I received lots of helpful info from people here on dealing with my aunt's recent crisis, and in case anyone is interested, I thought I'd post on how it all went.
First of all, you all were absolutely right on several essential things:
1. The SNF will try any trick to get rid of someone. Boy, was this true! Calling her elderly neighbors to try to get them to take her home, telling her she's going home in front of me, you name it. So glad I'd read this forum and was prepared to resist!
2. An eldercare lawyer is essential. Actually, I'm not sure I got my money's worth, but the lawyer joined in on a Care Plan Meeting and roughed up the SNF a bit, so they were on notice that they couldn't pull a fast one.
3. APS is on your side. Absolutely! The APS caseworker put in an impressive amount of time researching and talking to neighbors, etc. to understand the case, and she was very responsive whenever I needed advice.
4. I am not responsible for my loved one's choices (financial and other) that led to her current circumstances. (I repeat this to myself often.)
And here are some other things I found out along the way:
1. Turns out I had more to give than I thought I did, and wasn't willing to walk away and let my aunt be placed 2500 miles away. I found an LTC facility close to my home that would take her Medicaid-pending right away and have moved her there. It's taken a huge amount of time but wasn't too difficult (of course, she's not on Medicaid yet, so fingers crossed).
2. "Available services" aren't available. If I read one more thing about care in the community, providing support so people can live at home, etc., I will throw up. In the poor state where my aunt lived, there was a slick brochure, an endless waitlist, and no actual services at all. Big waste of time and energy.
3. ADLs matter most for insurance. From Medicare's perspective, the fact that she doesn't perform self-care functions is irrelevant, because she still has the physical capability to do so when directed to. I still don't quite understand why cognitive issues aren't given equal weight.
4. No one much cares about the cause of cognitive issues. I naively expected such issues to be treated like cancer would be: full testing, detailed diagnosis, options and treatment plan. Nope! Everywhere, I've encountered an attitude of just dealing with the surface manifestation. More details would really be helpful for making plans and arranging for whatever treatment might have an effect. I've made a neurologist appointment because I want that information, but no one at either the rehab or the current nursing home viewed that as important.
5. So many predators out there! After digging into my aunt's woeful finances and seeing how vulnerable she was to exploitation, I am having a talk with my other elderly loved ones about predatory "charities" and "memberships," worthless life insurance, etc.
It's been an eye-opening experience, and makes me realize that every day is a gift. Thank you to everyone who offered advice on my previous posts.
Be sure to take care of you.
You have done an awesome job.