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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
Marylisa

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Hello Marylisa. I live in NYC so I am sure government programs are different. Here we have Medicaid services for seniors which helps out financially. I am sure that Texas has Medicaid-type government services for seniors as well. If I were you, I would reach out to them and have your mother apply for these most helpful services. We did this not only for my own mother but my wife's mother as well and it works great. Just talking from my own experience, Marylisa. All the best of luck. Things will work out for your mother. In addition, I highly suggest and recommend that you hire an Eldercare Lawyer. Not just any lawyer would do. Eldercare Lawyers know and specialize in the ins and outs of the system for seniors and it is in your and your mother's best interest to do so. They can take the bull by the horns and get things moving for your mom. Our Eldercare Lawyer got everything and then some for both moms.
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Marylisa, this is from a previous post from Jan 2022: "We are a large family of 7 siblings. 2 brothers and, 5 sisters."

Why with that large family were you the one to take in your mother? You have to work fulltime. You only get $200-$300/month from her. You are subsidizing her for the rest of her expenses? And when the private caregivers aren't there, are you doing the caregiving?

What is the rest of your large family (7 siblings) doing to help?
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Same mess is getting ready to start here. Mom 89 will have spent all her cash on assisted living {$5000 a month x5 yrs} . I live in a HUD apartment..it looks like she will need to live with me in a 2 bedroom…I have a bad back disability..I am struggling to wrap my brain around how I can handle her showering etc needs! She is healthy, other than dementia and using a walker for balance/fall issues. It is reasonable to think she may live til 100…that will make me 83! I plan to check with medicaid and PACE to see if I will be able to get help in home for her!!! Good Luck!
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sp19690 Jan 2023
Do not move mom in with you. You are not capable of caring for her with your bad back. She will need to go into a facility when her money runs out.
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Flygirl59: Unless your mother has a monthly source of income such as social security or annuities, she most likely will have to apply for Medicaid.
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You are probably eligible for Medicaid already. If not apply
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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 https://www.yourtexasbenefits.com/Learn/Home 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.
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Many here know about these things.
Although go to the source and keep all records and receipts.
It depends on the situation now.
Medi-Caid
Medi-Cal
Medi-Care
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.
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you can get paid as a care giver.....thru dept of aging.
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apply for medicade with your county dept of aging.....she didnt sell her house because she did not have one to sell, right? it takes 3 months to get, do it now,
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Call Hospice or have your Dr. reccomend Hospice. They will come to ypur home and assist her.
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CaringDaughter7 Jan 2023
Hospice unfortunately does minimal. You still have to get home care aides on own.
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There are programs to help in every state. We have one here called IRIS. It will help pay for in home care and she can choose who she wants as providers (including family). They will also pay for things she needs in the home to help with her care. They may want you to check with her insurance first to see what is covered there for products.

As at least one of the health care providers for your mom, you can earn income that will help both you and your mom. Plus get help paying for the things she needs.
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PeggySue2020 Jan 2023
Clearly she is getting money from the state she’s in. That’s not 200k a year obviously.
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I have a few suggestions other than the great ones already mentioned. You can apply for community Medicaid which has a look back period of only a few months. Once approved for this Medicaid, your mom may be eligible for home care serivces or Medicaid will pay for a loved one to care for your mom at home. Medicaid may also pay for adult daycare services so your mom can be cared for while you are at work. Is she a veteran or a widow of a veteran? She may be entitled to some money on a monthly basis to pay towards her home care services or an adult day program. She may be entitled even if she nor her spouse has ever had contact wit the VA before. There are a few qualifiers such as income and the person has to have had served at least 1 day during wartime (but did not have to be in battle). There are also respite programs that are usually offered through faith based organizations and churches that are free of charge. One thing someone else said that I think bears repeating is if she will inevitably be going into a skilled nursing facility, you will want to do it sooner rather than later because she will look more attractive to facilities if she has private pay funds to start with before she applies for nursing home Medicaid. Of course all states are different so you need to check into your states rules and regs. A geriatric care manager would be helpful in navigating all of this with you. You can find a care manager in your area by going to www.aginglifecare.org under the "Find an Expert" tab. I hope this helps. Good luck!
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See if they offer Medicaid waiver in your state and apply now. It is a long process. You will be able to get some home care for a deeply discounted rate.
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Your mom could apply for Medicaid. Are you wanting to try to keep her in your home if care could be provided or are you wanting to place her? Make sure that her funeral expenses have been pre-paid out of her funds prior to her running out of money. Otherwise you will be paying for the funeral. Apply NOW...it takes a while for the approval process. We are on month 4, we used an elder lawyer and are still pending.
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Look into the P.A.C.E. program to see if there is an organization running it in your area. It is a Medicaid eligible program that provides home care. You are still limited to 35 hours of aides to assist you per week, but if that could work, apply ASAP as it can take a couple of months to get through the process.

If you must put your mother in a LTC facility, be sure to go as frequently as possible - preferably daily - as almost all are just warehouses for the elderly. In fact, I'm not sure what the advantage is over staying at home even with intermittent care. When my mother (of blessed memory) was in a "high end" nursing home, they rarely checked in on her - and when I proposed that they check on her every hour per Federal guidelines for someone with her limitations, the Administrator asserted they check on residents every 2 hours, and that would not change. Of course, they didn't check on residents even every 2 hours. :-(

You can set up devices in the home to monitor her and talk with her -- devices like an Echo Show, or Ring camera. With an Echo, you can also set up routines for music and radio and audiobooks, and reminders -- so they come on at at specific times. Perhaps that could help was well.
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Lots of great advise… planning for Medicaid…

contact your county office of aged and disabilities. They are a great resource, and my office would have made the Medicaid application for me ( my mom passed two days prior to that appointment)

was your moms husband in the service , and have served during a war? .. my father was in Vietnam and my mom was eligible for aide and attendance. Payment is retroactive to the date of application. Contact your county VA office

if you decide to move mom to a facility, then Google care advisors, Find an independent, or someone local. Someone who can meet with you. They work similar to a real estate agent , but are paid by the facility if placed. You don’t pay. They know your needs, availability, cost , Medicaid acceptance, reputation. They have a business relationship with facilities. I placed my mom twice this way , my in laws as well .
the sooner you place with self pay the better. My mom didn’t have the year of self pay, but because of the business relationship, the memory care accepted her. My in laws had no self pay , and my agent had a good recommendation for placement. I used a franchise called Carepatrol.

I wish you a positive journey here.. I know the anxiety of what to do etc…
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Oh and VA if your Mom herself or her husband was military. There are qualifiers and an extensive process but good to look into. And GoFundMe on facebook for quick $.
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Maybe get a loan for caregiving until Medicaid can kick in (apply now as it takes awhile). If she has Medicare, they might pay for caregivers. You can also take a brief class and get paid as her caregiver. The above is all Washington state. Try church or senior services volunteers. Friends, family for free or inexpensive care. Also, if you pay someone privately, it is cheaper than a caregiving agency. God bless!
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If your mother was married to a veteran who served at least 1 day during a war or conflict and didn't divorce him, then she is entitled to a veterans benefit as well that will potentially get her over 1200 a month to assist in aid/care whether in your home or in a facility. The process is long and it is best to have a specialist assist in the paperwork to ensure it doesn't get rejecetd or kicked back and have to start over, but worth it to get a little known benefit owed to veterans and spouses. There are many organizations out there that assist with walking you the process and paperwork if this applies to your mother.
https://www.assistedliving.org/assisted-living-near-me/assisted-living-veterans-benefits-didnt-know-existed/
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southiebella Jan 2023
I have been trying for over a year to get the VA benefits my mother deserves as a surviving spouse. After months and months of jumping through hoops, providing piles of paperwork and documentation (it's beyond ridiculous), I am enlisting the help of American Veterans Aid.

https://americanveteransaid.com/
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I am a son who was a full-time caregiver for my Mom. As others have noted, get going on the Medicaid application. There is a lot of paperwork to gather. Contact your county Dept. of Social Services and Office of the Aging for assistance. It is crucial to have a line of communication for any questions you may have. I was able to get Mom qualified for Medicaid through the use of a Pooled Trust that the Medicaid spend down amount would be deposited in each month. The Trust then paid a monthly bill we identified. As a Medicaid participant, she later qualified for Medicaid Managed Long-Term Care, which covered needed medical supplies, etc. In our case, Medicaid allowed me to keep Mom in the family home without the worry of how to pay for medical expenses.
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My MIL is in a very nice LTC facility on Medicaid and even has a private room. She gets great care and has been in there since 2017, even surviving original covid after a stint in hospice. It is run by the Presbyterian Church (she's not that faith). They see the care as a mission, and they have a lot of financial support from within the non-profit organization that allows them to keep the prices reasonable for private pay clients. I suggest you consider faith-based facilities, even ones that are not the same faith as your Mother.
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elisny Jan 2023
Good suggestion. IF you are going to find a good "facility," it is very likely to be one that is non-profit and faith-based. Not all faith-based are good - you have to check them out.
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Your Area Agency on Aging can help with direction as well as Social Services with what services are available.
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It's such a worry! My mother has $1600 to her name and that's it. She is fairly healthy and is only 79. Only has SS She is in an Assisted Living that accepts Medicaid/SS. They take all income except $80 (which pays for her needs (TP, Depends), cell phone, landline, and cable. All her meals are provided. It's so so stressful. She doesn't care that she doesn't have the money. She demands things that she doesn't really need and then we argue. It's aweful.

So there are some Medicaid ALF and NH who accept Medicaid bed but takes time to find them. I feel for you.
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Your mother will have to go into a facility once she no longer has the funds to pay for in home caregiving services. See below for great advice.
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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.
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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:  https://health.usnews.com/best-nursing-homes

US Dept of Health and Human Services/Medicare Compare Nursing Homes https://www.medicare.gov/care-compare/results?searchType=NursingHome&page=1&city=Potomac&state=MD&zipcode=20854&radius=10&providerRating_overall=5,4&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)
https://data.cms.gov/covid-19/covid-19-nursing-home-data

US Dept of Health and Human Services Nursing Home Quality data
https://data.cms.gov/search?keywords=nursing%20home%20quality
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elisny Jan 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.
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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.
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Have your mother declared indigent. I think the amount of money she can have is $1,200. Then she will be eligible for Medicaid. Medicaid will pay many of her expenses though she may have to be placed in a facility to get the help she needs.
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Agree with all above - I have found a local senior center. Sometimes they can direct further assistance.
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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.
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