Our family was blindsided by the rapid onset of my Grandmother's Alzheimer's' disease. Then we were shocked to discover how expensive quality care actually is. She has no long-term care insurance and now we are faced with the whole spend-down notion, Selling her house is an option, but it is rented and providing her income.

If I can find a more affordable Nursing Home, how far away is too far away?

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Well, Dave a/k/a Angels Respite, I was blindsided by the title of your post. "Interstate" means between states, not between countries.

I'm going to be very blunt in my answer, with no apologies.

First, the term "immoral" has no relevance to finding a good place for your grandmother.

Second, the issue of how far away is too far is a relative one. Some families might think 50 miles is too far; others will drive 100 miles.

Third, I think the question is more of whether it's appropriate to find a good, suitable, place for Granny, within driving distance of your various relatives and family members, using HER assets for her care if necessary.

I don't deny that asset preservation is a major and relevant consideration in any placement decision, but they are her assets, not the would-be beneficiaries. And they should be used for her care.

Fourth, I think you want validate what's already been done. That's not a criticism; others face the same dilemma. It's not an easy decision to make.

But there is this conundrum.

Your "On your Mind" comment is:

"Is it unethical to send my Granny to an affordable Nursing Home in Europe to protect her assets here in the States? " Putting it bluntly, hell, yes! It's not only unethical, it's irresponsible, selfish, and cruel.

And I'm guessing that someone in the family already has made arrangements to take over management of her assets.

Your description of the situation also states that Granny has been in a home in Romania for 6 months, so the question of whether it's "immoral" is a moot one. Granny's already out of the country.

In your post you write that she has no long term care insurance; you're faced with the whole spend-down notion, which infers she has some assets to spend down before she can get Medicaid.

You're in California, sometimes working in Eastern Europe. Where are the rest of the relatives? In Romania as well?

And who takes care of the assets she has here, including the home that's rented?

What's this really all about? The post is written in such a way as to raise questions of your real intent, and putting together your "on my mind" thoughts with the selection of words in your post makes me wonder whether someone has their eye on Granny's assets (and their inheritance) and just wanted to send her packing.

Honestly, I'm so appalled by the thought of worrying about her assets rather than her best interests, and shipping her off to another continent that I find this very disturbing, if not outright disgusting.

Then I read the full background in your post, and came upon this enlightening tidbit:

"Granny has been there nearly six months now. She has a healthy appetite and is very strong. I have independent people who check on her twice weekly and report directly to me.

Our situation has turned out better that I anticipated, so well in fact that I am starting a service to help other families who are in a similar situation. Come Check us out at Angels Respite Program website.

So, are you soliciting? Is that what this is all about?

If so, you're a real "piece of work".

You must have a high level job to be commuting from California to Romania, so I suspect the choice of words referenced above doesn't reflect your intellect or profession. Frankly, I think you were searching for ways to encourage people to read, and perhaps check out your website.

And to be even more blunt, I wouldn't even consider checking out your website, or your company, especially if your idea of care is to send someone packing up to an Eastern Europe country half way around the globe.
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BTW, and to other posters:

DO NOT check out Angels Respite; McAfee hasn't green flagged it, which means that the safety and security of the site are questionable.

I Googled it because I wanted to see if it really existed. Given the extent of fabrication in the post, it could be a site for other purposes.
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Just my opinion.
If someone retires to Florida, moving away from family and ends up alone in a NH, with visitors only a couple of times a year, I cannot feel sorry for them....they broke the family bond when they were younger and more able.

If someone lives family style all their lives and suddenly is sent away and cannot be visited by family frequently, i feel sorry for them.

If needed I would seek a NH for my mom, but I would find one I could visit al least once a week.....that would at least be my plan. That is not feasible for all, no judgement.

Your moral obligation is to have her safe and to do what you can to show her your love.
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"We send our kids to college, we participate in medical tourism and many family members live in other states. But when it comes to relocating loved ones, I think the real objection is based from inside oneself. It seems to raise fears, like where will my kids send me when it's my turn?"

No, no and no! Younger, more mobile family members may jet around the country or the world, or relocate to the other side of the planet, but that's their choice, based on what they want for their own lives. You can't compare that to moving an incapacitated, homebound individual to a distant country without their voluntary consent and for no purpose other than the benefit it would bring to others to "preserve" their assets. You may think Romania is lovely, but from granny's point of view, they only distinction between a quality nursing home in one place and a quality nursing home somewhere else is probably the proximity to family members and other loved ones.

How far is too far? If it's too far for family member to easily visit (and by family members I mean not just one person but all those who would normally visit and interact with the elder), then it's too far.

"Judge me as you may, but when it's my time to go I hope to preserve a financial legacy for my kids and their kids instead of hemorrhaging money for 24/7 care. Don't get me wrong, caregivers earn every penny, but I;d rather see my grandkids go to college."

That would be your choice to make when it's your money, but it's not your choice to make with your grandmother's money. You can't assume your grandmother would rather benefit future generations than live in her own country where all her family member are able to come visit her and keep an eye on the care she's receiving. What you describe as "hemorrhaging" money may simply be spending one's own money for one's own care in old age, which may very likely be the reason granny saved that money to begin with.
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I've never been able to figure out why some threads get shortened to the best helpful answers and others don't, it can get really annoying to follow some of the longer threads that have nothing to do with the original question if you don't want it added to your news feed.

Has anyone contacted the admins about this shyster? Maybe it is time for this post to disappear.
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I wholeheartedly agree with Everything GardenArtist posted, as her questions were the same as mine!
But as to your response to her, plan your financial future on your own dime, not on the monies your Grandparent's earned for their own future, that is money they themselves earned, and if in their right minds, probably would have preferred to be spent right HERE, RIGHT NOW, and certainly not be packed off to some foreign country, just so that you could save her money for your own financial gains! That's just sickening! How selfish can you possibly be! Let your kids earn their own way through college, like most every kid does these days, they end up appreciating their respective educations more this way anyhow! It isn't always best to have things given to you on a silver platter, most times, we appreciate things more, when we've worked hard for them! Skype, you Skyping your Love and respect through a computer monitor, how Loving! Not!
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Morality is completely subjective due to the fact that each person has their own set of principles which dictate their code of conduct. In my opinion, if you would have stated that you relocated her for better medical care or to improve her quality of life, I would have fully supported the decision but based on all the financial comments connected to the post, it sounds as though money was the deciding factor. If you think you are doing the right thing for the right reason, who am I to tell you you are right or wrong. In my opinion, by asking the question in terms of morality, maybe you are second guessing your decision and it is up to you to look inside yourself to decide if what you are doing is for the right reasons according to your own principles.
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Garden Artist, since I am working for a tech company, I could access the website safely. The website is the same story that was on his bio. It did not state the actual name of the facility. Dave, here is my problem is tacky and unethical to pretend your one of your own clients on your website and give yourself a review. You are charging fees for providing an escort for the patient and charging extra if it is a medical professional. Also, Romania spends lower than 3.6% of their GDP on healthcare, the lowest in the EU. Then it states you develop a medication program for the patient...for real. You were a movie producer who now is an expert on medical care. By the way, if your a legit company don't use hotmail for contact information, it is really outdated. I still will not say your immoral but it is unethical.
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Oh, I see; the posts have automatically been rearranged into the most helpful answer mode.
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Just to answer the question: Is it immoral to send a loved one interstate for the sake of more affordable nursing home costs?

It really depends on the underlying rationale for so doing. Nursing costs vary and are totally dependent on the person being cared for and how much 'nursing' they need. However you are not dealing with JUST nursing costs or JUST nursing home costs. When the decision is made to put a loved one into care it is really important that people consider the person being put into the care of others.

This isn't a matter of ' that one is much cheaper so we will choose that one' Yes nursing care in large cities or resorts maybe more expensive because that is the cost of owning in the first place and running a home where wages might be higher etc.

Perhaps with that in mind you may choose one a little further away for costs and no that isn't immoral in my opinion - it actually makes more sense. But that decision is that last one you make once you know you are comparing like for like...and I do mean like for like

Ask yourselves some questions

Is Mum religious and if so how religious and does that require dietary provision. What do their menus look like and the timing of them

Yes to any of those means you must check to see that she can access spiritual wellbeing and that includes food - this is particularly important if we are talking Halal or Kosher food. Do they observe the religious days be they Christmas Pesach Eide Diwali or something else (no offence to any religion I missed)

Does mum like to be in a room on her own or would she prefer to share.
Can they provide for this and will the match be monitored for the well-being of both parties? Is the room well lit does it have views - preferably not of a brick wall or the waste bins

Is there a GP attached to the home?

What activities do they have scheduled, Music to movement, singing,painting, drawing, trips out, community inclusion.

What PT do they encourage, is there a specific area for this

Do they have visiting hairdressers, chiropodists, manicurists

Do they have showers AND baths

Does the home smell at all - if it does it means that hygiene isn't as closely monitored as it should be

What laundry provision is there

Can residents bring their own possessions

Is there more than one common room?

Are there tvs in the room or is there just 1 tv room

Is there a library or a quiet room

Are there lifts and if so how often are they serviced and what is the call out protocol should they fail

Is the home close enough for you to visit regularly - this isn't about you this is about them knowing they haven't been abandoned into some strange place where they don't know anyone. Of course if you actually don't care whether they are frightened or upset then I would say morality has already gone out of the window

This is just some of the physical stuff without looking at the audit reports and recommendations of families re the care their loved one received. It isn't about costs until you are quite sure that the homes you are comparing are indeed matched.

As for morals? Your reasoning determines the morality - if it is for your personal gain then it is immoral no question about it. If not then have you done the best you can to make your mum's change of residence safe healthy and secure and that she FEELS HAPPY THERE.....that means she gets doesn't have to family but don't strip her of all friends and family and her home her location and her dietary emotional and spiritual needs and expect her to cope....that IMHO is cruel, thoughtless and immoral
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