How long does it typically take to set up 24/7 home care?

xina, I just found a previous post you had written https://www.agingcare.com/questions/how-do-i-choose-between-home-care-and-nursing-home-care-for-mom-206229.htm and I honestly believe your Mom needs to be in a skilled nursing home at this point in time.

When my Dad had around the clock care due to him being a fall risk because of all the stairs in him home, it was costing him over $20k per month, yes per month, not counting the cost of maintaining a large home, groceries, yard work, etc. If he had continued that route it would have cost him $240k per year on just care alone.

What I had to do for my parent is that I called a caregiver Agency and set up 3 shifts of caregivers per day. The night shift does NOT sleep, that person needs to stay awake to listen to see if your Mom gets out of bed or if she needs any type of help.

Since your Mom refuses to go to a facility [which is common for those elders who are much older as they don't realize that today's facilities are much nicer then what they might have seen back a half century ago], you would need to set up her condo like it was a nursing home.

You already have on your list a hospital bed. What about bathroom needs? Is your Mom able to walk on her own to use the bathroom? Would she need a potty chair in her room. Would she need someone to lift her from the bed to a wheelchair to the toilet? Would someone be able to lift her? Her bathroom might need grab bars on the walls, the landlord would need to have someone install those. Put on your list a shower chair, and toilet bars if Mom has trouble getting up off of the toilet. What a about a wheelchair? Would it be able to go through the door openings?

If you hire a caregiver who is not from an Agency, then you Mom would need to add a "workman's comp" rider to her renter's insurance, this rider is needed in case a caregiver gets hurt on the job [back injuries are the norm]. If hired from an Agency, the Agency is usually licensed, bonded, insured, and have their own workman comp rider.

Oh my gosh, there is so much to think about.

Xina, I understand ( and i think everyone here does) that we're preaching to the choir. (And obtw, you're incredibly fortunate that you live where you do. Medicaid doesn't cover 24/7 care inhome anywhere else that i know of).

My big question is, what do the discharge folks say? Are they helping you set up home care? As i posted previously, the doc has to script all this (services, hospital bed, therapy) in order for it to happen.

How is mom's grocery shopping going to get done? Is she going to accept Meals on Wheels? Is she going to be cranky hecause the aide doesn't cook the way she's used to? How will she get to Doctor appointments? Has she been using Access a Ride, or does that need to be set up?

I think the chances of home care working depend a lot on how flexible your mom is willing to be about a lot of issues. And frankly, she doesn't sound very flexible.

If you haven't already, make an appointment to sit diwn with the social worker at the facility to get an idea of what YOU need to arrange, which agencies to call, etc. Also, talk to the SW in your mom's complex and see what she suggests. She almost certainly knows which agencies already have aides working there,who is reliable and what resources you can access.

You sound like a wonderful daug hter and your mom is VERY lucky to have you in her corner. And i do understand that mom wants to go home. My elderly friend was the same way, and the three of us ( my ex, his wife and to a very minor extent I) were able to make it happen. But frankly, it was Heck on wheels.

Xina, has the discharge team approached YOU about this? If they haven't, I'd let it go until they do. If mom is pestering you say " I dont know mom, that's up to the doctor when you get discharged". Let her pester them!.

The other question, of course, is how mom is going to pay for home care. It's about $25 per hour. Until Medicaid gets approved, i guess she is going to have to pay privately. So each day would be $600 or 4200 per week. (That's the way I'd present it to her).

The thing that took a LONG time to sink in for us? The fact that mom WANTED something didn't mean it could be done, or that it was the best thing for her. And sometimes, rather than pushing back, you just have to let that sink in, both for you and for mom.

There are some holes in the thinking here. The biggest one is that Medicaid won't pay 24/7 caregiving service in the home. Programs such as PACE that work with people aging in place do work with Medicaid or Medicare, but there is a limit on caregiving services. The clients are expected to be able to live independently or with the help of a family caregiver. Medicaid will assist with payment for low-income individuals that enter nursing facilities.

What kind of trust was set up?

I would be interested to know how Medicaid would cover at home care for a patient around the clock in their home. There are no services like that, that am aware of in my state. I was informed that PACE may provide assistance, but it's to the family or privately retained caregivers and is not a main source of caregiving. I think I would get the details on how you expect that to work in advance.

If there were no other option, then mother might be better able to accept the idea of the NH. Have you considered that her expectations are unreasonable? With you working full time, it sounds very involved and very expensive for her to come home. Many people cannot afford in-home, around the clock outside help come into the home.

I recall that my cousin was completely convinced that she could live at home with the help of neighbors, but in reality, she was not able to prepare food, use her telephone, stove, washer or bathe on her own. Her expectations were just not based on reality.

The ability does not always match the belief the senior may have. I think I might have a NH lined up, just in case she needs to be admitted there quickly. Keep in mind that she'll have to get her Medicaid application in and approved if she will be relying on it for the costs.

NY state also has a site that provides what services they offer from in home care for those who qualify. I found it quite confusing. It's a wonderful benefit for those who qualify, but, I found it difficult to figure out the details. I would certainly seek out someone who knows the rules, requirements, etc. very well. ASAP, since, they are likely to require application approval. And if you have to see an attorney to set up Trusts, well....it's a lot to get accomplished. I'd make sure the attorney has taken care of everything in advance. I recently read a post around here where a woman had retained an attorney to prepare her mother's Medicaid application, submit documents, etc.

If you don't want to be the person who tells mom that it's not feasible for her to come home right away, then why not have the social worker or whoever is in charge of her discharge do it? When they learn that no one is there to provide around the clock care yet, they can figure it out and tell her what the truth is.

Xina, i would start by asking the facility social worker that question. "So, mom's discharge date is comimh up. Mom wants to be care for at home. How do i go about setting up home care". Have you started her Medicaid application yet? You need to get hold of 5 years of banking statements for starts, from what i understamd.

"I realize saying "no" is very difficult, because if you waver, you will be the full-time caregiver." freqflyer I agree; this is what will happen. Maybe it's your mom's real plan -- to be in your house/apt. being cared for by you.

"If time is an issue for setting up all of the home care, then I can't imagine how much more time supervising how things are going on in her home, once she arrives would be." Sunnygirl1 Exactly. Sounds like your mother would be complaining about the caregivers. And, as someone already mentioned, you will be on the hook if someone doesn't show up.

Now's your best time to act, since your mother is in rehab. If you go against your mother's wishes (facility for her), what is the worst that can happen? I can well figure out what the worst will be if you DO NOT keep her in a facility.

So, Std, does your agency cover NYC, and do you accept Medicaid?

My Aunt and Uncle, he with dementia and she with advanced heart disease and mobility problems, stayed at home successully with 24/7 aides until my aunt died. But they were millionaires.