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

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.

If Mom was denied because she was over the limit, see if your state allows a Miller trust or something similar.

With a Miller trust, the extra money goes into it. When Mom passes, that money reverts back to Medicaid. I know, weird but thats what u would need to do.

Hi Tired momma, I'm not as well versed as others here (maybe Igloo can hopefully join in) in LTC Medicaid (Long Term Care Medicaid, that pays for nursing care ) rules for different states and what happens when your monthly income is above the monthly limit. You stated you are in a state that doesn't allow Miller trusts? And her income is higher than the monthly limit allowed for Medicaid? There must be an answer, if you let me know what state you're in I'd be interested in researching myself. I can't believe there isn't a way to get Medicaid because there are thousands in a situation just like you. But if that is the case, what you are going to have to do, either sooner or later, is to "dump" her at the hospital. It sounds horrible and it is horrible but if you are out of options, that is the final one.

Yes, mstrbill mentions an important point -- "Unsafe discharge" will become your mantra if they talk about her coming home. Keep it on the tip of your tongue!

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?

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.

If she’s less than $100 over the income limit then spend down the money. You can get her a dental insurance policy or something like that. Her out of pocket medical/insurance expenses lower her countable income.

I haven't read the responses so hopefully I am not repeating.

Check into a Miller Trust aka Qualified Income Trust.

This is what will get her income lowered to be approved for Medicaid.

Go to www.nelf.org and find a certified elder law attorney in your area, they will know exactly how to help you get her qualified. Please don't use your money to pay for mom. You and your family need this.

Best of luck and I would never trust those siblings again, that is rotten what they did.

Well said AlvaDeer I completely agree with you!!!

OMG 😳 First of all, you will never be able to force your sibs to be financially responsible or become caregivers. You’re burnt 🥵 out to a crisp. My advice is take her to ER & say you’re not able to care for her anymore as you are not well yourself. Demand to have meeting with Social Worker at hospital. Tour a couple of facilities near you while she’s in there. You can work with facility Medicaid office or hire Elder law Atty. Funds from sale of house can be used to pay or maybe it can be put in trust. Don’t ask sisters for anything as you can’t depend on them. You deserve a life too! Hugs 🤗

Why exactly doesn't she qualify for Medicaid? If she is sleeping on a couch? If she has money she should private pay for a facility. I do not get this.

I’m not clear as to why mom doesn’t qualify for Medicaid (did you actually apply and she was denied or did something simply give you the idea she would be rejected?) or why you and your sisters would have to even consider paying for residential care with your own money and not mom’s if she has too much to qualify for Medicaid. None of you individually lol collectively should be even considering taking money out of your own pockets monthly never mind preparing to do that by selling your own home to support mom. Medicaid denials can be challenged too but given your current situation I would strongly recommend consulting with a Medicaid/elder planning attorney now before doing anything else. While you should be using mom’s funds to pay for it if that is too complicated I would use some of the savings you just created to pay for her care and figure out how to be reimbursed later.

Your mother shouldn’t be living with any of you at this point by the sounds of it and while I know how difficult that is to accept, especially for you who has been her primary caregiver, you said it yourself the current situation isn’t safe for your mom or your family, you might even want to consider putting mom in the hospital for observation (and safety) while you figure out the next step, this won’t give you much time but it will alleviate both the safety issue and the issue of mom on the couch for a few days as well while you find an attorney and make a plan. Only you know if this is the time to make the hospital move or not, it is not something you can keep doing so you might want to keep it in your back pocket too.

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.

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.

I don't understand, you should not be paying out of pocket out of your own money for her care. It sounds like Mom needs to go to a nursing home. How the Nursing home is paid for is out of your Mom's money. If she doesn't have enough to cover the cost, she pays what she can and the state (LTC Medicaid) picks up the difference. And yes, Alva's advice is the route to follow if you can't get her into a nursing facility on your own.

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.