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.
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.
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!
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.
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.
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!
You may have to move her in with you.
(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.
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.
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!
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.
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.
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.
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.
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.