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After my MIL had a series of 4 hospitalizations over 3 months, my wife and her sister decided their Mom (age 86) really couldn’t live by herself anymore. During a serious decline in health a few years ago, MIL lived with us for 6 months (I posted about that on this site then, it didn’t go well, after she recovered she moved back to her own home). My SIL tried to care for her at her home after this last hospital stay (lasted 3 days). The toileting and bathing wasn’t physically possible for SIL. Eventually my MIL came to agree with this. She is now in assisted living for 4 months and thriving. She has some short term memory issues, no diagnosed dementia, is fairly mobile for short trips with a walker, has had a few minor falls. We are now preparing to sell her home in order to private pay for AL, hopefully for 5-6 years. MIL has made quite an amazing recovery, with consistent meals, supervised meds, and social interaction. She is doing so well, we question the move to AL. But we realize AL is the reason she is doing well. Isn’t that a quandary! On her own she wouldn’t prepare meals (toast once a day, maybe), wouldn’t hydrate, etc. Our thought was after her resources are spent down, she could transition to a Medicaid bed. But what if she doesn’t need full skilled nursing in her 90s but is out of money (except Social Security)? Are there any options?

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I don't think anyone can honestly say what will happen in 5 to 6 years. Sorry.

I would try to invest in safe investments and grow her money to stretch those years.
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Is the facility for profit or not for profit? There can be a difference regarding care somewhat far in the future between the two. I say far in the future because that tends to be the case with aging though I certainly wish your MIL many healthy years. Sometimes issues develop and further care is required. The facility my mother is in is run by the Lutheran church although that is not her religion. She started there in AL. Now she is in skilled nursing. The facility has a benevolence plan. It is not a guarantee but I have been told that the more years a resident has been on private pay the more likeness a resident may qualify. I have also learned from this site that a facility may be more prone to accept Medicaid the longer a resident has lived at the facility.


But isthisreallyreal is correct in stating we can't know the future and the wisest choice is to sell her house and invest the money as wisely as possible. Then relax a bit because once a situation declines there are a whole new set of concerns to deal with. I wish you all the best and enjoy the fact she is in AL. It becomes sadder after that.
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In my opinion, most all elders over the age of 85 need Assisted Living, some even younger. Your MIL is thriving precisely BECAUSE she's being taken care of properly in AL, like you said. Not to mention, an elder does not have to require a ton of help to live in AL; they just have to be an elder and in no mood to take care of a home and live alone anymore. They like to have a hotel-like atmosphere to take advantage of, socialization available, and meals served to them in a dining room every day! If she's still alive in 5 or 6 years, then you can worry about where she goes next and if she qualifies for Skilled Nursing. Why borrow trouble now? Truth is, an elder's health can change on a dime, in one instant. Today she's fine, tomorrow she's hospitalized with pneumonia. Or she takes a fall and breaks a hip. That's how things play out with the elderly population, so what will be down the road is impossible to speculate about.

If you find yourself preoccupied with 'what if's' for your MILs future, make an appointment with an Elder Care attorney for a consultation. That sort of atty can normally lay out your options and tell you how to proceed accordingly and plan for the future.

Good luck!
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In my state of NJ, if you have paid privately for a at least 2 yrs Medicaid will pay for the AL. But, the AL has to except Medicaid and not hit their quota of Medicaid residents.

At 85 with Dementia, in 5 to 6 years she may be beyond the care that an AL can give her. You then get her placed in Longterm care on Medicaid.
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