So...what do you do if neither you, nor your Mom can afford assisted living?

Elder care is difficult to figure out NJCinderella.

why is it so hard to find information and get help? seems to me that there ought to be a standardized method of going about this. From what I am reading, its this or that, yes or no, maybe, depends. Good lord, got a headache from it and I'm not even in this stage of making that decision!

If your Mom sells her house, you can use the money she gets from the sale to pay for a home health aide. Depending on the state you live in, the costs vary.

So.......this might be an option for you too........just enuf "help" to keep your mom on track with her pills or house upkeep or what ever you see that she needs help with. And there are library books or senior-resources that can help you "navigate" this process. Ask your Dr for suggestions or contact the Dept of Aging. There are ways to get the help you need---keep asking Qs. That was probably the hardest part for us---to BELIEVE that we deserved to get the help we needed enuf to just KEEP ASKING. Hope this helps.

We skipped assisted living ie my sig-other lived with his folks until recently when they finally needed to go to the nursing home. AND still--during the last few years--he needed more help since they both had some physical challenges plus dementia. Anyway they qualified for home-care-helpers to come regularly to the home--all paid for by the Dept of Aging and qualified by a local agency to determine needs: financial and daily skills requirements. So for 1 year we had 6 hours of help weekly--at no out of pocket cost--and the last 6 months that increased to 15 hours weekly. And this is a savings to the state over nursing home cost. It took a toll on my sig-other physically and mentally tho'......yet he felt strongly that he wanted to keep them "in their home" as long as possible.....that is what they had wanted too.....when they could express their desires to him. Now, I see that this path turned out for the best--altho I wasn't sure when we were in the middle of it--because they have adjusted so well to the nursing home--where it may NOT have been so smooth earlier when they were still more aware of where they were etc.

@kjordan17, unfortunately many places will only take Medicaid residents if they've lived there for 1-2 years under private pay. Private pay means you're paying unsubsidized, full rent, plus care fees. If there is a life insurance policy in effect, you may be able to convert it to a long term care benefit (see the article on that on this site). The private-pay requirement may not exist in your state though, so it's a good idea to talk to someone local who can advise you about what options are available. Best of luck!

How do you pay for Assisted Living until Medicaid starts ??

Marwil, I understand! When I was a teenager my mom's mom moved in with us and she just waited, all day, for us to come home. My poor mom had no down time after work and it did my parents marriage no favors. That's why I said "know your limits". My mom thought my grandmother would maintain some independence, but never did. My parents were miserable for years. Honestly it took quite a toll on marriage, health, etc. over the course of a decade+. My cousin lives in South Dakota. She had gotten her mother on Medicaid. Then her mother took a fall in the bathroom and injured herself, and I think it all moved forward through Medicaid after that. Her mother had no assets and social security income of less than $700/month.

thank you Upstream, that was good info. where does your cousin live? I understand that its different from state to state. I live in Florida and its been up hill to get help. my mom is in the same position that your cousin mom was, and its depressing to see your mom in that state when you walk in the door after a long days work. She wont take her depression meds. sometimes all i want to do is lay down for a bit, but I cant cause she's waiting for me for some companionship. I'm the only person she talks to all day, unless someone calls her on the phone. its come to a point where my husband and I are thinking to move back to Philadelphia where my mom is from.
I thought being in florida where is warm would do her good, I quess not. sometimes she wont even come out of her room. its frustrating.

A private elder care attorney would likely be expensive. However, a local not for profit or government funded senior center might provide elder care attorney services or be able to refer you to an elder care attorney who provides some pro bono services/uses a sliding pay scale.

I took my dad in and it was hell on earth for my kids and I and my dad. What I thought would provide structure and support for him was either too much stimuli or not enough. There was every reason in the world to think it would help him but it takes a village to care for a sick elder just like it does a child. It is too much to manage alone in your own home many times. Everyone's situation is different but a near by facility to your home is my personal suggestion. It takes a huge toll on your own health and ability to take care of yourself.

Christine & HelperMom - I'd like to add to HM great answer on Area on Aging. All over the US are council of governments. Some states have 1 COG that is the entire state while other states have many. COG are regional (by county) planning & clearinghouse entities for funding between the Feds and state /local governments and some private funding sources. COGs more often than not are called "area councils". Like TX has HGAC (Houston Galveston area council); San Antonio has AAC (Alamo Area Council) and there like 15 area councils for TX. All COGs have Aging as division as required by law.But over time, aging has grown & become its own almost freestanding "Area on Aging" entity in most areas.

In phase1 of my life, I was staff for certificate of review & other health issues for a really huge, huge COG in the regional planning sector in the 1980's. At the time AOA was in the same building. Now in 2016, this AoA has its own building, staff, 2 satellite offices, etc although is still a part of the COG for funding flow.

AoA is your tax $$ at work. The ombudsman resident & CHAP programs are usually paid by AoA as are Medicare benefits counseling. Some AoA are very well funded and have residential modification /repairs programs, transportation assistance. COGs & AoA can't advertise per se because of how their funded. That why many have no idea that they even exist. But AoA is an way underused resource. Your tax $ - use it!

Wow. Thanks, HelperMom!

Christine - The Area Agencies on Aging are funded by the federal govt to help states provide practical support for families who have elderly relatives with problems. There's an Area Agency on Aging for every county in the country, or at least for most of them. I've found them very helpful.

I've been on this forum for over a year now and a term keeps coming up that I don't understand. I've never heard of an "Area on Aging." What, exactly is that?

The first thing you need to know is that Medicare is medical insurance and does not pay for any custodial care.

The next thing you need to address is whether or not your mom would qualify for Medicaid? If yes, then I suggest you contact your local Area on Aging to determine what if any type of benefit your state provides for Medicaid recipients for residential care. This varies by state since Medicaid is funded by both the federal government and individual states. Also, be prepared that your state may provide the benefit you want but call it something other than assisted living; for example, they may call it senior housing or adult group homes, etc.

Good luck!

Oops, autocorrect got me there. "Indignation" above should say "information"! (Although a substandard facility can make one feel pretty indignant, LOL.)

Agree with some of the answers above. First contact your local Area Agency on Aging. They'll put you in touch with a social worker who can help you sort out the options. They should also have a list of facilities that accept Medicaid in your area, and home care agencies that could be paid for on a waiver. (They should also know which facilities & agencies to avoid, and that indignation is both priceless and something you'll never find on a website!) The one piece of advice I can give is to consider the timing of a move into AL, especially if Medicaid hasn't started yet. Any proceeds from selling the house would need to be spent on her care to avoid delaying the start of Medicaid benefits. Best of luck!

Does anyone here have the medicaid waiver for at home care? I applied to get help with mom who lives with me and am still waiting. I wondered if anyone had it, how it was, how many hours etc. thx

An elder care attorney is going to be expensive so since you say you can't even afford living accommodations, I doubt you could afford an EC atty as someone suggested.

Have either of you applied for Medicaid?

Excellent fleshing out of all of the in's and out's of the AL waiver program, Igloo572. I neglected to do that and it's extremely important information. Thanks!

What state has Assisted Living facilities for only $2,500 a month? We pay double that

Sunnyg, we were able to rent out mom's house and it made Assisted Living affordable. Example: mom gets $1600 in SS and $1000 in rents. Assisted Living was $2500 a month. Avoid getting a reverse mortgage, because it becomes due in full if she moves out of the house.

Be cautious about making all the financials happen so quickly. Consult AT LEAST THREE financial professionals FIRST. The windfall of money from a house sale is only a temporary fix. Maybe putting those assets into a type of annuity or investment to pay for a facility is a better option than having a big chunk of cash. Besides, there are capital gains taxes, etc. Primerica Financial offers free consults; Ameriprise is a $150 consult; of course check with government agencies re: qualifications and limits of assets. Elder lawyer is someone you should have for the full duration of the 'ride' you are about to 'board'. BE AWARE: Government program guidelines change frequently. ALSO: each branch/agency/department does not communicate with the other (in most cases not permitted). Do your due diligence, keep accurate notes. THEN do your 'Ben Franklin': single sheet of pro's and cons for each individual action plan you are considering. Best way to sort out all the financial muck and make a decision based on facts not emotions. If we (three siblings) had done THAT prior to my mother and sister (without brother or me) setting up a POA and selling her house to my sister, my life would be different. As others have said here, yes, your mom's personality style is also a factor. (Our mom can't be with anyone who is not family: she will hold urine and stay thirsty and hungry with a paid caregiver, and wait till I get home! OY!) Formulate the questions you have for the finances, and ask your professions to answer each the same ones. That way you'll have a broad spectrum, and see the consensus pro opinions; will help you understand truth of the matters and best case scenarios. Good luck to you- let us know how you made out.

Medicare does not pay for nursing home or assisted living. Medicaid pays for nursing home, but generally not assisted living. There are a few assisted livings that accept medicaid. What you need to do is visit different facilities, find 4 or 5 really good ones, and ask what forms of payment they accept. The admissions person can help you through this.

Oh......yeh.....I meant with the "difficulty" of helping our elders do what's best for THEM AND US.....the books helped me with this. Those of us who CARE for others and yet WE have limitations too! Its a real challenge to switch roles too--like we (the off-spring) are becoming the parents now and they (our parents) are the ones who need the parenting......and it can happen so gradually too that it's hard to KNOW how FIRM to be and when or if they are just being stubborn etc. AND I didn't even have kids myself.....so I was taking a CRASH course in "parenting". So I'm speaking to the ways we can TALK and HELP them gently on a path toward ways to retain their INDEPENDANCE, as long as possible, yet helping them stay safe enuf too. AND YES, the Elder Attorney is also a great idea for the legal and financial OPTIONS.......not just any attorney knows how to NAVIGATE the complicated and ever changing LEGAL issues.......according to our Elder Attorney. Hope this helps....

Since she owns the house (and I am assuming that she owns it free & clear, without any mortgage or leins), she can do one of two things:
1.) Get a reverse mortgage and pay for someone to come into the house & help her during the day, or;
2.) Sell the house altogether, move in with you and use the proceeds of the house sale to pay for someone to spend the day with her in your home while you & your husband are working.

Assisted living is not really an answer---they don't stay with you all day. They just give help when needed.

Older people are stubborn when it comes to selling their homes----that is their biggest asset and they have control over it. Selling it means that they no longer have their biggest asset under their control. My mother is the same way. I hope the day never comes when she needs to go into a nursing home, because they will take everything she has due to her stubbornness about putting the house in my name. If the situation ever necessitated total care for her, I'd have her take out a reverse mortgage to pay for help in the home before going into a nursing home.

PapaTom & stargazer - about medicaid & AL. One thing to keep in mind is that medicaid paying for AL (AL & not NH) happens via a waiver. & waiver programs can start then stop or change. Waivers are diversionary use of federal funding allowed to the states to do within Medicaid. They are not dedicated funding. Medicaid for the elderly when initially done in the 1960's was written & placed into law (dedicated) to pay for skilled nursing services in a NH.

Over time, waivers started happening to off set the bigger costs of NH care. Some states have wide easily available waivers for AL that pay a good state reinbursement rate so facilities want to participate. Other states don't & for those an AL, if they even participate in waiver program, require a period of time (usually 2years) of private pay before they can get one of the set # of Medicaid beds. Like TX is a very very low reinbursement state so most AL do not participate in waivers, & due to this a lot of NH have residents who are might be ok in AL but are instead in a NH.

Waiver funding can change. What is trending now is that waiver funding is moving to PACE or expansion of other community based programs that keeps them in their home. There is a PACE center by us (Benson Center) that is medicaid waiver funded and seems to be going gangbusters (another is getting set up). But it's not all sunshine & champagne because what these programs do is shift some caregiving back to family either to do for free or private pay for outside of the elders time @ PACE or when the waiver paid inhome caregivers leaves. Most programs have a hour limit as to services provided. Once they go over the tipping point - maybe 32/38 hrs - its not cost effective so the waiver stops.

For family that works or has other priorities or just isn't cut out to caregive, or lives away, or the level of caregiving needed is too much for family to reasonably do, these programs aren't an option. I'm sure community based works for some. But it's not like have your elder being in an AL, NH or board & care home where there is 24/7 staff & oversight.

See an eldercare attorney for your options. You have to be very careful how you proceed when it comes to Medicaid. If she is already on Medicaid no worries. Only Medicaid will pay for nursing homes (unless you have nursing home insurance). If you get her on Hospice Medicare will pay for that.