What can I do when I can no longer care for mom?

You can find a reason for her to be hospitalized and then tell the SW she can NOT return to your house; they will have to find a Memory Care ALF or nursing home depending on her level of care. Be firm with the social worker and if needed, change your address to a post office box and change your phone number to unlisted.

Sorry you have such nasty, selfish sisters. I guess I won't be jealous of those who have siblings. I'm alone and have been taking care of my now 100-year-old Mother for about 6 years, 3 years in my home.

I don't understand the Medicaid system. My understanding is that the person who needs the care must go through all his/her assets down to $2or3,000. Then Medicaid kicks in to pay for the care.

You don't say your age. If you are too old to take care of her, or have health issues, perhaps you should call Adult Protective Services. If nothing else, they will get your lazy sisters involved.

Tell you what, call an attorney pronto. I don't know what state you are in.

Call for attorney recommendations:

National Academy of Elder Law Attorneys
https://www.naela.org/findlawyer
naela@naela.org
NAELA Council of Advanced Practitioners
1577 Spring Hill Rd., Suite 310
Vienna, VA 22182 
703-942-5711


I have an excellent attorney in Colorado:

M. Carl Glatstein

There is an agency called council on aging which will help. I have a brother in law has received a lot of help with no cost.
Cicoa I think is the initials. In Indiana we call 211 hope they can help you

From what you are saying...no assets, limited income, a danger to herself...there is no way she should be denied.  If she was diagnosed long ago and is a verifiable danger...there is not any question here she would qualify.
Now... if is was a facility that receives no state funding and is fully private...they do not have to take her and many do not want to deal with dementia patients.  Have you contacted a social worker with your issues.  If you are at the point of mental and physical exhaustion to the point of endangering yourself...this is not any good for anyone.   I would contact an elderly care social worker, explain your dilemma and they can send you down the correct path.  It might take some time, but they could get you started.  Again, with what you have said...there is no way she would be denied.

You poor thing. I do agree that it is time for your mom to go to a NH. You and your family must come first.

I'm confused. If she goes into a NH, has no money, and gets less per month in "income" than her NH care would cost, why wouldn't medi____ pay the rest? Did she used to have money and it was spent in ways that do not qualify for the approved "spend down" from getting to having money to not having money? Like if she gave $10k to a friend or relative, that money would delay her being able to get assistance or would have to be paid back, IIRC.

Best of luck. You might want to talk with someone at a local NH to see how they can help you get mom to be their newest resident.

Tiredmomma, I sense nothing has changed in the past week. I'm sorry you're still in this situation but if it is true that Mom's dementia is a safety issue for your kids and herself you need to remove her from your environment. I know it is very difficult to place someone in a NH on your own if you do not have the money. You won't be able to do it on your own. So you are going to need the State or an authoritative agency or the hospital to take over. We've given you some options in this thread, I hope you follow through with some of them for all of your family's sake.

While I realize sometimes it gets hard to read through all the responses, especially when they start exceeding one page, but you need to at least skim through them people!

Already Miller Trust has been suggested multiple times and most if not all were followed up with NC (OP/mom's state) doesn't do Miller Trust AND mom has No, read that again N...O... assets, so there is nothing to spend down. Mom's income exceeds the state MEAGER Medicaid limit. As OP posted, too many people use legal means to "protect" their assets and then use Medicaid to pay their way, leaving those with real need SOL.

The secondary problem is that every state has different rules/coverages. It appears that NC Medicaid will cover NH IF you meet the low income requirement, but doesn't cover any kind of AL. Not everyone qualifies for NH (has to be a real need for specialized nursing care - dementia alone doesn't qualify for most if not all cases.) Various State's Medicaid might cover AL, but usually it is limited, there are few places who accept it and some places are probably not where you would want your LO to be!

Please try to skim through the answers before responding.

Tiredmomma, have you looked into the Miller Trust or Qualified Income Trust? That's exactly what they are set up for -- over the limit situations. This is a quote from my state office: [Medicaid Planning – the majority of persons considering Medicaid are “over-income” or “over-asset” or both, but still cannot afford their cost of care. For persons in this situation, Medicaid planning exists. By working with a Medicaid planning professional, families can employ a variety of strategies to help them become Medicaid eligible. Read more or connect with a Medicaid planner.]

It sounds like you need a more professional Medicaid advisor.

My mother n law went into palliative care with in our area in New York and it cost $16,000 a month. We aren’t rich and we couldn’t just pitch in 16,000 a month so we had to use my mother n laws savings for the month and the my brother n law took her to his house with hospice. She was at the end of life and died 2 weeks later.

Your mom took care of all of you from birth. So it's the adult children to take care of her. What is wrong with people now a days?? You all see your parent's as burdens, when I am sure they didn't see you that way.
My 2 sisters and I took turns taking care of mom from 3 months to a year. She passed away at an early age of 58 due to Diabetic complications. She lost her eyesight 5 yrs before passing.
Before we took care of her, She was so independent, hard working, loved all her grandkids. Her diabetes got bad and worse when my dad and her divorced. She was depressed.
My dad remarried and died at 72 due to brain tumor. I helped his second wife with my Dads care.
We never thought of putting our parent's in a nursing home. They took care of us when sleepless nights when we were born.

It is tough..you need to consider your children and yourself.
If money for care is the problem..Apply for long term care medical. She will have a share of cost and my have to spend down for monthly care while in the facility. It is difficult to tell your mother where she must go...but you have to do it. To prolong this in your home you and the children will gradually change in your "tolerance" and will handle her out of "frustration" and my progress to anger. When she is in a facility there are Meds. that deal
with anxiety. You can visit daily or....she will know she still has you. You are both dealing with "loss". It is hard but she will adjust and you can have some level of peace in your home and family

You obviously have taken on a lot of the responsibilities for the care of your mother, and I can relate with how overwhelming the responsibilities can be and the frustration from other family members not taking on their share of responsibilities. There are ways for you to get Meficaidfor yoyr mother, so that you can get the help you need to alleviate some if the weight you're carrying. If you're mother was denied of Medicaid, it more than likely was because her income and asset/rsources was over the medicaid requirement amount. There are varous pathways to shielding your mother's income an asset si that she can get Medicad. Call an Elder lawyer in your state. If you're in any of the five boroughs in New York contact Health Trust at info@healthtrust-mltc.com

Good discussion in this thread. I'd like to summarize my thoughts for OP

Forget about the siblings. There is nothing you can do about them.

Forget about moving Mom to Assisted living/MC. Mom or you can't afford it. (you shouldn't be paying your money anyway unless you were rich enough where it wouldn't affect you or your future or future care).

DO try to get Mom into a skilled nursing facility. IF her Dr. judges she needs or meets that standard of care, Medicaid of LTC Medicaid will cover her, even though she makes too much for regular Medicaid. You will need the support of health care professionals for this. Start with her primary care Dr.

Mom needs to be out of your home ASAP. For her safety and your family's. You can go the take Mom to the hospital route if nothing else is working out for you. You tell them it is unsafe at home, which it is, and you will not be able to care for her. If you don't want to do that, then I would suggest you will need to call an authoritative agency (APS, CPS, Police) to help you.

Medicaid will Kick in when Her Own from Home RESOURCES are all Gone...All I can Advisse, Only that Tooo, You can Hire someone until all of this Money to is Gone and Begin the Procedure again for Medicaid....

Who has Power of Attorney? That person has decision rights. I hope you do. If not, get to a lawyer and get to be her POA.

Now don’t spend your money, spend hers down until she qualifies for Medicaid. You can use her money for someone to care for her to give you a respite or to take her to Bermuda.
Perhaps first see a lawyer ( with her money) to determine the laws of your State. Each State has it’s own laws regarding Medicaid.

Then find a nice place that will accept Medicaid and commit her.

You can visit her once a month, if you like.

And treat yourself to something nice. You deserve it.

Who has Power of Attorney? That person has decision rights. I hope you do. If not, get to a lawyer and get to be her POA.

Now don’t spend your money, spend hers down until she qualifies for Medicaid. You can use her money for someone to care for her to give you a respite or to take her to Bermuda.
in the meantime, see a lawyer ( with her money) to determine the laws of your State. Each State has it’s own laws regarding Medicaid.

Then find a nice place that will accept Medicaid and commit her.

You can visit her once a month, if you like.

And treat yourself to something nice. You deserve it.

Your siblings can't refuse when you drop over and faint. Wow. That's far too long to be providing care.

Area Agencies on Aging also have contracts with Elder Law attorneys or legal aids under the Older Americans Act. You do not pay for basics to use this service.

Tiredmomma,

I have only read the first few answers, but as your mother has no assets and only $1400 income, she in NO WAY, should NOT qualify for Medicaid Long Term Care. I work in this field, and although it does vary state to state, basically the income limit is approximately $2000 monthly. If she owned a home or a car, that would not count. But as you said, she has no assets. It may be expensive but seeking help for an elder care attorney could help get the process started more quickly. An alternative is to contact the Area Agency on Aging for your area. Google it. Call them .... they will help you file the paperwork for Medicaid LTC. It needs to be filled out very, very correctly.... and is many times difficult to understand to try to do it on your own. It can take a long time to get onboard and in the meantime, if you need to get your mom out sooner, what Alvadeer posted at the beginning is the BEST and "only" way of getting things done RIGHT NOW.

If you won't think of yourself, then do it for your children. You have given of yourself for a very long time. It is now time for you to have the help of LTC so that you can still have a life, and your mother will receive care. Be strong. Do it now, so you can still live.

Call an elder-attorney. Start here:


National Academy of Elder Law Attorneys
https://www.naela.org/findlawyer
naela@naela.org
NAELA Council of Advanced Practitioners
1577 Spring Hill Rd., Suite 310
Vienna, VA 22182 
703-942-5711
naela@naela.org

Personal recommendation in Colorado:

M. Carl Glatstein
Glatstein & O'Brien LLP

Tiredmomma,

I found the following on the North Carolina Medicaid website. Look at what it says for the “medically needy”, which I assume your mother is. Yes, NC Medicaid will pay for a nursing home for your mother. They require you to pay what you can, then they cover the rest. She will get to keep $30.00 per month for personal needs.

I found this information on my first Google search. Have you contacted Medicaid yet? Please let us know. You sounded so desperate.

Income Limitations – The applicant’s income must be less than the cost of care in the facility at the Medicaid rate of pay. Medicaid must approve the level of care requested and the applicant must use part of their income to pay for care services. North Carolina calls this “patient monthly liability.” If single, but not medically needy, the applicant’s monthly income (wages, Social Security benefits, pensions, veteran’s benefits, annuities, SSI payments, IRAs, etc.) must be no higher than 100% the Federal Poverty Rate. If medically needy, however, Medicaid will pay all long term care costs exceeding the applicant’s countable monthly income. Income that is not considered countable includes a personal needs allowance ($30.00/month per individual); health insurance premiums and medical expenses not covered by insurance or other benefits; certain spousal or dependent family members’ allowance; and a home maintenance allowance if the long term care recipient expects to return home within six months, but there is no one living in the home.

Miller trust is free at your bank an elder law attorney gets it started for you. It gets you to Medicaid threshold

Although some recommended the ER drop and run route, this shouldn't be on the table for consideration. Much as it sounds like a desperate move (it is and is not the right thing to do!), it probably won't work and the consequences could be worse than keeping mom at home!

Many EC attorneys offer an initial free consult. Try some others - not just a regular attorney, but those who only do elder care. Perhaps there is one out there who could guide you, rather than just telling you what isn't available to you for help.

Referring back to the link I posted, part of the problem is this:

"President Barack Obama’s health care law moved to standardize Medicaid requirements, specifically so any American making up to 133% of the poverty line could qualify. But that provision was challenged and overturned by the Supreme Court. States could expand Medicaid, but they no longer had to. Thirty-three states (plus Washington, D.C.) did; 18 didn’t. And eligibility across states has gotten even more diversified since the Trump administration announced it would allow states to impose work requirements for low-income and needy Americans receiving Medicaid."

Apparently NC is one of those states that suck in that the article says: "The state has not expanded Medicaid to cover all needy adults."

No way to force siblings to do anything they refuse to do, whether it be "chipping in" money or providing actual care. This is very sad, pathetic really, but it is a common theme on this forum. Some siblings are even worse, in that not only do they not help in any way, but they stick their nose into whatever YOU provide and some even try to sue or take you to court for spending the parent(s) money on their care (vs keeping it for them to inherit)!

I took a minute to do some lookup out of curiousity. Wow, is NC cheap or what? WHO could live ANYWHERE for $1,005/month??? That was the limit I saw listed in the following (this link lists ALL states, updated 9/2/19, so could be useful to many of you):

For ANYONE:
https://www.policygenius.com/blog/a-state-by-state-guide-to-medicaid/

This provides a lot of information AND includes (as of 9/2/19) requirements by state. Check it out.

For NC, OP's home state:

"Income requirements: For the aged, blind or disabled, or caretakers of someone with those characteristics, your income must be within 100% of the FPL — $1,005 per month for a one-person household,"

How ANYONE believes 1k/month would cover LTC is beyond belief! Even the amount OP's mom has for income is not going to cover LTC.  It wouldn't even cover expenses to live under a bridge or in a cardboard box! WHAT are they (government who makes these decisions) thinking and/or what rock do they live under???

P.S. reminder to all - mom has NO assets, so there is no "spend down" AND OP stated Miller Trust is not an option in NC.

You need to talk to an Elder Law Attorney. You said your're mother was denied Medicaid. Elder Law Attorneys can sometimes file a "Hardship claim" for an individual who has been denied and get them approved.

You can have her placed in an assisted living facility tomorrow. The fees in my State are around $3-4,000/month for a nice one (I didn't research the not-so-nice ones). Use the money she has and add the difference from yours and, if possible, your sisters' money. This can be a temporary solution until you can get her on Medicaid.
My mom was in a very nice facility for $2900/mo. Fortunately, her assets did hold out until she died so we never had to address filing for Medicaid.

Another option, find her a senior apartment, maybe one that accepts HUD payments.

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.

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.

God bless you for caring for her for so many years, and the sacrifices you have made. I, too live in NC and I’m trying to figure out how to get my Mom into a facility as we do not have the money. She has no assets but I’m afraid her income is too high. Do you remember the limit? I’d love to walk through this with you! It’s all so confusing and my mm needs to be placed soon.

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.