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I'm originally from India and mom was living there in a very nice senior center. But she became very forgetful and could not be left alone there any more. That place is not a memory care and there is no one to check on her daily. We hired aides but since no one was supervising them, they'd come late, leave early, take a day off suddenly etc....these aides were from reputed agencies in that town but were not working out. This was a huge blow to us.
So I panicked and brought mom here.


Mom now has a green card and has private (expensive) insurance. She's 85 now and doing ok since I'm a helicopter daughter.


How do we plan for her long term care if she gets really bad, cannot recognize me, or has a stroke or something? Mom has some money in Indian rupees- we are trying to convert this into $$ but that's proving to be a bureaucratic nightmare.


I know mom won't qualify for any government programs since she's not a citizen. If we need to place her in a facility, how can we finance this???? We can scrape through our savings and finance for a year maybe.


What if she lives to be 100 years???


I'm not keen on taking her back to India and making frequent trips to check on her.

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Answers below are appreciated; I wasn't aware "residency" could occur in a manner to have medicaid kick in for seniors. So I would repeat to check that out for your own state.
Of interest here is that in the United States not a few are shipping their own senior OUT of American for less expensive care, especially to Thailand and Mexico, where care is done by families, often very lovingly for a fraction of the cost in America. I have not clue how that happens with being not there and unable to monitor the care in any way, but apparently it does.
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It really depends on the state. In California, for example, even undocumented can qualify for nursing home Medi-Cal (the state version of Medicaid) and all green card residents do.

https://eligibility.com/medi-cal/how-immigration-status-impacts-medi-cal-eligibility
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This would be a good question for a hospital social worker. What would happen if your mom fell, needed surgery and rehab and a release to your home would be an unsafe discharge?
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Thank you all for being a sounding board for me - your feedback as always, is very valuable to me.

Merry Christmas to all!
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If your mom was approved at 85 to come to the U.S. and was already in assisted living in her country, she has money somewhere. Either it was proved to the American government that she can provide for herself and pay her own insurance and care, or someone else had to do the adjustment on her visa assuming financial responsibility for her. The government is not going to give her Medicaid to pay for a nursing home until either her money is gone (if she proved she's financially stable) or until the person whose name is signed on her paperwork that assumed financial support of her has spent down all their funds first. She did not pay into Medicare in the United States so she won't get any help there. Your choices are pretty much going to be keep her with you and hire private help to care for her, or send her back to India. I feel terrible that you're in such a situation. There's not a lot of options for you. Maybe speak with an immigration lawyer. They might be able fins out if there will be anything available for your mom if she needs a nursing home.
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Wren, there are often no ‘good’ options. It’s the art of the possible, you make what you hope is the best choice. Have courage!
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Wren, I would check out board and care homes.

They tend to be much cheaper and unless she requires specialized nursing care they will accept most cases.

I saw some that were owned by husband and wife nurses and they had some pretty challenging stuff.

Good luck getting her money to her.
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BurntCaregiver Dec 2020
There really isn't such a thing as a 'Board and Care' home. It's a nursing home. Nursing homes have residential areas that are 'Board and Care' only. This only means that the resident does not need skilled nursing care (although, a nurse will give out their meds). It is not cheap. My parent was in the cheapest one in the state of CT when downgraded from skilled care to board and care, and it was $8,500 a month. That has to be paid cash too because Medicare and private insurance do not cover room and board. When the person is completely broke they go on Medicaid and they will pay for it. Not before.
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How long has Mom been here? I think its 5 years of residency before she can get Medicaid. Check it out with ur State.

Maybe you could find a board and care. She has no money here? I guess ur brother would not help with cost of her care since he really didn't help with her in India. LTC is going to be at least 10k a month. And her not speaking English will be a problem. Finding someone who can interrupt will be hard. Doesn't India have different Dialics. Actually, even if she spoke English, when they have Dementia they revert back to their original language.

Sorry you are going thru this. You did what you needed to do bringing her here. But being a non-citizen causes problems. How is her decline? My Moms was monthly. I doubt if your Mom will live to be 100. Your Moms brain is dying. As such, eventually the desease will effect the part of the brain that controls heart and breathing. When that part dies, so will Mom.
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wearynow Dec 2020
Thank you, JoAnn. Mom's been here one year.
She has no money here and brother will not talk about her care.
She speaks English fluently.
She's ok for now but long-term I don't know
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Did you check thoroughly on alternative care options in India? It sounds as though something like Senior Living wasn’t enough, but it would be surprising if there weren’t other options. Do you have relatives there who could help with checking? We have had several posters who have chosen to leave parents in the Philippines, even countries in Europe, because the US is unaffordable without insurance or subsidy. If you could cope with a couple of visits a year yourself, to a facility that was on a flight route, it might be workable. There would probably be other advantages of language, food, and general familiarity. Aging family is one of the difficult problems of international migration that we don’t tend to think about when we are young and they are still capable – my daughter and SIL are coping with it at present.
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wearynow Dec 2020
Thank you Margaret. I'm sure there are other options in India but we don't have anyone to check on mom regularly. Actually my husband and I were talking about moving mom to a place in India on a flight route but mom will have to be in complete decline to be moved there - when she won't know where is.

Right now, she will stay only with me or at her usual senior place in India.
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Does your mother speak/understand English fluently? This ability may dictate her care plan. As if memory loss (or dementia) isn't bad enough, the language barrier will amplify the challenge of caring for her. You may wind up having to care for her in your home and private hiring caregivers who speak her native language. Private hiring makes one an employer, and this person will need to comply with their state's employment and tax withholding and payment laws, will need to vet backgrounds of employees and have a plan for subs.

Facilities are ghastly expensive and in no way should you be attempting to pay for your mom's residence in one. You will only be robbing from your own care down the road. Make sure your mom has her legal paperwork done (Power of Attorney, Medical Representative, Living Will) as without it you may be severely hindered in managing her medical care and finances in the U.S. I'm hoping others will have some better insights for you. My own grandmother was an Italian immigrant who hardly spoke a word of English and lived to be 96. Her family cared for her in their home for 15 years.
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wearynow Dec 2020
Thank you. Mom speaks & understands English very well.
I will keep thinking about this.
Take care.
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