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My mother is 74 yo. She has a history of diabetes, hypertension and high cholesterol. She had a stroke in 2008 but recovered well. She was living independently until mid-March. She was hospitalized for hydrocephalus (fluid build up in her brain). She had surgery and then was inpatient rehab unit until 04/14. Her short term memory is almost non-existent right now. The hospital said that she needs to have someone with her all the time right now. She only has Social Security as her source of income. My brother is self-employed and can't stay with her too much and I am an essential employee and still working. How do I get started with getting someone to stay with her? Who determines the need so that insurance will pay?

Do not let the hospital release her to you or your brother. You are unable to provide for her needs. The hospital Social worker should help get the process started in applying for Medicaid and long term care. The physician will sign off on the need for LTC Medicaid. Then the hospital will work to find placement in a SNF .
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Reply to mstrbill
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Is she currently on Medicaid? Talk to her Medicaid caseworker about how much in-home care she is eligible for.

Is she eligible to go to rehab? They can do pretty intense OT, PT and cognitive therapies while she is there and THEN a determination can be made as to what her needs are.

A good place to start is to find out who your local Area Agency on Aging is (all counties have them; sometimes they are agencies contracted by the local government). They can guide you and provide case management. There may be a waiting list for their services.
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Reply to BarbBrooklyn
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Hope and reality are 2 separate things. You both need to work is a reality. Hope can be a fantacy. Plus, the surgical drains can clog up. Many of us on this forum will say do not take her home with no supervision in place. Private hires 24/7 are more expensive than a facility. Sometimes a private hire will be a no show so it will be up to you or your brother. Most ALs are private pay and for a few lucky ones, there is a long wait list. Since it is past the 16th, she is now in the phase of partial pay of $165 per day or somewhere she will need to pay 5 to 7 k per month for her custodial care. That will double at 100 days. The rehab should have informed you of that.
It may be time for Medicaid and nursing home, which one of you siblings will need to gather the paperwork for a 5 year accounting look back.
IF she comes around with her health, then you can assist her. Meanwhile consider hope vs reality. A guide to her memory to consider is how much she has gained in the 21 days in rehab.
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Reply to MACinCT
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With only social security as her income and no other countable assets, I assume she's covered by Medicaid for her healthcare. Call your Medicaid office and your State Dept of Aging for help in getting answers.

Although she was living independently, she may now need assisted living or memory care. Homecare may be an option also. The diabetes, high BP, high cholesterol and hydrocephalus all are contributing factors for vascular dementia resulting in short term memory loss. However, these are all treatable conditions. She needs a thorough physical and an evaluation by a neurologist for what's causing her memory loss. Her history of strokes is also a major factor for VaD.
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Reply to sjplegacy
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Paxton72 Apr 19, 2020
She has regular medical care by her PCP. The neurosurgeon says the hydrocephalus is the main cause for her memory issues. They removed the excess fluid that was causing her issues. We are hoping that having someone with her will only be a short term need and she can get back to living independently again and that's what she says she wants.
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