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I need to know what happens when I get sick and there is no one to care for them. They can't go to nursing home as Medicare does not pay for long term care. Really am at my wits end I can't go anywhere or do any thing because of this. I need surgery but will put me in hospital for 5 to 7 days and there is no one to care for them.

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Wishing the best for you. Tough situation.
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Would your sister and brother in-law qualify to be in a nursing home? do they have dementia or what?  I would contact an Elder attorney to have their assets protected and they could be put under Medicaid (not medicare).  IF you need surgery I would not put it off because you might end up worse and then more care than just the 5 or 7 days.  Again contact a GOOD Elder attorney.  without knowing where you are located, google one for your area.  wishing you luck.
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You make take care of YOU, especially since you need surgery. Tell their town's elder case worker and social worker.
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Contact your local hospice and palliative care organization and ask about respite care.
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A note left on your refrigerator, in your wallet, that this person is without care and now will require EMS transport to a hospital. When you are too ill to function this will get help to your loved one, and we ALL should have this, even if all we have home is a kitty which won't get fed.
So that's it for emergency.
Now you are needing surgery. Who is involved in your care of your brother and sis? A doctor? A case worker? They need to know that you will be in care for a minimum of several weeks and unable to care for them.
I am wishing you good luck. I myself wouldn't know where to start. Call Adult Protective Services if all else fails. Otherwise you are left with calling EMS prior to your surgery and having your BIL transported to hospital, who will care for him or place him, just as if you had died.
If this is elective surgery now is NOT the time. Hospitals will soon be overwhelmed and dangerous places to be in our country for some time.
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I am in a similar situation. If there is an emergency then you need to tell 911 and the paramedics that your sister and brother in law need to come with you to the ER. Once there a social worker will need to place your sister and brother in law in respite care temporarily. Likewise, if you need to plan a hospital stay you need to identify a NH for respite care. If you do not do this, you could have someone in your home that you do not trust while you are away sick, taking care of your sister and brother in law.

Also look into your State’s Medicare Savings Program which is not Medicaid, but is based on a person’s income. Maybe your sister and brother in law are eligible for Medicare and Medicaid Dual Eligibility.
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Call the social work dept at the hospital where you will have your surgery for ideas on how to deal with this. How dependent are they on you? You might be able to get some help through Adult protective services since if they are very dependent it would almost be "abandonment"...maybe an elder law attorney would have some guidance as far as medicaid in your state.
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They can pay for a Caregiver that will come in and do what you have been doing.
And please extend the paid caregiver past the time you will be in the hospital, you need time to fully recover. So I would suggest another 5 days after you have resumed your daily activities.
You could go to a local facility and ask if they will take them for Respite. You would probably have to have some medical testing done on both before they would accept them (TB skin test of chest Xray is a common requirement as well as a general physical filled out by the doctor.)
If they would qualify for Hospice, or one of them that would give you a little bit of a break but while at home they would have only a CNA for 2 maybe 3 days a week and Nurse 1 day a week. They would qualify for Respite but that would take care of the 5 days they might be able to go a day or two longer but not more than that.
All caregivers should have back up plans for times just like this. Family members, paid respite are all options.
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Do they qualify for Hospice at home? Per my mom’s nurse this is an underused benefit. So many wait until the last days to bring hospice in. My mom has been on Hospice since Christmas for strokes. Someone comes in twice a week for a bath and a nurse pops in once a week. Respite care is also offered along with companions so you can run errands. My cousins husband was on Hospice for 18 months and actually graduated off of it.
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I don’t know what state you live in, but I live in Virginia and last year got a small state grant for respite care. It was a godsend!
I heard about the grant from our local Agency on Aging, which is a wonderful clearinghouse for information for seniors in communities throughout the US. Also, don’t forget to call the Alzheimer’s Association in your area. In addition to this type of information, they can lend a listening ear as you help your loved ones.
Finally, the folks on this site have walked in your shoes and are eager to share their experiences. Good luck!
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CaregiverL Mar 2020
Area on Aging referred me to Sunnyside Community Services which sent non English speaking untrained caregivers with no caregiving experience...they sent them to “learn” on my mother...who is the last patient one should start caregiver career on. My mother has dementia & immobile & we use lift machine. These people were useless & a waste of time. Better to place them in facility. BTW, all elective surgeries are put on hold for now. Hugs 🤗
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I just discovered a workaround called a Special Needs Pooled Income Trust. See if your state has these — just google your state + “pooled income trust.” It’s a way to shelter the “excess” income so the person can use it to pay living expenses from their income but still get Medicaid, and not subject to the “look back.” There are organizations that will help you through the paperwork.
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I care for my 84yrold father and like you I am his primary caregiver.
I had those same questions as you.
A lot of the services available are for Medicaid recipients which my dad doesn't qualify for and he doesn't have enough to pay for regular respite care.

There is one saving grace.My dad is a veteran and is enrolled in a Homebased care program.The
program offers respite at the VA up to 30days per calendar year.My dad didn't serve during a war time period so he doesn't get the same services as those who did receive.This is one that is available to him.

It's based on availability and a 48hr trial is required.My dad recently did the trial.I have scheduled two future respites.If either of your LO is a veteran who gets services thru the VA.I would look into the Homebased Care and Respite program at the local VA hospital.

Good luck to you.
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jacobsonbob Mar 2020
That's excellent advice. However, I suspect from what was said, vholbert lives far enough out in the sticks that there's no such thing as a "local" anything, let along a VA hospital! My parents' situation was somewhat like that--the closest VA hospital was an over 2 hr drive each way.
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Have you tried county Health Department? There may be some funds for care in the home through them or they may know what to do. Also, there should be an Area on Aging in your area. They are also helpful.
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Have you discussed your situation with your own Doctor?

It would be wise to have respite care as part of the care plans - for emergencies, planned surgery or just to give yourself a break (before you do break).
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See your circle. On my tablets its in the right upper corner. Click on it then click on profile. Click on settings then account. This is where u can put ur info.
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jacobsonbob Mar 2020
Thanks, JoAnn29. I'd like to add that on my laptop I see the circle (or "avatar") on the upper right, too. It's probably a standard format. However, I don't know what it would look like on a smartphone. (Even a "dumbphone" is quite "high-tech" for me!)

It's worth checking one's profile page from time to time because people sometimes send messages directly. I didn't know this for a long time, so eventually I found myself answering old messages after I (finally) discovered this.
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oh and to boot it all I live with them and they we live out in the middle of no where there is only one nurseing home in out town it has a waiting list and is a dump wouldnt put my dogs there.
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NeedHelpWithMom Mar 2020
What about neighboring towns?
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they are in a catch 22 they make too much to get medicaid but not enough to pay $3500 a month a piece for care and that is what it costs. there are no children to help my sister has two sons have even called in 5 years and other brother dont care.
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worriedinCali Mar 2020
It’s not a catch 22. You need to look up long term care Medicaid. They CAN get Medicaid and go to a nursing home despite their income. It can be done.
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Could you please fill out your profile. Its been 3 yrs since you have posted. Ages of the people you care for would help big time and yours too.
Are you living with them or them with you?

If they have money, I would use it for respite care in an AL or a NH facility. Otherwise, you are going to need to hire caregivers.

Go to your Social Services and ask about Medicaid for your sister and husband. Hopefully they will fall into the criteria. They can get Medicaid for LTC and there is in home caregiving. You posted 3 yrs ago Dementia/ALZ was involved. You will not be able to care for these two in the future. And you shouldn't.
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vholbert Mar 2020
where do I fill out this profill
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Just a clarification that you don't "enroll" in Medicaid...you apply for it and not everyone who applies qualifies. Depending on your state there is a 2.5 to 5 yr "look back" period so I'm hoping the OP is not co-mingling funds or taking or giving financial gifts to her LOs, or doesn't have her name jointly on credit cards or co-signed any loans with them.

FYI there are places that offer temporary respite care so you will need to research those in your area. Or you can engage your other family, friends, neighbors and place of worship to also help. I wish you a full and speedy recovery.
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You need to look for an assisted living facility for your sister and brother-in-law. If there isn't money to pay for it, look into having them enrolled in Medicaid which will pay for it. Even caretakers need time off. No one can do anything 24 hours a day, 7 days a week, regardless what it is, but especially not caretaking.
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Fitzgerald Mar 2020
depends on the state; not all states’ Medicaid pays for AL
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