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My mom has been suffering with dementia since she was 55 years old (she’s 68 now). I’ve come to move in with her 2 years ago. She also has major depression disorder she’s struggles with. We never got along but I’m here to do what’s right. I’ve cleaned out her home because it was a disaster from her hoarding. She continues to be upset with me and always accusing me of taking things because of this… I’ve done a poa for her since her debt was out of control. My mom has no ambition to try and do daily living skills which I realize she may have forgotten these skills. I just got the house transferred to my name but NYS and the 5 year look back I’m scared they will revolk the transfer if I put her in an assisted living home. I am a single mom with a job that has me working remote. I have an aide coming in a couple times to just give me some relief and it was in hopes it would give my mom some motivation but my mom just goes back to her room once they leave. I feel stuck I don’t have much family support and I’m an only child. So it’s just been sooo stressful and part of me feels that an assisted living home would be best now that she sorta knows what’s going on even though she can be super forgetful. But I’m just running thin with the stress and I’m just so unsure…. Help!

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I'm so sorry that you're being worn down by the caregiving. Has your mom ever been diagnosed by a doctor? Because what you describe (her age) sounds like ALZ. This only matters because the behaviors and trajectory are different than other types of dementia.

Has medication for her depression ever been discussed with her doctor? Meds often are very helpful to both the person suffering and the caregiver.

When you say you've "done a poa for her" did she actually sign the paperwork and understanding what she was signing, in front of witnesses and notary? If not, I'm not sure what you have going is legal. This matters most if you have siblings or other family members who may question your authority.

Does NYS's Medicaid pay for any of AL? I'm asking because many states do not, they only cover LTC and MC). There is an Elderly Waiver federal program you can research that provides resources for those who income qualify.

I would start by getting a formal diagnosis if you haven't already done this. Then contact social services for your county to get an in-home assessment for services. Your mom may be beyond AL at this point, requiring MC instead but she needs to be assessed.

As her DPoA I'm not sure you can transfer the title to her home to yourself, but I may be wrong. This may disqualify or delay her for Medicaid. Locate a Medicaid Planner in your area and invest in a consult so that you don't jump through a bunch of hoops only to have it be for naught. This is what I would do. In the meantime see if you can address her depression with some meds. Also, I highly recommend learning about ALZ and dementia. I learned a lot from Teepa Snow videos on YouTube, what dementia is, how it affects our LOs and why, and how to better engage with them so that your caregiving is as least-stressful as possible. You have a family and you and they have priority over your mom. If you burn out then who will be there to help your mom? Blessings to you for making such a sacrifice for your mom to this point.
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Assisted Living costs would be out of pocket expense. Can she afford that? (you should not have to pay for AL for her)
the ideal scenario would be that the house would have been sold and the proceeds used to pay for her care. That would be either caregivers that come in or Assisted Living and an eventual transition to Memory Care. Keep in mind that in AL a person can leave anytime they wish. All they have to do is sign out. So if there is a concern mom would wander off AL would not be a good option.
Very possible that mom also has depression, has she seen a doctor? You can not "cure" a hoarder by cleaning the house. Hoarding is the result/symptom of a mental illness that should be treated.

There will be others well versed in the ins and outs of Medicaid that will chime in on the transfer of the property.
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Lbkarutis22 Oct 2021
Ya I don’t think she would wander at this time. I know you can’t cure a hoarder it’s been a never ending issue but I was blinded in my early years as my father kept that from me noticing honestly. I ended up seeing it as her depression worsened when my father left her and when I left the nest and it just was a downward spiral. Now with dementia full force it’s just not even worth the fight anymore. It makes me sad/mad and everything in between watching her just sit in her room all day that she doesn’t drive anymore and just doesn’t have something she enjoys. I feel as though I’ve exhausted my efforts but it scares me to put her in AL since I just transferred the house to my name with her consent… she has to exhaust her other assets before applying for Medicaid to assist with coverage. The whole 5 year look back scares me because I’ve just gotten to do everything all at once recently.
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Unless your Mom is independently wealthy enough to afford the assisted living which would be memory care needs and upward of 10,000 a month, she would be on medical. Keep careful track of her finances if you are serving as her POA and be ready to show 5 years (2 1/2 in California) years worth of records of her finances. When she has spent down in nursing home she would move onto medicaid and what assets she left in terms of a home would be recovered from medicaid on her death, if such assets exist. The first thing you should do is invest in the 350.00 an hour for an hour of elder care time to discuss her finances, her diagnosis and her assets, as well as whether you are currently her conservator or guardian, or wish to be, or if you would rather the State takes over this onerous and burdensome task in terms of her future needs (which would not allow you any input into when/where/how placed, but would be the responsibility of the Fiduciary appointed by the court).
To be frank the time is now or some time ago for me, proving that this is an individual question for an individual caretaker, YOU. Only you can make the decision. I don't know the prognosis on your Mom's diagnosis, but she can live decades more in your good care. Only you can decide when you are ready for this. There is no reason to feel guilt; what you will feel is the other G word which is grief, that this must be the ongoing long ending for your Mom. I am so sorry.
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Lbkarutis22 Oct 2021
From the assisted living place I toured recently they stated out of pocket it’s 3500 a month. My concern is that transfer of her house to my name and obviously there’s no 5 years between transfer since it was so late in finding the diagnosis that ok she pays out of pocket til her funds run out to apply for Medicaid which would probably be 6 months if not sooner going off what I know she has of cash. We just transferred the house to my name in September.
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Yoy are stuck with caring for her for the next 5 years if you want the taxpayers to pick up the bill and you keep the house. You are right, Medicaid won't turn a blind eye to a large asset transfer 6 months prior to applying, and they shouldn't.

I don't think 5 years of your life is worth a crummy piece of property but, some do.
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