My mother of 89 years old moved in with me on June 2022. She can no longer shower or care for herself without assistance. She had some money in her savings and checking accounts that is now depleting rapidly for private caregiving services. She appointed me as her POA Medical/Durability. I have to work full time to keep my home mortgage and pay bills. She was diagnosed with Severe Vascular Dementia. I Only receive $200 - $300 per month from her to pay for Pampers, toiletry supplies, groceries and, entertainment. Several people have told me to charge for rent but, that will only deplite her finances sooner and, she will not have anything to pay out of pocket for Caregiver Services. Any advice on what to do next. I project that March/April of 2023 she will have less than $5,000 in the bank. I cannot afford to pay for her Caregiving Services.
Thanks from Texas
Marylisa
Have you applied for Medicaid?
Have you had a Hospice evaluation?
Be sure to educate yourself about what the last of her money should go to during the spend down process. You want her to have prepaid her funeral expenses, as allowed, and to have any eyeglasses/dentures/medical equipment up to date.
It sounds like running out of money is inevitable. Charging rent might make it happen a few months earlier, but at least you’d have a little money to set aside in your own pocket for whatever small purchases might make life more tolerable after her money is gone.
VITAS is a great service here in Florida offering respite care, help with hygiene needs, emotional support service for both patient and family. I would hope there is something like that in Texas you could tap into and there was no need to qualify for medicaid. I would ask the primary care doctor about Medicare Part A Hospice Services.
Yes, as others have said please research and pick a few Medicare/Medicaid qualified long term care facilities with high quality marks near where you live. You can check out places on-line first and then go visit. (See list of sources below).
Do this ASAP and start the process now rather than waiting until her assets are below your state's limit as many NH facilities LIKE it when the person can enter as a "private pay" resident (before their assets are totally spent down), and then the facility and you can apply for Medicaid. The longer the ability to pay privately, the more the facilities like that (it is a "sweetener" to them, if you get what I mean). Most facilities have someone on staff (social workers and/or business office staff) who understand all your State's Medicaid application rules and can likely be of help to you in this process. Ditto for your Area Agency on Aging; they may be able to recommend Medicaid "planners" to help with this process.
Getting all her accounts (Social Security, any bank or retirement accounts, health insurance/Medicare, etc) set up on-line with you having access; will make the paper work process for Medicaid qualification easier (your State will want copies of things like monthly bank statements going back 5 years; easier to do if you can pull all this info on-line). Ditto for getting copies of her tax filings going back 5 years.
And moving forward, it will be easier (from a paperwork standpoint) if you can handle it on-line rather than waiting for snail mail which is a hot mess these days. Example, an important letter from my mom's State Medicaid long term care program did NOT arrive to me for 8 weeks; but thankfully I had set up on-line access to her Medicaid coverage and I check the site monthly to see if there are any requests for something I need to submit. If I had not set up the on-line access; I would have missed an important deadline because the "letter got lost" in snail mail.
US News World Reports: https://health.usnews.com/best-nursing-homes
US Dept of Health and Human Services/Medicare Compare Nursing Homes https://www.medicare.gov/care-compare/results?searchType=NursingHome&page=1&city=Potomac&state=MD&zipcode=20854&radius=10&providerRating_overall=5,4&sort=closest
US Dept of Health and Human Services Nursing Home COVID data (something else to check out, cases and % of residents and staff vaccinated or not)
https://data.cms.gov/covid-19/covid-19-nursing-home-data
US Dept of Health and Human Services Nursing Home Quality data
https://data.cms.gov/search?keywords=nursing%20home%20quality
YET, Federal Law requires this of nursing homes: "Each resident must receive and the facility must provide the necessary care and services to attain or maintain the highest practicable physical, mental, and psychosocial well-being, consistent with the resident's comprehensive assessment and plan of care." (42 CFR § 483.24 - Quality of life.) Seriously, I would be surprised if there are more than a half dozen nursing homes in the country that meet this standard. The nursing home industry is, IMO, essentially a criminal enterprise that preys on some of our most vulnerable and dependent elders and other impaired souls. IF you have a loved one is such a facility, you must visit daily to mitigate the neglect.
I Googled up information. Texas has a 60 month lookback period prior to Medicaid application and 36 months up to last transaction. Contact a Medicaid specialist and eldercare attorney now to work with complex rules in your state of Texas. Every single red cent must be counted from the lookback period up to the application date.
Do not use your money or commingle with her funds to pay her bills. If you must assist, you need to keep detailed records of what your funds went to that covers your mother's expenses. Medicaid will investigate during the application process.
So there are some Medicaid ALF and NH who accept Medicaid bed but takes time to find them. I feel for you.
https://www.assistedliving.org/assisted-living-near-me/assisted-living-veterans-benefits-didnt-know-existed/
https://americanveteransaid.com/
contact your county office of aged and disabilities. They are a great resource, and my office would have made the Medicaid application for me ( my mom passed two days prior to that appointment)
was your moms husband in the service , and have served during a war? .. my father was in Vietnam and my mom was eligible for aide and attendance. Payment is retroactive to the date of application. Contact your county VA office
if you decide to move mom to a facility, then Google care advisors, Find an independent, or someone local. Someone who can meet with you. They work similar to a real estate agent , but are paid by the facility if placed. You don’t pay. They know your needs, availability, cost , Medicaid acceptance, reputation. They have a business relationship with facilities. I placed my mom twice this way , my in laws as well .
the sooner you place with self pay the better. My mom didn’t have the year of self pay, but because of the business relationship, the memory care accepted her. My in laws had no self pay , and my agent had a good recommendation for placement. I used a franchise called Carepatrol.
I wish you a positive journey here.. I know the anxiety of what to do etc…
If you must put your mother in a LTC facility, be sure to go as frequently as possible - preferably daily - as almost all are just warehouses for the elderly. In fact, I'm not sure what the advantage is over staying at home even with intermittent care. When my mother (of blessed memory) was in a "high end" nursing home, they rarely checked in on her - and when I proposed that they check on her every hour per Federal guidelines for someone with her limitations, the Administrator asserted they check on residents every 2 hours, and that would not change. Of course, they didn't check on residents even every 2 hours. :-(
You can set up devices in the home to monitor her and talk with her -- devices like an Echo Show, or Ring camera. With an Echo, you can also set up routines for music and radio and audiobooks, and reminders -- so they come on at at specific times. Perhaps that could help was well.
As at least one of the health care providers for your mom, you can earn income that will help both you and your mom. Plus get help paying for the things she needs.
Although go to the source and keep all records and receipts.
It depends on the situation now.
Medi-Caid
Medi-Cal
Medi-Care
Social Security
Help - seek out social worker or care / case manager.
Contact an Elder (or your) attorney
Are you the POA and/or have legal authority to act on your mom's behalf?
No. You SHOULD NEVER EVER use your own $ for this care. It'll drain you financial and this is not acceptable or prudent of you to do.
Charging for rent at this point will just deplete her money faster. You could be using her entire check to pay for the personal things she needs: like toiletry and letting her split the cost of groceries with you. About 60 days prior to getting her bank account at or below $2K, you can apply for Medicaid for her. In Texas, you can do it online or by paper application.
The thing to determine is if you plan to keep her in her home or apply for Nursing Home Medicaid. Texas has some in-home programs she might qualify for and then there is the NH bed.
If you have money to pay, get an elder atty. They know all the Medicaid rules and programs. If not enough money, contact Legal Aid in the area where you live. Best way to guide you and get her set up for the application process.