My husband's sister is in a nursing home with no family members around. We would like to transfer her back to her old home town. Any suggestions? - AgingCare.com

My husband's sister is in a nursing home with no family members around. We would like to transfer her back to her old home town. Any suggestions?

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She was placed in her present location to be near her son who recently died. Her other son lives many miles away in another state and has DPOA. He is agreeable to having her transferred but the nursing home we want to place her in requires a copy of her Medicare card which is nowhere to be found and the surviving son says there is nothing he can do. The patient is on Medicaid and has dementia and is unable to speak. She has been in several facilities over the past years and we have attempted to contact them all in hopes of finding the Medicare card to no avail. Her present facility did not require a copy of the card when she was admitted. We are so frustrated and seem to hit a brick wall every time we attempt to get an answer. We believe the surviving son (only child left) is the Payee Representative as well as DPOA but doesn't seem to comprehend some of the things he is able to do. Who has the authority to request an address change and a new Medicare card for a beneficiary? And how is this accomplished? Any helpful information is appreciated.

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If she is unresponsive she will not benefit from the upheaval of a move. Do not let guilt cause you to disrupt what is her life, if she is content where she is, let her be content. Plan trips to go visit her, change for dementia patients can cause so many problems, even causing the disease to advance more quickly.

The above post is all true, so be prepared for a mountain of paperwork and have something in place for the in between time. I found out the hard way that Medicare replacement plans end at the county line. You do not want to get stuck paying out of pocket for nursing home, they are extremely expensive.

Please think long and hard about this move, for her benefit.
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If sister is on Medicaid in the nursing home, the nursing home is probably receiving her social security as her share-of-cost for her care at the nursing home (instead of the brother being the representative payee). You need to understand that moving her out of state means that her Medicaid stops at the state line. Your sister-in-law will need to be moved at your family's expense (which will not be paid for by any public programs in either state or by either of the nursing homes) and she will need to be qualified to receive Medicaid in the new state. All of this requires a lot of paperwork, medical documentation, and boots on the ground to get her packed and prepared for move. You have to find a nursing home willing to take her Medicaid pending, as you really can't start application process until sister is a resident of the new state. If she owns a house in the old state that was exempt asset, moving her to a new state means it's not an exempt asset any more and the house might have to be sold. It's really a much more complex situation than moving an apartment from one state to another would be. Sister would also have to find new Medicare plan in her new state if she is Medicare Advantage as those don't cross county lines in many cases, much less states.  To answer your original question, whoever is her Power of Attorney can request a replacement Medicare card. If the other brother doesn't have Power of Attorney, you'd need to seek guardianship if her dementia is that advanced. And that's very expensive and would need to happen in her home state and be transferred to new one.
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I would seriously consider if the move is worth all the effort. If her dementia is advanced she may not get that much out of a relative visiting occasionally. Change like this is very hard on dementia patients who need routine.

I manage my parents care from 3 states away. They are at the point when my visits do as much harm as good, reminds them of home, and away we go with the confusion etc.....Staff calls me about meds or any issues and I call staff to check in about every other day.

I thought about moving them near me but the logistics, insurance issues etc were daunting.

This is just one situation but I’ve been able to make it work.
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