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I have been helping my husband provide care for his mother since 2019 after his father passed. My husband works as lawyer and last year he was able to use his connections to get her approval for 84 hours of in home care despite not technically meeting the requirements through the fair hearing process.



This is where the issue lays, the help he has gotten his mother was not done in a legit or proper manner. He had doctor friends submit documentation, and knew the Judge that was overseeing the fair hearing. He tried doing it the proper way but kept hitting road blocks. It is great we have the care, problem is I want her out now, I thought I could get by with the extra help, but I want my space and house back. I want our home to look like a home of 30 something year olds, not a pseudo nursing home.



I know placing his mother would 100% destroy him, but her being her is destroying me. He would not be the same person if he had to place her before he is ready. As my therapist has stated this is a situation where if it no longer works for one it no longer works for anyone. I know my husband is kind, he will go out of his way to help those in need, I am in need now, and the only thing he can do to help me is place his mom.



We spoke about it in the past and he knows his limit. He knows he will not be able to stand seeing his mother placed, he knows hearing the phrase can I go home with you would eat him up. He knows seeing others in that situation will just remind him what is to come. He also knows none of her friends or family will visit her.



She is happy here, she has friends in the neighborhood, she is active part of the church albeit with our assistance. She loves her day program, my husband regularly funds trips through connections he has made for the day program. I am just done, I love my husband, we have been married for 10 years. He has been my rock through everything, and now I feel horrible because in his time of need I am no longer able to be his. In short leaving him lost at sea.



I am not sure what exactly I wish to accomplish with said post, but I need something other than being told I am kind, and such a great wife for doing this. I knew marrying someone on the spectrum would be rough, but I do not think I have it in me to help him through another downward spiral of guilt like he had when his father died. Even to this day he still wonders what more he could have done even though he knows nothing could be done. In this case something could be done I am just not willing to be part of that something so it breaks down.



Do not get me wrong he helps in anyway he can, he just does not leave it up to me or the aids. He does work long hours though so he is not as readily available as he would like. He does make sure to make time if needed, and generally leaves work at work.



Thanks for letting me vent.

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Can you please clarify what "84 hours of in home care despite not technically meeting the requirements through the fair hearing process" means?

Does this have to do with Long term care policy? Or an Elder Waiver program?

Does it mean that she can't afford AL on her own?

Does she have a diagnosis of Alzheimers? If you two are only in your 30s then she can't be much older than 60s or early 70s... she can be living in your home for a very long time.

It's not wrong to stop being the care solution for your MIL, but if it's a money issue... more info would be helpful.
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Lostsea90 Jul 2023
Her hours are through straight Medicaid. Her official diagnosis is vascular cognitive impairment. Her initial assessment she was allotted 28 hours a week, plus 4 hours of adult day service five days a week. Her level of care is mostly prompting, and redirecting. She does not need physical assistance just yet.

"84 hours of in home care despite not technically meeting the requirements through the fair hearing process" means he pulled strings to get her the hours by bypassing the Medicaid requirements. Which means on paper she is worse off then she actually is in terms of medical need.

It is slightly a money issue, but not a huge one. I know my husband would go out of his way to make sure she gets the possible care, and we are not exactly hurting for money. That being said Eldercare is not exactly cheap, nor does it get cheaper as time goes on. We are comfortable, but by no means could we reasonably sustain the cost of providing care for his mother long term out of our pocket.

She is also on the younger side. Will be 66 next April.
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Reading for the 3rd time, and I hear you. There will be some good answers coming your way, I am sure.

And the good news is, you do have options!
It appears that even though you are calm about it, you have passed the burnout stage. However, you did the best thing for yourself that you could do at this time. You have gone to therapy!

So, agreed, your therapist says if it's not working for one, it no longer works for anyone. What's next? Does your therapist have experience working with 'special needs spouses' ?
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Lostsea90 Jul 2023
He has gone to a couple of sessions with me, but as my therapist put it. He too self aware, and logically knows his limits. He is willing blinding himself from the realities of the situation he is in. Pretty much during the sessions he knew was going to be asked before it was asked. Which made the session unproductive and uncomfortable.

My therapist recommended he seeks grief counseling with someone that specializes in dealing with neurodivergent individuals.
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I can understand why you are struggling with this situation.

You dearly love your husband but you hate not having your privacy.

I would like to express my thoughts on both sides of the story. You see, I had my mom move in with us after she lost her home in hurricane Katrina.

Mom didn’t need an enormous amount of care when she first moved into our home.

She couldn’t drive due to seizures and her Parkinson’s disease was in the early stages then.

She could still cook and fixed her own food while I was at work and the children were at school. Everything was running smoothly until her disease progressed and the years kept going by.

Eventually, I had to have additional help for my mom. I quit my job which threw me into depression.

It is hard to care for a parent in our home for an extended period of time. Mom lived with us for 14 years.

My husband was like you. He was very supportive in the beginning. As the years went by, he really missed not having our home to ourselves.

I was struggling like your husband, torn between wanting to keep my mom happy and wanting my husband to be happy.

Sadly. I wasn’t being fair to my husband and I horribly regret it. When he voiced his opinion about his frustration I ended up in therapy and it helped tremendously.

Mom ended up living with my brother for awhile. We needed a break! Later on she moved into an ‘end of life’ hospice care home where she died at age 95. She adjusted well and received good care.

You went to therapy and I agree with what your therapist said to you. I’m wondering if your husband would go to therapy. Your therapist would be able to act as a mediator for the two of you.

Have you asked your husband to go to therapy with you? Do you think it’s too late for that? I guess I am wondering if there is too much water under the bridge.

I truly hope that you will be able to find a viable solution for this situation. You are the only one who can answer what is best for you.

I don’t think that you should be miserable. If this means a separation or a divorce, it’s unfortunate but might be necessary. You deserve to live in peace.

I hope that your husband will value your relationship over his concern for his mother. He needs to be reassured that his mother will most likely adjust to a facility. Even if she wouldn’t, you should come first, not his mom.

Best wishes to you and your husband.
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Way2tired Jul 2023
I agree, it would be helpful if the husband would go to therapy , and/or marriage counseling.
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🆗 Sendhelp

Have you tried dividing the house? Is there a back door, an entrance for the aids? A yard, ability to expand?

Start dreaming of some changes.
Maybe a SHE SHED for you? See those on YouTube.
A space for you, and room enough for lunch and a visitor or two?

A tiny house or RV in the backyard? Most people would put the MIL out there, but consider it an escape for the two of you, or just you.

How do you feel getting a part-time job for yourself, something you would like to do?
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Reading further I see that she is only 66, she could live for another 25 years are you ready to live with her for that length of time? I doubt it.

Really do not understand why a 66 yo woman has to live with her son. What is her problem?

I thought of the Princess Diane quote "There are 3 people living in this marriage"!

He sounds like mama's boy, takes a special wife to live with a man like that, my father was one created many issues in my mothers marriage to him. She ended up divorcing him due to this.

I can only suggest that you have a heart to heart with him laying everything out seeking a compromise.

Knowing me, I would have to say it is either her or me. Possibly I would move out and live apart, let him feel the full impact of living with his mother 24/7.

That's all I have, wish you the very best!
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Lostsea90 Jul 2023
Would not say he is a mama’s boy. Based off the stories I got from him and his mother he was not an easy kid to raise. They were forced to move many times due his behavior issues that stemmed from being on the spectrum. Back in the day it ASD was viewed with a much different lens then today or the last 10 years.

He tends to go above and beyond for anyone in need, he has always been that type of person. He could give the shirt off his back to someone in need if he had nothing else to give. It has been a real problem cause he underestimates or simply does not see the dangers or problems such behavior can cause.
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You wrote, "This is where the issue lays, the help he has gotten his mother was not done in a legit or proper manner."

Respectfully, I don't think this is the pressing issue. And neither is the fact that your husband is "on the spectrum".

Your predicament (if I understand it correctly) is that MIL is on in-home Medicaid (the max possible) but probs wouldn't qualify for Medicaid-funded facility care since she doesn't medically need LTC right now (and this can vary by state but most states' Medicaid only fund LTC facility care). And who knows how long it will be before she qualifies.

Your predicament is that (even if your husband wasn't on the spectrum) you'd need to pay out lots and lots of money to have her live in a facility for who knows how many years.

She's only just 66... and I assume that her SS goes to pay for her in-home Medicaid care, so she can't contribute to household expenses.

She needs to be out of your home but paying for her care over that many years will be non-sustainable and robs you and your husband of your own future care funds. Seems like in-home care with privately hired aids is the only real option until MIL needs LTC. I assume your husband is her DPoA. Resigning this and permitting guardianship by the county is the other option but I doubt your husband will ever be willing to do this.

Have you tried talking to a Geriatric Care Manager? Or a Medicaid Planner for your state (even though she's already on Medicaid, you need a strategy to pay for her future facility care).

Research respite care options so that for now you can have breaks, and hire companions to keep her busy and drive her places (a companion aid doesn't need to have any certifications so are more affordable hourly). FYI hiring people makes you an employer in the government's eyes.

Contact the main office at her church to see if they have a Care ministry, which might provide regular volunteers for a few hours a week. This will require management (been there, done that in our church). See if her friends are willing to take her out for an entire day once a month, if you haven't already explored this.

You are in a sorority of adult children who are stuck in a financial conundrum with a needy parent. For the time being I don't see any other solution other than to pay for in-home companion aids and find volunteers.

You aren't wrong to want your lives back. Keep seeing a therapist so that you don't get eaten up with guilt and can figure out how to stop enabling your husband in this situation (and these boundaries will be harder to identify due to the conundrum).

If I've gotten anything about your situation wrong, please correct me.

I wish you much clarity, wisdom and peace in your heart on this journey!
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Lostsea90 Jul 2023
Prior to him getting the 84 hours he did reach out, to many agencies and representatives regarding funding and planning for care for an elderly parent. Sadly, it largely boiled down to two options wait until she gets worse so she qualified for Medicaid (which we tried but years passed and nothing changed on her front so he had to force it) or allow the state to take over revoking his advocacy rights.

Her friends are awesome, and caring we have offered to fund full day trips. They will gladly take her just not alone so either I or my husband has to go with them. That being said they do take her out to for a couple of hours every so often without one of us needing to be around and we pay for the entire outing. Understandably so they are worried about liability, and as they have told us they are friends not caregivers or companions.

I will look into her Church and see if they offer any services. If they did, I am surprised they did not offer it by now. I will still inquire about it nonetheless.

The spectrum aspect more so just makes it more challenging to have conversations regarding this issue with him. He has a very black and white view of the world. Extremely binary way of thinking someone needs help, then he finds a way to help. In this case it boils down to his mother cared for him, he cares for his mother.

Yes, she currently does not meet the medical needs for LTC, but generally requires too much oversight to live in AL and she cannot afford AL on her own. You are correct we have found ourselves in a situation that mentally I cannot see myself being able to sustain, but I do not see how we can sustain the solutions financially that would “solve” our issues.
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The OP has said that her husband is on the Spectrum meaning he is a very high functioning Autistic person it seems if he is a lawyer.

I am so with you. I like my home a certain way. Having strangers coming in an out would drive me crazy. If your husband was home all the time I would bet he would not enjoy this.

When did MIL start showing signs of ALZ? 66 is young for any Dementia. I really don't know what you can do. Maybe a separation to see if he then sees the problem. Autistic people look at the world so much differently than others.
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Hi Lostsea,

You and your husband sound like awesome, caring people.

Placing his mother doesn’t mean abandoning her down a rabbit hole never to be seen again. I don’t know what her issues are - dementia and other stuff will change this answer a bit - but you can visit, take her out, what about arrangements with that day programs she likes? Even when someone is placed it can be a ton of work still, but you see the compromise here…

Your husband may feel destroyed placing her, but he’ll also feel destroyed if you get destroyed. Sometimes out of lousy options only, you have to pick the least lousy one.

As for friends and family who don’t visit after someone is placed…BOOO!!! Yup this happened with my mom. It sucks. Very scant short visits are not too much to ask. They’re not good friends if they only sail in fair weather, huh?

It won’t be easy of course but I really think you guys can work through this. Really wishing you the best!

-Madisoncuckoo
7/30/23
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Given that you write your husband is on the Spectrum, it might not be so easy for your husband to pivot and change the plan that he has set in place. But you need to convey your unhappiness about the present situation. It sounds like she should be in an independent living or assisted living facility. But he might not be able to handle this.

If he is not receptive and if you value keeping your marriage intact, there might be an option of compromising by moving into a mother-daughter home that would have a separate space for your MIL. That way she won't be living in your space.

Your MIL is very young. You don't write what her health issues are but this could go on for years.

Good luck to you.
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Your husband may be going through an emotional period; he lost his dad not that long ago, he's trying to do the best for mom, then on top of that the stress of being an attorney.
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It would not be wrong of you to withdraw your help with your husband's mother.
You are already hard-pressed into service of your husband, supporting him beyond what you expected ("I knew marrying someone on the spectrum would be rough").
The results of forcing him to place his mother may not be the result you get.

Prepare your husband gently by telling him that he is great to offer others the shirt off his back, but not your's. Let him think about it. Just a note here: I may not agree that your husband knows his limitations. He may know to avoid emotional issues that will be a problem for him to confront, but if you look at his real focus, you can find out more. In fact, if you look up one of the characteristics of people on the spectrum, they are egocentric. Look that up.

Then, after you have thought this through, show him what withdrawing your support (of his mother)will look like.
You may decide to stop going on day trips to supervise his Mom.

Have you explored if the aides can go on those trips? Maybe get help reworking the aides schedule to bring about some free-time for you. Make use of the suggestions of a geriatric care manager.

Instruct the aides in some simple changes to the housekeeping which would allow for a less NH appearance to your home. Maybe some areas will be off-limits for an incontinent person? For example, some have a family room and a living room. One is her area, one is yours?

Arrange for Mil to be out for a couple of hours when dH gets home from work, have a nice dinner together, alone. Or, do not neglect the two of you going out at night, leaving an aide to watch Mil.

These are just some suggestions that may help you a bit, until a better solution can be found.

In the meantime, take a lesson from Mil's friends, who said: "They are friends, not caregivers."

Start touring some board and care homes for Mil.
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Lostsea90 Jul 2023
Hi, yeah we have looked into aids going on the day trips. Unfortunately, we are slightly at the mercy of her friends. We brought it up they were not comfortable with someone they do not know going out with them, and tailing them around. That said I will be going on fewer day trips if that means his mother cannot go then so be it. She has aides at home to watch her. One can only take some much golden girl outings.

Was not sure how else to label it, not sure if incontinent is the right word. She has this thing if she is left alone and has to go the bathroom for whatever reason she goes in a waste basket. If she is around people this never happens. Though to be on the safe side we do have commodes in her “favorite” bathroom locations. In her head she thinks we have more than two bathrooms.

Thankfully with the additional aid support this has not been an issue, we got the hours in January, and she has not used the commodes once if someone is around her.

I do believe my husband does have a care manger that would sometimes go on appointments with her if he is not able to, I will be sure to ask him if they can do more or provide more insight as to what we can do in the future.

If nothing else, I will start spending more time at my families house, just to get some time away from this. I feel for my husband, not only is his job stressful, but the home life is stressful. I know comparatively his has far more on my plate and a part of me does feel I am being ungrateful. If my family needed this level of support he would do it with a smile and say nothing else.
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If your husband didn't get help for mom in a legit way, does that mean he defrauded the government or insurance company by using his well-placed friends to get care for her?

If so, no wonder you are not okay with that. The penalties for fraud can be major.
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Lostsea90 Jul 2023
I am not going to pretend we are good people, and I am part of the reason he did it. If we left things as they were she would still be at the 28 hours per week. The requirements to get hours for cognitive issues is ridiculous. When we sought support and guidance we pretty much were told you have to wait until she gets worse, ask family and friends for help.

His mother needs the support, she meets all other requirements besides their requirements for “physical assistance” they ignore that safety and support play an important role when caring for someone with cognitive issues.

I do not think he defrauded the government just did what Lawyers do find loop holes around problems. The issue I have noticed is by him doing it this way is any LTC placement will see she does not meet the medical requirement. So she is stuck with us until she gets to that point, and who knows how long that will be. From what I gather vascular cognitive impairment is related to vascular damage that do not meet the criteria for a diagnosis of dementia yet.

Her doctors have told us everyone progresses at different rates, they have seen people progress slowly, or rapidly. Without my husband doing what he did I would have lost my mind.
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Does your MIL have any money for assisted living ?
It’s time your husband takes this off your hands, somehow . I hope a therapist can tell your husband that . Otherwise , if I was you , a divorce lawyer may be your next stop.
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Lostsea90 Jul 2023
All she has is her SS check, and she requires too much personal attention to be a candidate for AL. When she is by herself her she does some weird and unsafe things.Also will not divorce my husband over his mother getting sick. That is the root cause to our issues, and personally that is a poor reason to divorce someone in my opinion.
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You say she does not need physical assistance just yet, has vascular "cognitive impairment " which you don't seem to think is a big deal......then later say in a comment that she urinates in wastecans when left unattended! If this isn't full blown vascular "dementia" I will eat my hat. People with MCI do not urinate in wastecans and are able to recognize toilets and their purpose. Did you see your MILs diagnosis or are you relying on your husband's explanation of it? What was her score on the MoCA or SLUMS test she was given, or the cognition test the Neurologist Administered?

You likely will not be able to get thru to DH if the therapist failed. He'll be unable to care for her long term, as will you, bc you're both out of your realm with what's involved with dementia as it progresses. And it's ugly.

You may have to separate for a month or two to give dh a feel for how it is to live w/o you. But again, if he's hellbent on caring for mother, there's probably nothing that will change his mind. I was married to a man on the spectrum for 22 years and I know how their minds work 😑

Good luck.
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Lostsea90 Jul 2023
I do not know those exact details, that being said if she is around people she is comfortable with none of these behaviors are present. Sometimes she will ask where is the bathroom, but she does not show signs or intent to use the commode.

Her doctors said it could be attention seeking behavior or something flips when she is alone. As for the dementia, the way her doctors explained it to us. Her baseline has not altered from the moment she had her stroke, and said stroke is the sign of damage that can be seen. She is able to complete tasks and function with a person present. By herself she is all over the place and confession sets in. In short makes it hard to determine what is what. I think what they call it is show timing.

Even with that being said, from what I have gathered dementia in itself is still not enough to get someone in LTC with Medicaid. Based off what all the professionals have told us dementia in itself is not considered a skilled medical need under our state guide lines. Her issues are also not physical in nature, she does not need physical assistance to complete tasks, more so social or emotional support. We are in the wait for it to progress phase. They doctors keep calling it the gray area. Where to be safe they need someone to watch them, but do not need physical assistance. In turn gives insurance companies a way out of providing care.

I agree we are out of our depth, I am not built to be a caregiver. I do not have the patience or mindset to simply blame the disease. I cannot separate the disease from the person. I know they do not understand, but in my head I feel they should understand.

I was present for each nursing assessment each one stated she is functionally extremely capable. The way they explained it to be is confusing, but the nurse stated need is calculated based the task, each task has an amount of time associated with it. My MIL’s issues even with me exaggerating the frequency only got her 28 hours a week.

So yeah I do not know. I know my husband would not lie to me, and going based off what I have personally seen and been told by the nurses, and the social worker that came to the house. You appear to need to be a complete wreck to get any sort of meaningful assistance the legit way. If you personally have no funds.
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🆗 Sendhelp
7/30/2023
Sunday
To: Lostsea90,

The suggestions that I am giving you are meant to help you design a life for yourself within the context of your marriage. But separate from the enmeshment that requires you to be a caregiver for your Mil. With some improvements in your relationship with your husband.

Some things cannot be fixed, but can be improved.
Fully informed, not many women would have taken this on, to live this way.
You don't have to leave your husband to make things more tolerable for you.

Breaking through to you will not be easy, because I think I detect a bit of denial, and a bit of over-protectiveness. You don't have to answer this, but when, if ever, has your husband had a "meltdown"? That does not make him a bad person. What does it mean to you that he had to move a lot when he was younger for behavior reasons? He seems very different now.

Stay with us, keep talking. If you feel judged, ignore that and take what you can use to your benefit. You may just be what your husband needs to get by in life. Do you feel he may require his Mom to get by also?

Have you read books? The Other Half of Asperger's? Or,
The Journal of Best Practices: A Memoir of Marriage, Asperger Syndrome, and One Man's Quest to Be a Better Husband
by David Finch.

Have you watched some movies? Noah and the Whale is one.
Take some time, don't get scared away.
We voluntarily are here to support you.

I cannot see that it is good for you, or your husband to be emptying urine from waste baskets. Is there a work-a-round? What about diapers? It is truly not necessary for you to be living a quiet life of desperation. imo.
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Lostsea90 Jul 2023
Thanks, I appreciate it. I will be sure to check out the book recommendations. Thankfully since we got the 12 hours a day aide, the use of commodes has not been an issue. She does not appear as confused when people are around, and when she is confused and asks where the bathroom is she is easily directed to it.

I know I probably cannot change my husband but I can alter my situation, going to look to get back to work to give me an escape from house drama. Will spend more time with my own family. We have other support at home now with the 12 hour aides. I need to learn to let go, and use some of that time for myself.

I know based briefly what I have read here, and on other forums our situation could be a 100x worse. My MIL is a peach compared to other situations. I am going to try and find a way for me to cope with the situation instead of push for my husband to find a solution. I trust that when the times comes he will place her. If I want to prevent a downward spiral it has to be on his terms, if I force it he will just be riddled with guilt and what if’s and I will forever lose him.

If I can find a means of coping I can manage cause this will not be forever.
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So sorry for your situation. Good idea to spend more time with your family and outside of your home. If hubby is at work and aides are there to help MIL, go out as much as possible to be away from her. Go for a walk, drive, movie, etc etc.

If she needs too much help to be in AL, then I'm confused as to why she couldn't go into a nursing home? I might have missed a response addressing this, sorry if that is so. Does she have any assets? Or literally just her monthly SS? Could she live independently in subsidized housing where she would pay only what she could afford? My MIL did that for years because all she had was her fairly low SS cuz she had a low paying job.

You can avoid home as much as possible but that isn't a great solution for you. Not long term anyhow. When do you and hubby ever get to spend time together? Dates? You are young and need to have date nights and time with friends, etc. Time to put YOU first.

Good luck.
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🆗 Sendhelp
Sunday July 30, 2023

Correction on the movie title:

"Mozart and the Whale" (2005)
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Hothouse Flower
7/31, 7:17 am

I posted yesterday but want to add that I think getting yourself a job is the best idea. You will broaden your own horizons and you are taking care of you. You cannot sacrifice your life to taking care of her as a long term arrangement .

Plus being employed it is a good fall back position just in case of the worst scenario your husband chooses his mother over you and you cannot handle it. You will be better able to move on if you do this.

I hope that does not happen but it is a possibility.
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Do you work out of the home, Lost? If you don't then I think it would be a huge help in your situation. You will be away from the home and have something that will divert your attention from your MIL for a while. It's distracting to have a third party in the house, but it seems that her needs are being met by the extra hours your husband played the system for (which, I have to say, is rather repulsive to me since so many people caring for others struggle with care payments vs care time). Since MIL is looked after most days, go out and enjoy the hours you have to yourself. At the end of the day, since placing your MIL is out of the question, you need to ask yourself...do you stay in the marriage or not? Explain your wants to your spouse and then see what he decides. You're both very young (as is your MIL) and this will be a very long term situation.
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I think rather than "withdrawing help" it would be more helpful to frame this as setting boundaries in how much, when and what kind of care you are willing and able to give. So drawing a line at giving up family and social activities, toileting, solving the crisis du jour, etc. Everything beyond that line isn't your burden to bear and if it becomes unsustainable it isn't your problem to solve.
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Maybe you should be speaking to a lawyer yourself so you won't face any potential future fraud charges as an accessory to the underhanded AND illegal fraud your husband committed to hustle free homecare for your MIL.
The term for not "technically" meeting the requirements and getting the services anyway is FRAUD. You talk about a fair hearing process so I'm assuming you're swindling Medicaid for the free homecare for your MIL.

You get 84 hours a week of free homecare and your MIL is in a day program?
So basically, you don't have to do anything for her. She's happy in your neighborhood, your man is happy, and you don't actually take care of her.

Do her a favor and find her a place of her own in your neighborhood. You're ripping the state off for enough homecare hours that between that and her day program she'll never be alone.

Then count your blessings that the homecare hours you and your husband are fraudulently stealing are not being provided by my homecare agency.
If they were you would be reported to the state for fraud so fast your heads would spin.
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Fawnby Jul 2023
Husband could lose license to practice law.
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Did your in laws own a home prior to her husband's death? Since husband is a lawyer, I'm assuming he's moms POA & in charge of her finances. She basically has full time aids plus daycare. Most people don't have that luxury. Best of luck
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Lostsea90 Jul 2023
Sadly, no they rented there entire life.
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Dont let the naysayers get you down OP. I fully support your getting the proper aides and care for MIL.

The reality is doctors and nursing homes have been gaming the medicaid and medicare systems for a long time.

Why anyone would begrudge a regular person getting proper help no matter the gray area to do it is beyond me.

Today nursing homes are raking in record money whole warehousing old people. The rates are outrageous for the staff to patient ratio.

Doctors rake it in by having a revolving door if constant office visits, ordering this test or that test or surgery. It's truly disgusting.

Ignore the haters, they still think the universe plays fair. In reality its a dog eat dog world. Be the dog. Don't get eaten.
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Way2tired Jul 2023
196902,
I usually agree with you , but not this time. Working the system is one thing , what this lawyer did is beyond that .

Furthermore , these are not “ regular” people, who were ignorant or had no other choices and felt compelled to lie because they were in dire circumstances .

OP rationalizes their shady actions on the state requirements being too difficult and unfair . Well it’s unfair to all, but not all are committing fraud . This MIL was not going to end up on the streets without care .

These are privileged people who have the means to pull strings that the regular people don’t have , and their caregiver issue is solved , yet OP complains . Cry me a River , NOT .

She is no longer stuck at home with the MIL . The caregiver issue is solved for her . She can get a job and get out . So many other people are in worse situations , stuck at home caregiving . This isn’t even a caregiver issue any longer , it’s a marital issue .

That being said the healthcare system is a racket like you said , but in my book two wrongs don’t make a right and is even more aggravating when this OP had other choices . She said her husband did it ( fraud ) for her . Why didn’t she go get a job and her husband hire caregivers ?

This is a lawyer and a wife who could be , but is not working . She admits they are not hurting financially . The wife wants her home to , “ not look like a pseudo nursing home” . Boo hoo . None of us wants that. She should get a job and get away from this shady lawyer .

I do sympathize with OP to a degree , she obviously has been taking care of the MIL for quite some time and has every right to stop doing the caregiving . But this couple are not in dire straights financially . I do not applaud this husbands methods. The wife can get a job , and the lawyer not commit fraud. I believe OP is blinded by her commitment to her husband to see this situation for what it really is .

If OP was smart she would leave this situation entirely . This husband just sounds like too much to handle , he will never get unmeshed from this mother . So much so that he commits fraud . Obviously the mother comes first . It’s already been going on since 2019.
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Medicare has a discriminatory restriction on providing services to nursing home patients with mental illnesses. 

If a patient does not qualify for inpatient SNF services because of a physical illness it does not mean the patient's son committed fraud to get the care and supervision his mother requires with behavioral problems. A hearing may have been required because there is no parity for mental illness, but the law requires it.

There are approximately 730 hours in a month.

Making accusations against this couple is way out of line with the purview of
this forum.

The patient requires supervision, maybe 24/7.
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I am not going to judge. Elder care in this country is an absolute nightmare and if you are middle class with a small bit of money and a house, it puts you in a lousy position and it forces desperate people to do desperate things.
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BurntCaregiver Jul 2023
@Hothouse

The OP and her husband are committing fraud and swindling the state so the MIL can get free homecare paid for by Medicaid.

You certainly should judge and so should everyone else.
They are not desperate people. The husband is a lawyer. He got his doctor cronie friends to commit fraud by signing off on more homecare than the MIL needs.
The judge who oversaw the fair hearing proceeding is also a friend of his.
When your friends are doctors and judges, you're not hurting for money.
They should both be ashamed of themselves and I truly hope the get caught.
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Our advisors told us paying for elder care out of your own pocket is a quick way ruin our own retirement and lives. Elder care is simply not sustainable unless you are extremely wealthy. Say my husband did pay out of pocket for an agency, and we paid the aides what Medicaid is currently paying, that is $7560. What working class family can afford that? Our rate would probably even be higher for private pay.

I will tell everyone exactly what my husband’s friends told us. “Everyone in these fields do it, and have been doing it for years.” The standards they apply for mental or behavioral issues is ridiculous when it comes to getting assistances through Medicaid. Doctors and Lawyers are always using their connections to get ahead of the system.

I agree it is unfair, but that unfairness has more to do with the system itself. If the system was not stacked against people then maybe people would not have to do that.
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Way2tired Jul 2023
So fraud is ok if you have connections ?
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You guys can complain about the OP all you want but the reality is that even if she stopped right now there are hundreds of others (maybe thousands) who are still doing this with their own connections. It will never stop. So why should OP sacrifice herself?

Sure it sucks her husband moving mom in is ruining her life, just like so many others caring for elderly parents but it is what it is.

Its like regular people who think their recycyling is going to save the environment when the biggest environmental destroyers are still destroying said environment daily and regular people who recycle get to pretend their small part is making an impact even though it's not.
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Way2tired Jul 2023
I don’t think that recycling that is not helping the environment ,
Is comparable to willingly committing fraud .
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And just to add I have no connections for anything. So I am SOL like the rest of the poor people.
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There are laws making mental health care services benefits on par with physical health care services benefits. On par means that if you are physically ill, or mentally ill, the benefits are provided equally. In re: Mental Health Parity laws.

It is not a technicality . It is not scamming the system. The law applies to everyone needing mental health services. Not everyone is aware of these laws. Becoming aware and obtaining a fair hearing to access these mental health benefits (same benefits provided if you were physically ill) is not fraud.

The system is required to pay for these benefits by law. It does not take fraud, friends, cronies to access these fair hearings on a technicality. You just need to know about it.

It would not be an appropriate placement for your Mil to be in a SNF because they do not provide mental health services there. People needing this kind of care are often placed in a group home or board and care to obtain the supervision required if their family cannot provide it. However, the board and care homes are very limited in the physical care they provide. The law allows for these caregiving hours even if the majority of the Mil needs are supervision and behavioral issues, and not just post stroke physical care.

I feel that the OP has unwittingly misrepresented what she believed to be a "technicality" in accessing services for her Mil. The fair hearing judge did not likely do anything illegal in approving the hours. imo. Maybe in these cases, it just takes a "friend", or a strong advocate to listen. Definition of an advocate
is judge.

So, maybe the OP did not fully understand the law which provided the caregiving hours?

Why are common sense caregivers jumping to conclusions and literally judging this poster and her husband? No one here has ever been in their thirties?
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Fawnby Jul 2023
OP’s husband is a lawyer. He more than likely understands the law. It is very clear on the matter. The FBI investigates such cases. The husband would know that.
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Life is unfair, no need to lash at the OP. I am willing to bet if many of us had access to the same connections they would do the same.

I know for certain I would. Only reason we are upset is because while we are forced to give up our futures, or riddle ourselves with grief by placing our LO before we are ready.

People like the OP get to still have lives. It sucks but that is not the OP's fault. Friends with benefits has been a thing probably since the dawn of humankind.
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Way2tired Jul 2023
Sorry.

Fraud is unacceptable.
Don’t water it down .
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