Does Medicare cover a nursing home stay for my Mom in the last stages of Alzheimer's?

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She is almost totally non-functional (she can't walk, talk & trouble eating). Only last week she could say a few words; now she can't. She's in bed all the time now. Our caregivers have to have some time off leaving me to take care of her but I don't know how; where the things for her care are or how to move her - I saw somewhere Medicare covers 90 days of nursing home care - does anyone know about this?

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This is a tough time for you and help is likely needed but you'll probably have to start with private pay.

Medicare will cover this time if she is sent to the nursing home from a hospital, but not directly from home. I'd suggest private pay for now to get her settled and then hospice care which is covered by Medicare.

If her assets are spent down rapidly, then you'll have to have her transferred to Medicaid which will cover all costs for the nursing home and hospice.

Take care of yourself by getting help during this sad and challenging time.
Carol
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Is she eligible for Hospice care? Can you ask the caregivers to show you where the supplies are and what to do?

Your post suggests that you need more care for your mother now than she's getting. Perhaps a nursing home at private pay rates would be more cost effective in the long term, going forward.
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It sounds like mom will qualify for hospice - which is a Medicare benefit. Has her doc mentioned hospice? If not, I'd suggest that today you need to ask her MD to request a hospice evaluation. Then you contact the hospice providers. Hospice is used to getting calls and doing the evaluation within a couple of days. Vitas & compassus are 2 of the bigger ones. Most hospice is done at home with family providing caregiving for when hospice isn't there. Now some hospice have a free standing hospice facility where they can move to. My moms city has a vitas one at the old women's & children's hospital that is now all hospice & they also have a unit that is its own building at a CCRC. For those hospice situations, Medicare pays for hospice BUT their room& board costs are private pay or Medicaid. My aunt went to the in unit one for her last few weeks. I'd say most of the residents were younger cancer patients on serious pain meds or other black box drugs which require monitoring so an in unit hospice is especially good for that type of hospice. My aunt was late 90's with several comorbidities so in unit made sense to do.

Hospice can also be done at a NH -my mom was on hospice within her NH for almost 2 years. Medicare paid hospice for the entire time, there seems to be no time limit but they do get recertified every 60/90 days. A lot of what hospice does depends on what type of care she needs and how the NH coordinates with hospice.

It sounds as mom may not have much time left. If mom has assets over 2k or income over about 2,050 she may not financially qualify for Meducaid. They really have to be impoverished for medicaid. If mom has the funds to be paying for caregivers at home, she may have the funds to pay for her r&b at a NH or in facility hospice. The Medicaid application is within itself quite a bit of work to do. If yiu kniw that mom has funds, applying is probably not a good use of your time.
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Also as Carol said, the NH covered care by Medicare only gets paid if they are discharged after a 3 day hospitalization for rehab. I'd be concerned that if mom is end stage dementia, that even if she was hospitalized that the rehab orders would not be done. This is a tough call for a physician to make for dementia patients. They have to show some cognitive ability for orders for rehab to be done.

When my mom - who had lewy body dementia - has surgery a decade ago, she was totally cognitive to do rehab. But when she broke her hip at the NH 2 years ago, she did not have the cognitive ability to do rehab. She was probably ok for surgery health wise but rehab flat would not work as no cognition. So she went onto hospice instead. moms doc would not write orders for rehab as it would be a waste, there could be no rehab progress realistically.

There are no simple & easy answers in all this. Getting your mom on hospice is likely to be the most straightforward option as the system is set up to do hospice evaluation quickly.
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Yes, she has hospice. They have been so wonderful to us; they have supplied everything from walker to wheelchair to all meds plus sending nurses to the house 2-3 times/week. When I wrote this, I was concerned as I had to be here in the home with my mother who was bed ridden, unable to speak or move and I just dodn't know what to do or how to do it. So I was thinking it may be better for her to be in a facility where she would receive qualified care all the time. Mom passed on this morning. I kept her here at home the entire time. She was well looked after too as we told hospice that I could no longer care for her in these final stages of Alzheimer's and they sent someone. She also was a God-send and kept vigil all night and into the early morning. She called me at 5AM just after mom had passed away. Hospice is such a great thing and helped with everything I needed; all I had to do was ask. Thanks everyone for your replies. Much appreciated.
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This is not a comment. I just want to thank all the beautiful people that shared with me my concerns regarding my husband during the past 2 1/2 years he spend at the NH. Alzheimer won the battle and he passed away last Saturday at a beautiful hospice. He had his arrangements made for body donation to Science longtime before his sickness. If interested contact Science Care. No need to write back, I will be disconnected from this page.
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