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kara24 Asked October 2010

Is having Dementia enough to qualify for Medicaid/Medicare assistance to pay for nursing home care?

My 89 yr old mother who suffers from mild/moderate Dementia fell and broke hip, was placed in a NH to recover. When she recovers from the injury, shouldn't she be continue to qualify to remain in the NH due to Dementia alone? She was unable to prepare her own food, bathe independently, manage her own meds, stay hydrated at home, and has wandered away from home in confusion, although didn't get far enough to have a catastrophe. Shouldn't Medicaid/Medical Assistance pay so that she remains in the NH? Another issue that has come up is that she may have the foley cath permanently now. She has no savings/assets and lives from Social Security check to SS check. Anyone know about a situation like this?

EXPERT K. Gabriel Heiser Oct 2010
Hi: Yes, your mother definitely sounds like she should qualify for Medicaid. The nursing home should be able to help you get the papers from the state and fill them out, or you can contact the state directly. I have listed all the state contacts for the 50 states here: MedicaidSecrets.com/updates. Good luck!

Smogavero May 2011
You have to take a stand and tell them that you cannot take care of her and that there is no one who can. She has no money or assets. You are not legallly responsible for her, I know that sounds harsh, but it is true. I am dealing with my father who has dementia, so I do know a little about the process.

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joyce6551 Oct 2010
You did not say what state you were in. I am in Tennessee and my Mother lives with us and is on the waiver program. I have someone coming daily to bath and feed her and sit with her if I need to go out. You did say she was still in Rehab. for her broken hip, There is a social worker there that you need to speak with and they can help you with everything.It sounds like she truly needs to be in a nursing home. You need to check out all the nursing homes in your area and see what their ratings are, you can do this on the internet, but the social worker can help you get her in a medicade funded facility. But you will have to check the rating yourself. to make sure it is a fit place for your mother. And a little trick about a loved one being in a nursing home is , if they know that someone comes and visit regularly, they are more apt to be on top of your mothers care

Smogavero May 2011
Once, you apply for Medicaid there will be a pending status and that is all that the NH needs. What ever you do, do not take her out of the nursing home it will be then become your problem to find a place.

kara24 Oct 2010
State: Pennsylvania

kara24 Nov 2010
Follow-up: The Social Worker at the NH told me today that my Mom is ready to be discharged from the facility. She said that there is no need to apply for Medicaid because she is no longer eligible to stay in the facility now that her physical therapy will be ending (she is walking with a walker however balance remains an issue). She has had the foley cath removed this past weekend. The dementia issues are not even part of the picture. I do not understand this at all. So she is not eligible to stay in a nursing home, yet the social worker also told me that she needs to be supervised around the clock. Is there anyone who can shed some light on this? Anyone with a similar situation?

geegee Nov 2010
I hope you get some good advice. My mother is in a similar situation and I'm beginning to look for solutions.

karen111 Nov 2011
I'd like to hear from the previous folks about dementia and medical assistance.

Stressed1947 Oct 2012
My family lives in northern Virginia. My 93-year-old mother has advanced dementia/Alzheimer's and is in a residential facility where because her need for care keeps increasing the costs keep increasing. She has a small social security payment and a small state retirement which together total almost $1600. We have been making up the difference now over $5000/month. I know we can look for a less expensive facility, but do not want to move her more than needed. Is there anyway to see if she would qualify for assistance?

haoleberry Jan 2013
That's true, Medicaid will try to stave you off for as long as possible but if you take your loved one to the nearest emergency room and leave her there, which sounds awful I know, they will HAVE to place her. Sometimes homeless people get better care than middle class because there is no family to fall back on. If you take her to the ER and leave (you must leave or they will try to talk you into taking her home with you) the medical facility will not discharge her because they can't safely do that, so they will get their social worker to place her. Sometimes they have to go to a mental facility first if there are no nursing home beds but that is just temporary. Good luck. Going through the same thing with my mom and already been through it with my father-in-law.

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