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Can someone please me advise on the next step? My 70 y.o. bipolar brother lives alone in a 1-bdrm and now shows signs of dementia. He is now fighting me and forbids my help. He is losing, breaking things, apt is a mess, and now can't keep track of 9 drugs he's on. He cannot drive, has no teeth, has poor vision despite glasses. A recent hospitalization indicated he is in danger of stroke or heart attack with off-the-chart blood pressure. He can't keep track of his meds.



He survives on only social security but his monthly check is too high to qualify for Medicaid (last I knew). But I can't afford to institutionalize him. How can I prove to the state he is in (Georgia) that he needs 24-hour care?

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I am from NJ. The income cap for NJ LTC Medicaid is $2523. If your brothers SS is higher than that, then there is a Miller trust that deals with the overflow. He can't have more than $2000 in assets.

I would call APS and report a vulnerable adult. Explaining you are not in the position to care for him. If they find he needs intervention, I would allow them to take over his care especially if you have no POA. The problem would be, that you will not be able to chose where he is placed or involved in his care. The state will appoint a guardian for him. You could become is guardian but for you it means a lawyer, a large expense and a Judge, so court. Then you have all the responsibility. The State will get him placed much sooner.

I don't think Hospitals are under the "unsafe discharge" rule. Did you pick up brother from the hospital? If so, at that point you or whoever picked him up, took on the responsibility of his care. You (or whoever picked him up) should have refused saying it was an "unsafe discharge" also saying there was no one at his home to care for him and you are not capable of taking on that responsibility.
Again, the State can be called in to care for him. If he went to Rehab, you could have asked for a 24/7 eval. If found he needed 24/7 care you could then claim it would be unsafe to discharge him and he needed to transfer to Longterm care after his Rehab. You don't have to care for him but you can be involved with getting him placed and see to his needs once he admitted to LTC or let the State take over. Once in LTC all his needs will pretty much be met. Maybe just clothing bought and he will have a Personal Needs acct for that. This is where $50 is taken from his SS check to be used for his personal needs.
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I am so sorry that you are in this situation. I would suggest exactly what Barb has.

Keep us posted on your progress. Hopefully you will be successful in your attempt to find a place for your brother.

Best wishes to you.
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You call Adult Protective Services and report him as a vulnerable elder in need of care.

You call his local Area Agency on Aging and ask what else you can do.

Contact NAMI:

https://namiga.org/ This link includes an emergency number you can call.

Every state in the US will pay for Nursing Home care if the patient is both medically and financially at need. Likely when you looked at financial qualification, you were looking at Community Medicaid, not long term care Medicaid.

Do you hold power of attorney for him?

Was your brother released from the hospital after he was assessed as being able to care for himself or did he check out Against Medical Advice?
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mitch101 Jan 2023
I believe the hospital dropped the ball and I didn't know to refuse discharge and demand intervention. Right now I am waiting for the other shoe to drop, and have been documenting all the bizarre behaviors in the meantime. Many thanks to Barb, Joann and Needhelpwithmom -
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