My mother of 89 years old moved in with me on June 2022. She can no longer shower or care for herself without assistance. She had some money in her savings and checking accounts that is now depleting rapidly for private caregiving services. She appointed me as her POA Medical/Durability. I have to work full time to keep my home mortgage and pay bills. She was diagnosed with Severe Vascular Dementia. I Only receive $200 - $300 per month from her to pay for Pampers, toiletry supplies, groceries and, entertainment. Several people have told me to charge for rent but, that will only deplite her finances sooner and, she will not have anything to pay out of pocket for Caregiver Services. Any advice on what to do next. I project that March/April of 2023 she will have less than $5,000 in the bank. I cannot afford to pay for her Caregiving Services.

Thanks from Texas

Medicaid long term care coverage (aka nursing home/NH) is your only option.

Yes, as others have said please research and pick a few Medicare/Medicaid qualified long term care facilities with high quality marks near where you live. You can check out places on-line first and then go visit. (See list of sources below).

Do this ASAP and start the process now rather than waiting until her assets are below your state's limit as many NH facilities LIKE it when the person can enter as a "private pay" resident (before their assets are totally spent down), and then the facility and you can apply for Medicaid. The longer the ability to pay privately, the more the facilities like that (it is a "sweetener" to them, if you get what I mean). Most facilities have someone on staff (social workers and/or business office staff) who understand all your State's Medicaid application rules and can likely be of help to you in this process. Ditto for your Area Agency on Aging; they may be able to recommend Medicaid "planners" to help with this process.

Getting all her accounts (Social Security, any bank or retirement accounts, health insurance/Medicare, etc) set up on-line with you having access; will make the paper work process for Medicaid qualification easier (your State will want copies of things like monthly bank statements going back 5 years; easier to do if you can pull all this info on-line). Ditto for getting copies of her tax filings going back 5 years.

And moving forward, it will be easier (from a paperwork standpoint) if you can handle it on-line rather than waiting for snail mail which is a hot mess these days. Example, an important letter from my mom's State Medicaid long term care program did NOT arrive to me for 8 weeks; but thankfully I had set up on-line access to her Medicaid coverage and I check the site monthly to see if there are any requests for something I need to submit. If I had not set up the on-line access; I would have missed an important deadline because the "letter got lost" in snail mail.

US News World Reports:

US Dept of Health and Human Services/Medicare Compare Nursing Homes,4&sort=closest

US Dept of Health and Human Services Nursing Home COVID data (something else to check out, cases and % of residents and staff vaccinated or not)

US Dept of Health and Human Services Nursing Home Quality data
Helpful Answer (10)
Reply to Sohenc
elisny Jan 6, 2023
Good advice . . . AND do not rely solely on the info at the links. I can say with 100% certainty (and there are articles online about this as well) as to the inaccuracy of the online ratings. CMS is a crooked as the day is long, and the same for the CMS contracted agency in FL (and presumably in most states). There is virtually no serious oversight of nursing homes - you will only see them dinged for the most egregious and repeated offenses.

YET, Federal Law requires this of nursing homes: "Each resident must receive and the facility must provide the necessary care and services to attain or maintain the highest practicable physical, mental, and psychosocial well-being, consistent with the resident's comprehensive assessment and plan of care." (42 CFR § 483.24 - Quality of life.) Seriously, I would be surprised if there are more than a half dozen nursing homes in the country that meet this standard. The nursing home industry is, IMO, essentially a criminal enterprise that preys on some of our most vulnerable and dependent elders and other impaired souls. IF you have a loved one is such a facility, you must visit daily to mitigate the neglect.
How much does she receive in Social Security each month?

Have you applied for Medicaid?

Have you had a Hospice evaluation?
Helpful Answer (7)
Reply to BarbBrooklyn

You'll have to move her into a Medicaid Nursing Home.
Helpful Answer (7)
Reply to ZippyZee

Someone mentioned Hospice evaluation and I wanted to expand on that. My dad recently died, but when his behavior and needs got to the point where more help was needed. We were able to access the services of VITAS Hospice through Medicare Advantage by having his Primary Care doctor certify that he believed my father to have less than six months to live.

VITAS is a great service here in Florida offering respite care, help with hygiene needs, emotional support service for both patient and family. I would hope there is something like that in Texas you could tap into and there was no need to qualify for medicaid. I would ask the primary care doctor about Medicare Part A Hospice Services.
Helpful Answer (6)
Reply to kft4502

The only answer is to plan to place her in a nursing home. You can try to do it yourself (pick out and apply to facilities, submit mom's Medicaid application to the State), but I would recommend getting a social worker involved to help you. Mom won't qualify for Medicaid until she is almost out of money (less than $2000 in bank account in many States), but you should start planning now, and I would recommend getting a social worker on board so she knows the situation. Often the State SW will be able to find suitable housing and place mom quicker than you can. There may be a possibility of Medicaid in home assistance as well, but don't expect that to be available.
Helpful Answer (5)
Reply to mstrbill

You say she will have less than $5K in the bank within a few months. That is her savings. How much does she receive each month in income - social security, retirement, etc? You can go to to apply online or learn about programs. I think the income limit (gross, not take home amount) for single person would be just a little over $2500 per month. However, there are trusts an elder atty can do for you to set aside the overage and not count against the limit. She may even qualify for Legal Aid assistance to help her get things in order and process the Medicaid application.

Charging for rent at this point will just deplete her money faster. You could be using her entire check to pay for the personal things she needs: like toiletry and letting her split the cost of groceries with you. About 60 days prior to getting her bank account at or below $2K, you can apply for Medicaid for her. In Texas, you can do it online or by paper application.

The thing to determine is if you plan to keep her in her home or apply for Nursing Home Medicaid. Texas has some in-home programs she might qualify for and then there is the NH bed.

If you have money to pay, get an elder atty. They know all the Medicaid rules and programs. If not enough money, contact Legal Aid in the area where you live. Best way to guide you and get her set up for the application process.
Helpful Answer (5)
Reply to my2cents

contact your local department of social services and have her evaluated for LTSS (Long Term Care Services) through Medicaid. if she qualifies, there are other home based care service options in addition to nursing home settings.
Helpful Answer (4)
Reply to Tmessina86

Seek a social worker for your mother's assessment and help you look for a Medicaid licensed facility to place your mother in.

I Googled up information. Texas has a 60 month lookback period prior to Medicaid application and 36 months up to last transaction. Contact a Medicaid specialist and eldercare attorney now to work with complex rules in your state of Texas. Every single red cent must be counted from the lookback period up to the application date.

Do not use your money or commingle with her funds to pay her bills. If you must assist, you need to keep detailed records of what your funds went to that covers your mother's expenses. Medicaid will investigate during the application process.
Helpful Answer (4)
Reply to Patathome01

Many here know about these things.
Although go to the source and keep all records and receipts.
It depends on the situation now.
Social Security
Help - seek out social worker or care / case manager.
Contact an Elder (or your) attorney
Are you the POA and/or have legal authority to act on your mom's behalf?

No. You SHOULD NEVER EVER use your own $ for this care. It'll drain you financial and this is not acceptable or prudent of you to do.
Helpful Answer (4)
Reply to TouchMatters

you can get paid as a care giver.....thru dept of aging.
Helpful Answer (3)
Reply to lovelyliz

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