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It's complicated, but she's been living with me for 2 years. She was under hospice home care until a couple of months ago due to chronic pneumonia (hospitalized 5 times in as many months last year), but she's had no recurrence since then. She just got over a MRSA/cellulitis infection from stastis dermatitis in her legs, and I'm having a hard time keeping the house disinfected because of the constant messes in the bathrooms and her leaving her used tissues EVERYWHERE. It's a job keeping her hands washed, and she won't sit still for very long before she's wandering the house touching everything. And I'm following behind her disinfecting. I caught the infection from her already, I'm going nuts trying to keep the 3 other adults and my grandson who live here from getting it. The kicker is, I doubt she'll even qualify for Medicaid after her money runs out, which at this point would be in about 4 months. She owns a home in another state, but I don't know if that's enough to qualify her for that state's Medicaid since she doesn't actually live there now. And I don't know how to get there to meet with an attorney in that state to find out what needs to be done since I'm taking care of my grandson while he's in school during the week and my son and husband are at work. Anyway, I've been told that in order to be accepted into a SNF, a doctor will have to verify that it's medically necessary. For the record, neither she nor my dad were in the military. Honestly, I'm at a loss as to what to do other than drive her back home and leave her on one of my two siblings' doorstep. They're willing to help, but there isn't much they can do 200 miles away, especially when they both work. Sorry, but it's been a particularly tiring day and I'm taking this opportunity to vent.

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Vstefans, thank you for that bit of hope. I'll definitely find a way to consult with a Medicaid attorney about our options. As much as I love Mom, she's a lot of work, and the stress is getting to not only me, but everyone else in the house as well. I hate feeling like I have to choose between them, and they certainly don't make me feel that way, but I feel so guilty for putting them through all this. I have to admit I bit off more than I could chew. And I know Mom would never have expected any of her children to carry the burden of caring for her under the circumstances, as my grandmother also had dementia and Mom had to help my granddad place her in a home. Actually, after that she made it clear many times that she would rather not live at all like this, but that's God's decision to make. We have a DNR order for her, but I practice due diligence in the meantime. Anyway, thank you all so much for the responses.
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CallMe, you might want to go with an eldercare attorney and find out just what the penalty period - if any - might be. And yes, the home may still be exempt even if return does not seem a reasonable possibility, they don't presume to judge that, they just need the statement from the person; in my mom's case they took my word for it, even after 2+ years in assisted living. We did end up selling and using funds for care, but that's another story. You might need that option too, especially if there is a penalty period and/or spend-down. It's far from hopeless, though wildly complicated....
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Thank you, Pam. I figured as much. So now I figure out how to live without hope while trying to formulate a Plan B. Yeah, I can do that. It isn't like I have anything else to occupy my time...
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Callmecat, You may have trouble with Medicaid, because it looks like she was paying for a lot of stuff for other people. That will make the application bounce.
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Thanks, vstefans. My mom was on penicillin, cephalexin, clindamycin, then bactrim, none of which helped, even though the sensitivity test they said they did on the culture said the bactrim should work. She was halfway through the round of bactrim and her infection was getting progressively worse, so I started treating her with alternative methods. I've heard that being on antibiotics can affect the results of a culture, so maybe that was the case for her. I'm allergic to sulfa drugs myself, and I think bactrim falls into that category.

My mom hasn't lived in her house in the past 2 years, so I doubt that Medicaid would buy that she intends to return to it.

I've considered seeing a Medicaid attorney here who might at least consult with one in Mom's home state to familiarize him/herself with all the applicable Medicaid laws. Thanks so much for your input and encouragement.
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If it help any at all, "community" MRSA is most always susceptible to Bactrim (trimethoprim-sulfamethoxizole) so you would not end up needing Clinda again if it does not agree with you. Medicaid normally lets one home be exempt if there is an "intention" of returning to it. The eldercare attorney who is well versed in Medicaid for both states would seem like a great idea. You are obviously giving Mom great care, BTW, though it is sounding like a bit too much to manage!
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Thank you, all. Pam, I did find out that it's best to get her in a Medicaid NH through private pay first. The one I actually called said it costs $7800ish. Mom's income is about $1950 (after Medicare deduction), minus her medical and prescription insurance. I'm just really scared that she won't qualify for Medicaid after her money is spent because there are living expenses that I don't think are allowable. She hasn't lived in her house for 2 years, but she's still paying the utilities while my nephew lives there. My husband and I are both on her cell phone plan, even though she hasn't used hers in about a year. (The plan with the 3 of us was cheaper than the one she had by herself, and I was living with her at her home during that time, seeing my husband on weekends.) When she moved in she insisted on paying for groceries and gas for my car so she would feel "useful." As for her house, my brother-in-law & sister want to buy it, but I have no idea how Medicaid determines fair market value. Their realtor friend values it at $70k, but there weren't any comparable sales, so I don't know how he came up with that number, except that's what my sister said they thought it was worth. The appraiser said $135k, but that doesn't take into account the work they put into it, starting back when Mom still lived there by herself, and they gutted and remodeled her kitchen and the main bathroom at their expense. They've also paid for her sump pump and water heater without accepting payment from her, and my nephew has done some cosmetic work on his own (paint, carpet), with plans to do the needed repairs.

Anyway, I sure appreciate the advice. At least I know she can get accepted into a NH medically, so consulting with an attorney in her state will be worth the effort at least. We also have to figure out how to get her to a dr there as well. I'll count on the sis and bro for that part.
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Nothing to add about placement to Pam S's practical, step by step advice: hope it will see you clear to getting your mother comfortably and happily rehomed. Do you have POA? - it would help; if not, maybe look into guardianship?

But meanwhile just wanted to congratulate you on pulling her back from a nasty state of affairs - you've done a great job. Draw breath and pat yourself on the back before you re-enter the fray. Hope it all gets sorted.

Oh, and to answer the question, yes dementia should be enough on its own. It is medically a big deal, after all.
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You are always better off to get them in under private pay to start. So sell the house, and put the money in her bank account. Her MD will certify the need. The Nursing Home will also evaluate her and want to see her bank statements. They will figure out how long her assets will last.
Medicaid will want five years of financial records to be sure nothing has been gifted or hidden from use for her care. Let's say she gets$1600 a month from SS, but your state limits Medicaid to $ 1100 a month. You would think she would not qualify. BUT they look at the cost of care, so if the NH is $4000 a month, they will make up the $2400 difference, so long as her financial records are correct. If she sells the house and clears $60,000, she can self pay for two years before she will need Medicaid. There are facilities that will take her in as private pay and convert to Medicaid later. These are usually nicer places, and this is the route we took with my MIL.
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I would consult with an Elder Care /Medicaid attorney especially in your Mom's case due to home show she owns in other state. Many will do a phone consultation.
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She hasn't been hospitalized in a year, since last Mother's Day weekend. They set us up with the hospice agency, and the nurses visited every week, and the CNA came to help with baths because Mom can't shower herself anymore and just stands there and shivers. She loves her baths, but we have a deep claw foot tub, so it's hard getting her in and out by myself. Actually, I'm pretty sure it was the hospice nurses who passed the MRSA infection to her. She had a bad case of cellulitis that started Thanksgiving weekend, and before they took the culture, they didn't always wear gloves when examining her, although they did wash their hands and use hand sanitizer. Even I always wore gloves when I put dressings on her legs, and I was clueless about MRSA at the time. I thought you just got it in hospitals and nursing homes. The first swab in December came back as regular staph, and it wasn't until 3 antibiotics later that they cultured again and she tested positive for MRSA in late January. I got my first outbreak in early February, which I'm treating myself because it's such a pain in the arse to get to the dr, and I won't take antibiotics anyway because of I'm allergic to some, and others have side effects that I'm not willing to live with. I was on Clindamycin years ago for a tooth infection, and my stomach was messed up for over a year. As for day care, the one within a reasonable driving distance costs $88 a day for less than 8 hours, and they didn't seem too keen on dealing with her occasional bowel incontinence. She was sick a couple of weeks ago with some vomiting and a LOT of diarrhea that was pure liquid and which her disposable underwear would NOT absorb. I had it myself, but had to be up at 5:30 every morning to get the bathroom cleaned up and mopped (along with the hallway and her bedroom) before my son had to get in the shower by 6. My sainted husband helped out, bless his big ol' heart. He won't say it, but I know he's getting fed up, especially after incidents like that. I'm thinking of calling a Medicaid attorney in our home state to see if they'll do a phone consultation. I could send my sis and bro, but they don't know everything about her finances and spending, etc., and I don't want to get her in a nursing home only to find out we've drained her bank accounts and she won't qualify for aid and will end up back here with me anyway. My sister and bro-in-law just moved his dad in with them. My brother and sis-in-law have 3 huge great danes who LOVE grandma, but in their affection they can easily knock her off her feet (they've done it before). You know, there are some days when I'm fine with it all, but then I have other days when I just can't take it anymore. It's only the Grace of God that's gotten us this far.
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I'm really not expecting a lot of answers because, believe me, I've exhausted myself mentally thinking about it for such a long time. The empathy is VERY MUCH appreciated. My first thought reading your response was, "OMG! You GET it." Mom is into everything, and she goes to the bathroom every 5-10 minutes just out of boredom I think, because sometimes she doesn't actually DO anything. But she'll still sit down, use one or two squares to wipe, then drop it wherever. If it hits the toilet, fine. If not, she doesn't notice. Sometimes she aims for the wastebasket instead, and usually misses. If I follow her into the bathroom too much, she gets indignant. So I just have to clean up after her. I'm thinking of gates for the kitchen doors to keep her out of there. As it is I've had to throw out all kinds of packaged food that she'd stuck her hands in, so now I have to hide it all and spray down the cabinet handles she touches. Even helping her wash her hands is hard because she just doesn't understand what I'm telling her to do most of the time. If I actually physically help her, then I have to put on the disposable gloves first, then wash my hands after, which irritates my psoriasis, so I have to keep moisturizing with coconut and essential oils. I'm just tired today. I can't sleep more than 5 hours or so before I just can't lie down anymore, so then I'm tired by afternoon. Anyway, I'm so sorry about your situation, especially not having insurance. Natural remedies are effective, but many of them aren't cheap.
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Cat, you have a full plate. How long ago was she discharged from her last hospitalization? And how did the discharge planners not get that this was someone beyond home care? (JUST VENTING) Call the hospital sw department and pose the question to them, call her doctor too. I'm told that in situations like this you can drop parent at er and have them declared a ward of the state. I'm worried about your grandson...if he's being exposed to dangerous germs. Actuslly, in fact, he probably poses a greater danger to her in terms of germs. Can she go to adult day care?
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