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My mom has early stage dementia and mobility issues. I am her only living child and I have no other family nearby. I have been off work about six months now and desperately need to return to work for financial reasons. Has anyone been through this? What did you do to get through it? Any suggestions?

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Frantic - If you need to continue working, that needs to be your priority. Don't feel guilty. If mom had planned better, she'd had 7 kids so each covered a day in the week …..LOL.
I'm assuming that you & mom are in TX. As one who was only child & living in another state & has dealt with trying to find programs in TX for both my mom & MIL and hearing care (or as one of my HS friends calls them "could care less") stories from others with aging parents in TX, my take is that unless your mom is in one of bigger TX cities and ambulatory, your choices are stark. If she cannot get up, go and do somewhat on her own, I'd start looking to get her qualified for a NH. If you cannot be there for some type of 24/7 oversight, then you need to find a situation that is 24/7. Unless mom has oodles of $, that means NH as she can apply for medicaid to pay.

Not IL or AL or in-home care but a NH in a Medicaid bed.

For TX, AL are on a "waiver" program which means funding can change at legislative whim and run on a 2 -3 contract. Then add into this is that for TX, AL have 2 types of beds: CCF which means continuing care facility bed, which is custodial 24/7 BUT not covered by Medicaid; AND CBA which means community based alternative beds which ARE covered by Medicaid.
Problem is less than 20% of all AL beds are CBA. Enrollment small and the list of participating vendors smaller. Forgetabouit. Plus really do you want to have to move her into AL and then move her again for NH if you can help it?

I'd start looking at NH that take Medicaid. Cast a wide net and get her names on a waiting lists. Maybe 6. Try to go around 10/11 AM and ask to stay for lunch. 10 - 11 usually is some sort of activity, go and observe. Is the rhythmn of the NH something that would work for your mom? Some have busy activities programs and residents enjoying doing them. Others are more only in their room waiting for the next meal. Some have lots of community outreach so volunteers from everything like daily mass/worship to weekly movie nite. Are the rooms personalized or more sterile? You know your mom best, what environment will she mesh better in. Forget "happy" but go for safe, secure and cared for. Happy usually means turning back time.
See if there is milling of residents around the central nurses station - this really tends to happen. How staff deal with this to me is an indication of the contentment of staff working at a place. My mom's first NH shoo'ed them from milling; her second and much better NH had chairs and loveseats within sight distance of nurses station. It's like live theatre for the residents….. they love As the Nurses Station Turns.

Now Medicaid will mean mom needs to both financially and medically qualify to show to be "at need". This site has articles on Medicaid & Medicare and you kinda need to clearly understand what each pay for or do NOT ever pay for. For Medicaid medical eligibility, that means needing skilled nursing care with MD orders for this. Could she be at this point?
For Medicaid financial, basically impoverished with her monthly income under roughly $2,200 a mo and assets under 2K. If not, she will have to spend down paying for her care or her needs or her home. Could she be at this point already financially?

If she still has her home, that's to me kinda a separate issue to deal with that gets intertwined with Medicaid. Does she have a home? & if so are you living there or paying any of the costs on the property.
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Being a caregiver can drain checking and savings accounts.   It can be difficult even if the parent(s) have money they can use to hire caregivers or move to a very nice independent living complex.   But said parents refuse to have caregivers or to move.

I was away from my career for over a year because headquarters decided to cut my job... with me taking too much time off to drive my parents to appointments, shopping, groceries, yada, yada, yada.

There went not only my salary.... but also my health insurance [thank goodness for COBRA but it was costly].... gone was my matching 401(k).... gone was profit share... gone was tuition refunds... gone was life insurance.... vacation pay.... sick pay.... workman's comp insurance.... money placed into Social Security and into Medicare.   People don't realize the net worth each of those items cost.

If I had a crystal ball to see what would be my future finance wise, I would have made some serious changes.   Mom and Dad would need to open up those checkbooks and start paying people to help.

Thank goodness I had saved for that "rainy day", and eventually I found re-employment which was part-time.   Salary was ok, but no benefits at all.   Then I clamped down on driving my parents.   I learned to make back-to-back doctor appointments with the same doctor, and when a doctor would say come back in 2 months, I stretched it out to 4 months.   I also found a grocery store that had on-line grocery ordering and home delivery.

Usually we need to wait for a medical crises to happen to our parent(s) before we can get them into a safer environment then living on there own... [sigh].
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Are you concerned with her being left alone in the home while you work? I might check out Adult Day centers where she might stay during the day. Some are free or reduced rates. Is she able to walk with walker or in a wheelchair?

You might also see what services she might be entitled to from the state/county, that might come into your home a few days a week. I'd check with social services, Counsel on Aging, etc.

I'd also apply her for Medicaid Medical. Even is she has Medicare, Medicaid Medical can pick up the slack on co-pays and reduce monthly medical bills. Also, ask about Extra Help from Medicaid for Medication Supplemental policy. If you're disabled and living in your home, you may qualify.


If you think she needs placement in a AL or Memory Care, I'd explore her income eligibility for those things as well. It doesn't sound like she is in need of a nursing home yet. I suppose it depends on the severity of her dementia and mobility issues.

If her income and assets qualify, she may get LTC paid for, if she needs the assistance.

If she's considered disabled, I'd ask about reduced rates on your energy bill. Also, if she has county taxes, some states allow a discount or waiver on them for the disabled.

You might also qualify for food stamps.  And check out Meals on Wheels.

I'd go online and see if your state or county has one place where you can apply for all assistance.

It's a lot of work, but, hopefully, it can result in some savings.
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