My mother-in-law is poor with no savings and will soon need care. Any ideas of possible solutions?

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My mother in law (65) who is poor with no savings, is diabetic, vision is going, and having problems walking long distances is going to need care soon. I would consider helping, but there is no way as I am 130, and she is over 300 lbs. I have been told medicare only covers nursing homes, not assisted living. The doctors most likely are not going to tell medicare she needs a nursing home in the near future, but she will be needing care from someone sooner than when she would be nursing home ready. My husband and I are medium income people with two teens still in the house dealing with teen auto ins, and college in their futures. We really can't afford to fund her assisted living as it would eat 2/3rds of our salary and there is no way I could assist her and support her weight in the bathroom. Any one have any ideas of possible solutions that we just are not thinking of?

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If your MIL will need to be in a nursing home she will need to apply for and be accepted by Medicaid. Medicaid pays for the nursing home. The application process can be lengthy, it might not hurt to have the forms you will need on hand. One less thing to worry about when the time comes.

If your MIL ends up in the hospital with the next stop being a nursing home Medicare (as opposed to Medicaid) will pay for your mom's rehab for x days and that's usually when the Medicaid process is begun. If, at the end of that time period, Medicaid has yet to render their decision the nursing home/rehab will usually allow the person to stay while the Medicaid is pending.

This is how it is here in Missouri. You're dealing with California and Nevada and the rules may differ some.

It's never too early to start gathering information and come up with some semblance of a plan. Many people have to make these decisions in the midst of a crisis where tensions are running high and they are under a lot of stress. That's how I went through it-- baptism by fire.
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To begin, Medicare does NOT pay for long term care. (They do pay for rehab services after at least 3 days of admission in a hospital. ) Medicaid, designed to assist those without financial resources is likely what you mean. I had only found one assisted living (AL) in my area that would take a medicaid payment. But they only took it after 2 full years of private pay.
There may be financial help if she or her husband are veterans. I would suggest you start with your county office of aging. They should be able to pre-screen for services she might qualify for.
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You can look up area on aging for her county in Ca and give them a call. Tell them you would like them to visit her in her home as you are concerned for her ability to care for herself. Does she have Kaiser supplemental insurance? They might also come to her home and help her get started with a therapist and a dr to address the weight, Depression or whatever seems to be the problem.if she isn't already on CalMed the area on aging social worker might be able to get her started on the application. It's good that you are looking out for her.
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Medicaid is a federal program, administered by each state. Most states have recognized by now that keeping a person out of a nursing home is more cost-efficient than paying for a nursing home. Do not wait until a care center is actually needed. Medicaid offers in-home services in most states. My mom, for example, had three years of in-home help before she needed a nursing home.

Do start with her county office of aging, as geewiz suggests. Another thing to consider is whether she wants to stay in California or whether living nearer to you would be better. Look into the benefits in each place. Medicaid benefits don't transfer from state to state, so if she moves after she is on Medicaid she will have to apply all over again in Nevada. This isn't the end of the world and she would no doubt qualify again, but it is worth thinking ahead about.

By "nearer to you," I don't mean "in your home." That would be disastrous. Don't even consider that for short term.

You are providing a loving service by looking out for her needs.
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I agree with those above. I'd try to figure out what she qualifies for in her state before there is a crisis. I don't know much about CA benefits, but, you should be able to find out through their website, counsel on aging or social services in her county. I'd consider that if she has low income and limited assets, she might qualify for Medicaid Medical. If that kicks in, even if someone is on Medicare medical, they pay what Medicare doesn't and also usually pick up other medical costs. ( This can also cause a kick in from Medicare for Extra Help, which covers the cost of Supplemental for Medication costs.) This results in no out of pocket medical expenses and durable equipment.

And if she is considered to be disabled, due to some medical condition, it might open the door for more benefits. That would be up to her doctor, so, I'd make sure the doctor knows the extent of her ability to use toilet, prepare meals, bathe, etc.

Some states provide benefits for AL if a doctor says it's needed, assuming they meet the income and asset requirements. You can check with CA and your state to see about that.
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With ur MILs problems, she needs a Nursing Home. She also probably needs to stay in California to be able to get Medicaid since each state is different in their rules. Home are is not going to really help and cannot be depended on. You may need to go to her local Social Services to apply for Medicaid. Do u have POA. If not, good time to get it. A person with diabetes who doesn't take care of themselves is on borrowed time. Ur MILs may be caused by her weight. 65 doesn't seem old but it's the age where diabetics will suffer heart attacks, losing a limb, ect. I agree, you cannot care for her and shouldn't. Like u, I weigh about 130 and Mom weighed a little more and I couldn't handle her. I am also 5ft tall.
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Gjanda, when it comes to being trussed up and glazed, you can avoid a lot of problems by cultivating a sweet smile and a tightly closed pocket book. Make sure your husband does the same. Do not weaken. You have financial commitments of your own that properly take precedence, and you are not responsible for other people's mismanagement.
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Thanks, will start there, but she lives and hour and a half from us and is actually in california, with us in nevada. That is most likely going to complicate things for me. She was never married, and no military service. The AL places near me say they will not accept medicaid. I keep getting the two confused. Just trying to prepare for the future problem I see coming within a year or two. I just dont want to hurt myself physically with her weight, and have me be the one needing care.
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jeannegibbs- I agree, she can not move into my home. we are two different type of people. It would turn into a nightmare. I guess my best bet from all the advice is to look into the services offered to her after the holidays. She wont ever discuss stuff with us and wont give us a poa. Shes been on welfare since raising my husband and his brother. She has always had an attitude of everyone owes her. Just this last weekend we were told we need to buy her a car cause shes bored in her section 8 house and wants to get out and about and she will need gas money and ins. from us each month. SORRY, not going to happen. Looks like we are entering into some fun times with her, and just trying to get all my ducks in a row ready for this.
Thanks for the adive everyone has given and in letting me vent of the situation we seem to of been thrown into by moving back to this area after my husbands 20 years of service. Maybe we should of moved somewhere else.
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gjanda, It sounds like MIL has had a hard life. Did she raise two sons on her own, or was their father(s) involved in their lives? Having health issues starting in her twenties must have been hard. She has only held low-paying jobs. I don't think it is necessary to figure out how much of the hard life was of her own doing. Blame doesn't help now. She has had it tough and it is understandable that she would like a little more comfort in her old age. (Not that 65 is usually old age, but I think for her it is.)

I don't know what kind of relationship your husband has had with MIL, or how you feel about her. If you are inclined to be compassionate, I suggest that you do what you can to provide her some comfort, by helping identify what resources are available to her. Giving her an allowance seems to me out of the question. Paying car expenses is not your responsibility -- and if she is having vision problems may be a risky idea even if she could afford it on her own. But tracking down what low-cost transportation is available to her and encouraging her to use it is a way to help relieve her boredom.

(My mother and her sister, both widows, lived in subsidized housing complexes in different suburbs. They kept track of the schedule of the free buses a local casino operated and occasionally they'd arrange to catch the same bus and spend the afternoon at the casino and have a free ride back. This could be risky for some people, of course, but they had a great meal, talked and laughed with other folks on the bus, and only took a small amount of money to gamble with. They didn't just sit around complaining of boredom.)

Adult Day Health Programs usually provide transportation to and from the program, a hot meal, activities, social interactions, and many of them have services such as toenail care or help with showers. Is anything like this available to your MIL? Medicaid covers this, in some states at least.

You MIL has had a hard life (in her eyes at least) and could use a little comfort now. The contribution you and your husband could make, I think, is research and encouragement. That is a little complicated in that you don't live in her county, but the internet makes this kind of task much easier than it has ever been.

Good luck to you all! Stay in touch here.
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