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Mom is 93, so I’m trying to prepare for what lies ahead. Palliative care, hospice, nursing home? How common is it for NH not to have an available bed? Concerned about all of this. Mom lives with me at this time and I do everything for her.

Dear Need, let me try to some stuff out here.

1. Palliative care means that you treat symptoms and let go of trying to "cure". If mom has " chronic and stable" conditions, this can be a good course of action.

2. Medicare does not pay for long term care. It WILL pay for rehab ( which sometimes takes place in a NH) for 20 days following a three day in patient admission ( not "observation"--she must be admitted for 3 days to qualify).

3. If mom is in rehab and it is determined she needs to be in a facility, you can request that she stay there " Medicaid Pending". You apply for Medicaid to fund her stay there as a permanent resident.

4. Not all NHs accept Medicaid. Some will accept Medicaid after a two year stay as a private pay patient.

5. Does anyone have financial POA? Will mom assign you? Without your knowing her financial situation, it's going to be difficult to navigate this.

6. Make a list of all the NHs in your area. Call each one and find out if they accept Medicaid and if they require a private pay stay before. Make appointments to see them. If mom gets hospitalized, this way you'll have an idea of where you are willing for her to go.
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NeedHelpWithMom Jan 28, 2019
I am not sure if she would designate me as power of attorney. I am a woman and she doesn’t see women as smart or responsible as men, even though I have been the responsible caregiver. My brothers do nothing to help. She has an old school sexist attitude. I feel lost as to what direction to take. Thanks for your feedback. I appreciate it.
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No, have not even had time to make an appointment with an elder attorney.
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Need; Are you saying that you asked mom's doctor about Hospice and s/he recommended palliative care at this time? That might be because your mother doesn't meet the eligibility criteria for hospice.

When you ask about how common is it for a NH not to have an available bed, are you talking about one specific nursing home, or nursing homes in general?

From reading your other posts, it sounds like you are fast approaching burnout with caregiving your mom and you are trying to find your way to next steps; is that an accurate portrayal of the situation?

Does your mother meet the medical criteria for needing NH care at this point in time? Have you discussed the financial aspects of this with an Elder Care attorney? Have you looked into home health care to provide you with some help in mom's care, if nothing else so that you can get some time away with your husband?
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NeedHelpWithMom Jan 25, 2019
Yes, I guess because of her age I am becoming very anxious. I would feel better and could relax with a plan in place.

Plus, you nailed it. I am burning out and trying to sort things out.

I did ask primary doctor if mom was ready for hospice. She did suggest palliative care. I’m still confused as to what that means.

I called about receiving info on medicaid. She doesn’t have lots of money. I don’t know exact situation. I do not have power of attorney. I have medical power of attorney. She has a will. She has small amount of money in cds. I have two siblings who do not help. Yes, I admit I am stressed and frustrated.

The person I spoke to about Medicaid told me that not all NH even accept Medicaid and there may be a wait for a bed. We have a high amount of senior citizens in our area.

She has medicare now and Humana gold plus. Will that cover NH? I am trying to make decisions and feel overwhelmed. I appreciate your responding to me. Do you have answers for me? Do you need to know anything else from me in order to explain it to me?
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Hi! The expressions palliative care and hospice care are used differently in many places, and they have overlapping meanings. Palliative care aims to make a disease easier to cope with, rather than to cure it. So if a cancer is not curable, a palliative care approach says no surgery, no chemo, just pain control, help for other symptoms like constipation, perhaps exercise to improve mobility etc. Hospice takes the same approach, but in the USA it focusses on intensive nursing and social support when death is close. In some other countries, a hospice is a place for the infirm where palliative care is provided. I hope that this helps.
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