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Hello-I have been caregiving for my mom with dementia for 13 years now. She is at a point where she needs Memory Care. She was denied Medicaid. My sisters help on and off on weekends with no consistency. I am told I cannot force their help. Mom's dementia has become a safety issue for herself and my family. She is violent at times with my kids. She is mean to us but very sweet to everyone else. I told my two sisters everyone takes mom for a month giving the other two a two month respite. They refuse. We decided we would pay out of pocket. I did all the necessary paperwork needed by mom's doctor, It took three appointments. I had mom assessed for a facility my sisters found, I sold my big house for a smaller one to insure I could make my share of payment. Then on the day they were supposed to sign her in, they decided neither of them wanted the financial responsibility. So here I am, in a smaller house. Mom is sleeping on a couch living out of a suitcase. I am burned out. Does anyone know anything I can do to get mom the help she needs and deserves, or if there is anything I can do to force my siblings. Thank you

Why was your mom denied? Does she have funds? If so you need to get her into memory care where those funds will be spent on her until there are no longer funds; then she will go on medicaid and she will go wherever she can be on medicaid.
I hesitate to say this because I have recommended it before and I loathe it. But you are down to what we call
THE ER DUMP.
You will have to take your mother to an ER. You will have to say she cannot return to your home, that she at this point constitutes a danger to your household. She will be admitted and assessed. You will get in touch with hospital Social Workers on DAY ONE and make it clear. No argument. No listening to the platitudes of "We can make this work" "we will get you help". They can't make it work and they won't get you help. Have the finances ready to give to Social workers. All Mom's assets and all her bills. Let them know you cannot take her and if they wish to have her put on State Guardianship through the courts that is fine.
Give your Sisters one week notice that this will happen.
This sounds cruel. But what you are going through cannot work and no, there is no way you can force your siblings. In fact I agree with them. I would not attempt to care for your mother in my home were I them. I would not spend my savings on your mother when I will need them (sorry. So sorry) for myself.
I couldn't be more sorry but you are down to bare bones reality now. This cannot go on. If you need to give over guardianship of your mother you will have no control on where they place her, but she will receive care. Many elders don't have children. Many people don't have sisters. That's about where your Mom sits now. Everyone has been all used up.
I am so very sorry. I hope you will update us. Please spare yourself further speaking with your sisters until you have a plan. They are not obligated to care for your mother. They do not intend to do so. Nor can you anymore.
Remember, the Social Workers and hospital want to/will do and say ANYTHING to make you take your mother back home to this life you and she have. Do not allow that to happen. 13 years. You have given up more than a decade of your life. This could go on a decade more if you allow it. What will be left of you? To say nothing of what will further attacks do to your children? Why must they live this way for no reason.
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AnnReid Oct 16, 2019
So very VERY well said. And NO, when you are “living this life”, this DOES NOT sound “cruel”.
We all wish that there was some simple, peaceful, comfortable way to resolve conflicts, assuage guilt, provide humane care, all of that. THERE IS NO WAY, except as detailed above.
Your Mother has dementia and additional physical issues, of her three daughters you are the only one who has cared for you, you have paid your dues, it is time to MOVE TO A NEW PLAN.
Hopes and best of luck that you have the courage to make the only choice that will benefit all of you.
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Do you have that much guilt as far as putting your Mom in a facility? If so, talk to a therapist because at this stage, she will take you down and it sounds like your siblings don’t care and are putting it on you. I hated putting my Mom in a facility but we did it. You can check on her anytime you like. Mom was wearing my Dad out and he had congestive heart failure and couldn’t tend to her anymore. Just no other way.
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disgustedtoo Oct 17, 2019
Guilt? Where is guilt coming into play here? OP wants to place mom, now that she has more advanced dementia and is becoming a threat to her children. Income is over NC's MEASLY limit and sisters won't pay (no one can force them to either.) She is between a rock and a hard place, no guilt involved!

Also, another comment you made talks about spend down, etc. OP's mom has no assets to spend down - rejection was because mom's income (gross) is over the Medicaid limit in NC.
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I can understand not wanting to take on the financial responsibility for mom. I'm wondering if she's not eligible for Medicaid because she gifted her house to someone less than 5 years ago? They are the party that should be paying for her care.

You absolutely should not have an unpredictable, abusive elder in your house abusing your kids.
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Tiredmomma Oct 16, 2019
Hello surprise-No, my mom never owned a house. She has zero assets. Her only money is her social security and small pension, $1400 monthly, To clarify, she is verbally abusive. Has raised her hands to my kids though, but not physical at this point.
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You have horrible family members as they won't help. You have gone way above and beyond and now it is your turn to have some peace. Most likely a nursing home would be the answer so there is more financial help. Start seeking out professional advice from medical organizations and aging organizations. You cannot and must not allow this to go on. And walk away from your siblings. They are simply not worth having them in your life.
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https://www.familyassets.com/nursing-homes/resources/medicaid/north-carolina

Tiredmooma, it appears North Carolina has such a convoluted system! They don't do Qualified Income Trusts, but what have a deductible system in place for those that make too much monthly for Medicaid. Basically from what I'm reading it all works out the same, your Moms income goes toward her medical bills and the state will pay for the rest (as long as she is deemed medically needy). In your state, It is just set up in a weird way involving paying deductibles every 6 months that seems too complicated. But ultimately the state will pay the difference. You need a good county social worker to help you place Mom, but if that service is lacking then you may need to drop her at the hospital.
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Why was your mom denied Medicaid? When your mom was denied Medicaid, had she applied for health insurance or for long term care? Because there is Medicaid health insurance and Medicaid for long term care and the requirements are different for both. for long term care Medicaid, they look at her income and assets. If she’s got no assets, just a monthly income & it’s too high to qualify for Medicaid then look into a qualified income trust or Miller trust. Her excess income will go to a trust account that Medicaid is beneficiary of.
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sudalu Oct 19, 2019
worriedinCali, thank you so much for the info on qualified income trust or Miller trust! We live in a "cap state" and my mother's SS exceeds the limit for Medicaid. I had no idea this trust was in place. All though she doesn't need it now, I was concerned for the future. Very helpful information.
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Your Mom absolutely will qualify for LTC Medicaid, please see an expert in your area who can structure her income (via trusts that can be set up where her excess income goes into) so she can qualify. How do you think the hundreds of thousands of elderly just like your Mom in Nursing homes are having their bills paid? If you can't find an elder law attorney who will help you, and I understand they cost a lot of money, what you will need to do is give her up to the state. They will find a place for her. You typically do this by not letting the hospital release her to you (alva's advice). You do not sign any paperwork from any nursing home stating that you will be held responsible. in fact don't sign anything at all. The social workers at the hospital and nursing home will get her approved so they can get paid.
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Tiredmomma Oct 16, 2019
Hello mstrbill-Not sure what LTC Medicaid is, however her income is due to her social security payment and a very small pension. I talked to an attorney in my state who said a Miller Trust cannot be done here. Thank you for your advice.
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Read AlvaDeer's response below. And then read it again. And a third time.

I want to particularly stress that you are NOT to believe anything any hospital SW (or anyone else) says about they will help you "make it work." No, they will not. They just want her OUT of the hospital and to be YOUR responsibility. You see, when THAT happens, they are off the hook! And easier than making the many phone calls and arrangements to find her a facility. Do NOT let them guilt you into taking her back home.

There is nothing anyone can say to give you help on how to guilt your sisters into sharing payment for a facility for your mother. Most here agree that your sisters should NOT be paying....but neither should YOU be paying!

One question - you say your mother is violent towards your children. How old are they?
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mstrbill Oct 16, 2019
Agreed, and to add, the hospital must be made aware that OP's home environment is UNSAFE, for both Mom and the family.
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Consider a visit (always encourage one who has a flat fee for consult) with an elder law attorney specialist (i.e. certified)...they know the ins and outs of the process which is too complicated for most people to know. Consider it an investment in everyone's well-being and sanity.
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elaineSC Oct 17, 2019
Great Answer!!!
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Most Memory Care and AL facilities are private pay and will not accept Medicaid. A Skilled Nursing Facility may be the best option. If the elderly have no one, irregardless of income, the state will make sure they are cared for, though it may not be the choice facility we would place them in. So there is a way. Speak to an Elder Law Attorney. And research your state Medicaid laws, speak to a representative even, just to be well versed on the subject. Good Luck, and yes, please share your solution when all is settled.
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Myownlife Oct 17, 2019
That is NOT true about Memory Care and AL. It would be hard in my state to find ALF for MEDICAID ONLY. BUT most have Medicare / Medicaid and CAN go to ALF. Now I am not in NC so not sure about that state, but my state has them.
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