My mom is 86 years old. When the time comes, I will place her in a nursing home, though she has said she doesn't want to.

I DO NOT want the responsibility of being the caretaker. I am the only sibling here. How do I prepare for this next phase?

She has excellent insurance, so I'm wondering should I start interviewing N.H. now?

Have you discussed it with her and do you have Durable POA and Healthcare POA for her? Does she have an advanced medical directive? I might discuss plans with her to let her know her options now, so it is clear that you will not be able to provide her daily care. Is she realistic about how much she can do? I know that some seniors who have extremely limited mobility seem to have magical thinking that they can continue to live alone, prepare meals, manage hygiene, etc. when they are not able to even walk unassisted. I'm presently trying to get my parents downsized into a more practical living arrangement, but, that is easier said than done.
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Reply to Sunnygirl1

Your profile doesn't suggest that there is anything amiss with your mother mentally, is that correct?

If it is correct, then with respect this is not your decision. It is for your mother to plan her own later life and end-of-life care. You can make it clear that you will not participate, and you can stick to that, but you cannot choose to place her in a nursing home without her agreement; so as she has excellent insurance I should start researching what other options are available to her.
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Reply to Countrymouse

It may not be your decision about placing your mother into long term care, but it sure IS your decision not to have her come live with YOU. Since your home is not an option, her only other choice is to use the insurance policy she's paid handsomely for for years, or find another relative to move in with.

That said, find out if her insurance policy pays for Assisted Living and if so, find a facility with a continuum of care. She can start out now, or soon, in Assisted Living, then move to Skilled Nursing as her needs increase, depending upon how long her policy pays for. My mother has been in AL since 2014 and she has a good time with all the activities and other elders to hobnob with. AL has extended her life....she is 93 in Jan and would have passed away long ago if not for the nurses catching 2 cases of pneumonia immediately. There's lots of good to be said for AL, that's for sure.

Go check out some places and speak with the staff and the residents about their satisfaction level with the facility. I've found that to be most beneficial when looking for a good place for my folks.

Gold luck!
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Reply to lealonnie1

No idea how far off this placement might be, but keep in mind places you research and visit now may not be the best at the time you’re looking at your mom moving in. NH’s are often corporately owned and experience being bought, that can change things quickly. A good sign is how stable the higher paid staff, such as director of nursing and therapists are, when they’re long term and stay it tends to show a more positive place. But anyplace you feel good about now will need to be reevaluated before actual placement. Best wishes, this is never easy
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Reply to Daughterof1930

I would start looking into places. My brother & I went to 15 places for his Dad and his wife, for AL. It sounds that like your mother at this point doesn't have to be in a nursing home. We chose a very nice place that has a step up program, IL, AL, MC and then Nursing home, right now they are both in AL, however his wife will need to go into MC at some point.

They really like where they are, have made new friends and attend the activities. We would have engaged them more in the search however, they were being moved from AZ to Florida. If I were you, I would do the initial search narrow it down and then take her to see the best options.
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Reply to DollyMe

Big, I assumed by “excellent” insurance, your meaning LTC policy, if so a couple of things to think about imho......
she cannot just enter a NH at will &
the LTC policy will have needs restrictions &
some NH do not take LTC policies.
Now if she’s got tons of $$$, she can get into an only private pay type of exclusive facility whatever her needs are & it will be breathtakingly expensive. But otherwise, she will need a referral from her MD & a needs assessment done by the facility. This is all about ensuring her care needs are what facility can do. Sometimes NH will actually decline admission as the elder needs locked ward MC or does not actually need skilled level of nursing care or has medication management that the facility is not set up to do.

Regarding facility not taking LTC insurance, my moms NH did not. It was MediCARE, Medicaid or private pay only. In chatting with billing, I was told was that LTC policies were flat too much of a bother. That there tended to be myriad of items / paperwork needed to get paid & foot dragging about something or other. NH could easily fill their beds without LTC insurance residents. I have no idea if this is common, but I was surprised. I’d try to clearly find out what’s what for facilities in her area. Also ask if the NH puts an extra fee on for administrative costs associated with LTC insurance policies.

Please carefully review policy as to the terms. Like if has inflation rider. Also what gap is for start of policy. Most have set period of time for start day of of eligibility - perhaps 60, 90 or 120 days from her entry for LTC with documented need for skilled nursing care that is private pay. She needs to have cash to pay for the gap as MediCARE or secondary health insurance is not going to pay her room & board. Also look as to daily amount paid once LTC policy is activated & if it’s enough AND if there are restrictions as to who must provide care.

If she is still in payable premium mode, look to see if an increase is looming. Lots of folks encounter. If this is a last millennium policy, several insurers do not write new policies and service on LTC specifics is spotty. Really read the fine print now so minimal surprises later.
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Reply to igloo572
gladimhere Nov 21, 2019
That was my question. Is excellent insurance a long term care policy? Medical and hospitalization insuance will only pay for a certain number of days. Will not pay for long term care. This is something that is often misunderstood when first learning about insurance and what it will actually pay for.
We are interviewing LTC facilities now for my FIL and the main thing I've learned from caregivers on the AgingCare forums is: go prepared. Have a list of questions of everything you can think of and then schedule a meeting with the admissions officer. There is so much to know and so many levels of care they'll go over that you won't be able to remember it all (or will be doubting yourself as you try to remember what you think they told you). I have six pages of questions and ask them all, from 'how do we pay?' to 'how often are fire drills conducted?'

At the very least if you don't go with questions, take a notebook with you. Record the name of the facility, date you visited/called, names of people you talked to, and their phone numbers for follow up questions.

You say that mom has 'excellent insurance' but it might be that not all facilities accept it. Assume nothing and ask them.

The amount of info you need is daunting... and the financials can be overwhelming when you are being asked to complete multi-page forms. From doing these I put together a one-page 'cheat sheet' on my FIL that includes everything being asked, from when and where he was born, active dates of service duty, marriage, employment history, banking account balances, life insurance face and cash value, burial plot, etc. It's all there so we can readily see it.

Good luck!
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Reply to TekkieChikk
cherokeegrrl54 Nov 21, 2019
Awesome advice for all of us facing this in the future!! Thank you
Here is a link to the Medicare site which offers ratings on Nursing Homes based on inspections that were done and allows you to compare several at a time:

Good luck to you - it's a daunting exercise but if you're prepared and ask the questions that are important for you and your Mom, you will feel better about your decision.
Helpful Answer (4)
Reply to AvaC42

Don't make any assumptions about what insurance will cover. Check and double check. You may not have the choices you think you have.
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Reply to Robinlynn

bigsispjt: Why are you jumping right to Nursing Home care? Do you think that she requires that high a level of care already, when in fact she may not?
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Reply to Llamalover47

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