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Butterflies Asked March 2021

How easy is it to put a parent in a memory care facility?

My husband and I have been married 32 years and out of that has been 30 years taking care of one mother, then two mothers and back to one mother. Before the virus mom was going to a adult day care which worked but took an hour and half of my day driving back and for over 3 miles for free pick up. She is now starting to talk to herself because she has no one to talk to. For 15 of those years I took care of the 2 of the in the same household and they did not get along. And my mom never contributed money for bills. When WIL passed, they told mom she needed to pay something. Now it's getting to the point all mom wants to do is spend her money on figureines and not help pay bills, and put up temper tantrums. My mom lost her house because she was to busy going to fast food restaurants and buying food for her and her dog and was not buying her medicines and paying rent so we took her in. 12+ years ago I was laid off and now 24/7 caregiver. So we lost my income and can't get a job because all of mom's dr.s appointments (she can't drive anymore). So now with this virus all she does is cry 75% of the day crying woe is her. We are getting tired of it. The other day I was in a very dark place and cops came to the door to see if I was ok. Because I emailed my doctor on how bad it was. Since then she gave another medication that is helping. But we decided that mom needs to go somewhere where there are more people to talk to. Because she has used up all her money and we are struggling ourselves, we probably need someplace that will accept Medicaid. How do I break the news to mom and is it hard to get someone into a memory care facility? Early signs of dementia.

disgustedtoo Apr 2021
How does she "spend her money on figureines"? If she can't drive, who is facilitating the purchases? If she has dementia, does anyone have POA? If someone does, take away her access to her finances. If her only income is SS, sign up to be Rep Payee. There is no charge to do this, call a local office for appointment (most likely appt will be done by phone or video.) If they approve it, you set up a special account that only YOU can access. The first payment will come as a check, but once the account is set up, you can call the local office again and set up electronic payments. Yearly reporting has to be done, but can be done by mail or through your own SS account. Her funds should be used only for her needs - food, clothing, medication. Keep good records. Housing would qualify as an expense, but if she's living with you, there would need to be some kind of legal agreement about payment for "rent."

As others noted, typically Medicaid doesn't cover AL and MC, usually only NHs. That becomes an issue because NHs, especially with Medicaid involved, requires the patient to qualify for skilled nursing care. Too often just dementia alone isn't enough. You could start by calling a Medicaid office and asking. Online searches for care facilities will often list what payments are accepted.

Frances73 Apr 2021
You will need to do some research on senior facilities. In Ohio Assisted Living are not required to accept Medicaid waivers although most will after you have been a resident for 2 years. And then only if they have room.

I found out that most nursing homes don’t have Memory Care units while most Assisted Livings do. It's a cruel fact that people who have dementia but are somewhat physically capable are seen as too healthy to require skilled nursing care.
disgustedtoo Apr 2021
Qualifying "resident" to mean self-paying for 2 years, if they accept waivers.

The sad part is many with dementia don't qualify for NHs and also can't afford private pay. I am hopeful that if this new bill can get passed, it might help change that situation! There is an allocation in it to make changes to Medicaid and address the elder care situation. It will take time and effort to get it passed and then it will take some time to implement. Meanwhile, those who can't afford to pay are up the creek.

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Worrydaughter4 Mar 2021
It’s never easy! We did a lot of research on different places. We didn’t let him pick cuz nothing would be good enough for him.

mstrbill Mar 2021
Unfortunately it is not easy to get placement in a memory care facility without money. You are going to need her Dr. and a social worker to help get her placed in a facility that takes Medicaid, which means having the Dr. certify that she is medically in need on 24 hr skilled nursing care and having the social worker help get her approved for long term care Medicaid. There may be a MC facility that accepts Medicaid in your area but if not, you'll have to try to place her in a SNF. If mom is not quite ready for a nursing home because she doesn't qualify as medically in need and you can't get placement in a MC covered by Medicaid, seek out the state social worker and whatever help she can provide or if there are any other community services that may be helpful to you.

gladimhere Mar 2021
You cannot just decide to put her in a facility. There has to be a doctor's order. Early dementia? She may not qualify. Each facility will do their own assessment of her care needs.
disgustedtoo Apr 2021
We had no doctor's orders. Not even a formal test of any kind. The "hard" part is facilitating the move. POA does NOT give one the "power" to force anything, including a move. Fibs, however, if done right, can be helpful.

Perhaps a NH would require doctor orders. Generally Medicaid pays for NH if it is medically necessary (aka dementia usually isn't enough), but most states do not cover any AL or MC.
Lvnsm1826 Mar 2021
How easy or hard depends on their willingness to go there, and having the legal documents. If they are willing, it makes it easier, because we legally can't force them, unless you have guardianship.
disgustedtoo Apr 2021
Legal documents (POAs) are good.
Willingness is good.
Fibs can be our new best friend, if done right!

I'm glad to read a post that states "...we legally can't force them..." My mother was adamant she was fine and refused to consider moving anywhere, least of all AL. EC atty told me we couldn't force her and suggested guardianship. I honestly don't think she would have qualified for guardianship at that point, but it wasn't safe for her to remain in her own place alone anymore. Even if she did qualify, the place chosen for her would not accept "committals."

So, Fibs-R-Us to the rescue! She was madder than a wet hen, but she bought it and went with my brothers (I had done most everything up till then (and since) and told THEM to make the move happen - figured I would get the blame anyway, but for some reason it seem to have worked! She never accused me and never asked me to take her back, only YB.)
NeedHelpWithMom Mar 2021
I feel your pain. You have been a perpetual caregiver. God bless you!

I am married 43 years next month and I took care of my parents too. I had mom in my home for 15 years.

It’s definitely a struggle to be a caregiver. Please make arrangements for her to be placed. You can visit her. She will settle in.

My mom was recently placed in an ‘end of life’ hospice facility.

She is completely bed bound with advanced Parkinson’s disease.

She is settling in fine. The nurses are angels.

You will be glad that your mom is receiving the care that she needs and you can reconnect as a couple.

You deserve peace in your lives.

Daughterof1930 Mar 2021
Clearly you’ve done way beyond what should be expected of anyone and it’s definitely time for your mother to move to a setting appropriate for her needs. Don’t assume that places that accept Medicaid are all bad. My mother went from private pay to Medicaid and there was zero difference in her care. I hope you won’t “break the news” to her at all. She won’t understand and it’ll only draw you into a looping conversation that has no end

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