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My mother has some dementia, severe balance problems (she has been using a walker), and now her right knee is so bad that she can barely get to the bathroom. She has asked me repeatedly to take her to a nursing home this past week and my brother and I and my middle sister are in agreement that if she wants to go, then we'll let her go.

The problem is this - I've just read that nursing homes cost on average about $200 a day. My mother has about $60,000 in the bank and that will probably only last for about a year in a nursing home. After that, maybe Medicaid would pay, but I'm not sure how it all works. I feel really lost and helpless because I know she can no longer live alone (she's 90) and I also know that neither myself, nor my 3 siblings are willing, or able, to bring her to live with us or to move in with her. We all have physical and mental problems of our own, plus our own families to deal with and we don't know what to do.

I also believe we need a doctor to fill out paperwork to say that she needs to be in a nursing home and I'm not sure she meets the criteria for that. I know she's not currently well enough to go into assisted living, as she can barely use the bathroom without falling or walk to the kitchen. Also, she can no longer cook because of the dementia, but we provide her dinners and she has cereal for breakfast and a sandwich for lunch usually.

Since her knee has gone out and she only has one "good" leg, she feels she can no longer even fix a bowl of cereal or a sandwich for herself. She also needs helps on the toilet sometimes and wears either a panty liner or a Depends, although she isn't really incontinent - she just can't get to the toilet in time sometimes.

Additionally, she hasn't been in a bathtub or shower for about two years because her balance has been too bad to get herself in and out of the bathtub. She takes a "bath" every morning by bathing herself with soap and a washcloth at the kitchen sink, but since her knee has gone out, she can't do that, either.

She is still able to take her medicines correctly with a pill caddy (she got confused once). She can still write a check, but it takes her a long time to do so.

Her dementia is mostly repeating what she's already said and not being able to retain new information.

I know this has been garbled and probably doesn't make sense, but I need help and I hope someone out there has some suggestions or answers.

Thank you very much.

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neverland, you have me scratching my head. What does a doctor have to do with Power of Attorney? Just curious as it's a legal thing which my parents put in place in another state with their lawyer. When my mom moved to my state, I printed the appropriate form I found on the internet, my mom signed it, I signed it and a woman from our bank notarized the form.

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Ahhh, I just re-read your comment and it is regarding diminished capacity. Now I understand. Tryingtrying, if your mom's mind is sound enough, this can be done very easily. Wishing you the best of luck. My mom is also physically challenged and her AL assists her to the toilet, helps with bathing and wheels her to the dining room for meals. It's around $3,600 a month, not cheap, but it's certainly saved my sanity.
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Regarding the POA: My mother's was the same. Needed two doctors to activate it. If you decide to move your mom into a nursing home, they will have a doctor on staff that can be doctor number #1. Fyi: Assisted living facilities do not keep doctors on staff, but nursing homes do. In my case doctor #2 was Mom's general practitioner.

Basically the NH needed one "outside" doctor and their own doctor to put the POA in effect. Grab a pen and paper because add this to the list of questions when you inquire about places for your mom! Gotta laugh, right? :)
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Thank you so much for all your great answers. My brother is the Financial POA and I am the Health Care POA, but the way it's written is that it is only in effect is my mother is incapacitated in some way. I would say that she has "diminished capacity" due to her dementia, which is progressively worsening. That said, I'm not sure if the doctor has to document that she is incapacitated or if Mother herself can now sign documents to go ahead and put the POA's into effect before she has more cognitive decline. I've heard of people having to go to court to have their parent(s) declared incompetent, but I'm sure Mother would be fine with going ahead and instating the POA's - I just don't know how that's done. She had a Will and POA documents drawn up through the local credit union. They had a special offer where members could go in and meet with a lawyer at the bank and get all these documents done for $250. The lawyer doesn't work there, though. I have no idea who to turn to in order to get the POA's put into effect right away and I don't know who to ask. We don't have a family attorney. I wonder if I should ask the bank? Or Mother's medical doctor? Or maybe the nursing homes? There's so much I don't know. Thanks again so much for all the help - I really appreciate it!
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I recently moved my mother from assisted living to a nursing home. In my state, your NH costs are spot on. My mom also currently has 60k in the bank. Here's how it worked in my case:

The nursing home did NOT require doctor's approval to move her in. I would suggest you start making calls and tours to NH's you are interested in.

The NH has a social worker on staff so when mom's money runs out the SW will assist me with the Medicaid process because like you, I really don't know how all that works either. I would inquire about Medicaid/Social Worker assistance when you research homes.

The place my mother is at now, said her 60k would last approximately 10 months (she's in a private room...more expensive) and for me to contact their social worker when mom can no longer afford the next month's rent. That is cutting it a little too close for me, so I will contact their social worker sooner than that.

Ask the NH if they require up-to-date medical records, flu shots, etc, before admission or if they can do it on site once your mom is admitted. Also ask about you or a family member having medical and durable power of attorney. I had both before my mom was admitted. Unsure how it would have been handled if I didn't.

Best of luck to you. It's a lot of work even under the best of circumstances.

PS: I also checked into live-in care for my mother and like you, it was more expensive than AL or NH.
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Tryingtrying in the place where my mom is (in Independent Living) mom could get help to get to the dining room if she needs it. So even if your mom gets to the place where she can't walk to the dining room, she can probably pay extra to have someone push her in a wheelchair to meals. Good luck with your decision!
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We found "our angel" by word of mouth. We have 2 neighbors who recently hired live ins. Both of their women were found through acquaintances of their church. Both our neighbors and our situation has worked out well. For us, family relieves the live in.
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I did look into live-in care some months ago through the company that my neighbor uses. His is paid for completely because of a policy he and his wife had, but my mother doesn't have a policy like that and the cost of live-in help was much higher than assisted living or nursing home care. I realize that one-on-one care would be ideal if we could find a good person, but I'm not sure anyone who even want to stay with her. She lives in the old farmhouse that my Grandfather built and it only has one bathroom and the toilet is set up for Mother with one of those "built-up" handicapped chairs over it.

May I ask - how did you go about finding good live-in help? Thank you.
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Medicaid can be applied for once the person is getting close to no more than $2,000.00 in assets left, and you do want to start getting POA papers and making sure of any other policies or assets beyond a burial policy, a car and a home. An estate planner or elder law person who knows the state Medicaid rules and regs inside and out can be of help. You are thinking ahead, and that's the first step. There is a lot to learn!
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Is there anyway you would consider getting a live-in for her? It has worked out well for my mother in law. she gets 1:1 care.
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Thank you so much for replying. I didn't think she was well enough for assisted living, but after reading your reply, I called the assisted living facility where my Aunt lives and they said they do help them with bathing and even toileting, if necessary. I suppose as long as she can make it down to the dining hall with her walker, she'd be okay there. And her bathroom would be even closer so she wouldn't have to walk anymore than she is now probably. Also, many thanks for mentioning the benefits for WWII vets. My father was a WWII vet, so maybe my mother could quality for that, as well. Thanks again!
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She might be a candidate for Assisted Living. We were able to get mom on a one month trial at Emeritus Bassett Park Manor. The basic rent was $2195/mo with a $6K downpayment, plus $200/mo for level one care. They took HALF off for the trial month. Mom gets $1600 a month from SS and since her husband was a WWII vet, she can get up to $1113 a month from VA. (we are just hoping they will pick up the $795 difference). That would leave her savings intact for medical co-pays. Look around, a good ALF will evaluate her and connect you to a benefits specialist to help find ways to pay for it.
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