I do not even know where to start. Advice?
Cost of Living Calculator-NH for MIL. I used the one on the forum here. Hubbie and I are trying to figure out how we are going to put his mom in a nursing home when that time comes. We only put her info in. She only gets SS which is approx. 1100 a month. She owns nothing, no car, no home. She has no life ins, no stocks, nada. That's it.
We don't own now, selling ours to help our daughter. We are on one income, my husband's and we still help 3 of our 4 kids and one grandchild. I don't even want to think about hubbie's and my future years as we're no where prepared.
We have, with whatever her savings is (which she's depleting on her darn dog in vet bills), set up her funeral arrangements. That is done. We have not done a POA yet and not sure if we should. She does pay 300 a month for her room here because that is what it is costing us for that extra room. If she weren't with us, we could have rented for less elsewhere. But everything else such as food, water, electricity etc, she does not contribute to.
I do not even know where to start... she could do assisted living now, but is Alz diagnosed and will need more as her disease progresses.
Each state runs it's Medicaid program under an overall federal guideline. So the exactly monthly income limit varies. My mom's gets $ 1,800 a mo and her state income ceiling is $ 2,094.00 a month. State info mucho importante!!
About getting into a NH from being at home: this is a real challenge to do & this is what I was against in getting my mom into a NH. Most NH admissions are from a 3 or more day stay at a hospital and then they are discharged from the hospital to the NH for "rehabilitation". Rehab is a Medicare paid for stay and done routinely. Now Medicare almost always pays for the first 21 or 28 days of "rehab" and then after that depends on how they are progressing in their rehab. The NH gets paid the much higher Medicare rate during this period of their stay too. Most elderly seem not to progress so apply for Medicaid once Medicare is over and after the first month @ the NH. Many time the NH don't approach family on paying till the end of month #1 as Medicare has paid to that point.
But for those living at home or in IL the situation is different. I got my mom moved from IL to a NH and bypassed the whole AL phase. It is not easy and you have to be pretty dogged in a plan to create the fat medical file for skilled nursing services needed that Medicaid requires. Most of the posts on Medicaid are all about the financial aspect but Medicaid also requires a whole medically necessary review in order to qualify for Medicaid. When they come from the hospital that is there but not when they are still at home or in IL and then move into a NH. Now the medical director of the tiered IL (it went from IL to AL to NH with full hospice and I thought it was perfect as mom could stay there forever and I was wrong on all that, oh well) where mom was thought that mom was just fine for totally private pay AL and no matter what was not going to change their viewpoint. So what I did was to get my mom seeing her gerontologist on a set schedule. Now her gerontology group also are medical directors of nursing homes so they know what needs to be in her medical history & her medical file to pass Medicaid review. It meant basically every 4 - 6 weeks appointments and monitoring of some specific health concerns. the day she had a 10% weight loss and a critical H & H lab results, she got the orders written by her gerontologist for skilled nursing services needed and I got her into a NH within the month. Most MD who are GP's or family medicine doc's do NOT know how the medical history has to be done for skilled nursing requirements. An MD who is also a medical director of a NH will know this and will be invaluable in getting this part done so they can get in.
Just being old or having dementia or having ADL issues is not enough to get into a NH and have it covered by Medicare or Medicaid. There has to be the medical need for skilled nursing services. They need to have some co-morbidities in their file. Some stuff is easy like an RX for aspirin for heart disease (a co-morbidity) or changing their medication to something compounded which they cannot do on their own. The Exelon patch is great because most elderly cannot place the patches correctly on their own, so they need skilled help to correctly do that medication.
the goal is getting into a NH and through Medicaid. The first NH does not have to be where they stay either, moving them to another NH is pretty straightforward once they are on Medicaid. I moved my mom to another and much much better NH with another of the gerontologists in her group as medical director within her first year as Medicaid totally allows for this & without penalty.
In addition, you might also choose to engage a service like "a place for mom" which is free to you (fee charged to facility). They can help you assess things like nurse to resident ratio, activities (which really helps if mom is active or engaged), cognitive therapy, altzheimers treatment etc.
Wishing you the best. It's so heavy on your heart until you get settled, but one you get her in a good place with great care, you will feel so much better.
Sending love and light...
Step 2 - As one poster mentioned $1100 a month is most likely to much money to qualify for Medicaid. You need to call and ask questions. If she can not afford a NH, you need to see what all of her options might be. They may have information that you need to help with decisions.
Step 3 - You did not mention if you have brothers or sisters. If you do have siblings, are they set up in a better position to take your MIL into there home. If not, since this is your husband's mother, he needs to understand how much work having mom in your home will be. How much work and time is he willing to give his mom.
Step 4 - You need to do research now, home care, is expensive, see what kind of free senior services are in your area. What products, medical devices, home care does her health insurance pay. If she has to live with you, then she should pay rent, and for some of her care. $1100 a month is quite a bit of money if she has no expenses.
Step 5 - Ask her or talk to her about her living arrangements. Does she have any sisters or brothers that she could stay with.
Step 6 - If you do decide to keep her in your help, get a support group set up, a back-up sitter, people you trust to visit your MIL, help with transportation to doctor's appointments, etc.
Hope this helps.
One question. Who is going to help you out when you get dementia? or hubby has to go out on disability? Are the kids going to be there for you?
This is a hard hard world. Try applying for any kind of assistance the poverty level is so low. It's not true that people are living high off the hog on welfare and SSDI. It takes at least 2 years to get SSDI so how do you live while you wait and if you have private disability insurance those guys also know all the tricks of the trade to deny you. Private disability takes just as long and don't
think of doing a minimal amount of work just to pay for food and meds, your claim goes right out the door. Been there done that. The other trick the private insurers pull when they know they are going to pay is to turn it into a psychiatric claim which has a 2 year limit. So cut those kids off NOW as long as you pay they will keep coming back with their hands out. You may be young 50 + with no significant health problems now but that rarely lasts into your seventies
As for children and other family? You've heard that it takes a village to raise a child? It also takes a village to care for an elder--especially one with dementia/Alzheimers.
If you feel particularly overwhelmed and need someone to walk you through steps, processes, and what might work best in your situation, there are people who do just that. I found one on this site. She helped me step back from the situation and figure next steps. Of course there is a charge. Also, social workers connected with elder agencies can assist.
Best to you!
1.) POA
2.) Medicaid
Get that POA ASAP. This will make things much easier for you as you continue down this road. A lot of people suggest using an elder law attorney but I took a POA form off of legalzoom.com, had my dad sign it, a witness sign it, got it notarized and I never had a problem using it.
And you can investigate Medicaid if/when a nursing home is necessary but be warned: Medicaid takes forever to go through so start early. I think my dad was finally accepted after 6 months.....which was 2 months after he died. Here in Missouri, Medicaid for a nursing home is called 'vendor Medicaid'. My dad, who was in a nursing home, was admitted from the hospital. Once his insurance ran out he had to be on Medicaid in order to stay in the NH. But as long as I was in the process of getting him on Medicaid and could show the NH's social worker that it was in the works, he was allowed to stay in the NH and the Medicaid would take care of his stay there retroactively.
I would try to save as much of the MIL's social security for her future needs. She seems to be a candidate for Medicaid to cover her nursing home needs if she has no assets. However, that is a bleak way to end ones life. There are few good nursing homes who want Medicaid patients. They are more interested in self pay patients (who spend down their life's savings with the nursing home) and then they will perhaps have a Medicaid bed for the remainder of their life.
AL facilities are there to generate a profit, not really looking for Medicaid patient beds which do not turn a profit.
However, in the present, you need to see an elder lawyer for advice. Get a durable power of attorney to help MIL with your financial affairs, get an advanced directive to help get her the care she needs and wants. She should have Medicare and if she does she will at least get a decent level of medical care.
She should be eligible for some programs like Meals on Wheels and perhaps
elder transportation which could make it easier to care for her at home. Visit the office of aging, she should qualify for most of the programs in your area. They might have memory loss programs too which would help her.
Good luck these are difficult economic times.
RUkiddinme - stop helping the next generation, you have a lot on your plate now. AND, as an aside many memory care places (not all) do take medicaid after private pay for a length of time. Good luck