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Hi..things are getting really hard. Mom hurt her back and stopped going to the bathroom both ways. Dr. got nurses out and we are working on that....but I am needing nurses to stay the night as she is getting worn out and really cold...and asking same questions a lot. Right now I am paying out of pocket. This will break me shortly. She has no money so how do I switch her to Medicaid? Do I need a lawyer? She has one...am trying to get him back..mom fired him during that incident this summer. Does anyone know if it is a long process? And am I restricted to the nursing service I can use? She already gets state help for medicare..thank you!!

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Rw, have you made any progress on Medicaid? Ask her doctor to order a shower aide. Sorry for the rough ride. Nursing homes don't always look pretty, but my mom is getting excellent care and they have the knowledge and knack to deal on the spot with withdrawal symptoms, dark urine and showering. I worry about your health. Godspeed.
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Hi! Been on and off....It was big step for me to put her on the seraquel... we cut the night ativan by half.........the last time we cut ativan by half it was weeks of hellish withdrawls..............with the seraquel she cut her calling me at night from 30 times to just a few..............big difference................but she seems drugged and tired all day.

today she was so tired at noon I postponed the ativan til 3pm ....big mistake.........I am desperate to have her get cleaned up........she has not been able to shower in weeks but we were working together to wash. But she has been refusing....I know she has a bad yeast infection in her groin areas from skin rubbing..........I need her to clean it so I can get the medicine on it..........but she was very upset...grabbed my hair and told me I was gay....so I gave her the ativan ..she calmed down but still would not wash...well I got her feet and underarms done and cut her nails but I will have to call the doctor tomorrow to see if he will send a nurse. maybe she will have better luck.

Her urine also turned REALLY dark..I see that is a side effect with the seraquel....need to ask her urologist.

Trying to break in a few more helpers.......costing a fortune....

but I would rather have her little stoned and my work harder than when I see these nursing homes...

Rick had a few days off and went to the keys with his daughter..I am glad he could go..but am sad I cannot go anywhere ever....but am going to see if these new sitters might consider staying overnight if she can get balanced out...

hugs!
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Rw, hope that all is well!
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I hope you and she both got some rest last night.
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Hugs to you!!!
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thank you so much....I know it is a tremendous effort trying to find the right place...I am praying I won't need to...but your support shows me I need to be aware...I asked the lawyer for three top places..

the seraquel stopped her from calling last night...but she was more out of it all day today...not sure if I am doing the right thing..but both doctors agree on the treatment and I am hoping it will keep her manageable.

will know in time...

hugs
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Really worried, I copied and pasted this answer from another discussion, and it was to a working caregiver, which may not apply to you but it outlines my concentrated effort for a care facility with Medicaid.

the process for medicaid and placement in a skilled nursing facility is daunting but here is how I got through it, sounds like it may be time for you to make this very difficult decision for the best of both of you.

I worked with a Sava Senior care facility in Houston, TX to place LO in a medicaid pending nursing home, I see that they do have some facilities all over US- I was not able to pay the 4,000 to 6,000 for private pay so I was limited to a facility that would take Medicaid Pending. It is my understanding that the states requires some of the facilities to have both Medicaid Pending and Medicaid beds available but it is a limited number.
My LO was falling two to five times a week at home, not able to walk or get himself up and down and was totally incontinent, plus weighs 300 lb and I'm am only a third of that, I was his only caregiver and had to leave him alone while I worked which was just not good. I wanted him in a facility for his safety. My situation was such that my health was declining taking care of him by myself while trying to work and take care of all of my chores as well, it was just too much for me and could not afford full time help to care for him. I took him to the ER a number of times after his falls, they always just checked him out and sent him home, so waiting until he fell and broke something was not an option for me. I never tried to refuse to take him back so I really don't know how that would have worked.
I was desperate to get him into a facility and was trying to check places out in the evening or at lunch, was not getting a lot accomplished. So I just went to my boss explained what I needed to do and took two days off of work. I had been missing a lot of work with him and hated to take more and I was lucky my boss was very understanding and even gave me a few tips. I did some internet research and the Department of Aging here in Tx has a listing of all nursing homes that accepts Medicaid, I called as many as I could to find out if they took Medicaid pending and made a list of the ones I felt were okay. Note, I did not do this on my days off but rather in the evening and lunch otherwise I would have probably had to have taken another day. I made a map and my first day off, I went and visited as many Medicaid accepting facilities that I could including a few that I knew did not have Medicaid Pending available, as they can put you on a waiting list. I visited 8 nursing homes that day and talked to the administrative staff at each one - explaining my story to them, they were most helpful and answered a lot of questions for me, one of the facilities that did not have a Medicaid pending bed actually made some calls for me and recommended a sister facility (this was a Sava Senior) that I eventually placed him in - one that was not on my list so it was a huge help.
But ask a lot of questions - one of the places that was close and I really liked would have crammed him into a room with 3 other people - that was something I noticed in the walk thru that they had some 4 people rooms and I had to ask to clarify that - and indeed the 4 people rooms were Medicaid pending, I did not feel that the transition from home to NH for a dementia patient would be very smooth even sharing a room but 4 in a room (a small room) was just too chaotic. So ask a lot of questions.
By the end of that very long day, I was exhausted but had chosen two that had Medicaid pending beds available, a first choice and then a second for backup and knew what they needed to start the process.
My second day, I collected the paperwork that the nursing homes needed as well as bank statements - SS info etc. (In retrospect - I should have done this the first day, as I could have just given the nursing homes the paperwork when I visited as this could have made things quicker. but as I was going back with LO to have him look at facility as well, I just took them the paperwork that day.
I needed full medical record from Primary Care Dr - along with medical record from his Neurologist (this is very helpful in getting him accepted at the NH especially if he has dementia) and record from his last ER visit. I called the Drs offices and hospital in the morning and explained to them what I needed and that I would come that afternoon to pick them up - did not take no for an answer as one of the dr's offices tried to put me off. I had printed out his bank statements for the last six months, downloaded a Medicaid application and filled it out, made copy of his DL and SS card as well as his insurance information and made a copy of his small life insurance policy, I then carried all of this to Kinko's and had 4 copies made, one for each nursing home, one to use with the Medicaid application and a spare just in case.
When I took LO to NH to visit - we only went to the first one because he was okay with that one, I was able to hand them all the paperwork needed to start the process, and a week later I was able to get him into the facility. Now this was not an easy decision and I am still wrestling with guilt - he is being pretty good but asks to come home - but he is getting physical therapy, regular bathing, his medications and has only fallen once in over two months. I know that a lot of caregivers that comment here do not like NH - and truth be told, neither do I, but I do think every situation is different, in my case - since his children would offer no help or support and with his financial situation the SNH really was the best choice for his much needed full time care and safety. I do feel better about placing him because I did the multiple visits - you would expect the more expensive homes to be the nicest, but that was not always the case and a couple of the places I got no further than the front door and I knew that it was not going to work, however, I did the tour and talked with them, well just because I was there and wanted as much information as possible in making the decision.
Now just so you know, once he is Medicaid approved - you can easily move him to another facility as Medicaid approved beds are more available than Medicaid pending.
I may move LO as the facility he is at is not as close as I would like but will leave that up to him, he is about a 25 minute drive, there is a facility about 10 minutes away so I could visit more, but he is adapting and doing pretty well so will think long and hard before moving him.
For your information, the nursing home submitted the Medicaid application on the day of his arrival - approx 8/15/14 and I just last week got the approval back, I do think that filling the form out correctly and providing them with all paperwork required at the time of submission makes it go faster.
Good luck with your LO, I hope that this helps. I really think that waiting for a LO to fall and seriously hurt themselves before getting the proper help is a very serious flaw in the medical and insurance care of elders.
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This is an answer from the question "Can I refuse to take my dad home from the Hospital. It's a detailed description of how this nice lady, Louise44, got her LO into a good nursing home, Medicaid Pending. I thought it might help give you some ideas on how to proceed.


Pyrrhe, not sure where you are at in Alabama, but I worked with a Sava Senior care facility in Houston, TX to place LO in a medicaid pending, I see that they do have some facilities in Alabama- I was in the same situation not able to pay the 4,000 to 6,000 for private pay so I was limited to a facility that would take Medicaid Pending. It is my understanding that the states requires some of the facilities to have both Medicaid Pending and Medicaid beds available but it is a limited number.

My LO was falling two to five times a week at home, not able to walk or get himself up and down and was totally incontinent, plus weighs 300 lb and I'm am only a third of that, I was his only caregiver and had to leave him alone while I worked which was just not good. I wanted him in a facility for his safety. My situation was such that my health was declining taking care of him by myself while trying to work and take care of all of my chores as well, it was just too much for me and could not afford full time help to care for him. I took him to the ER a number of times after his falls, they always just checked him out and sent him home, so waiting until he fell and broke something was not an option for me. I never tried to refuse to take him back so I really don't know how that would have worked.

I was desperate to get him into a facility and was trying to check places out in the evening or at lunch, was not getting a lot accomplished. So I just went to my boss explained what I needed to do and took two days off of work. Like you, I had been missing a lot of work with him and hated to take more and I was lucky my boss was very understanding and even gave me a few tips. I did some internet research and the Department of Aging here in Tx has a listing of all nursing homes that accepts Medicaid, I called as many as I could to find out if they took Medicaid pending and made a list of the ones I felt were okay. Note, I did not do this on my days off but rather in the evening and lunch otherwise I would have probably had to have taken another day. I made a map and my first day off, I went and visited as many Medicaid accepting facilities that I could including a few that I knew did not have Medicaid Pending available, as they can put you on a waiting list. I visited 8 nursing homes that day and talked to the administrative staff at each one - explaining my story to them, they were most helpful and answered a lot of questions for me, one of the facilities that did not have a Medicaid pending bed actually made some calls for me and recommended a sister facility (this was a Sava Senior) that I eventually placed him in - one that was not on my list so it was a huge help.
But ask a lot of questions - one of the places that was close and I really liked would have crammed him into a room with 3 other people - that was something I noticed in the walk thru that they had some 4 people rooms and I had to ask to clarify that - and indeed the 4 people rooms were Medicaid pending, I did not feel that the transition from home to NH for a dementia patient would be very smooth even sharing a room but 4 in a room (a small room) was just too chaotic. So ask a lot of questions.

By the end of that very long day, I was exhausted but had chosen two that had Medicaid pending beds available, a first choice and then a second for backup and knew what they needed to start the process.

My second day, I collected the paperwork that the nursing homes needed as well as bank statements - SS info etc. (In retrospect - I should have done this the first day, as I could have just given the nursing homes the paperwork when I visited as this could have made things quicker. but as I was going back with LO to have him look at facility as well, I just took them the paperwork that day.

I needed full medical record from Primary Care Dr - along with medical record from his Neurologist (this is very helpful in getting him accepted at the NH especially if he has dementia) and record from his last ER visit. I called the Drs offices and hospital in the morning and explained to them what I needed and that I would come that afternoon to pick them up - did not take no for an answer as one of the dr's offices tried to put me off. I had printed out his bank statements for the last six months, downloaded a Medicaid application and filled it out, made copy of his DL and SS card as well as his insurance information and made a copy of his small life insurance policy, I then carried all of this to Kinko's and had 4 copies made, one for each nursing home, one to use with the Medicaid application and a spare just in case.

When I took LO to NH to visit - we only went to the first one because he was okay with that one, I was able to hand them all the paperwork needed to start the process, and a week later I was able to get him into the facility. Now this was not an easy decision and I am still wrestling with guilt - he is being pretty good but asks to come home - but he is getting physical therapy, regular bathing, his medications and has only fallen once in over two months. I know that a lot of caregivers that comment here do not like NH - and truth be told, neither do I, but I do think every situation is different, in my case - since his children would offer no help or support and with his financial situation the SNH really was the best choice for his much needed full time care and safety. I do feel better about placing him because I did the multiple visits - you would expect the more expensive homes to be the nicest, but that was not always the case and a couple of the places I got no further than the front door and I knew that it was not going to work, however, I did the tour and talked with them, well just because I was there and wanted as much information as possible in making the decision.

Now just so you know, once he is Medicaid approved - you can easily move him to another facility as Medicaid approved beds are more available than Medicaid pending.
I may move LO as the facility he is at is not as close as I would like but will leave that up to him, he is about a 25 minute drive, there is a facility about 10 minutes away so I could visit more, but he is adapting and doing pretty well so will think long and hard before moving him.

For your information, the nursing home submitted the Medicaid application on the day of his arrival - approx 8/15/14 and I just last week got the approval back, I do think that filling the form out correctly and providing them with all paperwork required at the time of submission makes it go faster.

Good luck with your Dad, I hope that this helps. I really think that waiting for a LO to fall and seriously hurt themselves before getting the proper help is a very serious flaw in the medical and insurance care of elders.
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Oh, RW, I hope so to! Good thoughts and (((((hugs)))))!
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Hi

things got really difficult and the doctors both want her to try seraquel tonight and ease a tiny bit off the ativan. I know it is controversial so I am hoping it works.......she has been calling 30 times a night...I do shut my phone off now..but she called the cops last night saying she was in a hotel freezing. at night she says she is being raped..locked in rooms...she accuses me of trying to kill her and then she snaps out of it and does not remember.....she is also mean to the help and then gets upset when she realizes it....

I did go to her lawyer and medicaid covers only limited at home help here and she is on a wait list....and I did ask for the best nursing homes just to look into....I really hope it doesn't get that bad.

praying tonight is better with the seraquel and it does not hurt her.....ahhhh..
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I agree I will do some investigating. Just dealing with her back compression fracture....doc gave tramadol....helped with pain but caused unreal nightmares when awake....I am now shutting off my phone...but one night she called me 40 times leaving weird messages..........and called the nurses who were at home .....telling them she was locked in her room and not out for days.........ugh. Doc took her off it after a week and she will have to deal with the pain. Seeing Geriatric Psychiatrist tomorrow....to see if we can switch her off ativan to something that does not affect her memory.......any suggestions?? I hope a new med will help...it gets odd here at night..esp after 7pm...sundowning. but hanging in! trying not to take it personally..........and try to work, exercise and give some time for my relationship. thanks for the support!!!
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RW, I understand YOUR point of view, but I also think that you should call all the nursing homes in your area and ask if the accept Medicaid. Does mom have any funds? Could she perhaps private pay for a few months with pension, Social Security? Some places will accept a client as "Medicaid pending" and they will help you through the application process. I wouldn't just accept the attorney's views without doing some investigation of my own. What does her doctor say she needs?
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I know your point of view...I am just not able to do that to her at this point. Her attny even said the homes in the area that take medicaid are just so so. I have to get her on medicaid first....started the ball rolling...but they do not supply night nurses??? that surprised me! am meeting with her attorney to discuss things next week, right now trying to catch up with work.. thank you though..I know you are looking out for me....
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Honest, RW. You get to visit and not argue. She gets to keep the temperature where she wants it. She gets to wake up 9 times a night and it's not you waking up.
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RW, for the sake of your own health, get her to a Nursing Home. It takes three shifts of nurses and aides to relieve each other for two reasons: 1. Better care for the patient. 2. Survival: both yours and hers. It will give you more time to be together in the long run. Honest.
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Hi.I know you are right....I just want to keep her at home as long as possible. The doctors found the break in her thoracic region...and put her on tramadol as he said it was non-addicting.

But the doctor feels that the ativan may be accelerating the memory loss and when my mom is feeling good, she is shocked by the tapes I play of her.

So we are going to discuss with the psychiatrist about switching her to another tranquilizer......I hope there are others out there that are not benzos.

I was reading reports from the UK and they say benzos are causing longterm brain damage and are harder to kick than heroin but marketing dollars are keeping it quiet. very scary.

going to try to figure things one step at a time.....

trying to get through to medicaid today...thanks so much for your support...

hugs
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RW, If you are paying nurses to stay with your mom at night, where is the logic in allowing mom to fire them? They are working for you, not her. See, the thing is, you can't reason with mom, because she has dementia. This is why she needs to be in a care facility. To save your life, health and sanity.
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And P.S. --- about making the nurses leave --- Does this fit into your mother's history of getting rid of people who she sees as coming between you and her? That is, the past boyfriends, your present boyfriend, your hairdresser.
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What ba8alou said. I'm glad she brought it up.

I've been tiptoeing around the nursing home question for fear of your reaction. If you read many, many threads here, you see that people start out saying "my mother would never survive in a nursing home," or "I promised I would never put him in a nursing home," or something of the kind. Once you refuse to discuss the question further, you get stuck. Put aside the "I would never put my mother in a nursing home" and think about "what would happen if I put my mother in a nursing home." To her? To you? Surely, she'd be safer and calmer---and you would get a good night's sleep for the first time in years. I just re-read your post from last night --- your mother "made the night nurse leave" and "threatened to call the cops." RW, for heaven's sake: those aren't rational acts; your mother is suffering from dementia! She needs to be in a place where she isn't the night nurse's boss, and where qualified people can prescribe actions or meds to calm her down.
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Ask the doc about a Lidocaine pain patch for her back. works wonders for my mom.
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RW; I know that you've always said that your mother would decline rapidly in a facility. She's declining rapidly at home and she's going to take you down with her. I'm so sorry that this is happening, and I don't mean to hurt you with my words. But to me, it's very clear that your mom is going to need 24/7 care very shortly, if not now. Make the Medicaid calls tomorrow. But also check out some local nursing homes (If, when you talk to the doctor, he thinks that's the level of care she needs) and get the ball rolling there too. And don't ask her permission to do this, or even mention it to her. You are going to have the be the one who decides to save your own life and future in this situation. RW, we all love you and want to support you through this difficult journey!
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mom just made the night nurse leave....ahhh this is the third one she didn't like. and this one I really did like...but she threatened to call the cops....

my mom got into bed with her bad back--which she knows can be a problem..and when the nurse tried to help her apparently she said it hurt more..

and the nurse tried to ask her to please stop calling me.....

ugh.....unreal...I am not answering her calls anymore tonight
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Thank you so much!! Actually all her tests are normal---and she has never had cancer or heart disease or any operations of any kind....so I do not think she would qualify for Hospice as technically she is healthy.

She has declined through rapidly since the summer with the Ativan and Hyrdocodone issues.

The doctors think her back pain..perhaps a broken bone they cannot see-----caused her to get constipated and that slowed her urination.

After all the home treatments and nothing working...the doctors sent a nurse for a high colonic.....and it got things moving. And she peed a little more.

Now they are waiting to see if things can resume naturally....right now it is slow and she is not feeling too well....lack of energy etc

The doctors are sending nurses to examine her...

The coldness is an issue she has had for years but it is getting worse....she is now keeping the room at 90degrees..

again the doctors have run all the tests...normal!!

I am getting on the medicaid plan asap..thank you!!

I totally forgot with everything what to do....as I am trying to keep my business running...

but when I saw how much just a few nights of nurses are costing I realized I would be broke again in no time......and I cannot let that happen again.

Thank you for your support...I will be making calls tomorrow.

after I go to my doc...the stress is getting to me and I have not been taking care of myself...so I want to get some advice...

I realize from all of your support how easy it is to let everything go...money, health , relationships,work....I see now how I was trapped in a situation that was getting odder but I was so close to it I could not see it...I was just in survival mode...

now I realize I need to preserve my health ..money and relationship...this could be years of this left....

although honestly I pray not for both her and me..

thanks!!
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Oh, RW, poor you! You have a lot to deal with. Take Pam's and ba8alou's advice: ask for help. Now! A local hospice provider, local nursing homes, her doctor, the local Medicaid office, the Council on Aging --- you're probably going to find that they're all very helpful. Just call any one of them, tell them you need to apply for Medicaid for your mother, and ask who to talk to to get the ball rolling, and go on from there. I don't think you really need a lawyer --- this is an administrative process, not a complicated legal matter --- but there are lawyers who specialize in Medicaid matters if you think it's too much for you to deal with yourself. When my daughter-in-law decided to apply for Medicaid for her mother, the staff at the local Medicaid office basically took her by the hand and walked her through the process.

I suspect it will be easier than you think, although other folks on this forum know much more about it than I do. And I'm sure it varies from place to place.

Also --- when you say your mother "stopped going to the bathroom" --- do you mean she is using a bedpan, or that she's incontinent in the bed or in her clothes, or that she has actually stopped urinating and defecating?

And when you say she's cold at night --- are her hands and feet actually cold to the touch, or is she still feeling drafts that aren't there?

Finally, back to Medicaid --- sorry I'm jumping around, I'm actually at work --- don't be afraid of the agency. I think they'll admire you for having kept an elderly, blind and disabled person off of Medicaid at your own expense for so long.
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RW, you need to have a heart to heart with the doctor about her condition. Does the doctor think that she has more than six months to live? Does s/he think that her condition would improve with round the clock care? Yes, you need to get her on Medicaid asap; does she have a caseworker through Social Security Disability? Call your local Council on Aging and ask for help.
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If she is not peeing or pooping, and her extremities are cold and she is delirious, she needs Hospice now. Hospice is fully covered by Medicare. Call the Palm Beach Hospice in Del Ray, (561) 265-6000
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