Follow
Share

Cost of Living Calculator-NH for MIL. I used the one on the forum here. Hubbie and I are trying to figure out how we are going to put his mom in a nursing home when that time comes. We only put her info in. She only gets SS which is approx. 1100 a month. She owns nothing, no car, no home. She has no life ins, no stocks, nada. That's it.

We don't own now, selling ours to help our daughter. We are on one income, my husband's and we still help 3 of our 4 kids and one grandchild. I don't even want to think about hubbie's and my future years as we're no where prepared.

We have, with whatever her savings is (which she's depleting on her darn dog in vet bills), set up her funeral arrangements. That is done. We have not done a POA yet and not sure if we should. She does pay 300 a month for her room here because that is what it is costing us for that extra room. If she weren't with us, we could have rented for less elsewhere. But everything else such as food, water, electricity etc, she does not contribute to.

I do not even know where to start... she could do assisted living now, but is Alz diagnosed and will need more as her disease progresses.

This question has been closed for answers. Ask a New Question.
You have been given some great & detailed real-world advice.

Each state runs it's Medicaid program under an overall federal guideline. So the exactly monthly income limit varies. My mom's gets $ 1,800 a mo and her state income ceiling is $ 2,094.00 a month. State info mucho importante!!

About getting into a NH from being at home: this is a real challenge to do & this is what I was against in getting my mom into a NH. Most NH admissions are from a 3 or more day stay at a hospital and then they are discharged from the hospital to the NH for "rehabilitation". Rehab is a Medicare paid for stay and done routinely. Now Medicare almost always pays for the first 21 or 28 days of "rehab" and then after that depends on how they are progressing in their rehab. The NH gets paid the much higher Medicare rate during this period of their stay too. Most elderly seem not to progress so apply for Medicaid once Medicare is over and after the first month @ the NH. Many time the NH don't approach family on paying till the end of month #1 as Medicare has paid to that point.

But for those living at home or in IL the situation is different. I got my mom moved from IL to a NH and bypassed the whole AL phase. It is not easy and you have to be pretty dogged in a plan to create the fat medical file for skilled nursing services needed that Medicaid requires. Most of the posts on Medicaid are all about the financial aspect but Medicaid also requires a whole medically necessary review in order to qualify for Medicaid. When they come from the hospital that is there but not when they are still at home or in IL and then move into a NH. Now the medical director of the tiered IL (it went from IL to AL to NH with full hospice and I thought it was perfect as mom could stay there forever and I was wrong on all that, oh well) where mom was thought that mom was just fine for totally private pay AL and no matter what was not going to change their viewpoint. So what I did was to get my mom seeing her gerontologist on a set schedule. Now her gerontology group also are medical directors of nursing homes so they know what needs to be in her medical history & her medical file to pass Medicaid review. It meant basically every 4 - 6 weeks appointments and monitoring of some specific health concerns. the day she had a 10% weight loss and a critical H & H lab results, she got the orders written by her gerontologist for skilled nursing services needed and I got her into a NH within the month. Most MD who are GP's or family medicine doc's do NOT know how the medical history has to be done for skilled nursing requirements. An MD who is also a medical director of a NH will know this and will be invaluable in getting this part done so they can get in.

Just being old or having dementia or having ADL issues is not enough to get into a NH and have it covered by Medicare or Medicaid. There has to be the medical need for skilled nursing services. They need to have some co-morbidities in their file. Some stuff is easy like an RX for aspirin for heart disease (a co-morbidity) or changing their medication to something compounded which they cannot do on their own. The Exelon patch is great because most elderly cannot place the patches correctly on their own, so they need skilled help to correctly do that medication.
the goal is getting into a NH and through Medicaid. The first NH does not have to be where they stay either, moving them to another NH is pretty straightforward once they are on Medicaid. I moved my mom to another and much much better NH with another of the gerontologists in her group as medical director within her first year as Medicaid totally allows for this & without penalty.
Helpful Answer (0)
Report

Never feel guilty..for loving and caring someone with all you have...to give..till you can give no more....It is Way past time for you to put away money for your own care...Like you...I enabled a few people I love...I worked 4 jobs to GIVE AWAY MONEY....spent thousands at Christmas to show I love them so much...This last few years as I have gotten a bit older...and some of my clients sold there homes and even though I have life time friendship I treasure..I lost employment...I am down to 2 jobs now...and this makes it comfortable for me to live...but no extravagant, or super large Christmas gifts..and I realize it is time to start saving for my elder care and Funeral or cremation upon my death..NOT a happy thought...but my husband is a veteran..and Some things we did think of when we were young...Others...we just let pass.....In the days when I was OVER GIVING...I was happy to give.....Now I am unhappy that I cannot give...but I also realize....the Chore of Selflessness in giving care....and it is very hard to have this GIFT in your heart......some of us are willing...but more that ...some never will....and in exploring...the WHAT IF I BECAME ILL...who would come to my aid....QUESTION popped in my mind....and as I shuffled through the list of names in my mind....I really do not know anyone...who would allow me to LIVE in my own heart, with my own faith..to serve my God...and treat me as I would like....I would have to join a Convent..LOLOL....as much as I love all my family...There are very few that would want me around everyday..LOLOL so I like you..I WANT to stay sane...and HEALTHY...cause if we get sick..or have some mental issues....WHO will do what we do for us and what kind of care will we get???? I am SURE YOU WILL BE BLESSED...for all that you have done...GOD takes care of those who look after the sick and meek and He will BLESS you...GOD sees into the HEART...he will bless those who care...with a longer life...There is a lil prayer...about Speaking LIFE to the dying places....When we have storms in our life...we get blown over sometimes, with all the wind, rain, and sometimes we lose the roots of our very life...but we must remember when we cannot stand alone...our friends will be our stakes that we can lean on..they will hold us upright...speak words of compassion and love and understanding...they will pray for us and with us and speak blessing over our lives...until we are well rooted, and blooming, ....day after day...will find you standing tall, strong and flourishing..NEVER under estimate the POWER of all your words .....GOD HEARS YOUR CRY....sees your Love, knows your heart...what is blown over now due to the storms...will not be uprooted...as long as you speak life...you will flourish....my friend...It is not easy....when you are a true genuine giver....to dwell even a moment on yourself......remember...GOD created you...he treasures you...and all you are...and he wants you to thrive...and live...as sometimes...it is HIS WORDS that can change a life....for the better....more so than any amount of money...or the best gift you could buy....SHARE JESUS....He was the very first GIFT...GOD gave the WORLD....Imagine...knowing your own son...would come, give, live, and die...so all the children in the world could meet God...now that is something to give! .....Share ...just a word...and Let GOD do the rest....We are farmers..sewing seeds...and it is always in GODs hands...if the SEED...will take root grow and bear fruit....!! Focus on GOD too...and He will supply you all you need!
Helpful Answer (0)
Report

WOW! I am 78 yrs. old & just starting to plan so I won't be a burden to my daughter & grandchildren. I, too, worry about taking care of my family; I have always helped them out & now realize tough love would have been much better. I have spoiled them all thinking it was loving them but now I realize I enabled their bad habits. My mother did the same thing so this is what I THOUGHT was best. This will help me through overcoming my guilt and learning to take care & FOCUS ON MYSELF. It is very difficult to change my thinking but I must for the sake of me & my entire family! Thanks for the wonderful wisdom that I am gaining from your posts!!!
Helpful Answer (1)
Report

You don't have to explain the Expenses....No one can live anywhere for free...You should look into HOSPICE Helping out..they take care of more than Cancer patients with you..and they are great...and since they have been at this a while..they can make all things a bit more clear...when to make changes...how to make them...even how to get you paid for taking care of her if there is a need...REACH OUT to groups in your area...go to the meetings..and Find out all the benefits you can get for her...and yourself..YOU Have to take care of yourself..or you can't be of help to anyone else....I love my daughter in laws...I hope and pray to GOD ...I stay healthy..I would never want to be a burden to them...or a strain on there income, home or health...so whatever you have to do ....Just keep a diary...even on your computer..how each day is going...document everything..I keep in in my Google calendar...good days bad days...doctor appointments, frame of mind, sometimes if it was a really good meal...eating habits...This way...if she does have to go into a Nursing home..You have a record of what you did...and you can see that they know..how she lived..what she likes..amount of foods she is getting and medications...You will not be in the nursing home 24/7..but she will..and it will be better if you have something to show them...they are on the right track...or off the beaten path....GOD BLESS YOU!!
Helpful Answer (0)
Report

Some very good advice above. Be sure you understand all of the federal and state resources and support that you can get (was her husband in the service? Are there VA benefits? Does your state offer additional supplements? Some do)

In addition, you might also choose to engage a service like "a place for mom" which is free to you (fee charged to facility). They can help you assess things like nurse to resident ratio, activities (which really helps if mom is active or engaged), cognitive therapy, altzheimers treatment etc.

Wishing you the best. It's so heavy on your heart until you get settled, but one you get her in a good place with great care, you will feel so much better.

Sending love and light...
Helpful Answer (0)
Report

Step 1 - Get a POA both financial and medical. If she is starting to have signs of ALZ, that can progress fast, and if you do not already have both POA's in place, it will be so hard once she is not in right mind.

Step 2 - As one poster mentioned $1100 a month is most likely to much money to qualify for Medicaid. You need to call and ask questions. If she can not afford a NH, you need to see what all of her options might be. They may have information that you need to help with decisions.

Step 3 - You did not mention if you have brothers or sisters. If you do have siblings, are they set up in a better position to take your MIL into there home. If not, since this is your husband's mother, he needs to understand how much work having mom in your home will be. How much work and time is he willing to give his mom.

Step 4 - You need to do research now, home care, is expensive, see what kind of free senior services are in your area. What products, medical devices, home care does her health insurance pay. If she has to live with you, then she should pay rent, and for some of her care. $1100 a month is quite a bit of money if she has no expenses.

Step 5 - Ask her or talk to her about her living arrangements. Does she have any sisters or brothers that she could stay with.

Step 6 - If you do decide to keep her in your help, get a support group set up, a back-up sitter, people you trust to visit your MIL, help with transportation to doctor's appointments, etc.

Hope this helps.
Helpful Answer (3)
Report

My dads ss income was 1677 per mth. They have a special kind of medicaid for nursing homes where you are allowed to make up to 2000 per mth (all income combined) to qualify. If no one has told you yet, the nh will take all the income except for 30.00 ( amounts are different in nh's ). the 30.00 is for personal use for the resident. I live in Florida but I think all states have nursing home medicaid available to those who qualify.
Helpful Answer (3)
Report

RUkiddinME
One question. Who is going to help you out when you get dementia? or hubby has to go out on disability? Are the kids going to be there for you?
This is a hard hard world. Try applying for any kind of assistance the poverty level is so low. It's not true that people are living high off the hog on welfare and SSDI. It takes at least 2 years to get SSDI so how do you live while you wait and if you have private disability insurance those guys also know all the tricks of the trade to deny you. Private disability takes just as long and don't
think of doing a minimal amount of work just to pay for food and meds, your claim goes right out the door. Been there done that. The other trick the private insurers pull when they know they are going to pay is to turn it into a psychiatric claim which has a 2 year limit. So cut those kids off NOW as long as you pay they will keep coming back with their hands out. You may be young 50 + with no significant health problems now but that rarely lasts into your seventies
Helpful Answer (0)
Report

Yes, get the POA right away. Also, contact your local Senior Services Center, there could be Legal Services available for the elderly that may help you with Medicaid. Where I live, if you don't qualify for Medicaid, there are ZERO services available, and all services are paid out of pocket!
Helpful Answer (0)
Report

All good suggestions. I would just want to note that if she receives $1100 in SS, she will never qualify for Medicaid, income too high. Her income is probably too low for ALF in that part of the country, but is does buy you some time 1-2 years. You need to get POA right away to be able to conduct transactions on her behalf as she declines.
Helpful Answer (0)
Report

And make copies of your POA, because you will have to show it for many visits and items: discussing bill payments and medical treatments, respite care situations, long-term and temporary nursing home stays, home health equipment, etc. Many places request a copy on file.

As for children and other family? You've heard that it takes a village to raise a child? It also takes a village to care for an elder--especially one with dementia/Alzheimers.

If you feel particularly overwhelmed and need someone to walk you through steps, processes, and what might work best in your situation, there are people who do just that. I found one on this site. She helped me step back from the situation and figure next steps. Of course there is a charge. Also, social workers connected with elder agencies can assist.

Best to you!
Helpful Answer (1)
Report

Everyone already wrote what I was going to write.

1.) POA
2.) Medicaid

Get that POA ASAP. This will make things much easier for you as you continue down this road. A lot of people suggest using an elder law attorney but I took a POA form off of legalzoom.com, had my dad sign it, a witness sign it, got it notarized and I never had a problem using it.

And you can investigate Medicaid if/when a nursing home is necessary but be warned: Medicaid takes forever to go through so start early. I think my dad was finally accepted after 6 months.....which was 2 months after he died. Here in Missouri, Medicaid for a nursing home is called 'vendor Medicaid'. My dad, who was in a nursing home, was admitted from the hospital. Once his insurance ran out he had to be on Medicaid in order to stay in the NH. But as long as I was in the process of getting him on Medicaid and could show the NH's social worker that it was in the works, he was allowed to stay in the NH and the Medicaid would take care of his stay there retroactively.
Helpful Answer (2)
Report

This appears to be more of a lack of income problem than an elder care problem. I would suggest focusing on improving your income flow into your home. Unless the adult children are handicapped in some way, they need to become self supporting and your funds need to be saved for your care and your MIL's care in the future. Adding a part time job to your family might help dig out of the economic hole you are describing.

I would try to save as much of the MIL's social security for her future needs. She seems to be a candidate for Medicaid to cover her nursing home needs if she has no assets. However, that is a bleak way to end ones life. There are few good nursing homes who want Medicaid patients. They are more interested in self pay patients (who spend down their life's savings with the nursing home) and then they will perhaps have a Medicaid bed for the remainder of their life.
AL facilities are there to generate a profit, not really looking for Medicaid patient beds which do not turn a profit.

However, in the present, you need to see an elder lawyer for advice. Get a durable power of attorney to help MIL with your financial affairs, get an advanced directive to help get her the care she needs and wants. She should have Medicare and if she does she will at least get a decent level of medical care.

She should be eligible for some programs like Meals on Wheels and perhaps
elder transportation which could make it easier to care for her at home. Visit the office of aging, she should qualify for most of the programs in your area. They might have memory loss programs too which would help her.

Good luck these are difficult economic times.
Helpful Answer (3)
Report

I agree with Zdarov. The greatest gift you can give your children and grandchildren is to be financially stable (even secure) as you age. While many people will never require long term care, those of us who are on this site, clearly see the thousands of dollars it costs to care for seniors. I've been primary or 2nd in charge of 4 people. I was fortunate in that each of them had financial resources that were used for their care. One had live in help for 3 1/2 years. ($40,000+ a year for care plus lot's of special equipment). The others got moved to continuing care communities and subsequently to assisted living facilities ($5000- 7500 month). Millionaires? NO. Depression era people, YES!. They were factory workers and waitresses and secretaries. BUT they didn't waste money and they did (Thank God) save for their future. Each has/had the best available care and what a blessing that was for the families.

RUkiddinme - stop helping the next generation, you have a lot on your plate now. AND, as an aside many memory care places (not all) do take medicaid after private pay for a length of time. Good luck
Helpful Answer (5)
Report

I agree with all the answers after working in the field for 34 years. I am having the same problem. My MIL lives at an apartment in her son-in-laws home, which he is selling. She is 94 years old, and he has been helping her. Her daughter passed away a few months ago and he is selling the house. It is so hard to get her into a nursing home without a hospital stay prior. She is eligible for Nursing Home Care, we did the application, but not Medicaid since the limits are lower. My MIL is a very stubborn not so nice person, so this will almost be impossible for her to submit to a hospital stay prior to NH admission. We live two states away and I am recovering from Breast Cancer and do not have any physical capability to handle a move. She needs to remove herself from the premises so the house can be sold. She does not understand that both her sons are both not medically fit and can only take care of themselves with their health issues. I am just so frustrated with all of this and it is a nightmare. Thank you for letting me vent. Sometimes you just need it.
Helpful Answer (4)
Report

I have a friend in her early 70s who has little reirement, has to work, and is splitting what little money she has with grown children and grandchildren, and it exasperates me so. They are fit as a fiddle, guess they're busy 'finding their way'? I'm not saying finding good work, a place to live, etc., is easy, but your MIL doesn't have the option to even try, and has paid her dues I imagine. So have you, and you deserve security for your future. Just want to pipe in that maybe the kids need a little tough(er) love now. Parenting is not a lifelong guarantee of provision, is it??
Helpful Answer (5)
Report

Get the POA stuff lined up, both financial and health care. And she should be able to apply for Medicaid; that will cover nursing home care though usually not assisted living; depending on community waivers that may be available, it may cover some home health services as well.
Helpful Answer (3)
Report

Start asking around about local nursing homes. Find out if there are any that you most certainly would not feel comfortable having her reside in. Her Dr should be able to write out an order for her to be admitted to a nh. One thing I learned is that it is easier to get admitted to a nursing home after a hospital stay. My father was admitted for confusion because he was acting out very badly at home and a social worker talked to me and asked if he was going home or into a long term care facility. They will send out referrals to NH's and if the home has a bed they will accept her. The home will call you sometimes almost immediately so don't be surprised if they do. They will ask you to come in and tour the facility. You really need to get POA while she is able to give it to you. I got it and made decisions for dad and signed paperwork that he couldn't understand anymore. you can meet her at the nursing home if that is where she is going and be there for her arrival. It may make you both feel better. They will transfer her from the hospital in an ambulance. As for the payment involved. If she is only receiving 1100.00 per month she should qualify for medicaid. Medicare will also pay for some of the cost also. While she may not need the nh now, it is important to be prepared and aware of things you need to do on her behalf. Hope this helps. I was lost at first and wish I had had the information to make good choices based on my help from here. Good Luck to mom and you.
Helpful Answer (3)
Report

Contact your county office of the aging and they will help. Get a statement from the MD confirming Alzheimer's. Forget AL, Medicaid won't cover it, but if the MD says she needs a memory care nursing home, start the application.
Helpful Answer (5)
Report

This question has been closed for answers. Ask a New Question.