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When the times comes, what do I need to do to accomplish that?

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Check with your state/county/national laws. Or, spend the money and get advise from a local lawyer that specializes in elder care.
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Reply to Taarna
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Will Medicaid cover LTC for a stroke victim?
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Reply to Patathome01
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I do have to add this...or I should say ask this...
Can you honestly care for him SAFELY at home?
Is your home safe for him?
Can you care for him alone or will you have to hire caregivers to help you?
If you can not care for him SAFELY you really should look into having him remain in LTC.
This does not mean you have "failed" this means that you have accepted YOUR limitations and are doing the best that you can to keep him safe and card for.
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Reply to Grandma1954
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I would never have the hospital keep me alive in the event of a stroke or another condition requiring long-term care. I don't call that living and don't expect Medicaid for assistance. It's on my health directive requesting to pull the plug if not able to recover in one day. I am alone with no one to care for me.
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Reply to Patathome01
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AlvaDeer Jul 5, 2025
The problem is that most strokes don't kill you; they allow you to live, but very impaired. And while you can decline treatment, you won't die of that. Rather you will go to placement where they will continue to nourish and care for you whether you wish it or not. There is no plug-in cord s/p stroke.
When my hubby was in acute stroke condition and in hospital and refused clot buster and embolectomy and telling them "Let me go" I told him "I am willing to let you go, but the truth is you aren't going ANYWHERE but to a nursing home to drool for the next 5 years; this is your only chance".
The clot buster worked.
My advice is get to the hospital ONLY via ambulance at FIRST SIGN of a stroke; it may be completely reversed, as it was for him. It may not. But it is your only chance to avoid a life lived the hard way.
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I was in this position 10 years ago.
While my husband was in the nursing home, I started preparing for his eventual return home. I got a hospital bed, diapers, extra blankets, I even moved to a small, ground level apartment. Then, suddenly, the unexpected call came on a Friday evening; he was being kicked out of the nursing home because they couldn't manage his behavior. I tried to find another care home placement for him, but could not find anything that would work. So, I brought him home, quit my job, and learned all about caring for someone post-stroke.

So, my advice is, first, prepare for his physical needs; do you need a special bed?, incontinence products?, wheelchair?, a hoyer lift?, .... spend a lot of time at the nursing home, observing and learning what it takes to take care of him, so you can be better prepared.

Second, the only way you are going to get paid as his caregiver, is if he qualifies for Medicaid. People who have the financial means, hire caregivers and pay directly. If you have exhausted all your assets and resources, and have no more than $2,000 in the bank, then Medicaid will pay for a friend or family member to provide care under the HCBS program (Home and Community Based Services).
Find out by first applying for Medicaid. Ask the Medicaid application worker about being his caregiver.
It will depend on how disabled he is, what his needs are, and every state has their own requirements. When I started this journey, we lived in Minnesota. Pretty much anyone could be his full time caregiver. That person had to choose a fiduciary representative to manage the budget and payroll. The budget is something that I worked with a case manager to create, and was submitted to the county for approval. My husband needed 24 hour supervision and care. The approved budget included his dietary needs, his incontinence supplies, pay for me (or someone else) as a caregiver, plus pay for respite care. Based on his income, there was a monthly co-pay amount, or spenddown amount, which was, on average, around $1,000 a month. However, I was earning enough as his caregiver, and he received Social Security disability income, so it was worth paying the monthly spenddown. It made up for my income lost when I quit my job.
We subsequently moved to Arizona. In Arizona, I have to be employed by a home care agency, and I need first aid/CPR certification, as well as annual continuing education units in order to keep my job. There is no monthly co-pay, but not as many things are covered, so it works out about the same.

Arizona, as in some states, will send a case manager to determine how many hours of care are needed each week. They will add up, in 15 minute increments, how long it takes to provide the needed cares. You may end up with 20 hours or less. In my case, I had to fight for 40 hours a week, because my husband can not be left unsupervised, so I got hours for supervision, and had to say, I refuse to do it for less. Fight for as many hours as you can get. It will cost Medicaid a lot more if he is placed full time in a nursing home for long term care. They are saving money by paying you to do the job.

The point I am trying to make is, every state has their own requirements, and you would do well to find out what the Medicaid HCBS covers in your state, before he comes home. And, have all the physical components ready in your home.

Be prepared for the emotional and physical exhaustion. It is the hardest job you will ever do. And, you will find yourself doing it without the support of your spouse, and you will become isolated from friends, and the outside world in general.
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Reply to CaringWifeAZ
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CaringWifeAZ Jul 4, 2025
I never wanted to do this. My husband should have died in the hospital, but modern medicine does everything in their power to keep people alive. No one considers the long term cost. My husband in non-mobile, lays in bed or in his recliner, watching TV 24 hours a day. He is resistant to any personal cares, he fights me, grabs my hands, pulls away when I try to clean him, and none of his friends or family want to visit him, because it's not enjoyable for them. It is a very lonely existence, and emotionally draining every day. I wish you the best. Remember that there is no shame in letting him be cared for in a nursing home if or when it becomes too much for you.
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Wirtzk: Go to Medicaid.gov.
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Reply to Llamalover47
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I’d read a lot about what the reality is of caring for someone in the home. Even with help, it’s a huge job that may provide no breaks and limited outside support…especially if resources are limited.
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Reply to Sunnygirl1
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Spouses don't usually get paid. Maybe better to try and get medicaid in home and have them supply the aide and you continue to work.
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Reply to JoAnn29
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The Social Workers in rehab are there to help you. Discuss with them and they can help you define the options better than we strangers from all round the country and at time round the world. Ask to see a Social worker tomorrow, and best of luck.
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Reply to AlvaDeer
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If your husband is a Veteran the VA will now pay a spouse to be the caregiver for the Veteran.
If he is a Veteran and is not in the VA system now is the time to get started on that.
Contact your local Veterans Assistance Commission or your States Department of Veterans Affairs and find out what benefits he may be entitled to.
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Reply to Grandma1954
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Ask the nursing home discharge planner. Please realize that caring for a stroke survivor is very difficult work. And spouses don’t usually get paid for doing it.

What training do you have?
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Reply to Fawnby
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