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So my grandma ended up with a broken hip at the end of July and also needed a pacemaker installed, which is why she fell in the first place.


She's been in a medical facility for about 2 months now and it's getting extremely expensive, $270 a day. Skilled therapy will not accept her again even though restorative therapy (which isn't a reason for her Medicare to pick up the tab like they would for skilled therapy) says she's doing better and she is. Skilled therapy said after 20 days that she was "recovered" and no longer needed their services. At the time she couldn't even walk the distance of the room on her own.


A big problem is that she lacks motivation, big time. My mother and I are trying to get her to see why this is so important but it just goes over her head. We really believe that some dementia is setting in which is why she belches loud over and over in the room she's in that she shares with another person so it's not like she's alone when she does this. We showed her the bill the other day and she looks at it for a while, threatens to walk home (how?? lol), and that's it. Her sister that she was living with is 80 and I don't think she's going to be able to care for her if she's not able to at least care a bit for herself. It's hard to say what she is capable of because the medical care covers their own butts by making sure a CNA is always there to help her get up and transfer herself. She has been caught transferring herself from the bed to wheelchair and even off toilet to wheelchair but then the nurses yell at her because of it which is understandable but at the same time the family doesn't know if they're capable of going home or not.


She's really not able to stay in our home either, we really have no room and it's not set up for that sort of disability. Medicaid isn't even really an option right now because of all the paper trails they'd look at when applying. So my mother and I have decided to put her into an adult foster care home. We mentioned this to her yesterday and didn't seem to care so essentially no input from her on the idea. It would be much much cheaper to stay there and she'd still get cared for by someone in the business for years and is BBB accredited. But at the same time they do have a few pets and she doesn't seem to take as well to pets as some because of breathing issues. But we must get her out this week before the bills get any higher from that place. We're visiting several AFCs in the area and one was really nice but more expensive but also has no openings at the moment either. We're planning on checking out another one today and apparently it's a bit cheaper than the other one but that's depending if they have room and conditions of the place.


As far as the medical care, that bill in itself would wipe out 3/4s of her money so that's why it's imperative we get her out now and into someplace cheaper. I'm just concerned because that house we live in has grandma's name on it but we've also been on the deed for 10+ years, both my mom and I, and it's been our lifetime home. So I'm worried about any of them trying to step in and either put a lien on it or do something to screw us over. Mom and I have very little money and almost no savings of our own so we're scrambling in what to do. Grandma has had two doctors sign a paper saying that she's incapable of making her own decisions now even though for the most part she still seems quite sane but when it comes to making important decisions, it's like she'd rather someone else do it and so she doesn't have to think about it. Even though she's been listed with it, none of the doctors have figured out how this dementia even works. She seems to have gotten a lot better since having the pacemaker installed as in a lot more lively and alert but as far as decision making, she's as useless as using a feather as a paperweight. She'd rather sit there and talk about the clouds outside or someone working on the building across the street.


So we just have no clue where to turn to. My mother yelled at grandma's sister because she's been opening up grandma's bills to show her. Since the bills come to her address, rather than her giving them to us and letting us decide if she needs to see them or not, she takes it upon herself to open them up. Grandma really couldn't care less about them at this point and it's obvious. Her sister just wants to snoop at them. We're certain she's thrilled over this because she always complained whenever my grandma would give us any sort of money for anything. But now she's acting like a child because my mom yelled at her over this incident and it was in a public place, despite the sister having no problems belittling my mom and I in public, but that's when it's funny. I'm kind of derailing the subject here but because grandma has "lived" with her sister for four years before this, nobody knew what it was like to live with her.


-continued below-

OH boy! You really need some education on the process. First those inexpensive care homes have years on a wait list. Once the LTC reaches 100 days, she will be billed the full amount of 10 to 14 K/ month. We all understand the 20 day limit on Medicare so your posting is not new. It is in everyone's policy. Showing bills to someone with dementia does not work and staff are already telling you that she cannot go home.

Wake up and stop denying. Work with the social worker to get Medicaid going.
All of grandma's income has to go to her.

Once on Medicaid everyone can stay in the homestead while she is alive and if her name is only on 1 home, but you all will have to figure out how to pay taxes and house expenses on your own to stay there. Yes a lien will be placed. Perhaps you can rent a room to make ends meet.

IF you ignore the application process. The medical facility will have no choice but to petition the court to set up a guardian or conservator. Two doctors are signing papers so the process will be ramping up. A lawyer will soon be appointed and will set up a forensic accountant to dig through the paperwork you fail to produce. Whatever paper trail you are trying to avoid will be found.

I am not trying to be cruel, just telling you like it is after working 40 years in a facility and reading social worker notes in medical charts with similar stories.
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tbb279 Oct 7, 2018
Thanks for your input MACinCT. Yes, it's a pain in the butt but if you have experience in the matter, then it's understandable on what you have to say.

As far as a paper trail that I'm talking about, it's very complicated and would take a long time to really explain it in full but one of the things was that she lived in a house with her second husband and when he passed away, the house went to his kids and the kids put her name on that house so she could claim it as a homestead. Last year they decided to sell the house and so she signed off the deed and claimed nothing because they gave her nothing from it. So that's one thing I'm worried about. They'll see it as "giving away her assets". As such, she's also given us assistance as well when we needed it. She never had a lot but quite honestly, I'm thinking the workers will look at that stuff as well. There are many other things too but some of it is more personal than I'd rather post. But I am working closely with the social worker and I think that we're coming to a bit of a solution in which I'll be following up with tomorrow after work.
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when you say medicaid is not an option because of all the paper trails,, what do you mean?
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tbb279 Oct 7, 2018
Take a look at what I replied to MACinCT as far as the paper trail for Medicaid.
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It sounds as though money is as confusing as the actual health needs. Spending down your grandmother's cash may make her eligible for Medicaid. The problem is the house. It sounds as though it is in at least 3 joint names (check - not tenants in common?) and possibly 4 names if grandma's sister is on the title too. It would be good to see a lawyer experienced in Medicaid issues. If any Medicaid debt would only be for a third or a quarter of the value of the house, you and your mother could probably raise enough on mortgage to pay it off without having to sell. If you could get enough information to separate health and money, it would be easier to look at more and better health options.
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tbb279 Oct 7, 2018
Her sister's name isn't on the house, it's just hers, my mother, and myself. Moot point but just thought I'd mention it. I guess that I'm really confused on the Medicaid debt issue. Exactly how does this happen? I've been talking to another person experienced in Medicaid but was never really told about penalties in it except she can only have so much money, and can have a house and a car and that's about it. So does Medicaid debt happen because you use Medicaid or because you fraud the system or have undeclared income of some sort?
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Their mother would say that nobody knew what it was like to live with grandma's sister until they did so. So during this time when grandma was living with her sister, the dementia part didn't even really strike a bell with us because we thought it was sort of her defense to deal with living with her day to day which involved letting her sister make the decisions because whenever grandma came up with something, it was always wrong. She also started sleeping a lot during the day and even admitted to me that it was her way of getting away from her sister. So it would be much easier to accept the fact she has dementia if she had been on her own and without the influence.

But since getting into the medical care, she seems better on some things. Her mind is clearer than it had been. Before the pacemaker she looked half dead most of the time. But then she couldn't remember her sister being there to visit her for almost 3 hours yesterday when we clearly saw it on the log book. So I don't really know what to think.

So that's where I'm at. I'm quite sure at this point that her mind is somewhat going but she's still spunky enough to make it seem as though she's her old self but that's what I'm afraid of when we put her in an AFC.

One last note. I'm going to see if the medical facility will accept payments on the bill but I'm unsure how to proceed if they don't. I hate opening up a loan but I can't just spend all her money at once because of any other medical bills that come in or her medication that she'll need each month.
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