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

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.

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.

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.

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.

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.

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.

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.

I just want to say, an AL is limited to care. They may not except MIL anyway. Also, her sight problems may be caused by cateracts which are common in diabetics.

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.

Even though she is only 65 she has been severly overweight since her mid twenties, and I think the years of all that extra weight is finally causing problems. She also claimed s.s. right at 62, thus limiting her money she could of gotten if she would of worked her low paying job for just a few more years, and now wants us to pay for that mistake by also suppling her an allowance. It doesnt help that her sisters has catered to her over the last few decades and always tries to get her what she wants. But now they are retiring and getting older and have money problems also and we are being eyed like a christmas ham ( their meal ticket)

Thank ur husband for his service.
If she is on welfare than she is getting Medicaid. Medicaid has services for low income. She maybe able to get an aide to help with personal care. Maybe daycare to get her out of the house. In my area, a bus is provided to and from. She maybe eligible for for Senior busing. Call her local Office of Aging and see what services they provide. Glad ur not giving into her. Do what you can and if she doesn't take the help, that's on her. I have a friend who complains all the time but won't take advantage of what our county provides and she worked for them. Always has an excuse.

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.

Based on a hunch, as I have not credentials in these matters, I think she may qualify for skilled nursing care and not just assisted living...it would be through Medicaid. If you could have her assessed to see if she is a candidate for Medicaid, then that would be a first step. As about an FL2. I do not know that it means except that in order to be qualified one has to go "have an physical exam of sorts and it is called or produces something called an FL2. Don't worry about where she will be cared for until you find out if she qualifies.

I wish I could U could help more..

Grace and Peace,

Bob

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.

OldBob, looks like you're right. I just googled "FL2 form," which kind of looks like one for somebody already in the hospital and on Medicaid:

https://ncdma.s3.amazonaws.com/s3fs-public/documents/files/dma-372-124-ach-ia.pdf

Gjanda, my own mom with Alzheimer's and already in a NH recently had to have a similar-looking form filled out by her doc there, since Medicaid made us apply to the VA for Aid and Attendance. She's only 114 pounds but the doc says she needs "two-person assist for all ADLs," among other real specific answers to the questions. At the NH, I have met two other active hefty ladies in motorized wheelchairs who are mentally very sharp and seem to get around with no problem. Hope your MIL is able to get all the assistance she deserves.

Medicaid is being cut by the new Trump health plan. Here is a link, you may have to cut and paste. http://www.businessinsider.com/what-is-medicaid-who-could-lose-coverage-under-senate-healthcare-bill-2017-6

You are amazing for being on top of things and thinking about this early. I agree with others here who say to get it all figured out now before things hit crisis mode. Your story sounds similar to mine. My mother had advanced Alzheimers and needed a very, very high level of care. Translation: she needed very, very expensive care. She also had no assets, no savings, no pension, no home, nothing. I spent months trying to figure out the ins and outs of Medicare vs. Medicaid and what would be covered and what wouldn't be covered. I spent thousands of dollars to get court-appointed guardianship because she had no POA and became too incapacitated to appoint one. I took many hours off work dealing with paperwork related to financial and medical issues and trying to navigate the Medicaid application process. I did all this while trying to keep Mom safe and well and fed and bathed and dressed; while taking care of my 3 teenage sons; while working full time; while making appointments and driving to doctors for my Dad with Parkinsons; while losing my own sanity to the point that I think now I'm forever broken.
So my advice is to take time now to figure out how to navigate the Medicaid system and get applied even if she doesn't yet need skilled nursing home care. I don't know how it is in CA, but in Florida where we are, Medicaid has a "community" option that provides support toward assisted living or in-home care. It doesn't cover everything but you can at least get someone to come in and do light housekeeping and meal prep, etc.
Does anybody else out there think about how frustrating and difficult it is to navigate through the Medicare/Medicaid system and Medicaid application process? Maybe some states are better than others, but Florida is a screaming mess. I have a PhD in a scientific field and I could not make heads or tails of the whole thing. It took months out of my life to figure it all out, and I now find that many of the office staff in doctor's offices don't understand it all either. One receptionist will tell you "oh, we don't take that kind of Medicaid," and another will tell you everything will be just fine, that they'll be able to charge Medicaid. It's soul killing and frustrating, especially when you just want to take care of your loved one and not spend hour after hour tracking down paperwork, making appointments, on hold with the Medicaid office on the phone, blah, blah, blah. . . I digress, but I'm really overwhelmed by how confusing the process is for many people. I think as an intelligent a country as we are, we ought to be able to come up with a more streamlined process to help people in the caregiving role.
Anyway, sorry, in answer to your question. . .figure it out now while you have time because crisis mode is coming and then it will be too late. (and I applaud you for not agreeing to take her in to your home. Stand your ground and keep your sanity!)

If she is in California you can apply for medi Cal. It's ca. Medicade program. It requires lots of paperwork so I would get started now. If she truly has no money then she should qualify. On the medi cal web page there is a list of AL places that accept medi cal waivers. The waivers also need to be applied for after you qualify for medi cal. It is a long process ( lots of waiting). There are many facilities in riverside county with openings. If you want her closer to you she needs to be a resident of your state for three months ( proof required) prior to applying for medicade . It's a lot of waiting so the sooner you get started the better.

Yes, I agree she wants more comfort as she ages. We have no issue with getting her new glasses when she needs them, a lift chair to help her get up cause her knees are bad. At christmas time we get her stuff she needs around the house, from cooking pans, bath towels, blankets, toiletries that food stamps wont cover to make her life in her place a bit more pleasant. But again we are going through the expensive years with teens. Sadly these things we buy her have just become expected and we never get a thank you.

She lives in a small rural town which I have discovered doesnt offer much in the way of transportation, no public trans. and they only have one van for the whole town which is only offered for appointments to doctors. Looks like I need to figure out how long the process is to bring her nearer to us, and in housing around our town as our town has public transportation and I know has vans that drive the senior citizens everywhere for a small fee, plus we have a senior activity center.

She has always been bitter, we dont have a good relationship, and she never misses a chance to take a mean jab at me as she views the kids and myself kept my husband from being her money machine through the years.

Im just gonna continue on figuring this all out as she keeps us totally ignorant on what she has available to her and whats shes on. She has the mentality of its none of our business, yet wants alot from us. I am finding the medicare/medicaid system very confusing and daunting. I will learn though. I think near term, pushing her to move closer where there is public transportation and more senior servies would be better. for her short term, and easier in the long term when she needs more services. But getting her away from the small town where she grew up may be impossible as shes very set in her ways and stubborn.

We have limited income as well, as we are Seniors. When hubby retired due to disability and our income bottomed out, I got on the Internet and researched what help was available. The biggest help was our local Social Security office. I was blessed to speak with an agent who was quite possibly the biggest help in this whole long journey with my husband. You can apply through your local SS office or online. You can also call 211 to find area agencies who can help.

You can and should call the local Area Agency on Aging for her county to find out what is available and what she might be eligible for.

Gjanda- Please really for the sake of your sanity & that of your sons, hold fast & firm that you & hubs are NOT going to become "bank of mom". It's going to be VERY time consuming dealing with your boys college applications, vists, & FAFSA. As a military family, you may find they need to cast a wider net in the schools they apply to to find the best package. If they are looking at schools that require "the common application", well imho it will turn into a part-time job to keep college applications & the required references on track (been there & done that as we have a rising college junior). Also FAFSA is pretty narrow as to determining parental contribution, it's all about your & hubs income & fafsa is synched with IRS. So unless you & hubs have court ordered guardianship for MIL & she s viewed as a legal dependent of your household, any $ provide to her will NOT be viewed as deductible income for the parental fafsa determination. Even if your boys apply early, file for all sorts of aid, have 29+ ACTs, get big ticket scholarships, forgo going Greek (I'm in the South & its greek life or be social outcast still!! at many schools)....... Your boys are going to need extra $$$ from you & hubs every year.

Honey, you will be some kinda peeved, if $ instead has to go to MIL. Please please try to make hubs understand all extra $ needs to be about the boys. Hubs cannot signed off on financial responsibility for MILs AL or for any in-home care or anything else. If your boys school has a dedicated college advisor perhaps you go and meet with him/her to get a feel of what costs will be like for the application process, testing, etc. Also if your boys are looking at schools that have defined pre-application programs (like they are interested in architecture, some engineering, maritime), they kinda need to do the program (usually they are a 2 day, so you need to plan on hotel, travel; some college prep type of high schools organize these type of trips) to have application viewed more favorably. & doing trips like this have costs that fall to family. Also keep in mind that financial aid has to be reapplied for every year. Even if they do community college & they each get a Stafford & do work/study, they still are going to need $$$ from mom & dad. they need to be the priority over mil. Good luck & stay fast & firm!

OMG, so much good advice - can't read them all but here is something to check out - I recently read a book called GET WHAT'S YOURS. It's about social security and had little help for those average ppl but I was shocked at what benefits are available to divorced ppl. If she was married for a minimum number of years (10 I think) or maybe less - and her ex- is over 62, he can register for SS and "suspend" it - this would affect his benefits NOT AT ALL..... she is eligible for SPOUSAL benefits. The rub is they are not required to, nor will they volunteer whether or not the ex has registered or not. To get it started, I think it needs only his SS# which he may not want to divulge. He can not prevent her from collecting, though he could refused to register and I believe once he hits 64 or 66, depending on his year of birth, he will be registered automatically and she would become eligible. SS will NOT notify NOR volunteer that info, you must have his social security number. I was shocked by the examples in the books of ppl with 3 ex-wives, all collecting spousal benefits off of the one guys social security, and even dependents (SSID) benefits. Maybe an elder lawyer might know how to find out? I'm i CA and if she's got section 8 housing, hold on to that until she gets PERMANENT placement somewhere else. FUnding is being cut, and once you have funding, actual places that will take section 8 funds for rent are almost nonexistent in my county. Please keep us posted, or PM me.

Gianda is MIL's only solution to her problems to expect family to pick up for her. If she is already in Section 8 housing there may be other subsidized housing with at least some kind of supervision that she could transfer to.
I agree with everyone else keep your purse tightly closed unless you want to pay for something like an emergency call button although she probably qualifies for that free anyway and most likely would not use it.
I feel sorry for someone in her position but having helped people out in the past in the hope they would get on their feet I have only been used so no more.

TheresNo Try, just to correct some things. MIL never married. Spousal benefit from a spouses social security are limited to a certain percentage of his own SS benefit and it there are several beneficiaries it is shared amongst them. This will include any children the couple had even if they
were not married

Gjanda, you've gotten lots of good ideas here. I certainly support the kudos to your husband for his service and the stand-fast-to-your-limits approach so many mentioned. I'd like to add another option for CA to the mix of researchable information.

There's an animal out there called Resident Care Homes -- located in traditional houses in residential neighborhoods, and in general, vary in design, services, personnel, cost, entrances qualifications, and licensing requirements. However, CA has the greatest # of resident care homes, called Resident Care Facilities for the Elderly (RCFEs), and the tightest licensing requirements. Each home operates under the state standards mandated by the California Department of Social Services, Community Care License Division. On-site inspections occur every five years, with non-compliant homes inspected annually.This means oversight and regulations help residents and family maintain some peace of mind that the care home isn't some fly-by-night business designed to scam seniors. Each RCFE is required to show you its most recent state inspection if you ask to see it.

CA RCFEs position themselves as having 6-12 beds and offer room, board, community rooms, supervision, and personal care assistance with hygiene, dressing, transferring, eating, and walking. Medication can be stored and distributed, but the resident must be able to self-administer. There are limiting factors: no tube feedings, treatment of open bed sores, anything that requires 24 hr nursing care like IV treatments. RCFEs are non-medical facilities and aren't required to have registered nurses + CNAs on staff -- though most do on a shift basis. It's possible that the supervisor who lives in the community could be a licensed R.N., but there's no requirement.

RCFE costs vary significantly -- from a low end of $1000/mo (residents living on Supplemental Security Income [SSI] or Medicaid equivalent) to $9000/mo, wich is driven by dementia and hospice care that require more one-on-one supervision. On the low end, there are fewer and fewer beds available for this segment of the population. And, like most states they want you to pay privately for a year or two before converting to low-income rates, if and when there are beds available.

In addition to asking to see the most recent state licensing evaluation, be sure to ask what health crisis could make remaining there impossible. And, ask which family members of past or present residents would be open to speaking with you by phone about the home and its care.

Lastly, I'm in no way an advocate for this type of housing and services; what I do advocate is the best possible situation that fits your needs. I have no idea whether or not this is a viable option for you and yours, but I thought it might be useful to add it to the mix of possibilities you could investigate. It seems like you've got a potential can of worms with your MIL that's assuredly going to turn into the real deal at some point. You're so smart to be addressing it now behind the scenes . . . because life can change in the blink of an eye. Chin up, hold the line, and know you've got a good group here to support you. Best of luck.

Sorry!! I have nothing more to say -- just entered my missive twice by mistake! :-(((( Deleted the duplicate . . . 

Gianna you mentioned that your husband is a Veteran. Would there be any VA benefits for his Mom?

veronica91- there is no va benifits for a parent of a service member, only for my husband and myself when we age.

Thanks everyone for the advice. I will get my ducks all in a row so to speak over the next few months and be ready for when the problems start to arise.

On a positive note, my son passed his drivers test today at the dmv. He was so happy and I was proud of him cause he was so stressed and nervous waiting to be called. We got home and had the joy of updating our insurance policy with him.......ouch!!!!!

Veronica,
Not sure u are correct. Doing this from woman side. First to collect Social Security you must have worked 40 quarters (10 years). Must be 62 to collect partial. 66 full SS. Will give me as example. When I turned 62 my husband was already collecting SS, 1500. I was collecting 750 from my work experience which was already half of what my husband receives. If he made 2000, my SS would have been brought up to 1000 half of his SS. If he passes before me, my SS will drop and I will get his. Reversed, because he makes more, he loses my SS and keeps his. Children do not receive parents SS unless a parent dies before the child is 18. A disabled child, after the age 18 may collect off of parents, but not sure of this. An ex spouse can collect if married over ten years. If u have never paid into SS you can't collect. This is where SSI could come in.