Follow
Share

Mom has severe dementia. I haven't been able to get a good night's sleep. She is also delusional. Last week she suddenly was unable to stand or walk. She is now in the hospital and has been given a thorough physical and psyciatric evaluation. They are working on adjusting her meds so we can both sleep. All of the sleeping pills and calming meds have not worked in the past. She is up all night!

The doctor and I agreed to put her in rehab for physical therapy. He believes she is strong and will walk again. I explained all of this to her and she agreed. She will be transfered any day soon. Now she is complaining that she wants to go home. I can't handle her if she can't stand up and walk.

I work full-time and I have a HHA that stays with her while I'm at work. Any ideas on how I can handle this?

This question has been closed for answers. Ask a New Question.
I had to move my mother, on Easter Sunday. (She was private pay.) There is a lot of differences between various rehabs and NH. Good luck and I hope things get better.
Helpful Answer (1)
Report

Bring your mom home and ask her doctor for home health agency referral for "safety and adl and fall risk evaluation" just because she reaches maximum potential for nursing home doesn't mean she's actually reached potential. My mom (who's a retired nurse and director of home health agency) said she's seen stroke patients plateau for a while then make more progress once home. The issue sadly with the nursing home is once she's reached the 100 days they don't get anymore money regardless of her rehab status.
Helpful Answer (0)
Report

Try a different place next time! Some facilities are very cookie cutter or assembly line rather than thoughtful or careful...a lot of it is corporate culture,sometimes a good individual staffer or two can make all the difference...
Helpful Answer (0)
Report

The lawyer can only give you advise. My mom is rehabbing in a nursing home and she gets 100 days of Medicare which they pay at 80%. She also has Tricare for Life as her secondary and they pick up the remaining balance. Ther are two sides to a nursing home. One, of course, is for the permanent residents which they call long term care. The other side is for rehab patients. Sometimes these are their own residents who need some rehab or they can be someone who is in independent living rehabbing from a hospital stay. My mom is 91 years old and if she has a hospital stay, she quickly has problems standing up and walking on her own. That is why she has to go to a nursing home for rehab so she can come back home and stay with me. However, nursing home rehab is so bad and they almost kill her with their incompetence. I am going through that now and they want to kick her out (she's not on Medicaid) because they don't think she'll make much more PT progress for the stroke she had in their facility. They don't know that for a fact, they just "think" that. I would rather bring my mom home to die on her own terms than have a nursing home kill from negligence/incompetence. What do you do?
Helpful Answer (0)
Report

I don't plan on putting my mother in a nursing home. But I was told that if I have to an Elder Law attorney can help resolve the issues.
Helpful Answer (1)
Report

Debbie, the IRS rules are not the same as Medicaid rules. Medicaid wants it ALL back for her care or they simply will not pay. So my advice to gingin and her family is GET IT BACK by either paying up during the penalty period or taking out a loan for the full amount to pay it back. Any attempt to hide or dump assets can result in jail time or judgments against you.
Helpful Answer (0)
Report

You are safe with gifting when it is only $13000.00 a year to the same person after two years. If she gifted more money than that to each person then they have to give back. Every year the gifting amount might change.

My mom is living with me and she has dementia. I know exactly what it is like. I believe that she is in the early stages, but she is getting worse. Her doctors give her lorazapam twice a day, and she sleeps very well at night and takes naps during the day. I hope this helps
Helpful Answer (0)
Report

One of the first things they ask when you start looking for help or placement is "was your mom or dad a veteran?" because there are quite a few options that non-veterans do nor have.
Helpful Answer (1)
Report

GivIng. I'm so glad you were able to I out that at least you will get reimbursed. With regard to Nh not accepting reimbursement, maybe ask to talk to the person the nh reports to? When someone says no, I always ask to talk to their supervisor. Nicely.
Helpful Answer (1)
Report

I spent all afternoon yesterday talking to Medicare and CHAMPVA. My mom is in a nursing home with a rehab dept. Because she's in a Nursing facility Medicare will only pay 20 days and then there is a $152 per day coinsurance. My mother has CHAMPVA and they will pay the $152 per day coinsurance. The facility won't accept CHAMPVA so the customer service rep had a 3 way conversation with the Nursing home and told them that not only will they pay the $152 copay but when Medicare stops paying they will pay in full up to 100 days. If the Nursing home doesn't accept it and I have to pay for it CHAMPVA will reimburse the money to me.

It's an excellent rehab center but I don't know why they have to make things difficult.

Don't take anyone's word for it, call Medicare or CHAMPVA yourself. They were extremely helpful.
Helpful Answer (5)
Report

After the 20 days if you have to take her home demand that the doctor send her home with home health care and order PT, OT, RN HHA and Social Worker. Even though you have an aide there already this aide will help with personal care, PT will continue what was started in hospital and OT can get equipment to help make her more independent, RN can evaluate dementia and Social Worker can help locate services for you and your mom. I worked in homecare for over a decade and my mom was a homecare nurse for 34 years before she got cancer and I ended up being her caregiver.
Helpful Answer (1)
Report

I have the same problem when my mom is in the hospital. I am her POA. I put up a big sign in her room that she has dementia and cannot make decisions so they must call me for answers to any questions. In the past, they ask her where is going after she gets out of the hospital, and of course she tells them, "my daughter is taking me home" to my house where she lives. I put up a sign in her hospital room immediately so that I can head this off right away. I work full time and I cannot have my mom at home if she cannot get up out of a chair and walk with her walker. She's dead weight and I cannot handle her. Just think of us, what is the first thing that you want when you are in the hospital - you want to go back home. She is not any different. One of the problems that I have occasionally with my mom is that, like a baby, she gets her nights and days mixed up. Unless her daytime caregiver tells me she is going back to bed after breakfast and sleeping most of the day, I don't know this but found out on the weekend. I discussed it with mom and she actually, for the moment, understood the problem, so I started on the weekend and made her stay up until a short nap after lunch and it was only a matter of days before she got back on a somewhat regular sleeping schedule. Plus I gave her one Advil PM so she slept really good and woke up pain free. Bottom line is that I tell my mom that her doctor said she needs to go to rehab from the hospital so she can learn to stand up and walk safely so that she can come back home to me. Somehow this sinks in. Good luck and God bless.
Helpful Answer (2)
Report

I wouldn't phrase it as " she's not coming hone with me"...sounds like your threatening to put her out on the street. The overriding message you need to get through to them is "I can't do this alone. I don't have the financial,
physical or emotional resources to

care for Mom on my own" . when my
mom is in the hospital I always remind my self that I don't have to take delivery until there is adequate at home or at facility care in place.
Helpful Answer (2)
Report

Sorry to disagree. But my understanding is that there has long been a coinsurance charge of about $150 per day after day 20 of rehab. Which is what supplemental insurance is for.
Helpful Answer (1)
Report

Momrocker - They changed the law beginning 01-01-14. It used to be 100 days; now it's just 20 days and you're out on day 21.
Helpful Answer (1)
Report

Get some legal advise from an attorney that specializes in elder law. An attorney could help shed some light on the gifted money issues. Also, call your local Area Agency on Aging , Senior Center or Senior Services bureau for services that may be available to help you care for her in your home. Are there other veterans benefits she can benefit from?
Helpful Answer (3)
Report

Not going to rehab, is not an option. You need your life. Then, spend that time finding out how to get her into a nursing home. Not all nursing homes are bad. The one that my mother is in (very small town) saved her life. Go to a nursing home and talk to someone about admittance. They deal with families every day, that are in your situation.

I have seen a daughter have to stand up for herself and say "She is not going home with me." The hospital, etc. then has to come up with a solution.
Helpful Answer (3)
Report

Send her to rehab while you find another place for her in a memory care facility. It will only get worse and better prepare for the worse now than have to wait and rush into a facility you may not want. My best to you and your mother.
Helpful Answer (2)
Report

Medicare normally pays the first hundred...I think someone is getting/giving the wrong info. I would question that. Good Luck.
Helpful Answer (0)
Report

You have a real bonus when mom goes tohospital/ rehab; a social work and discharge dept that knows the ins and outs of Medicare/medicaid, etc. If your mother has severe dementia (and it should be pointed out that she probably had some demential when she sold her house and gifted the money, that was only a few months ago), then you don't even entertain what she says about wanting to come home without therapy. You need to engage in therapeutic fibbing....just a couple more days mom......we're getting the room set up for you, I need till next week. With regard to insurance/Medicare and rehab, sometimes you have to know the right questions to ask. "will Medicare pay for HHA?" The answer is no. Will Medicare pay for HHA if ordered by the doctor after hospitalition is a different questions. Will CHAMPVA pay for rehab? the answer was no. will Champva pay the copay for rehab that is ordered by the doctor after a hospital stay? My mother also has secondary insurance; the first three times we asked about the copay, they told us no. the Medicare liason at her rehab/nursing home asked the questions and the answer was yes. Dont' undertake this by yourself!
Helpful Answer (6)
Report

Your mother definately should go for rehab. She is not able to make decisions on what is best for her. You want her to be the best she can be. The physical/occupational therapists are well trained to deal with dementia. There are many things they can monitor while she is there. Once she is home I think she qualifies for home physical therapy, visiting nurse, and possibly an aide who can supplement some care the HHA is giving. Tell your mother the therapy is temporary and to work hard so she can come home after. An elder law attorney can help to sort out the financial aspect of her selling her home.
Helpful Answer (2)
Report

May I suggest an Elder Law Attorney or SHINE (SHIP) counselor? They are good advocates to keep you on target & stress level down.
Helpful Answer (2)
Report

ChampVA states they are secondary coverage, Medicare is primary. Do the 20 days with Medicare, and ChampVA will provide home health care if it is ordered by the doctor. One step at a time.
Helpful Answer (2)
Report

My mother has CHAMPVA which is a Veteran's insurance and they do not cover rehab.
Helpful Answer (0)
Report

Does your Mom have secondary insurance or a Medigap policy? My Mom's secondary health insurance covered 80 % of the amount in excess of what Medicare paid after day 20. Check it out or have the rehab check it out for you.

BTW dementia patients often talk about 'going home'. For my Mom (and many others) the home they are referring to is the one they grew up in.
Helpful Answer (3)
Report

She sold the house in June 2013 and gifted shortly thereafter. She moved in with me in September 2013.
Helpful Answer (0)
Report

How long ago did she gift the money?
Helpful Answer (0)
Report

Send her to PT. Then enlist dr and her care team to reinforce that she cannot go home until she is able to walk, etc. --don't promise anything, and just say "mom you can leave as soon as you can walk twice around the ward" or whatever.

Talk to social worker about the funding and how Medicare can pay for longer if she isn't ready after 20 days.

It might be time to start researching care facilities that can take her if you can't any longer with your home situation. Depending on her needs and income, there might be group home, or memory care, VA, etc. I don't know about the gifting, but you can reach out to ricipients to see if they can return some of the funds.

IMO anyone who is gifted the money should place in a savings account for 5 yrs earmarked for caregiving expenses if needed prior to 5 yr look back period for the very reason you state. This technically should still be regarded as part of the estate to use for medical care if the person needs it during the look back period.
Helpful Answer (2)
Report

I'm also paying for the HHA out of her money. Medicare does not cover HHA.
Helpful Answer (1)
Report

She gifted it to her children and grandchildren, none of who are wealthy. I'm sure the money has been spent i.e. grandchildren bought new cars, paid toward college, and some of her children are struggeling so I'm sure they used their money to pay bills. She did this on her own before dementia set in. She still has some money left so I'm thinking she could afford to pay for a few additional weeks in rehab.
Helpful Answer (1)
Report

This question has been closed for answers. Ask a New Question.
Subscribe to
Our Newsletter