My mom (now age 92) has had home care (private pay) services in her house for the last 5 years. As you can imagine, the cost has been prohibitively high. Now I am at a crossroads, feeling I have to make a change to facility care, just to preserve her dwindling finances. Have been looking into alternative sources of funding and also the types of eligible facilities. So here's the question:

Would it be better to move her into a private pay facility and sell the house, which would probably buy her another 3 years before she would have to go to a Medicaid facility OR

Go into a Medicaid facility which will from what I've seen be really depressing for her and probably start her demise?

An attorney I've consulted recommends just going right to a Medicaid approved facility to avoid the trauma of a later move when she is older. I don't necessarily agree.

Thanks for any and all responses on a question with probably no "right" answer.

Thanks, everyone! Just to clarify she has home care with me doing about 27 hours a week of care. I'm the only one doing EVERYTHING and cannot do more. So moving somewhere is the only option. But the 2 choices are to go straight to a Medicaid facility or go to a "better" memory care first and hope she never has to relocate to a Medicaid facility. Thanks in particular, mollymoose. Since I posted this, I met with an attorney. Their fee is $8,000 (!) and I feel like their focus is to try and preserve assets...but not necessarily for her care. I have no designs on ANY of her assets. I just want to manage her money/care the best I can. Your answer was very comforting.
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Reply to tornadojan

My recommendation is if she has her wits, find a nice AL where they keep the MC residents in a separate area. Sell her house but if you ever think Medicaid will be involved, it must sell for Market Value so have it assessed. The money you spend on her care now and no house to keep up should help with paying for an AL.
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Reply to JoAnn29

We just went through this with my mom. Met with different two attorneys regarding mom’s money and ALL they wanted to do was set my brother & I up with my mom’s money for our personal gain, while they found the loop holes to put mom in the nursing home on Medicaid! That’s NOT even what we were looking for! Attorneys suggest that Because that is how they make their money!!! My mom didn’t scrimp & save all of her life for me to steal her money & slap her into a nursing home!

We sold her house & used the money for as long as possible for her care. She is now in the nursing home, but we kept her out of one as long as possible because that is what she wanted. And I have nothing to feel guilt or remorse over.
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Reply to mollymoose

I think it would be better to sell the house. She is 92. You don't know how much more time she has. Some facilities have options if a resident has private paid for a period of time. I would have thought the Medicaid process would have needed to start but perhaps I am missing something.
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Reply to Riverdale
JoAnn29 Mar 9, 2019
From the day you file for Medicaid you have about 90 days to spend down any money you may have, find a facility and move in. If this isn't done in the 90 days, then you have to refile. In NJ anyway. With my Mom the process started in April. Mom entered a LTC facility May 1 and private paid for 2 months, (this was her spendown) May and June and Medicaid started paying July 1.
My father did better than expected in an MC he resisted entering. After just a few weeks of adjustment, he was healthier and happier in the MC. Dad's income paid about 65% of the MC cost so I sold his house and drew down against those funds to make up the difference. I estimated that would fund 10-12 years which I thought would be beyond his life expectancy (the facility would have kept him on with Medicaid after 3 years of private pay). Although you should consider that Mom may need NH at some point, it may never come to that. My father with vascular dementia and CHF did well in the MC for over 3 years until his fluid retention increased and he entered the hospital to balance his CHF medications. He resisted standard treatments like fluid and salt reductions and worked himself into such a state that the long anticipated major stroke occurred and he died a few hours later. I would place her where you believe she will be safe and the most content even if you anticipate she may need to move in 3 years or so to a Medicaid facility. Let her enjoy what remains of her life as best her health allows; at this age a rapid decline is very possible. By the time she needs the Medicaid facility, her health may be such that she wouldn't be able to enjoy the amenities of the private pay LTC anymore anyway.
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Reply to TNtechie

Maybe you could cut back on hired home care and take over some of the chores yourself or with family, thusly leaving her in her home till the very end, if she is there now at 92, and has been, a move to a NH of any sort, is going to most likely be her end if she still has her wits about her. Also maybe look into a reverse mortgage??? Just an idea.

All NH's are horrendous, some just wear better wrapping paper.
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Reply to Cherrysoda

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