My mom just came to live with me. She needs some amount of care. I can foresee that she will likely need more care as the years advance. My plan is to look into some of the home healthcare benefits that she might get from Medicare and from her supplemental insurance. From having my incapacitated grandma living with us when I was young, I know there are things I can't do. My mom was strong and could lift and move grandma. I'm a scrawny weakling and I doubt I could ever be able to lift her, if she needed that.
However, I have to wonder if Mom got incapacitated if she'd get better care in something like assisted living/nursing home than for me to get home healthcare.
On the other hand, my mom doesn't have much money. Despite scrimping and saving, most of her money was eaten-up by "rainy days" (like a leaky roof). I fear that any kind of place that would take someone so broke might not give good care.
Is anyone in this situation? For me, I'm trying to look into all options ahead of time, but want to know what kind of experiences some of you might have had with either decision.
As for the nursing homes, I hear people who have relatives in nursing homes who talk about how they go there to make sure things are done, correctly, and it sounds like they spend as much time on it as they'd spend with the person at home.
On the other hand, there is the strength issue and, seriously, I'm really a scrawny weakling. I've got stamina but no real strength, so I doubt I could manage and kind of lifting.
So, thanks for the advice on this. I'm going to eventually look into the options. I'm not procrastinating as much as I've got so many other things I'm currently trying to get settled for her, right now.
My dad came to live with me. I told him that I would never put him in a nursing home unless he became bed bound but after 5 years I couldn't do it alone anymore. He went into the hospital then was discharged to a 'rehab' (nursing home) and he was unable to come out and he died 6 months later. But my one mistake was promising him that he would never have to go into a nursing home unless he became bed bound.
Medicaid (not to be mistaken with Medicare) is for nursing homes. Here in MO it's called 'vendor Medicaid' but I'm sure it's called something else in other regions. This is how we were able to afford a nursing home for my dad as, like your mom, didn't have much money either.
If your mom were to enter a nursing home (due to a fall or an infection or some other unforeseen health issue) Medicare will cover your mom's stay for X many days (there will be a social worker on site who will walk you through all of this). I don't recall exactly how many days. 90? 100? Whatever, someone will know. Anyway, her own insurance will cover her temporarily. Your job will be to get down to the Medicaid office and apply on behalf of your mom. Now, there are many horror stories about what a hassle it is to go through this Medicaid process. You'll need THIS form or THAT document and on and on and on. But it was my experience that my dad's finances were so simple we didn't have to jump through a thousand hoops to get him approved. Of course, there are different situations depending on your mom's finances. Like, does she own a house? Does she have a life insurance policy? All sorts of little details that will have to be worked out and you'll be assigned a caseworker who will walk you through all of this. We were told that it takes about 3 months to be approved for Medicaid but it took us 6 months and by the time my dad was approved he had died. But as long as you're in the process of getting approved for Medicaid for your mom the nursing home won't boot her out and the Medicaid is retroactive from the day Medicare stops paying for your mom's care. We had to regularly provide the nursing home with documentation showing them where we were in the approval process and as long as we did that my dad was able to continue on in that nursing home.
Now the other part of your question: what to do if your mom becomes incapacitated. The burden of care will be upon you. Her insurance may pay for up to 6 hours of home healthcare but they may not. This is something you might want to find out now. If you decide to keep your mom at home if she becomes incapacitated you will give up your life to care for her and I don't think anyone would argue that point. You will need a hospital bed (and if your mom is on hospice at some point they will provide you with a hospital bed) and unless your mom can afford around the clock care in the home you will be responsible for her. Cleaning her, changing her (if she's incapacitated she won't be able to use the toilet and will need to be in diapers), feeding her, ensuring that she doesn't get bed sores (by keeping her skin clean and dry and protected, mainly on her rear end), keeping her sheets clean and dry, bathing her (usually about 2-3 times a week), changing her and cleaning her when she urinates or defecates in her diaper, and a hundred other little things that we need to do all day and all night to keep our loved ones at home. So you will have to make a decision about whether are you are able to provide this kind of care and if you're not can your mom afford in-home healthcare. If you are unable to provide this kind of care and your mom can't afford in-home healthcare your only other option is a nursing home. A nursing home does not care for our parents the way we do. In a nursing home our parents don't get individualized care (usually). There is maybe 2-3 staff members for every 30 patients. When my dad went into a nursing home I learned that I had to let go of a lot of things. I had to pick my battles and I had to let them care for my dad the way they care for their patients which was usually not the way I would have done it. But that's the way it is.
There is no right choice in these situations. There's what we can live with. There's what we can and can't afford. There's what we're capable and willing to do and each person/family has to take everything into consideration before making a decision and again, you're very prudent to think about these things now instead of in the middle of a crisis. Most people who have been through this (and that's just about everyone here) will tell you to give up the guilt and I agree. There's no room for guilt because we do what we have to do and we do what is right for 1.) us and 2.) our loved one. And like I said, it was really easy to tell my dad that he would never have to go into a nursing home. It was quite a different story once I became his caregiver and the need for care continued to increase. There is no greater stress in the world in my opinion. So tell yourself now that whatever happens you will not feel guilty. Your needs have to be considered too. I could have gone on caring for my dad in my home. I'm sure that's what he would have preferred (in fact, I know it was). But I couldn't do it anymore. To this day, and my dad has been gone for 10 months, to this day I will wake up in the middle of the night thinking that I hear him calling for me. Caregiving for a parent changes us, I think it warps us in a way but that's my own opinion. It left such an impression on me that I can still hear my dad calling for my help months after he died.
Take everything into consideration. Do some research. Do some soul searching and then make the best decision you can with what you have to work with. And then come here whenever you need to and get the support you need.
A more immediate concern is respite care. No one can care for someone else 24/7 without breaks and retain their sanity. Who will be with Mom when you go on vacation? Can she stay alone for a few hours while you go out? When this becomes unsafe, who will care for her so you can get away? This is NOT something to put off until you experience burnout. Plan for this right from the beginning.
Another thing to consider now is Mom paying you for room and board and/or for care. Her SS or other pension she gets can be used to pay her own way. It sounds like she is going to need financial aid if/when she needs long term placement. There is no particular benefit in her saving her money. It will be better if she pays her way all along. You should set up a written agreement for this. An elder law attorney can help with this, along with POA, health care directive, and will, if those are needed.
In a facility that accepts Medicaid payments, all residents receive the same level of care. Staff generally don't know which patients are there on government programs. Also, Medicaid has a program to help keep people in the community with in-home care.
Become familiar with the options you might need to consider in the future. Focus most on the short-term issues that need immediate attention.