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My mother is being discharged from rehab/nursing center in two weeks time. I'm the healthcare POA, although I don't want to be. My sisters and my mother are expecting me to find 24 hr. in-home care for her at an affordable price. I've called and it's going to cost $205 per day. My brother wants her to stay at a facility because her money will last longer and her home isn't set up for a disabled person. If I do what my mother and sisters wants, Mother's money will be gone in a little over a year and she'll probably end up in a bad nursing home. So now that my sisters have found out how much it costs, they say mother can stay by herself during the day. She's 90, has dementia, and balance problems, etc. Previously, we had all agreed she would NEVER live alone again, but they're back off that now.

I'm the youngest, and the most stupid one in the family, so why am I having to make these decisions alone and try to please everyone? I thought the folks at the rehab center would help, but the "Discharge Care Plan" meeting is only going to last 15 to 30 minutes. That's not enough time for them to help me figure out what's best for money.

I'm all alone in this and don't know where to turn or what to do. I need help making these decisions and no one agrees about anything and no one will help.

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One thing I want to add, please pick a facility that is close to YOUR home - preferably not further than 5 - 15 minutes away. If the facility is a half hour away, then that's an extra hour of your time anytime you need or want to visit your mom. One of my friends placed her dad in a facility that was an hour away from her house - she chose it because a nurse friend of hers said it was the best one in the area, but the quality of care turned out to be the same as they had experienced with her husband's mom in a facility less than a mile from their house. So putting her dad in a facility that was further away only increased the stress and amount of time care taking took. It didn't make things any better for dad than they would have been if they had placed him in the facility close by.
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Boy do I feel your pain. I have a sibling that walked away from any responsibility along time ago. My parents moved to a different state when my grandparents became elderly, so I have no help or role models to help me out in caring for my mom. I had two weeks to find a place for my mom also. Was your dad or mom veterans? If so, she should be eligible for housing assistance from the VA which is about $1100 per month. That made the difference of where my mom could live. Tour some facilities. Make sure if you choose assisted living, that they have 24 hour nursing as well as aids. Also confirm that they distribute medication. Three meals per day provided in a dining room or delivered to her if she can't make it down for meals sometimes. My mother lives in a facility with a movie theater, happy hour and a bunch of other features she never uses. I've learned that those "extras" are there to impress the "kids" not the adult living there. Pay more attention to the cleanliness of the facility, how kind the caregivers are to the residents, how the residents interact with one another. Are the residents happy? I went to the facilities during lunch or dinner hours. This is a good time to see how everyone gets along and look. Listen to your nose...does the place smell bad? Talk to the financial counselor at the facility. They will help you figure out the financial aspects and they should be able to put you in touch with someone that can help with VA benefits and help put money in escrow if appropriate. If you go with a long term care facility, it's my understanding that the nursing homes take all but $1500 of the patients' assets and then Medicaid kicks in. Above all, listen to your gut. check out 4 or 5 facilities. Don't overwhelm yourself with looking at more than that. Honestly, I looked at 2. The place my mom lives in about 20 minutes from me, which sometimes feels too far, but it just felt right. I still have self doubts sometimes, but she is as happy there as she would be anywhere. I know she's safe and is getting good care.
One more thing. There is a book you might find at your library entitled, "Nursing Homes and Assisted Living: The family's guide to making decisions and getting good care" by Peter Silin. There's some good info in that. Good luck.
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Who is your mother's financial POA? That is the person who is going to have to make the decisions in regards to where your mom will live and how to pay for it along with you. Your mothers assets will need to be liquidated to pay for her care. Also the financial POA cannot give any cash gifts or valuable gifts (such as sterling silverware, appliances, cars, furniture) to family members from your mother's estate because there is a 5 year lookback period for Medicaid. If gifts are distributed, then Medicaid would place a value on those gifts and the financial POA would have to pay with his/her own money for your mother's care until the value is recouped. Basically, the assets are liquidated and then spent down and then Medicaid kicks in to pay for your mothers care. You mother needs to be in the kind of facility that has memory care. Google memory care facility and your city and state name and that should bring up a list of possible facilities. Call and make appointments to see them, then go visit. These facilities vary a great deal. Depending on where your mother is in her dementia, she may only need assisted living for memory care now or if she is more advanced, she may need full on memory care, which is in a locked facility. Either way, she needs to be in a facility that offers both levels of memory care.
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You say your mother is also expecting you to find 24 hour in-home care? If she has not been declared incompetent, her choice for the in-home care has set the precident on the decision. If that is the case the only thing you can do is find the 24 hour care and when the money runs out she will qualify for Medicaid. If she has been declared incompetent you have more legal leverage to find a suitable place to make her money last. Either way 2 weeks is not very long. The best advice I can give is find an assisted living place and if she owns her home, sell it and use the proceeds to pay for the assisted living facility. You have not mentioned any family member willing to provide for her care so obviouslt that would not be an option.
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It is not your job to please everybody. Like it or not, you are Medical POA and it is your responsibility to do what is best for your MOTHER.

For mother to go home to live alone is NOT in her best interest.

So you need to start looking for a facility for her. Her money will not last forever there, either, so look ahead to when the money runs out. Some places will convert a resident from private pay to Medicaid if the resident has been private-pay for a certain length of time. Some will not accept Medicaid at all, and Mother would have to leave when she runs out of money. As you are exploring places, find this out right up front.

Make an appointment with the rehab's social worker now, before the discharge meeting. He or she can give you information about what is available in your community.

Does Mom need skilled nursing care? Is she a wandering risk? Does she ever have violent behavior? You'll want to look at places that provide the level of care she needs.

Two weeks may not be enough time to find a suitable place with an opening. Ask the social worker what you can do on a temporary basis. Mom could go home with the 24-hour care until a place opens up, but I think it would be much easier on her if she doesn't go back home.

A social worker at a rehab place should also be able to give you information about veteran benefits, Medicaid, and any other programs Mother might be eligible for.

I don't know what your level of education is compared to your siblings, but you are definitely not the "dumb" one! Your mother appointed you to this position confident that you would do what is right for her. Your older sibs may have a history of expecting to tell you what to do. Be friendly but firm. It is your responsibility to make these decisions. You can listen to their input, but then you have to do what you determine is best for Mother. I'm sure you can do it!
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If she can do private pay, she will have lots of choices. Most will convert to Medicaid later, most will take VA Aid and Attendance. VA will pay up to $1113 a month for the widow of a war veteran. Just make it clear you cannot take her home.
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I meant to say, "that's not enough time to help me figure out what is best for MOTHER." (not money) I don't care if she spends every dime, but I don't want her to end up in a bad place. She's very unhappy at the rehab center, so she'd probably go nuts in a really bad place.
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