, again a lot depends on assets. Medicare covers 20 days (the last I checked) of nursing home care if they come out of a hospital, but not if they go to the facility from home.

Not every move needs an attorney's advice, but if there are a lot of assets, it's advisable.

You all have such great advice to offer because each of you has had a different, but related, experience. You're all the best!
Carol
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Dear crislynp, my own Dad was hospitalized, and very ill. He could barely walk, couldn't talk, couldn't feed himself, and I never saw him look so bad. I spent many hours and days at his bedside. He did get better, but didn't regain everything. In fact, after he went back to the Nursing Home he had come from, he had truly lost ground from his previous state. It was sad to see him spend so much time in bed, and all the other losses. He wasn't thriving. I decided to move him to another facility. They told me moving him was the best thing I could have done, because if I hadn't, it would have killed him, because he just wasn't getting the care he needed.

For the longest time after his move to the new facility, he didn't do well. I had expected so much more, because it was a much nicer place, and his care so much better. But Dad struggled...for months. I was so disappointed, because I had such high hopes. And then I watched him suffer some seizures. That was so scary! I thought more than once we would lose him. But one day, a few months later, he did get better. And he surprised everyone, including the Nursing Staff, and has exceeded their expectations. He became ambulatory again, and more active; even social. We marveled. That was a while back. He is still doing better than during his bouts with illness, though he'll never be 100% due to his Alzheimer's Disease.

Medications can help, and other factors, as well. I've heard they lose ground with each relocation. That may be true in some respects, but it isn't necessarily always that way. My Dad is adjusting, finally, and does fairly well.

On the flip side, we have spent a lot of time in Nursing Homes over the past several years, with loved ones there, and it can be very sad to watch the other residents you come to know decline. Some decline rapidly; some slowly. Some rehabilitate, and some do not. There's no guarantees. I think it's an individual issue. We have learned to value each moment as precious.

I also understand feeling overwhelmed. We rarely anticipate illness and its effects, and are often unprepared for it. That is a helpless feeling watching a loved one suffer. It causes us heartaches. And the decisions that need to be made quickly are often beyond our understanding. I made tons of mistakes. But things smooth out eventually. Ask lots of questions, and try not to be bullied by the pressure others are applying. Tell them you'll do the best you can when you have enough information to make the right decisions.

An Elder Law Attorney will usually give you the first 45-60 minutes free. If not, go to one who will. And definitely get a second opinion. I mean, make that second opinion with another Elder Law Specialist, not just a "regular" attorney. It has to be someone well acquainted with Medicare/Medicaid, etc. I actually did everything without one, and haven't had to pay the $2,000.00 to $4,000.00 to someone else to do exactly what I did myself for $40.00, so be cautious who you trust. Some give real poor and costly advice, but there's also good ones.

Most of all, remember to also take care of you!:) SS
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I don't know if they ever get it completely back, but if you are able to create a stable predictable environment that is stimulating, without being overwhelming it may help.

I did notice that music helped as well when I brought my mom home from the hospital after a lengthy stay. I feel for what you are going through.
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Do they ever come back out of it? The Drs cant answer that I was just wondering if they ever go back to the way they were pre fall, hospitalization, confusion etc?
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Great ideas from everyone. When an elder's body is shocked by such a fall, then the added trauma of the hospitalization, that often brings out the dementia full blast. The confusion of the hospital is hard on them.

She'll have 20 days on Medicare in the nursing home, then it will go to private pay until she spends down to Medicaid. The divorce definitely complicates this. An estate attorney or elder attorney is definitely recommended.
Carol
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No wonder you feel overwhelmed, crislynp. You have had a lot to deal with, especially during this last week by the sounds of it. I am sorry everyone is asking for everything and I can understand your need for time to learn about it all first. I hope you can withstand the pressure of people asking you to make decisions on the spot. I think you have the right to say that you need a bit of time to think before you make each decision. Surely all these people that are hounding you can grant you a day or two to think. At least I hope so!! You need time too to catch your breath. May you have a restful Sunday.
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Thanks to everyone who responded. Let me clarify- I spoke with two social workers which prompted me to post here because both lead me to believe that I couldnt do things like pre arrange her funeral, and to use money for her. For example they told me she could keep 50.00 a month. To me that isnt right. She doesnt have much but her seperated husband has a lot and because of that they count his assests because there is no divorce. So when I said the state would take everything I was referring to everything that she has, owns etc leaving me with enough to pay for her hair cuts, and some snacks and maybe an outfit now and again. Her pension is only 1100.00 a month. I get "why" they do it just that it isnt enough left over. What if she wants to go do something? And on top of that I did call the funeral home and she told me that I could sign over the insurance policy to them before medcaid stepped in so I guess I feel like everyone is telling me what to do and not why. Which is why I made the appointment with the attorney. Its a very tough situation- and also we built an apartment onto our house, if we sell our house she would go with us. Do I feel guilt? yes. And every other emotion all at the same time. Do I want her here with us? yes but the question is am I willing to do it at the expense of my entire family, no which leaves guilt because we are supposed to care for our elderly parents. Another question is can I afford it? no I cant and I have had to deal with the guilt of that too. I spent the majority of today at the nursing home, its a sad place. I personally dont think that they are going to be able to deal with my mother. She is a tough one, but at the same time even though she is hateful, onry and yells at people I dont want to see her cry. And lastly the reason why I said that I was going to put everything in my kids names is because I dont want them to have to go through this. I also am going to check my insurance policies because if they dont cover long term care then I need one that does. It would be different if I could sell my moms house and use that money to pay for someone to help me with her, I cant because its tied up in divorce court so I guess its that lack of control that I am feeling too like everyone, drs, nurses, social workers , her lawyer his lawyer all just swooped in on me all at one time. Everyone is asking for everything and I just want time to learn about it all first, even the nursing home admissions lady is pushing me into all sorts of directions. I told her mom is just there for rehab I need time to think. Last week she was living with me with mild demensia and a lot of grumpyness. This week she has severe demensia, sundowning and is broken. Its like someone flipped a switch and turned out world upside down. I am just overwhelmed.
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Good point, Cat. Healthcare finance is an interesting puzzle. I understand your U.S. president is trying to bring into existence some kind of healthcare system - somewhat like we have in Canada. I believe I heard that Obama is thinking of upping the taxes on the rich to help cover some of the cost of this new health system he has in mind. That idea will probably go over like a lead balloon even though America claims to be a Christian country and thus it would only be right for the rich to be their brothers' keepers.

But back to you, crislynp. I previously made the suggestion that if you have time, you might google "guilt". It is a very hot afternoon here where I live so, instead of being outside attacking weeds, I took a few minutes to google "guilt" myself in order to save you some time. I came across an article that led me to the website livestrong.com . If you go to that website, when it comes up click on mental health. When the mental health page opens you will find a place in the upper righthand corner where you can enter a search term. Enter the word "guilt" and click on search. Two articles will come up on the first page, both titled "Handling Guilt". You might look into these and find them helpful. I hope so.
But going back to the articles that came up when I googled "guilt", the fourth article deals with the topic of guilt from a Buddhist perspective. The author is of the opinion that guilt has such a prominent place in Western culture "because of the Judeo/Christian background of our culture." The author goes on to state that "the concept of being born onto the earth with an 'original sin' easily puts a feeling of guilt in our minds."
I hope you can have some time this weekend, while your mom is in the hospital, to take a break with your husband and do something that you both enjoy. Best wishes.
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The state "takes everything" because it is looking to recoup what it spends on the elder for their care when they are signed up for a state Medicaid plan - and usually are placed in a nursing home where the expenses are high. As long as the care is paid for privately without getting state fund, then the state isn't involved.
Although it can seem draconian, the system is fair to the state taxpayers as a group. Its an interesting puzzle - healthcare finance.
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