My mom cannot afford to remain in assisted living. What are the options?

A lot depends on the income and assets your mother has, and also the state she lives in. I am in the process of moving my mom from an Assisted Living community in California to an Independent Living place in Colorado, largely for financial reasons. The Assisted Living in CA costs more than she can continue to pay--and she's at their lowest level of need/cost! (Needs medication management only). The Independent Living place in Colorado (which is designed for seniors and has lots of support like clinic visits, on-site counselors, meals programs, and more) has an Assisted Living place associated with it, to which she can move if/when her needs reach that level, but for now she needs only med management and I can do that, and I can provide other help--without our living together so that eases some family strain. So the Independent Living place is good for her. In California, she couldn't get government assistance unless she actually needs a nursing home--which she doesn't. But in Colorado, the Independent Living place has HUD subsidized apartments with rent based on a certain percentage (about 30%) of her income---whereas the California Assisted Living place had no such subsidy and was costing her about twice her actual income, which meant her limited assets were fast running out. Now she will have a nice little apartment with lots of people in similar situations, and a community designed to meet the needs of seniors, and when her needs increase she can move next door to Assisted Living where Medicaid will take over once her assets are gone (they will be soon, once she has to pay full freight there--a few months, and she'll be approvable for Medicaid). This seems ideal! But you'd have to look carefully at any such places--whether HUD subsidized or not; some are safe and clean and lovely, and others are not. It's your job to determine that by repeated visits, surprise visits, and so forth. The place I've settled on for my mom is church-related (grew out of a church-run home for elderly people) and has maintained that flavor, and that makes for an atmosphere she likes. It is also dedicated to elderly people, so doesn't have some of the problems other HUD places for needy family with lots of kids might have. No place is perfect, but this one looks very good for my mom: it is safe, clean, has a happy atmosphere--all this could be said of her place in California--and is affordable--which can't be said of the California place.
Good luck finding a way to help your mother--I can hear in your letter the anxiety you feel, and the need for her to be safe and happy and yet for your family to remain as it is--hope you can find a place like this that has some subsidy to help your mom's finances, and some community support so that YOU don't have to "do it all"!

Here in Missouri, my dad went into a nursing home. He had Medicare and less than $7,000 in savings. While in the the NH Medicare paid...up to a point. Before his Medicare was going to be cancelled (the social worker in the NH informed me that this would happen) I went to my local Medicaid office and applied for Medicaid on behalf of my dad. Certain criteria have to be met but even if your mom has a ton of dough laying around there are ways to get around that. Our social worker helped us with this as well. Medicaid for a nursing home resident is called 'vendor medicaid' and vendor medicaid applications are rarely denied. I had to jump through about a thousand hoops: tracking down this or that document, gathering information, but my caseworker at the Medicaid office was very helpful. It was a pain in the butt but we knew that Medicare would eventually drop my dad so I knew it had to be done. It took 3 months but my dad was finally approved. I got through all of this impossible red tape with a Medicaid packet and the assistance of the Medicaid caseworker, along with the facility's social worker. Now my dad's monthly income goes to the NH and Medicaid picks up the rest. And while my dad's Medicare was dropped as far as his living in a facility, he retained his Medicare coverage if he has to be hospitalized AND it covers hospice.

Good luck. It's a mess to wade through but if I can do it anyone can. :-)

Our personal experince: we were told by a VA representative that our mom, who was still married to the vet husband when he died, is entitled to his 'survivor benefits' for long term care financial assistance, EVEN THOUGH she remarried.

I believe you have been given misinformation. Your mom IS entitled to your veteran dad's survivor benefits for her long term care financial assistance. Call the VA.

Recommend you contact MEDICAID. They can let you know if/how to qualify for there assistance. If my understanding is correct it is a state by state qualification process dependent on the individuals net worth. Unfortunately there maybe a need for some type of liquidation, however, once that is met the individual should be cared for the remainder of their life.

Great info from Chimonger. You cannot be forced to take an elder into your home. Key words to say to social worker are "fall risk", "danger to self", ect. You have to be strong!! Of course the state would like you to take your parent home - even if it is not in the best interest of the patient - because it saves them money. Assisted living situations are profit driven and usually private institutions but they cannot put your Mother out on the streets. If you are unable to take her home then they need to start looking for placement. The information about the hospital was correct. If she is admitted inpatient they are responsible for placement if you are unable to take her home. Not to say they will not pressure you, try to put guilt on you ect... Just remember to be a broken record. Good Luck

If your elder qualifies per income levels, they should qualify for a combination of Welfare & Medicare.
The tricky part is finding a way into the system.

Absolutely check with VA reps and helpers.
A VA facility should be able to hook you up/put you on some path to find information.
The Govt has fairly recently changed some rules for housing & helps, but not all govt workers know all those changes.
Keep asking!

Your local "Area Agency on Aging" has good information for you.
Also, check with the nearest City of good size, where there should be an active, Senior Citizen Center--people hold workshops, programs, information sessions there, &/or could hook you up with people who can help you find what might best work for your situation.

Because most States are virtually bankrupt, Welfare departments try EVERYthing they can, to force families to take in their elders
--this is simply not feasible for many families.
You have to be very firm in your refusal to take an ailing elder in, IF you do not have capability to handle it.

If you take your elder into your home, the way various rules are structured,
it can set a family up to be Stuck Indefinitely housing the elder, unless the caretaker gets really strong in their refusal to take the elder in,
or else, gaining strength enough to get them moved out elsewhere.
Good clear communication with Social Worker is VERY important when telling them you cannot have your elder in your home, & there are no other family members who can.

SOME families have been forced to move their elder into a studio apartment in senior housing, faking that the elder can handle it.
Once the elder is in that rental situation, it starts getting clearer they cannot fend for themselves.
THEN the State steps in & finds a place for them.
OR...
The elder suddenly needs a trip to the E.R. with a health issue.
Make sure they go to the E.R. 1st, & get "admitted for treatment", NOT "observation".
Make it CLEAR to the Social/Case Worker that your elder MUST be placed into assisted housing of some kind--suggest a nursing home or assisted living, or a senior group home--something...& specify that you cannot have them at your house any longer, due to your own family issues.
You may be required to prove to the State that you cannot afford to assist paying for elder care, & may need to prove health reasons why you cannot care for them. IF there are mental-emotional-physical-historical reasons, you may need to state those, too.

State agencies often push hard on families to take relatives in.
People need to get just as good at pushing hard, right back.

Once a person is admitted to a hospital, that person is now the responsibility of the facility they entered as a patient.
They are legally responsible for them.
Throwing a patient into the streets, is "patient abandonment".
That is illegal.
They cannot force a family to take them in,
ESPECIALLY when it would be forcing the family into poverty,
or, forcing family to take in their elder at their own peril, since that would be endangering the family.

I cannot tell you how often I have come across all levels of "wet-behind-the-ears" support staff, nursing, medical, welfare, etc.,
who have --zero-- understanding of how an elder might be found living in terrible circumstances, or homeless...it is virtually always because family cannot take them in, for MANY reasons.
OTH, family members often take in their elders believing the elder's claims, believing they can handle it, believing it is the right thing to do....but it is NOT, especially when care-taking relatives have problems they have failed to deal with, that will most likely become far worse, as the elder' mental/emotional status changes for the worse.

Please keep being persistent with the VA.
They require that your military spouse had enough years in service on active duty, and/or that he retired from the military after at least 20 years, I think. BUT, there might be exceptions.

Please be persistent with Welfare help.
Might also check Hospice service providers in your area, to see what they will cover.

WHILE you are doing that footwork, do everything you can, to keep your Mom in her own place, somehow, because that keeps her in a different category than if she moved in with you.

I pray you get the information and help you need, soon!
Keep us posted!

Some assisted facilities have a few rooms that are subsidized by the government. See if any in your state have this program. Also, the bigger AL facilities have studios or room share arrangements for residents. Small board and care homes are often less expensive, too.

Sorry to hear of your difficulties. I wouldn't give up on VA just yet. I was told that if a woman remarries after her Vet husband dies, by the VA, that it invalidates her ability to collect under first husband. Then my best friend's mother qualified even though she had remarried after her first husband died and #2 had no service background. The family contracted with a legal firm that specializes in VA applications. It took about a year. They were given the firm's information by an admission person at one of the assisted living facilities they looked into. She ended up in a different facility and I'm not sure how they were paid or how much but check into this with various facilities, office of aging etc. In my mother's case she would qualify but it would boost her income and make her ineligible for the services she currently has. It would make her further behind than she already is. I will reapply if she needs to leave assisted living and go to nursing home.

Try the Aging and Disability Resource Center (ADRC) in your mother's county. They have a wealth of information and knowledgeable folks waiting to help you. Every county has an ADRC office.

If your mom is nursing home eligible (health, income and assets), oftentimes the nursing home will contact the public assistance provider in your state. Ask them. You have nothing to lose. Also, the Department of Aging and Department of Health may help. Although a moot point at this time, I cannot stress enough the importance of seeking assistance BEFORE our parents NEED it. I did this over eight years ago for my mom, and now that she needs it, it is in place. Good luck in your search. It is a very difficult, time-consuming and heart-wrenching process. My prayers are with you.

I live in Virginia. My husband lost his business due to his progressing Multiple Sclerosis. That was two 1/2 years ago. We left California and moved to Virginia. He has been in and out of hospitals and rehab facilities. All has been paid for by Medicare and Medicaid. He after two trips to two hospitals and a trip to the rehab facility......he is back for the third time at the rehab Golden Living Center. He is still being considered in rehab.....but we(not him)know he isn't coming home. Soon they will start taking money from his SS check but a county social worker figured it out for me and said there will be enough for me to continue paying the rent. When he dies, if that happens before I die, then I will get his SS check and not any of mine. The place he is in now, would cost $6,200 a month for a shared room if he didn't have medicare/Medicaid. I am the one that thinks he should stay in rehab forever. Every time he comes home he ends up at the hospital. Stupid. So far this year I think the hospital bills have to be close to $500,000. This country has a screwed up plan. No one can fix him and he is like a 200 lb baby. If there is money to pay to help this man there certainly must be someone who can help you with your mother. Call any county office and they will direct you to the person that can assist you. I have talked to many many people....and they have been so nice and made miracles happen for us. Good luck and I am sorry. I have 4 younger sisters and the baby took care of mom because she hated the nursing home. Living to be OLD isn't always a good thing. I see so many people at Golden Living.....that don't even know they are alive. So sad. Sorry this is so long. I am a talker :) Best wishes and prayers for you.

Sitters not sisters. (see my previous reply

I don't know your and your mom's financial situations, but some state run Medicaid programs will pay you to care for your mom. I know that you said the burden may be too great, but maybe your spouse could do that or you could hire another caregiver to care for your mom at your home. Certain Medicaid programs cover that in different states. So maybe you could check that out with your Medicaid office.

I don't know where you live but in California we have some facilities that will just take your Mom's Medicare as long as she doesn't have anything. She can have a certain amount of money and that's it. In Southern California it is the Jewish Home for the Aging. They take care of patients the best. They have skilled Nursing and an Alzheimer's unit and they pay nothing when they run out of money. Maybe you have something similar in your area. It is there you just have to find it. The other advise as to where to go would be your best bet.

http://veteransupportcenter.org/

This office can look over your VA .application paperwork (free) and let you know if the VA denial was appropriate. Check with your mom's doctor and have her seen by a geriatric specialist. Check out Hospice. I was Shocked that my mom qualified. She's had her heart condition for decades that got her admitted. There are volunteer sisters (hospice can direct you) and home health care that medicare will pay for if you qualify clinically. Again geriatric specialist and hospice companies know who these people are in your area. Our geriatric specialist became mom's primary care physician and he has social worker's right in his office.
I have no idea if he is any good, but maybe my doctor, Robert Burns in Memphis can advise you or I can ask him for a referral in your area.

Go to the Dept of Health website for your state and you will find a wealth of information, as well as phone numbers, on who and where to call for assistance. Normally nursing homes allot so many beds to be paid for by "public assistance" and a little bit of info that most people aren't aware of is that the bed count is higher for that type of payment because it is a guaranteed payment.....unlike private pay. You already know that mom's health needs are more than you are able to take care of.....and yes, the reality of the situation is that it would affect every aspect of your life and marriage if mom were to live in your household. Where does your wife stand in her willingness to assist in finding suitable care for mom? One or the both of you will have to do some footwork......make a list of nursing homes or other care facilities in your area and start making phone calls, visiting and talking with admitting personnel. You already know the VA is a dead end and waiting to hear back from a congressman or rep is a waste of time that you don't have. Good luck!

Other option is residential care for elderly or boarding care which is more way cheaper than assisted living . I don't know what part of United States are you but look on to it online .

I would see if she can obtain any benefits under her second husband if he happened to be a veteran. She should be able to get into a nursing home under medicaid if she has spent down all her savings. I would get on the congressman's staff and your 2 US Senators to see if they can advise you of any emergency relief and they should be able to hasten her approval for medicaid. If you have any church related nursing homes see if they will take her in while you get the medicaid funding going. Assisted living facilities are profit driven and they are less likely to be helpful. Church and veteran homes tend to be more patient driven in my opinion.
If you can keep her home with help and if you think she has very limited time left (ie months vs. yrs) it might be worth attempting to keep her home. See if you can use family leave to secure your job. Some states NJ and CA have paid family leave for such situations. Most states don't have paid family leave. It isn't your full salary in most cases it could keep you afloat while you render the caregiving needs.

Ask the doctor if your mother can get hospice services. That is generally paid by medicare/medicaid and lifts some of the stress of caregiving off you while helping your mother.

I will pray for you as you make this decision. None of this is easy and as a concerned child you have been doing your best for you mother. Unfortunately we don't have lots of support for primary caregivers.

Elizabeth

It's so sad that in our world today , info such as this can be so difficult to obtain.
It should be at the top of the list to help our elder.
Have you tried your 211 info line, your local Center for Healthy Aging, your Senior Center , Church , Social Service Dept. or your AARP branch ?
I wish I could offer more immediate help for your very urgent concern.
ang