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She “can” somewhat prepare a meal but is often to depressed to do it. So she doesn’t eat much and is losing weight. She "can" get up from bed or a chair but gets dizzy and is in danger of falling. Therefore she remains in bed a lot of the time. She can make it to the bathroom but also has accidents often. She can manage a shower once a week or so but again she is dizzy and in danger of falling. This is hypothetical because she is also very against an assisted living facility.

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Her policy does include assisted living but not in home care. But she needs to be missing 3 ADLs to be approved.

she won’t take the anti depressant medication prescribed by neuro.

her regular dr recently tried to get her some in home help through Medicare. They came out for an evaluation but declined because they said she needs more help ( long term) than they offer through the insurance.
her Medicare insurance does not include In home long term care.
the long term care policy will do assisted living and nursing.

the dizziness is most likely do to vision problems and bad circulation from a bad scoliosis and laying in bed all day. The dr is aware.

it’s difficult to know what other meds she takes as she is very very protective of them. ( one reason she doesn’t want to go to ASL. )

bought a fall monitor… it sits on the bookshelf. Her phone is a senior phone with a red emergency button

to add to all this. I live overseas and am an only child. and neither my mom nor I have have finances for things not covered by insurance.

she has a cleaning lady that helps with groceries and dr visits.

im just trying to be sure if I manage to talk her into it … that they will actually approve her. They say ( MetLife) they cannot say for sure till she is actually in the facility.
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AlvaDeer Jul 2022
Thanks for these answers. Your MD will be USED TO writing writeups, so tell them that you need at LEAST three reasons, and more the better. So you are already giving us a whole bunch. She doesn't qualify for in home or therapy and has balance and other concerns. Likely she has chronic problems with spine and some pain. She is unwilling to make meals with proper nurtition and likely is no longer safe with cooking and stoves, she has depression likely exacerbated by isolation, and whatever else he can stuff the letter with. You should also keep the materials involved in refusal of home care, which is proof you have tried other modes to address this. When you apply you are going for OVERKILL basically to PROVE it is no longer safe for her to be on her own, and she requires in facility care.
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An AL is just that, it assists. It may only be one thing you need help with. The more you can do for yourself the less the cost of your care. Maybe Mom has no problem dressing herself but she needs help showering. Be aware though, ALs are not skilled nursing. Its an RN and maybe and LPN. The rest of the staff are aides with no medical training. Their training consists of dressing, bathing, toileting, and doing some light housekeeping and laundry.

Seems to me ur Moms depression is the problem. Is she taking medication for it?
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That depends entirely on the LTC policy that was purchased, something we can't know, and something it may take you a while to research. The contract with be long and I would imagine full of fine print. Some don't include ALF or ILF (independent living). Some only include needs that require facilities with full time RNs, believe it or not, something non- existent in even memory care facilities.
So you have some reading to do.
Your next step is a visit to Mom's doctor, who will be writing the qualifying letters. He may have suggestions of PT or OT or some other kind of rehab, antidepressant, in home help to delay this move that Mom doesn't want. Dizziness is something that should be discussed with MD ASAP as there may be adjustment in medications needed at this time to prevent a fall. A simple in home pushbutton blood pressure monitor and BP diary is called for now. Mom may actually enjoy learning that and keeping a record for you. Omron, in my humble opinion makes the best ones. Titrate your readings with those of the MD when Mom visits to make certain they are within 10 points of one another.
You should be certain all of your POA papers for medical and general POA are in place at this time, while Mom is still capable of doing it.
The things you have mentioned for the most part are addressed without a move. The dizziness indicates something medically is off, and that needs an MD consult.
There is adult incontinent wear for frequency and urgency after a UTI is ruled out.
There are meal delivery services, and I can tell you at 80 I am down to one meal a day, all I need to sustain 150 pounds. I also don't like to cook much any more,so make a huge pot of marinara or a huge pot of beans and can eat off of them for weeks at a time.
There are also options for some light in home help.
A try at anti depressants may be in order.
A fall monitor should be considered.
In short, there's lots of work ahead in seeing what works and what doesn't as well as long long talks with Mom that are gentle, forthright and ongoing. Tell her that her ability to stay home is now in peril, that you want to help to keep her at home as long as possible, but it will take the two of you cooperating, with a good deal of will to prevent the ALF she dreads.
You might consider a few visits to ALF in your area. My brother's made ME want to move in with him! And I am more or less anti-social!
I sure wish you the best.
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