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Hi- What is needed to admit my father into a nursing home? My mom is named on his health directives and his doctor has diagnosed him and said he needs 24 hour care. Is that enough? Even if he doesn’t want to go...


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First of all, take the information about Medicaid provided by people here with a huge grain of salt, because rules vary from state to state, and people's financial situations are very different.

I'd recommend consulting with your folks and an elder law attorney who specializes in Medicaid Planning, as they will know the rules for *YOUR* state. In my state, yes they do put a lien on the house if the well spouse is still living there, so when the house sells in the future, the state will collect some of the proceeds. There's a formula for how much they'll take. They will also collect from any other available resources they are legally allowed to collect from (real estate, investments, bank accounts, vehicles other than the 1 allowed for medical transportation). Some resources can be legally transferred prior to their death, or put into a Medicaid-approved trust. Many couples will do a "quit-claim deed" to put the house in the well spouse's name, so it is protected. That's why it's good to consult an attorney. In my state, they DO NOT take personal belongings like jewelry, furniture, artwork, etc. So please find out what your state's Estate Recovery rules are, and don't be scared of applying for Medicaid.

So this is how I see it, having 7 years of experience screening people for Medicaid eligibility and helping them get on services: If you didn't save up enough money to pay for all your care needs out of your own pocket (which let's face it, is impossible for most of us!), Medicaid is another way to fund what you need now by leveraging the other assets you've put away through the years... People are often mad that the state won't just pay for everything and let them keep their hundreds of thousands/millions. The state is going to ask you to spend your own money on your care needs before they will ask the taxpayers to pay. As a taxpayer, I am glad for this rule!

The problem is that Baby Boomers have the expectation of leaving inheritances for their children, like their parents did for them. But the reality of long-term care costs and inflation mean this is likely not possible for most people. Sad, but true.
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This is a tough one - a few years after my dad's stroke - his doctor said he needed 24/7 care and couldn't be left alone. My dad was still capable of making decisions so he said no to nursing home. My step mom didn't have the back bone to say "NO, i can no longer take care of you 24/7" and also didn't have the backbone when my dad refused in home care offered by the county. So she was exhausted and in the hospital due to stress. It was only after my dad fell and broke his pelvis that she got him into the nursing home - where he remains and should be.

How firm is your mom willing to be in all this? if she caves to your dad, she'll be stuck 24x7.
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No, doctors told my mother she needed 24-hour care 10 years ago. That doesn't mean it has to be a nursing home. It simply means he cannot be left alone. The diagnosis could be mental, physical you weren't clear. My mother is both. So I quit a great job in Chicago as I really didn't believe she would live this long but then I am a great person so I guess it speaks volumes for my caregiving skills (wink). Seriously your mother and yourself are the best people to diagnose his situation. I bought a security cam I have on her in her room that is real time. I can watch her from shopping at Walmart! We have bathroom and meal time and bath time all ironed out and she has a cat which has been a wonderful bed companion for her. Just depends on how much effort and energy can be given within reason. Best of Luck
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The hard part is "if he doesn't want to go." Is your father still considered competent to make is own healthcare decisions?
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The point is, does his doctor agree that he is not able to make decisions for himself? If his doctor does agree and will certify that he is "incompetent" then your mother can legally have him admitted to a nursing home even if he is resistant to the idea. Depending on how much of a fight your father puts up, your mother may have to apply for guardianship to take control.

If the doctor says that your father needs 24 hour care but doesn't agree that your father is mentally incapable of making his own decisions, then you're a bit stuck. But in that case, perhaps the doctor can talk to your father and help to persuade him that he needs more care than your mother is able to provide?
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I’m going through guardianship for my parents currently, even though I have a POA....Long story.....

This is the way my attorney explained it to me:

Competence is a legal term which can only be decided by the courts.

Doctors can fill out forms stating that persons cannot live alone, take care of themselves etc. this form is used in a competency hearing along with forms from court appointed experts to determine competency or lack thereof.

Nursing homes like to at least have the doc’s can’t take care of themselves/ form on file.

In my case, the assisted living facility did not require even that. It would be quite clear to anyone that my folks could not be on their own.
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Shirt off your back, eh..? I'm not sure that the image of a civil servant wresting an old lady's wedding ring from her gnarled old finger is entirely realistic.

It IS a sad thing to see, a person's lifetime of possessions dwindling to fund their care. But the alternative is that the state funds care for people who would rather not lose their grandkids' college funds, jewellery, nice furniture, car, plasma tv... Well, wouldn't we all rather save our money for nice things instead of prescriptions and laundry detergent? Tough!
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For facility living doctor will have to complete a medical history. That in effect, is a prescription for needed assistance with activities of daily living. However if he is competent he has the right to make his own decisions no matter how bad they may be. And if mom is his POA and she is incompetent the only answer may be guardianship. Or a health emergency that results in needing a higher level of care.
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My mom now says she will admit him and the dr says he is unable to take care of himself... next step is how to pay 😳
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When it's your turn and your children are rushing to have you put away; I wonder how you will feel? If the person has their own home and resources, they should be able to stay home. This comes from an RN who has seen way too many elderly people shoved into homes for convenience sake. BTW; it takes two doctors to have someone deemed unfit...legally.
Pay; the state will take the house and any and all assets to make a plan to spend you down. That means the ring on your mother's hand as well, checking accounts, cars, everything. The state will allow the one spouse who isn't put away to stay in the house for however so long: in most instances. It's an ugly thing to witness having someone spent down. Those are things to think about before thinking the government will just let you put your parent into a home unless you can afford say 6 to 12 thousand a month depending.
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