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Mom's living in a private pay facility and has 5 months of funds available. I don't know what to do or where she will have to live. It seems such a shame at 93 1/2 that we have to move her. We can't afford to pay for her monthly rent and care plan.


I am looking for ideas on where to start.

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If your Mom is in AL and has lived there at least 2 years she may be able to use a Medicaid waiver to help pay the fees. That's the way it works in most ALs in Ohio. Talk to the director to get a clear understanding of their rules. She may have to move to a smaller room but it's worth it if she likes the facility.

Did she or a husband serve in the military during a time of war? Mom qualified for an Aid and Attendance pension because my dad was in the army at the end of WWII. She got the maximum of $1200 which was a big help. Any war qualifies. Check with the VA, it’s a lengthy process so don’t wait.

Definitely get an appointment ASAP with a social worker at Medicaid to start the process before your mom runs out of money. Check any religious affiliation you might have, too.
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Talk to the facility social worker to assist you w/the next step. If mom has enough monthly income, they may keep her as self pay. May even offer a deal to match her income. If she doesn't have enough monthly income after savings is depleted, social worker can help you apply for Medicaid. It is very possible this facility will have an available Medicaid bed and mom won't have to move out of the facility. (May have to change rooms if she happens to be paying for a more spacious or single bed room). The only other option is to take her home and use her monthly income to pay for whatever care that will cover.
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You only have a couple of choices. Get her qualified for Medicaid as soon as she runs out of money. That is you should be consulting an elder law attorney now!! If she can't qualify for medicaid you will have to pay for out of pocket OR have her live with someone in family.
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I am sorry if my earlier response "take her in" was to some seemingly uncaring or "a blanket statement". It was meant as a possible choice based on my own experience - that's all. I grew up in the 50's with a HUGE family with ONE bathroom - we staggered. (my mother grew up on a farm and went through enormous challenges during her time period and that was considered "usual". We once visited and her house was so tiny today it would be considered a "tiny house" yet she had many sibs. I learned a lot from her.) We moved after surviving the Psalm Sunday Tornado (Indiana). (but decades later I found out from my mother when my father was dying that he, being a CPA had discovered the "other" set of books for the "trucking company" (we moved within days!!!)

I was obtaining my MA in health care (working 80 hours a week with a double major and minor at night) when our bld in NYC had a fire and that was the end of my life as I planned it. (chemical injury where I was paralyzed and internal organs breaking down). Years of natural therapies (one friend from Oregon where we were both from) and only there part time meaning no care at all in between (yes a nightmare).

I eventually after years was able to "walk and talk" but had to live isolated due to not being able to be around synthetic "fragrance" products (made of petroleum by products and millions in America are homeless or die early from this diagnosis). Many live in tents and cars - I lived in the stairwell. (the renovation chemicals - all illegal, were coming up through the floors). Only after 9/11 did the EPA have the fire department come to shut the illegal activity down.

I had been a nurses aide (as mentioned) and I took care of many of the elderly in my building (they had no family) and many dying of AIDS when even the hospital staff would often ignore then or not even admit them - this was when it first hit and was erroneously thought to be airborne - just because I could not NOT.

When my mother (RN and PA to four neurosurgeons) was misdiagnosed and in the hospital, I flew out with oxygen (difficult to get on airplanes) and a huge OSHA mask and other safety measures to stay day and night in the hospital to ensure she was taken care of (and glad I did as when her Morphine wore off and I had to restrain her with sheets as the "care" was outside eating pizza and ignoring my buzzes for assistance). All the family had offered to take her in but she did not wish to so so, and we had other arrangements made until the last three nights in the hospital. She passed on day three.

Now I have a recent diagnosis even though I never smoked (got it banned in NYC but much damage was done as it was everywhere at the time) and am trying to plan to go "out" without much pain as "it's" spread everywhere, as again I live alone on very low indigent SS (due to being young when I was in the bld fire).

What frightens me is not dying but the current medical care where I am with refers to one doc to another to another for apx 15 minute visits and NO one wants to know your history so on. (I was xrayed as a baby - huge amounts month after month - the dirty old x rays with no lead blankets and many babies were thus treated and many now are paying for it with "it") (sorry can't say the word even).

And my eldest sister has an empty one bedroom in a gated community (I lived in HUD housing) and her husband won't allow her to "take me in".

That is the "point of reference" I was coming from - nothing more.

Sorry if I offended anyone. And I mean that sincerely. Going to sign off as I have much to do and little time to do it all in. Thanks for the many great post on these boards.
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BBS2019--No, many people lived to ripe old ages before WW II. The AVERAGE life expectancy was lower, but that was because of infant mortality, childhood diseases, accidents, etc., but in a family having several children, probably at least one would live to be "old". However, there IS a difference--years ago, an old person might live, for example, to 88 and still be ambulatory with a mind reasonably intact; now that person lives to perhaps 93, and the last couple years might involve considerable decline both physically and mentally, thus requiring care. On the flip side, any obituary page in recent years will still list an "uncomfortable" number of deaths in one's 50s or 60s.
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Medicaid is the answer, though she won't qualify until she's below a certain asset threshold, you can start getting prepared to apply for now. If the facility she is in now doesn't accept Medicaid patients, ask the social worker for recommendations on other facilities. One thing though, other here have told you to take her home , or you "may have to take her in". Please be aware you in no way are obligated to do that if you are not able to adequately care for her needs or if you simply do not want to take on that burden. A State social worker could help you find placement in a Medicaid facility.
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Inquire about county [senior services] or organization support for social worker.
Apply for or check into Medi-CAL.
Likely, there may be some differences depending on where you live.
The bottom line: if a person doesn't have income, there is little support / financial or otherwise, out there.
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Imho, you may have to file for Medicaid. Prayers and luck sent.
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There was a time when families took care of their own. My opinion. Take her in. Get what ever help she needs for in home care (Medicaire/Medicaide) I am gong through this myself for myself. Takes some research and State and contacting others.

Parents take care of us for decades (or less) and in olden times children took care of the parents. Now it is "relegated" to often horrific, uncaring Gov sponsored agencies (unless one is so wealthy one can afford better)

Get home health care and what ever is available. (I worked in health care, nursing homes in senior high and would NEVER let myself or a loved one be so placed - horrific! )

Do your best.
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babsjvd Apr 2021
Not everyone can take in a parent ...I can guarantee, taking my mother in would mean choosing between my marriage...my house has one bathroom . Just for starters... to make a blanket statement is not helpful
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Yes - check with current facility, if she's been there for a while they may have a program - like a grant, if not then she will have to move.

My father didn't serve in WWII, but did go in just after WWII and dates served were included with WWII veterans, so if your father served during or just after WWII check with VA for Time and Attendance benefits for your mother.

If you mother owns no property, you may be able to navigate applying for medicaid for her without the expense of an attorney. When my father needed to move to SNF, I went to an elder law attorney, even tho there was no house or car because my mother still needed money to continue to live in AL. But if her time comes to go to SNF I will probably attack it myself - nothing but savings, group term life ins (no cash value) and prepaid funeral home services and prepaid burial both nonrefundable.

We are talking state of MO here. Dad was transferred to the SNF and 1st month was paid in full, and SNF was told we were applying for medicaid and the office calculated what they thought his share would be and charged a portion of that amount while medicaid was being applied for. After his medicaid was approved we had overpaid and a refund was given which went to mom. Dad died just before he was approved for Medicaid. Your mother could have a private room but would have to pay the difference between private and shared room.

Check with social services, department of aging for resources. The social worker at your mother's facility may be able to assist you in getting your mother placed.
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sazure Apr 2021
Great post and shows how much "work" is involved. Endless and although we pay "in" hard to "receive" said assistance.
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I'd like to suggest that having a roommate in a nursing home isn't necessarily a bad thing. My mother has had at least eight roommates (I may have forgotten one or two!) over the course of her eight years in two facilities (with over three-fourths of the time spent in the second one), and most of the roommates were fine. They provided a certain amount of company for our mother, and my sister and I enjoyed visiting with them, too. In most cases, my mother outlived them. One was considerably younger and was there because of medical reasons as opposed to dementia, and she had worked as a nursing home administrator (elsewhere), and we were fortunate that she "kept an eye" on my mother such that if she noticed anything wrong, she would take the initiative to report it to the staff, and then tell us about it when we visited. When certain things weren't running as smoothly as they should have been, this roommate and I joked that perhaps she could get a job there in addition to being a resident, and help them get their act together! Unfortunately, her health took a turn for the worst, so she lived only a few weeks after that, and we missed her.

Each room was designed for two residents although in a few cases there was a vacancy so some residents didn't have roommates. Although my mother was private pay, there were residents who were on Medicaid.

In the first facility in which my mother resided (in PA), the layout was such that there was a bathroom between two rooms, so usually four people shared one bathroom. This was less than ideal, and in my mother's situation, there was a woman in the other room who used to "park" on the toilet and stay there, so the staff often had to get her out when any of the other three people needed to use it! Her second facility (in OH) had a bathroom for each room, so only two people would ever have to use it--I believe this is the way all the facilities should be.
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https://www.va.gov/pension/survivors-pension/

In addition to the long-term care benefit within Medicaid, if your mother or her husband was a war time veteran, she may qualify for a benefit from the VA. I have heard that the VA now expedites applications for those over 90 years old.
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disgustedtoo Apr 2021
Anyone reading this should read:

https://www.agingcare.com/articles/va-pension-medicaid-180064.htm

There is a lot of good information in the above article.

Highlights:

*Recommendations on several sites are to apply for the VA benefits first.

*Most states do not consider it income, or only a portion does, so it doesn't disqualify the applicant.

*NOTE: if approved for Medicaid, VA benefits is reduced to $90/m (but it doesn't go to NH.)

***BIG NOTE: "Medicaid long-term care is intended for people with low income and limited assets who meet medical and/or functional criteria for a nursing home level of care."

What that last note means is that most state Medicaid programs only cover NHs (there are exceptions) AND have requirements for NH care.

The problem is that many do not understand that the person needing LTC must also require NH level care. Too many say put someone in a NH and apply for Medicaid. It isn't that easy. Dementia alone isn't enough to satisfy the NH requirement and people fall into the income donut-hole.

Hoping at some point this will change, but for now the ridiculous income limits and restrictions to NH qualification leaves a lot of those needing assistance out in the cold. I am thankful we were able to preserve mom's liquid assets and then add the proceeds from the sale of her condo to that, to cover the cost of her care. I would have used every last dime for her care if it was needed. No way would I consider Medicaid until ALL of HER funds were exhausted!
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Immediately talk to the facility - do they subsidize patients. Some will and some won't but at least you will know. Talk to a social worker and contact the local Office on Aging and start learning about Medicaid. If she is placed into a nursing home, Medicaid should be willing to pay. There is help out there but you have to start searching for answers. I do not think they can just dump someone on the street - so find out what your options are. And contact an Elder Care attorney for help and advice. Also ask the local hospital if they have someone to talk to.
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DianaMiller Apr 2021
I have a mom with Lewy Body Dementia 83, a mentally challenged Aunt 73 and my Dad 84 all under one roof. My Aunt would like to get away from my mom so I did a little research into Medicaid. My Aunt has very little money and can't take care of herself but can do chores so she would like a room and bathroom to herself. You will have to check with your state since they differ. I live in TX and I contacted Medicaid and was told that if my Aunt went into a facility Medicare would cover the first 100 days while we filed for Medicaid. It was a little difficult to contact Medicaid by phone since it under different names in the different counties. So contact a facility in your county to find out the name. Hope it helps and good luck.
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It just shouldn’t be this difficult to care for our elderly loved ones.
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TouchMatters Apr 2021
Yes. Amen. This country has no respect for us as we get old. It is disgraceful.
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If she still has a house i suggest you ecplore a reverse mortgage. Medicaid. Prays. Mt heart goes out to you you are in a dif guy ivukt position. God bless you
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disgustedtoo Apr 2021
IF she still had a house it would be better to sell it outright. Reverse MTGs cost money, and the house itself would be taking needed funds (utils, ins, RE taxes, maintenance, etc.) I doubt there's any house involved here.
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If you can just hold out a little longer, President Biden is working on it. He put back $400 Billion for senior care and there caregivers: https://www.washingtonpost.com/us-policy/2021/04/02/caregiving-elderly-white-house-infrastructure/
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sazure Apr 2021
Sure more Government bureaucracy. If it passes at all it will take many years if not DECADES before the final (mandate, act, resolution??? will be passed if at all) (recall the separate houses of Congress)

(I minored in that area in NYC long ago - lots of talk, talk, talk...) We shall see. The bottom line is people pay into social security and medicare and it is difficult to get assistance later.
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I would start by contacting your local Adult Services Program, a local DHS in your area, and let them know your situation and maybe get hooked up with a Social Worker
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Her facility should have access to social services. Talk to them about her situation. They can help you apply for any financial help through the state and federal government. If she will not qualify to remain in her current facility on government assistance, then use the time she has to seek out a facility that will help her apply for government assistance and will accept clients on Medicaid and Medicare.
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Does the place take a Medicaid waiver, some states have that program but there can be a waiting list. Ask the place.
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Bunnymom02 May 2021
What is a Medicaid waiver?
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Talk to the business office where she is now. My mom is now in memory care and has a few months before she runs out of money. The accounting office is helping us to gather the info and forms that my mom will need to apply for Medicaid to make the transition from their memory care to their skilled nursing unit.
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You need an eldercare attorney because Medicaid rules vary with each state.
You may have to move her in with you.
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I urge you to see a Medicaid Attorney TODAY (not an Elder Care Attorney)--someone who specializes in Medicaid rules and allowances. There are answers, but you can't wait until the 11th hour to seek them out -- I'd say you're at 10 o'clock right now.
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Medicaid.
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Check for PACE a program nationwide that combines Medicare with Medicaid.
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This is a NH correct? If so and it’s only private pay accepted at this place, I’d get a copy of the contract and find out exactly how much Notice mom needs to give to leave without penalty. Give Notice and drill down big time in the 4 weeks (hopefully not more Notice needed than 30 days) to find a NH that takes Medicaid AND private pay. And move her. Believe me there will be a NH that takes Medicaid & would love a resident who can private pay for 4 months prior. If mom has a somewhat higher monthly SS or other retirement income, that is a real plus as well.

Now if this is AL, it’s going to be different challenges. Mainly you’ve got to find out ASAP is if in your state Medicaid pays for AL. AL is overwhelmingly private pay nationwide. Most state’s Medicaid do not cover AL. If that is your situation you are going to have to do things to build up her health chart to show “need” for a NH. So mom moves into a NH rather than an AL.

Medicaid has “at need” requirements for BOTH financial & medical “need”. financial is what you hear abt the most but medical is just as important. Most go into a NH from a hospitalization & the common drama is mom falls & breaks a hip; gets hospitalized (MediCARE pays) & has surgery (MediCARE); then mom discharged for rehab at a NH (again MediCARE pays & for up to 100 days); usually they plateau out at 20/21 days & it’s determined mom cannot return home so she segueways from a rehab patient to a NH LTC resident; MediCARE does not pay for LTC so they apply for Medicaid. Now under this scenario, NH has gotten the much much higher MediCARE rate for weeks so they are happier, AND, the elder has a nice fat health care chart that clearly shows them to be “at need” medically for skilled nursing care. So facility knows the medical “at need” is ok. Family often don’t even know the Medicaid medical “need” has to be justified. Family is busy with getting years of financial & legal stuff so that’s their priority.
BUT
Your mom is not coming from a hospitalization. What might happen is that Medicaid will want to establish that mom is medically “at need” for care. If she’s been in a NH sometimes a NH will accept a private pay resident who is actually “custodial care” rather than being “skilled nursing care” as a resident. If your state actually pays for AL, that too will have “need” but it should be pretty straightforward review of old AL chart. State will want to review her health chart in some way.

I moved my mid90’s mom from IL to a NH and mom’s Medicaid application had medical need issues & I had to file an LTC Medicaid medical appeal. NH takes lead in this type of appeal as they have to input stuff into health chart. For us, it was RXs and labs from her doctors office that were left out of her chart at the NH when she entered. It was all resolved way b 4 the appeal hearing date. My point is, if your mom could in anyway be viewed as purely custodial care, & she’s wanting to go into a NH, she might need to have her chart beefed up before she files for LTC Medicaid.

if she is currently single room status, pls realize once she goes onto Medicaid more than likely she will have a small closet & will be sharing a room. So keep that in mind as you pack and try to jettison what you can. Often the most they can bring in is a chest of drawers & a chair; maybe a narrow bookshelf. If your mom has a ton of clothes, perhaps convert 1 of your closets into seasonal storage for her clothes & shoes.
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disgustedtoo Apr 2021
"...perhaps convert 1 of your closets into seasonal storage for her clothes & shoes."

OR as a place to find replacement clothing for missing items. I've been trying to sort through everything they boxed up and sent to me when mom passed. We were not allowed in, so this it what they packed. I had already, before the lockdown, noted mom wearing some things I'd never seen before.

I've found about a dozen stretchy undies (she NEVER wore any like that and had been in briefs for several years - we removed all her undies to help the transition.) I've found towels that I KNOW are not hers. She was partial to pink colors, so all hers were pink or had pink. There are some pink ones that I also know aren't hers, but blue and turquoise? There are also clothing items that I know aren't hers. Styles and sizes are way off, and I knew what most of her clothes looked like. I feel bad for those who have "lost" these items, but I have no way to know who they belong to, is the person still alive, is the person still living there?

So, the closet storing the "extras" can be seasonal, but also spare clothes!
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If your mom has uncomplicated assets (no home owned, no car, just a checking account and SS) AND you have not been co-mingling her funds with yours or doing anything that appears as "gifting" money, property or assets to each other in recent years -- then you can certainly fill out the app yourself. You'll need basic information like her birthday, SSN, address, ability to provide copies of banking statements, copies of medical bills, etc. After application it can take about 3 months to hear if she qualifies. In my state of MN there is a 5-year "look back" period for the application. This means if my mom signed over any assets to me (or anyone) that long ago then Medicaid will include that info as they consider her eligibility.

If it's more complicated then I would certainly invest in hiring an elder law attorney to advise you and help fill out the form.

FYI usually a Medicaid bed is in a shared room, but my MIL has been in LTC on Medicaid since 2016. We moved her to a different facility that was closer and better managed. They have been remodeling and improving this older facility and she's been in a private room since last June.
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This is what I did. Mom had 20k left in her bank account. I placed her in a nice LTC facility. The 20k paid for 2 months privately and got her under the 2k income cap. She moved in May 1. Medicaid, in my State, only allows 90days from initial application to place the recipient, get them spent down and get all info needed to them. Mom paid May and June and July Medicaid took over. I started the process in April.
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Nor should you attempt to pay for the care, as this will rob you of funds you will in future need for your OWN care. Your Mom will have to move to a place that accepts medicaid now. You will need to begin process of application. It would be wonderful if the facility where she lives would be able to suggest and help you. I would explain to them just where you are and ask if they have any ideas for you.
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Find a Skilled Nursing Facility in your area that accepts Medicaid; get her in there NOW and private pay with your Medicaid application PENDING. It's easier to get a person into a SNF while you are private paying than it is AFTER her $$$ runs out and you are THEN applying for Medicaid. Then ask the SNF if they can turn you onto a person/company that can HELP you go thru the Medicaid process; the SNF I will be using for my 94 y/o mother gave me the name of 3 such companies that will help me; they provide the forms and the assistance to apply for Medicaid, then the gal puts the application in herself and keeps up with the process, and any further requirements needed, etc. There is a fee for such a service, here in Colo for me it's in the neighborhood of $1400.

I feel the same way you do; I hate having to move my mother at 94+ years old but in a while, there will be no other options as her $$$ is running out for private pay. Extreme old age is nobody's friend, that's my opinion on the matter. With advancing dementia and a good many other issues at play, the quality of my mother's life has diminished tremendously at THIS point. Having a roommate in a SNF surely won't make it any better.

Good luck!
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I found this for you, hope it helps
https://www.payingforseniorcare.com/illinois/medicaid-waivers/hcbs-waiver-for-supportive-living

And it's never a good idea to leave it to the last minute to talk with her AL facility.
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