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Mom has Alz. 86 yo Dad has cancer and has been her CG. Mom's sleep cycles have reversed. Paying for overnight CNA so my Dad can sleep as Mom is agitated, in/out of bed, confused, delusional, etc. They had enough retirement money to live until 90 *but* not to pay for dementia care or extensive care for either of them, really. As we all know, it's exorbitant. They're burning $6300/month for overnight care. They'll be out of money in a year at this rate. Actively working with geriatric team to try to get the sleep cycles back with hope that if she sleeps 5 - 6 consecutive hours, my Dad can take care of her and CG can switch to days. Right now, though, a professional absolutely needs to manage her.


Think I understand the basics of Medicaid. Problem as I see it is they have to spend the bulk of their remaining money before they quality *but* they don't own a home to 'keep.' If my Mom needs placement, Medicaid will cover that, but my Dad, as the community spouse, won't have anything to live off of beyond his ss and since he doesn't have a home to stay in, nowhere to live? There's senior housing here but with a 12 - 18 month wait list. If we can keep her at home and they can live together, Medicaid will cover care for her in the home but they still won't have enough money left to cover rent.


Am I understanding Medicaid? They don't have life ins., veteran's benefits, or LTC insurance. Both had been extremely healthy until the last two years and other than their respective, primary diagnoses, are otherwise healthy; I think this will go on for years.


Have three siblings but my husb. and I are local (chose to have them move near us 1.5 years ago 'in case' they needed help, which we did eyes wide open knowing they would). Two sibs could financially contribute, as can we, one sib can't. Hasn't been great, though, trying to get them to understand our parents' situation. My brother recently announced after a three day visit "I don't see any of the sundowning." Meanwhile my Mom has developed a slew of dementia-related behaviors documented by an entire care team.


Am I understanding Medicaid correctly? I've talked to the county social worker but it seems quite complex. Thought I'd check in with others' experience. Unless I'm missing something, I'm thinking we're going to have to provide housing or funds for housing. Thanks for any insight. Sorry so long.

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1. Check all assets. Medicaid looks back 5 years at all assets they have before anything is done. Then they will use it before qualifying for Medicaid. Get an elder lawyer that can help you get everything in order and maybe a power of attorney because you may need this to do any financial transactions. Im going though this now too. Also if you decide on a nursing home Medicare will not pay for room and board. They only pay 100 days then you still have to come up with 175.00 a day. Research all you can now. As far as your sister and brother talk to them and ask who wants to be in charge of all this and get it in writing or there's going to be issues especially when it comes to money. Im sorry im blunt but if I can help you I believe we need to help others too because its a cruel world and the govt will take all they can get. If they have a trust or irrovacable trust the assets would be safe but it has to be done 6 years prior to doing a Medicaid application.
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worriedinCali Nov 2020
If OP decides on a nursing home, Medicare won’t pay any portion of the bill unless her parent is admitted for temporary rehab and it will likely have to be after a hospitalization. And Medicare will not pay for 100 days in full. They will pay for the first 20 days in full. After that, the parent has to pay around $165 per day unless they have a supplemental to pick up the tab.
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We had issues with mom sleeping, have you talked to her doctors about meds which might help.  Anti anxiety plus sleeping pill as needed REALLY helped
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rigamarole23 Nov 2020
Yes but that’s been difficult. We’ve tried several different ones but none have been great. She has a very good geriatric /dementia specialist so we’ll keep at it. I think the current one is helping. Glad you landed on a helpful combo for your Mom!
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I’ve just posted to someone else like this:- There is a lot of information on site. Click on Care Topics at the top right of the screen, then click on M for Medicaid on the alphabet that comes up, and you will see articles plus old questions and discussions. Then do it again for Medicare, which is a couple of steps to the right. Sometimes a care facility will take over doing this for you, but it would be a good idea to check the general information first.
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Good insights from WorriedinCali. Also, the Medicaid application "lookback" period can be as long as 5 years, as it is here in MN where I live, so you should be informed what that period in your state. If there has been any co-mingling of your parent's funds with yours or siblings, or they have gifted money or given away assets, this could be an issue. A consult with an elder law attorney is an excellent investment and education. FYI once a person needs a CG 24/7 and a higher level of care qualifications (like being a nurse) the monthly cost will exceed that of even a good facility. I wish you much wisdom and success as you move forward and make decisions.
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rigamarole23 Nov 2020
Yes, thanks for the heads up. We purposely have not mixed assets as we were aware of the 5 year look back. My Dad could easily live at home without my Mom from a physical standpoint but, having put each of his parents in a NH 25 years ago, he really doesn’t want to do so until my Mom doesn’t know who he is.

Rn, my Mom really doesn’t need nursing care. Just supervision overnight as she’s a fall risk with her sleep cycles currently in upheaval .

i just haven’t come across anyone whose community parent doesn’t own a house to live in if/when Alz spouse goes into care. No doubt they exist:) . Just don’t have a roadmap to follow between my friends and clients who’ve walked this road.

thanks!
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Does your mother have her own income sources? If so, your father will be allowed to keep some of all of her income if she goes on Medicaid first. Medicaid will not leave a spouse impoverished. He will be allowed to keep enough income to live off of. Since they are married, a consultation with an elder care attorney well versed in Medicaid is something you should seriously consider. Because again there is a community spouse and all of their money may not have to be spent down before mom goes on Medicaid. Now if they both need to go into LTC care now, then they would have to spend down their assets first. But if your dad has a few more years at home, he is allowed to keep some of their assets.
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rigamarole23 Nov 2020
Thank you very much. She has some small income sources. My friend who went thru this a few years ago used the same phrase you did around “Medicaid won’t leave a spouse impoverished.” I think I must be understanding the county social worker because she said “since they’re married, their combined assets are considered but once they qualify, we pull your Mom’s income out.”

I think I will go to an elder care atty. I wasn’t sure if it would be worth the expense as they don’t really have assets to protect. Thx for the help.
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