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I have asked a similar question previously, but things have changed a bit.
After moving my Aunt to ALF in November, she was understandably confused and unsettled. I thought maybe moving her to Montana with me was a good option. Opinions were mixed.
In January her friends and my husband and I all visited her together for an intervention. Reiterate that her home has been sold and she is in her new home. She was doing much better after that. But with the quarantine and isolation her dementia has increased substantially. Now the ALF is strongly recommending I move her to memory care. The cost of this particular place is $8,000.00 a month. At that rate she will run out of money in a few years. It's much less expensive in my small town.
The problem is that she absolutely refuses to leave her (mentally ill) son. She hasn't seen him since September, but she obviously is not going to forget about him.
Her physical condition is great, but her short term memory is totally gone.
I know the answer is to move her here closer to me in a place she can afford for years. My question is how on earth do I make this happen??
I am so worried about what this will do to her already declining mental status.

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The "how you will get her there" is a good question. I just put in Cal to Montana and its almost 21 hrs and that is not specific to where you are coming and going to in each state.

I would not even consider a plane if your Aunt is anyway incontinent or disabled. Those bathrooms just about hold one person. 20 hrs is a long time on the road. At 8 hrs a day thats almost 3 days. Someone suggested an RV a while back.
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xrayjodib Jun 2020
JoAnn,
It is a 2 day drive. It is definitely a question I have been asking myself too! Flying seems to be the best option. Although flying requires a layover because there are no direct flights to the airport closest to my home. That also adds to my stress! Ugh!!!
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I moved my 90 year old dad from WV to Mi back in September. Dad has dementia, no short term memory and was in a memory care facility in WV, fell, broke a hip, surgery then rehab. My mom died in 2018 and I’d been making the 12 hour drive caring for them for years. Just couldn’t do it any longer.

I was worried about such a major change for him and the grueling drive but we pulled it off. Loaded up the SUV with the wheelchair, snacks, water and all the elder care stuff and drove straight through. It was rough, lots of potty stops, but we made it. I don’t know how far the poster has to drive. I suppose a motel stay is possible, we thought we may have to, but it would have been tough to pull off so we just kept the pedal to the metal.

he had a pretty rough few days adjusting to the facility in Michigan but the staff was wonderful and he’s done well there. I’m glad I made the move. Until the virus I was able to see him most every day and making a 10 minute drive instead of 10 to 12 hours. He’s on hospice now, not actively dying but getting weaker and sleeping most of the time.
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xrayjodib Jun 2020
Windyridge,
That's good to know about the drive!
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You've received several opinions and some advice for your question, mostly about financial issues. My concern is for the move itself. Would this be by vehicle or plane? Either one may be a traumatic experience for her ( and possibly you!). A change in environment can be very confusing and disorienting to her. You have no idea what behavior you can expect from her. I think a plane trip would be the most disorienting with all the commotion involved. A long ride in a vehicle might also be more difficult than you expect. What would you do if she insisted on returning to be near her son? What if she became delusional on the trip? No, I believe the best choice is to keep her where she is.
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xrayjodib Jun 2020
These are all good questions. I worry about the "how".
I think a plane is best, but you're right, I don't know how she's going to react!
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You’re aunt is in California right? Medi-cal and facilities here are a whole different ballgame. You don’t have to self-pay first. But it is difficult to find a facility that takes medi-cal.
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xrayjodib Jun 2020
Thanks Worried,
Yes, she's in California.
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My opinion...you do need to consider Medicaid in this. What do they require for residency in your State. Six months, one year, two years? When you find out, how long will her money last? In my state Medicaid will pay for care in an AL/MC after the resident has at least paid privately for two years. Then, that depends on how many Medicaid residents are allowed and if the facility has met their quota.

What I would do is ask the MC in her state if they allow Medicaid after private paying for so long. Lets say they do after two years and Aunt has enough money to private pay that long. Then I would keep her where she is. If they don't, then I would consider moving her.

Are you POA? If so, and she has been declared incompetent to handle her affairs, then you decide what is best for her. Maybe allow her to go to MC where she is now. If she adjusts well, leave her. If not, then bringing her to your State won't make a difference.
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xrayjodib Jun 2020
Thanks JoAnn,
Yes I am her POA.
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I think the people who tell you that money should be a secondary concern are making a big mistake (or maybe a big assumption about your finances).  Yes, speak to facility, but remember, especially if facility is for profit, they may get sold, and your years of private pay may be meaningless.   I don't know about "many" facilities keeping people on once they can no longer private pay, this may be state specific, may depend on what states subsidize.
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Many facilities will keep residents if they have been private pay for a while (usually at least a year or two) if they have to go to Medicaid. And the facility can help with that application as well.
I would not move her again. That would cause a more rapid decline.
If she is adjusted where she is work with the facility when it comes time to apply for Medicaid.
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The right thing is to leave her right where she is. Every move causes a sudden decline that she might regain what she loses, but likely not. And add not being able to see her son would only add to her confusion. The money is a secondary concern. Does her current facility accept Medicaid? Find out what will happen when she runs out of funds and plan for that day.
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