Do we put my dad in a nursing home or keep him at home and risk spending everything?

It sounds like he may need a nursing home instead of AL-if he stays at home with around the clock care maybe if he had a live in it would be cheaper and when his money runs out he would be able to get medicaid and then be placed -would he want to stay in his home and new jobs are so hard to get theses days so you might want to keep the one you have-I am not much help just able to give you one optionand I hope others will be of more help.

If you have round the clock care already in his home, stay with that for now. In the meantime, research the nursing homes in his area, quickly. GO see them and get him "on the list." That's number one. The nursing homes will want some money . After you've done the research, you'll know how much it costs (varies in different parts of the country -- (we pay a whopping $14k a month! but only for two months). If they have a bed open and you're ok with the place, take it. Also solicit help from your local social services department. It comes down to money. If you can afford to keep him in his home with help, do that. We ran out of money so Dad ended up staying the NH after a short term rehab from which he never recovered. It sucks but that's the way it goes. YOU need to get on with your life. There are many of us out here that have devastated our own lives with care giving. I'm on the edge but coming around because I decided my life and my own family HAS to number one, not my Mom and Dad. They had their time. And I too, have useless, selfish siblings that haven't seen their parents in years. Take care of yourself first becasue no one else can do that for you. If you have any guilt, you'll get over it.

Now - if he does go into a home, you'll need to apply for Medicaid and that is an exhausting process, but has to be done and you'll be glad when it's over. There's a good thread on here about everything you need to think about including the 5-year look back. Search out. Good luck and stay on this site. It could save you. It saved me.

- SS

oh, and since you do have round the clock care, hire a service to do the errands and the groceries. I just did that and it gave me huge freedom. Or set up PeaPod for groceries delivery. Then go back to work.

xoxoxo!

Memsobelle, I suggest that you contact a certified senior advisor, and quickly !!

I am so sad to read this. Your father was in denial it seems and did not plan for the future. Now it is your responsibility to take care of him, just not right. He should have set up trusts and made sure his children were not left with this problem. Do not give up your job. It sound as if the money will be gone anyway you look at it, unless he has an enormous amount. NH will be expensive and in home care will be expensive.

I feel for you, I know there must be deeper issues here. I have a daughter and son in law who are corporate lawyers in Boston. Lawyers should know what they need to do better than anyone. Of course, his expertise may be in many other types of law. But surely he had some idea about elder care and the problems of not planning. He made the choice not to do anything.

My mother is doing something sort of the same. I have tried to stop it before the time comes and the train wreck happens. She refuses to listen. So I will do what is best for me and just make sure she is taken care of.

Our parents expect us to take care of ourselves when we grow up but they need to take care of their business so their elder years are not a nightmare for their children. I hope it works out for you.

Personally, I would not give up my job. Having that income will allow for you as you live abroad (?) to pay for a geriatric case manager to oversee the whatever's for your dad. Being abroad makes for a whole huge layer of extra issues. Contact the Agency on Aging to see what's available where your dad lives for case managers or advisors. This site has a listing of all of them by state. Some of the "in home" caregiving services offer this service. this could be good or a conflict of interest - kinda depends on the company. If the AoA doesn't prove useful, many of the NH have a short list of geriatric case managers that out of state family private pays to check in on mom/dad, report back to you & go to the care plan meetings.

At my mom's NH, there is a "retired" RN who does this for at least 3 of the ladies on my mom's floor. If I wasn't a freelancer and can go in on the odd even though I'm states away, I would have hired her. $ 35 - 65 hr.

If you don't have the following done , you really really need to do these before U go
- Durable Power of Attorney (not just POA)
- Medical Power of Attorney
- Living Will &/or Advance Directives (DNR)
- Declaration of Guardian in Event of Incapacity
- HIPAA Waiver (umbrella/general one)
- Will or a Living Trust

The Declaration of Guardian is one that most don't have - this is really important to be done as it sets who mom/dad wants in her current & cognitive state to be her guardian(s) - once they get a dementia that can change on a whim due to their changing mental abilities. Like if they decide to take back the DPOA.

I'm a firm believer in having an elder care attorney take care of all this. It will not be expensive as most is done by the paralegals. You do want to go in prepared with the information for the documents (e.g. the residence located at 123 ABC street, aka parcel #5678; Ann Smith, wife of John Smith, with the info on all the births, deaths & prior marriages) as well as valid ID for the elder. If the decisions have been already made, this should all simple, straightforward paperwork. Should take 1 - 2 hrs for intake & then 1 hr a couple of days later for the signatures to be done.

If mom/dad has assets, then all this should be paid from their assets. This also is important if you or other family ever get challenged on who is DPOA or end of life issues. If you pay for all, and you benefit, then other family could go to court to find it a coerced document.

Many facilities will require the legal & DNR done in order to accept a resident.

As far as AL, try to look for a facility that is "tiered" - by that I mean one that has admissions from AL to NH and also does hospice. You don't want to have to move your dad, say 7 months from now, and have to find a place all over again....

I am DPOA for my mom and I forced her to move from her home into IL - as DPOA I could do this. She could not function at home alone, we had done the home health agency route too (she would lock the door, tell them to leave early, etc so they couldn't work as she didn't need them). I got her to have meal delivery and she went to a senior center X2 week with a van pickup.It seemed to be OK but looking back a lot of this was a show she would do for us when we or others would visit. The last straw was coming to visit unexpected and literally getting thrown back by gas fumes when we opened the kitchen door. Gas had been running for hours, there she was in her room watching TV. Oblivious. It was the stove's fault too. Then when my son went to open the other back door to get the gas fumes out, couldn't as the roof had an awning beam down and it was stuck AND the key was broken in the door. Again not her fault as a burglar did it. Put her on a couple of IL lists that afternoon and moved her in a couple of months later. She was major PO'd but it needed to be done. She did IL for a couple of years and then NH a yr ago. Not easy but you really need to go with your gut on what's best for both you and dad for the long, possibly super long, term. Good luck.

Memsobelle, you have several choices, but first you should get organised wit POA, Will, etc. as previously suggested. I would also find a Geriatric Care Manager in your area, they can help you sort through all your options.
24 hour care is expensive and depending on your fathers health Assisted Living or Residential Care may be an option.

I would suggest investigating local memory care facilities in your area. There is one in our area that specializes in this. You may want to talk to your lawyer or a senior care specialist regarding finances. Is your father a veteran? If he served in one of the World Wars and was active for a time he may be eligible for veterans benefits that could help out a lot with the expenses. You will likely need to exhaust his assets to be able to get help. But, after that, you may find that monetary help is available from several sources. Don't give up your job. I say that because taking care of an elderly parent day in and day out can be very stressful for you. You need to get away from him for a while and make your own life. Our need to help our parents in a situation like this can be all consuming and very detrimental to your mental and physical health. Much better to leave his care to those that are trained in this field. You just need to find a good place to take him and check it out thoroughly before you move him there. He may resist, but in the end it will be the best for both of you. Good luck and God bless both of you.

BTW, just move my elderly parents into an Independent Living Facility in our area. They were living in their home before that. They were both pretty upset at first but they are not settling in and enjoying it. The transition from one situation to another can be difficult. But, many older folks find that once they move they are far better off then they were before. 3 meals served where they live now. Before we were always worried about burners being left on and sanitary conditions not being the best. They can't see well enough to really clean up after themselves and so on.

You are not doing your father any good by staying. Go back to your life. Just be sure before you leave that you have him situated somewhere where he is safe. If it were me I would get him into a foster care home with a family you line up now and know you can trust. He will get more idividualized care there. If he has dementia be sure that the foster home you find for him is used to dealing with memory care issues. if not-find a nursing home. Likely you will need a place that will take a spend down to Medicaid program. He will continue to spend his own money until he spends down to $2000 in his bank account then medicaid will take over. You need to set this all up before you go. Get him somewhere where he is safe and you won't have to feel guilty for having your life restored to you. Other than his knowing you are doing this to make him safe he likely won't remember anything for long anyhow with dementia. I hope this will help at least a little. In our town we have firms that will help you find the right facility for your Dad. See if there is a service in your town like this. Our's is called Living Right-I think it is national. They are paid by the facilities for helping them keep full so it does not cost your Dad anything.

I would seek legal help as stated in previous post, Power of Attorneys etc, visit and line up Nursing Home care, some Nursing Homes will help with the Medicaid process, if your Dad was a Vet there could be some financial assitance there. If your Dad has Medicare, I believe that will buy you some time ( up tp 100 days) while he gets qualified for Medicaid.

I'd do my best to keep my job, they're hard to come by and you must take care of yourself too! It's okay to have a life but not ok to give up your life. Take care of your Dad by getting him the best help you can then know you've done your best.

Nursing Homes aren't what they used to be, my Parents would rather live on their own again but it's just not realistic. Mom complains about everything but also says, 3 meals, snacks, laundry, housekeeping, entertainment and around the clock health care, no responsibilities, can't beat it. And it is the safest and most healthy living situation for us all, Dad, Mom and just me.

Let us know how it goes for you and best wishes.

You must consider yourself, yes it is hard putting your father in care, but you have to consider your life. You have to do some soul searching-do you enjoy your current job, if you change, and that job is not enjoyable, you may resent your dad. there is all sorts of guilt in taking care of our parents, but you will have it if you stay or leave. make the best decision for you, you will live longer and happier in the end.

An alternative to an institutional nursing home is an Adult Family Home (Residential Care Facility). These facilities are typically less expensive than instutional care and are able to provide support for all activities of daily life. Most facilities also have nurse delegation so they are able to manage medications (not involving IV or IM injections), diabetic care. Facility quality can vary significantly just as in institutions. So you may need to look at several to find one that matches your desired level of environment. Many will have pet therapy as well if your father enjoyed animals. Because residential care facilities are in homes, they can be significantly more comforting to dimentia patients and the care is more individualized and personalized. Instead of ratios of 1 caregiver to 11 to 20 residents, typical ratios are 1 caregiver to 6 or even better. As for cost, in the State of Washington, the Washington State Residential Care Council reports that Adult Family Homes are 39% of the cost of nursing homes. Most of these facilities take medicaid, although some private pay facilities may require a period of time as private pay before converting. There are also options available to supplement medicaid payments when a higher quality facility is desired and the medicaid falls short of the cost. You might work with an attorney to see if it is possible to have assets transferred from your father to you such that you could use those assets to pay the additional.

This is a continuation of my last post. Medicaid actually pays less to residential care facilities than to nursing homes, even though these facilities typically provide a better quality of care. While these facilities often take medicaid, those who are working to increase the quality of the environment may not be able to operate on just what medicaid provides; so while they may accept medicaid, they may require supplemental payment from relatives--medicaid recipients have to do what is called "spend down" before they qualify so they generally cannot contribute to the supplemental payment. On this site there is information about the medicaid program and the look-back period for qualification (i.e. 5 year window for dispertion of assets). Depending on the equity your father has, dispertion of those assets that are in excess of the cost of 5 years of care would allow you to set those asside for future suplementation to keep the facility quality levels higher than you might find from those facilities that will accept face-value medicaid. The out-of-pocket for the first 5 years will no doubt be high, but it should be significantly less than 24 hour in-home care. Even if the assets won't cover 5 years, you may be able to place him in a higher quality facility now. In the future, if his condition degrades and required care plans call for higher levels of service, then medicaid may increase what it will pay and he may be able to stay at the same facility even without supplemental cost. Wish you the best.

I feel my "in put" is needed here...as someone who struggled a similar path with no knowledge of anything or what next or how~ LOL !!!!! Somehow I got to a point of doing it all and still handling details... I could write a book!!!
Focus on what's best for the person who needs care, If they have money, certainly spend it on the care in their "best interest" be honest and look out for those who are not honest in the process. One day at a time... baby steps. It's overwhelming for sure, but if you go with your heart things will just be on your path. A good heart goes a further distance than any dollar. Your heart filled with the relief of "you did the best you can" under the circumstances is a great reward. The people on here have alot of experience and great advice serious, steps you need to take, that others that haven't gone through personally don't realize the importance of.
Keep logs of... spending... dr's appointments.... keep copies of everything... get legal papers and id's in order, accounts, incomes, assets etc. for starters... igloo is correct about papers you need, in order, before it's to late.

I understand a lot of what you are going through and it is not easy. 1 year ago I became the care giver for both of my parents, My mom has severe dementia and my dad has parkinsons symptoms broke his hip and was in and out of nursing homes 3 times last year for rehab. I hired a live in care giver so that they can stay at home as long as possible. I have two sisters who live out of state and do not help me in any way shape or form. Had to pre pay their funerals and now am liquidating their assets. I have to pay all their bills etc, It gets to be overwhelming at times and I am dealing with my own illness that my sisters could care less about, it is still my responsibility to do it all. My goal is to keep them in their home as long as possible but things are changing fast and I feel it might be best to place them in a nursing home sooner than later, which is heartbreaking but I don't know what to do anymore. My prayers are with you, stay strong and do your best, that is all you can do. whatever decisions you make ,I know it is not easy but you can do this . Do seek help from someone like a social worker, to help you through this process

Octavia I hope there is someone for you to help you through this-I know your sibs are not help -I do hope you were able to get help from a social worker but my dear you need to take care of you and your health problems-and when it comes time you feel it is too much for you please place them-of course then you will probably get advice from the sibs but try not to let them get involved they lost the chance when they refused to help-please keep in touch so we can give you support.

thank you so much for your support. I feel so alone in all of this and I really don't have much support. It is comforting to know that I can connect with people who know what I am going through. Thank you,

I agree with the others. Please don't give up your good job. They are hard to find. You might quit your job and one month later he would pass and you would be w/o your good job. Keep it and do this from afar. There are computers, phones, faxes, etc. Like the others said, look into firms who could help you. If he goes into the NH and spends all the money, you will need a good job. I feel for you.

Mother in law had a stroke in Dec placed in nursing home applied for medicaid she wants to come home with us but dont know how much medicaid will pay for around the clock nursing, do you know and does medicaid take her ss checks and pay the nursing home so we dont have to bother with that. Thank you for your assistant

It depends how much help you will get the agency that did home care here said medicaide pt's get five hrs. a day but here they were not enough aides to go around due to the agency getting so much of their pay so it would not have been that much. Medicaide will indeed get her SS check. I would not take her home-the social worker will do the paperwork which is extensive if she is there-if you take her home you will be stuck with it. You will still have a role in her care but it will be different-after a while you could bring her home for a day or two-but mostly it will be visiting her and making sure she is getting good care. After a while she will adjust to the NH.

fathibird - if your MIL qualifies for Medicaid, then her states Medicaid program will pay for the "room & board" and medical care (that Medicare doesn't pay for) BUT in almost all cases Medicaid paid for expenses needs to be done in a facility like a nursing home or skilled nursing facility. For the most part Medicaid doesn't pay for 24/7 around the clock care in a private home - which is sounds like what your MIL is needing. Medicaid is a joint federal and state program so each state runs their Medicaid program slightly differently so you should check to see what is available in your state before you take her out of the NH she is in now.

Regarding her SS checks or other income, if they qualify for NH Medicaid, then all of their income less whatever is their states personal needs allowance (this runs from $ 30 - 80 a month, my mom is in Texas and Texas has it @ $ 60 a mo.) has to be paid to the nursing home. She can opt to still receive the SS check and direct deposit it in her bank account and then she or you pay the NH each month OR she can have her SS check sent to the NH. The NH then deposits the SS check and places her personal needs allowance in a trust for her at the NH.

The NH trust $ is kinda tricky in that she has to spend it so that it never goes above 2K which would disqualify her from Medicaid. At my mom's NH, some of the ladies use their monthly to pay for going to the on-site beauty salon or for shopping needs that they can do at the "canteen" where they have inexpensive things like socks, hair barrettes, etc. You or whomever is her DPOA can go and take $ from her NH trust to buy things for her too. Most NH have a book that you sign in and say what the $ is being used for, like "new clothes" "cosmetics" whatever personal needs items she wants.

I would suggest you speak with the social worker & the care plan team leader for your MIL at the facility where she is now to see just how truly feasible it is for her to come home and whether or not you all have the ability to take care of her needs. Ask about how they are managing her bathing and bathroom needs. For bathings ask how they are doing it - if she is on a 3 person bathing team, then do you have family that will consistently be there to do that for the many months or years she lives with you. Is your bathroom set up for doing it?. If your MIL is a large person, it can be a big problem. My mom is petite and weighs maybe 90 lbs and can still walk on her own but she is on a 2 person bathing team because her dementia is such that 1 person has to distract her while the other bathes her. About the bathroom things, my mom can still go to the bathroom on her own during the day and her toilet is set up with attached to the floor grab bars. But wets or worse in the bed at night, so she is on diaper at bedtime which they check &/or change @ shift change at 3AM. If your MIL is incontinent, who is going to be there to manage this the 4 - 6 times a day? Most family and their living situations are not set up for dealing with someone who needs 24/7 care and don't realize what all will be truly needed to do it. None of this is easy. Good luck and please speak with the social worker @ the NH.

This is always a hard decision. We all know that life in a nursing home is not ideal for anyone, and it's always hard to feel that you're abandoning your family, but this may be the best option. You're not superwoman, but you're doing the best you can for now. Maybe he can be in a nursing home temporarily, and if you do happen to find work near your father, you'd eventually be able to take him out and live at home with him? Good luck with your job search, and make whatever decision is best. You can only stretch yourself so thin.

I am in the midst of a similar transition right now. I had my 90 year old father come for a visit and then took him to see independent living facilities. I second all of the advice given above on getting sound legal advice. My Dad's trust attorney is an incredible resource for me. Once the trust was set up, he charges about $450 annually to maintain all of the documents and help me make decisions. I used to complain about this, but now I see that his services are worth every penny.

Some of the most important things that I learned were that the medicaid spend down transition to a nursing home varies by state. In Utah, there is a 90 waiting period once a person is in a nursing home before medicaid starts paying. Also, the facility prices are all negotiable. One place offered $300 a month off the published $3075 monthly rate for a one bedroom without my asking for any discount. They also discounted the medication management to $7 per day (twice daily) from $15 per day.

Also, because Dad is showing signs of dementia, we chose the place that has memory care (even though it is an older facility) so we don't have to move him again. A key was to let him spend the day at two places. They had activities that he enjoyed and residents who made him feel welcome. They were the ones who convinced Dad that he could be happy there. Also, I let him make as many decisions as possible. He wants to be in control so I give him two choices where I am indifferent to the outcome, e.g. would you like to keep this dresser or that dresser, this sofa or that sofa.

As for my siblings, no one else came through to do the heavy lifting so I just have to do it myself. I am literally camped out at Dad's house right now helping him make decisions about what he will keep. One brother will criticize, sigh. A brother-in-law will question my decisions every step of the way, sigh.

Finally, on your decision re work, if I were in your shoes, I would keep my job. It will allow you to keep helping your Dad. Take care of yourself. If you are stable, you will be able to make better decisions for him.

I would suggest that you must have him settled somewhere before leaving .. And i think that the nursing home that is located in the area near you must be most suitable... I mean if there is such kind of facility available in your town then you must definitely shift him over to the place..

My mothere is living in an assisted living facility and has dementia. However recently it has become a puzzle to the staff because of the things she's doing.
One minute she's perky and "with it", the next she's in a stupor and can't talk.
they said she's not had a stroke, but can't figure out why she can't talk or even
get two words together.
She's recently had a UTI infection and has been on antibiotics for that, and seemed to be getting better. They were giving her a time line of about 5 days out from finishing the meds to see how she reacted. She also has an ostomy bag, not ili, but the other
She's nothing like she was 6 mos. ago. She still recognizes me, and all her grandchildren came to see her last weekend along with her one great grandson.
It's like she knows what she wants to say, but I see her eyes searching for the word (it breaks my heart!!) She also has an ostomy bag, not ili, but the other.
She's barely able to walk but last week went to get her hair permed at the centers beauty salon. She can't use the phone, as I sat talking with her last week, she picked up the phone and turned it upside down, I said "mom you want to talk to someone?" we can call them, then she layed the phone down "beside" the holder.
Besides having two major surgeries, having this change in my mother and being sick myself and having my cat of 11 yrs die in my arms, I feel so lost and lonely.
my husb doesn't want another cat due to the $$ involved having an animal and as they get older it gets costlier also.
I feel like I could take my last breath, missing my baby cat.
Thanks for listening.
I

Maure I hope you and your husband can come to a comprise -you get the cat and he gets something he wants-if I were married now that is how I would work it and plan to talk to my [ GOOD FRIEND] when we meet in person next time-that seems to be the most fair-my late husband would never comprise but I would not want another relationship without it at this stage of my life.

Well, it seems as though I have a complete different lookout on this type of situation than most of you here. I am "the caregiver" of so many elderly that fall into this category. I guess some of us are just born to take care of others. I never thought when I was younger that I would be doing now what I do. I went to the local Community College and took the 3 month CNA course and passed the state test. I then was accepted into the LPN program. I was getting ready to enter into my last quarter of clinical labs when I had to drop out of college. .I was a single mother of a 15 year old son, going to college 5 days a week full time and working 5 to 6 days a week at night bar tending. (I live on the southern part of the outer banks in NC), so that is one of the best paying jobs in this area. Along with of course being a caregiver for an elderly person around here. The need is here because of so many people coming here to retire. And most have the money to be able to pay for in-home care. It bother's me but I will not judge anyone for saying, just put your parents in nursing homes because you need to go on with your life. I sort of see things like, our parents raised us and was our protectors and as they go through life, it gets turned around and they resort back to child like, and I feel like it is us as their children to make sure they receive the best care possible. Some are blessed to have the money to pay for around the clock care. And as their children we should not concern ourselves as to how much their care will cost "them", because isn't that why they put money back in the first place as to be reassured that they will financially be able to pay for good care in their later days?? I have never worked with an agency, I just place an ad in the local newspaper and usually get a job within 4-6 weeks. Through the different types of care I have provided for people I feel as though I have more experience than a lot of LPN's if not even RN's. Most all people I care for, I stay till the end. At one time I even had an Lady with Alzheimer live with me until she passed. She knew me at the end of her life when she couldn't even recognize her own sons. She had 2 sons, which one lived in New Hampshire, taught at MIT and was an inventor and the other son lived in Virginia but worked in Washington DC. The Dr. would make conference calls to her two sons while we would be at her office visits in case they had any questions. Each time I have lost someone that I have taken such loving care of a part of my heart gets ripped out. But the blessings I receive in return for caring for them outweigh anything. I took care of a man that lived in Beaufort, NC for 13 months last year, not once did I call off work. I am now taking care of a lady and have only been with her for about 3 weeks now. She is a Dementia patient and I have been sitting back watching the lack of care this woman is getting. To this day, I still haven't been told what medications she is taking and what are her Dx's. They(a Man and Woman (his sister) leave her meds in a small bag for me to give to her before bed and the following morning. The man is a student that has her POA and I think that she is being neglected. One of them told me that the Dr. said that she "had" to have someone with her around the clock, but when I leave at 7am they are not there until around 730 or 800 or later. They leave sometime at 4 and I don not come back until 700pm. There has not been one meal cooked at her house since I have been going there. She usually has a chili dog or a arby's sandwich, or a salad. The lady gets sick and throws up all the time and gets the diarrhea really bad. They do not buy any food for the house besides soda, bottle water, and fruit. I asked the man/friend/POA last week if he could please get some bread and cheese and turkey in case she would like to have a sandwich in the evening and he told me no, that she eats before I get there. I have been taking pictures of the food that is in her house. The freezer is so full you can't hardly close it, it is frozen vegys, but ""all"" have expired by 4 to 10 years ago. All of her lotions and deodorant and things such as that are even expired. No milk, bread, meat, not anything but fruit is in her home. I found out yesterday that she has to take calcium and iron pills. But yet, no one cooks any healthy meals for her. They go to a fast food restaurant and bring her back something, had it to her and leave. I don't know what to do......I need the job, but feel that this needs to be reported as well??

Sorry about writing so much, but I guess I was sort of trying to get across to some of you as well, that is in the situation of trying to find someone that is experienced and compassionate about caring or others. Please don't don't overlook those ads you might see in the local paper for a caregiver seeking employment to care for your loved one. We are a special breed....and I love it

Maure, first let me say I am very sorry about your cat. Your sadness cup is running over right now, isn't it?

About your mother ... it is possible that she is such a puzzle to the staff because the staff may be familiar with Alzheimers and not other kinds of dementia. There are something like 50 diseases with dementia. Alzheimer's accounts for about 60%, but that means nearly half of all people who have dementia have a different kind!

For example, in Alzheimer's it is common to lose recognition of loved ones; in the disease my husband has, Lewy Body Dementia, that is not typical. Hubby will probably continue to know me and others right to the end. This is just one little example of how different dementias have different symptoms. If the staff is expecting your mom to behave as if she has Alz but she has some other kind of dementia, they will be puzzled indeed.

Is your mother being seen by a dementia specialist?