How long does it take for Medicaid to kick in when you’ve been admitted to a NH?

Hanging, have you been paying the share of cost to the nursing home? Please don’t be paying the house bills for your mother with money that should be paid to the nursing home as her share of cost. Your mother still owes the money due to the nursing home for her care from the date she was admitted even if the money is still being deposited to her bank account. You CANNOT spend the money that should be paid to nursing home for your mother’s portion of care even on her bills. You can’t just wait for Medicaid to start taking it or you could end up owing many months of payments with no money left in bank. Please check with the admissions office to find out how much money should be going to the nursing home.

I'm sorry your mom is going through this. It could be a couple months or more before Medicaid would kick in.

I'm assuming mom has been on community medicaid. Have you talked to the business office office of the NH what it takes to switch her over to nursing home medicaid.? You may need to apply, rather than it just "kicking in". Make sure that you don't sign anything that makes YOU financially responsible for these costs.

Medicaid does NOT take her $ directly.
But as of the day that she applied for or transitioned to LTC NH Medicaid, she is REQUIRED to have all her monthly income- like her SS - be paid to the NH as her copay or SOC (share of cost). The facility has told you this. That $770 each mo less the $30 (her personal needs allowance) should be / must be paid to the NH. So every mo NH gets paid $740. In order for her to be within compliance for Medicaid that monthly income must be paid. 

If she’s been out of rehab and in the LTC part of the NH for May & June, she owes $1,460 as her copay. 

Often a NH is made their representative payee, so the NH directly gets her SS/SSDI and the $30 is set aside in a Trust fund account at her / DPOAs disposal at the NH. 
But it sounds like that didn’t happen and her SS/SSDI is still going to her bank account. And you are using that $ to pay her bills and not doing the NH copay. That’s it, isn’t it? This cannot happen under Medicaid rules. It could be viewed as a breach of the required fiduciary duty required of a DPOA and cause APS to get involved. 

Medicaid has no concern about debts.
Medicaid is all about income and assets.
Either you or other family will need to pay her property costs & other bills or she defaults on them. That is the harsh reality of Medicaid. The $740 to the NH must be paid. Otherwise she’s out of compliance for Medicaid and can be suspended. Or the NH as they have not been paid can issue her a 30 day notice to move out or they contact APS to get her made a ward of the state as her DPOA (you) is not doing the copay. Really you don’t want APS to get involved.....

Isn’t it the situation that she has a reverse mortgage? Why not have them take over dealing with the house. She needs to stay in the facility to get the care needed. She cannot find herself ineligible for medicaid because you did not follow the rules.

We started looking at medicaid 12 months before we needed it. We applied 6 months later after Mom's spend down was completed and her assets depleted. Even while in a "pending" status and not approved yet, we definitely paid her mandated share to the nursing home each month - it's called Patient Liability in our state. And it's due each month - even while the Medicaid application is only pending. Mom is only allowed to keep $50 of her Social Security each month and the rest is her Patient Liability and is paid to the nursing home. Medicaid mandates this and they don't want to hear about anyone's reason why it shouldn't be that way or why they don't have the money or whatever else it got spent on. Medicaid doesn't care about other expenses and costs. If Medicaid is paying for a nursing home, that Patient Liability amount is required and it's no joke. We sold Mom's house before we applied for Medicaid because we knew it was getting sold eventually anyway & we didn't want to worry about taxes, maintenance, etc. We used the proceeds from the home sale to pay the nursing home until those funds ran out.

you mention that you're waiting for Medicaid to start "taking" your mom's social security & leaving you unable to pay her house bills. In our case, Medicaid never "took" Mom's SS directly from her, but rather POA writes a check for that Patient Liability that's due each month after her Social Security is received. This process started as soon as Mom's Medicaid application was pending and it was very clear that this money was due to the nursing home and could not be spent on anything else. It does not sound like anyone clearly explained any of this to you and I'd think someone should have.

For starters, check with the business office at the nursing home. Find out what money is due and when. They will be happy to tell you. Ask how to find out about the status of the Medicaid application. Please don't delay. It will not get any easier if you wait.

Overthedge17 yes I remember filling out a long form the business office gave me a few months ago & maybe it was the application for the NH Medicaid & when I spoke to the admissions lady what she told me was that mom’s Social Security (not SSI) would go directly to them (NH) and mom would be left w/$30 a month to spend on what she wanted.
She NEVER told me how or when this would happen except she did say “ok so starting May 1, thats when it will go into effect” but when I mentioned to her “how are mom’s house bills going to be paid in the meantime?” She said “we’ll they don’t get paid”..
That’s all she said, and then we hung up.
 I was thinking how bad that was because my mom has a few of those bills paid by automatic debit (she authorized prior w/the companies & her bank) so she wouldn’t be late or have to write checks every month.
I can’t undo any of that because mom’s bank won’t have anything to do w/me so the money continues to be withdrawn each month when that bill comes due.
I think THIS is going to be the reason why my mom will have to be made aware that her house is going to be sold & she’s not going to be able to go back to it to live.
But I CAN’T BE THE ONE TO TELL HER.
I’m very afraid she’s going to have a heart attack when she hears this.
She’s going to definitely see ME as a “traitor” or “instigator” in this whole ordeal, meaning I’M the one who put her in the nursing home, for her house to get sold, etc because to this day she continues to BLAME ME for her first time in rehab when she fell 2 years ago.
She’d say “I could have stayed at the hospital but YOU sent me there (NH rehab) & I kept telling her “no mom, I didn’t send you there, the hospital discharged you to go there for PT until you got stronger & finally did go back home becauae the hospital said they couldn’t do anymore for you to stay there, you needed physical therapy & they don’t do that at the hospital”..
, she just won’t give up on that shaming thing she has with me.
I haven’t paid anything to the NH because I don’t have it myself.
I’m a dog walker & barwly $25,000 a year so there’s no way I could ever pay ANY of my mom’s bills let alone her NH portion.
I’ve been wanting to disconnect my mom’s house phone for months, but again they won’t do it because they’d have to speak to mom & she’d have to authorize it so she’s been paying a house phone bill every month even though she’s not at home.
I haven’t notified the reverse mortgage yet because it hasn’t been a year that mom hasn’t lived in the house & that’s what it says on her contract.
She has up to a year before the contract would be broken then the house would need to be refinanced (by me if I wanted to live in the house which would never happen since I couldn’t qualify for a loan)
or sold.
Since the house value is under what is owed, I couldn’t sell it either & was told to I’d have to “walk away” from it when the time comes or sign some deed over (I don’t understand all that)
This is all too frightening & I’m having a difficult time getting this to go the way it needs to.

I need step by step directions because my brain is very foggy right now.
So much going on & I’m feeling very inadequate & stupid.

The posters are correct that Medicaid doesn’t care about her bills.  Are you absolutely sure that that the SS money will be sent directly to the NH? That was an option on the form I filled out,  it I opted out, so I would check on that just to make sure. 

So when SS finally catches up and stops depositing her check, she’s going to be overdrawn. So first, I would try to stop the bleeding from her checking account. The first thing I would work on is getting the the automatic payments stopped. You have her POA, so I believe you need to talk to the individual creditors, not the bank. When I had to do this for Mom, the bank told me that they couldn’t stop the auto payments, I had to go through the individual companies to turn it off. I had to send the companies copies of the POA and a written letter telling them to stop the auto payments. That way I had control of them and could decide what to pay/not pay out of my own funds.

Same with shutting off the phone...stop paying the bill, copy of POA and shut it off. 

I know this is overwhelming. Moms approval took 4 months. And I didn’t fully understand it either, but I worked directly with my county Medicaid office (not the NH business office) and Medicaid was very helpful. 

RMs can allow for up to 1 yr before loan is called in.
BUT you do NOT have to wait that long.
Mom could walk on the RM tomorrow.

The harsh reality is that there is no-zero-nada of $ for her to pay on anything from her preNH life due to the required copay / SOC / Patient Liability (thank you Edge17!). You don’t have the $ and there’s no other family who would step up to do so. House is underwater, there no point in spending another dime or time on it. Mom will default on her other debts whether it’s this week or later on this summer. LTC Medicaid requires them to be impoverished. She needs to be in a facility and needs Medicaid to pay for it. 

Medicaid does not care about debts. 
Medicaid is all about income & assets. 

RMs require that the property owner pays the insurance on the house. If mom does not pay the insurance - which seems to be due soon based on your posts - shes then in default of the RM contract. Let it happen as it will trigger the default so that the RM can takeover the house. Make a copy of the insurance bill and send a short letter as her dpoa that due to Medicaid Patient Liability requirements she cannot pay the insurance and is effectively defaulting on contract. Let the house and all attached to it to become their problem. RMs are used to dealing with these scenarios.... it’s their monkey now.

If utilities get shut off, what does it matter now. She in a NH.

And Hanging, really really you have got to pay the copay to the NH and have mom current for Medicaid’s required copay. Personally I think you should like manana go to the NH and have them become the representative payee for mom’s SS so they know their getting paid and it’s nothing you have to deal with for the future. You really don’t want any ruffles with either the NH or Medicaid if you can help it. In your prior posts you’ve written that mom has paid your car note and other expenses. That is gifting and not allowed by Medicaid. You don’t want anything at this point in time to cause Medicaid to delve deeper into a lookback for your mom’s finances as her “gifting” will surface. 
I’d bet that as she was already on Medicaid for 20 years that the state did not do a deep dive on her finances; that your state did a simpler transition from in-the-community Medicaid to LTC Medicaid without the heavy documentation that new LTC Medicaid applications requires. The state didn’t require her / you to submit 5 yrs of her bank statements, now did they? The state didn’t know that she was getting $ from a line of credit RM either I’d guess as well. You don’t want anything to make the state or the NH be concerned about now. Pay the patient liability due till now and let NH become payee for the future. That’s my suggestions. The gifting & RM proceeds may surface anyways - which will be it’s own hot mess - but by her being current on her copay it at least keeps the NH happy in the interim. 

Mom defaults on all debts.
Anything house is a loosing proposition at this point in time. 
Let go of house stuff so you can be with your mom without those worries looming over you. You don’t want it that every time you go into the NH that someone from billing is behind you asking about when your paying the past due. Stuff like that snowballs and NH can contact Medicaid & APS if nonpayment persists. You don’t want to go there....

It may be daunting, but it is relatively easy. Any money direct deposited to mom's account will go to NH as the other members have posted. Medicaid, NH and the bank does not care. In fact it is a win win for the bank, because if a auto withdrawal is still submitted, and no money in the account, the bank would charge overdraft fees. If you can at all possible stop the auto withdrawal please do so. NH may have already sent you a bill for the co-pay, if not, they probably will.

Out of curiosity, what happens if loved one who's on Medicaid with SS going to NH, passes at NH. Does SS go after NH for reclamation if check is sent to them after death?

Excellent advise from igloo. stopping the auto payments may leave some more in the checking account when the nh bill comes due since it sounds like money will be tight. It’s a huge juggling act trying to be there for Mom and navigate the system.

SS will do a clawback & pull the $ from the account deposited into. NH likely has quite a few residents SS going into a single account so there’s $. No NSF.

When my mom died it was almost at the end of the month, so the following month she got both her SS and federal civil service retirement paid. SS clawed back maybe within 15 -20 days. Yet civil service took almost 3 months. I just left the $ in her bank account. But the account - I was a signatory on it - switched over to my name & SS upon her death and I used it as the “estate of” account. Mom was on hospice in the NH so death expected. It was the bank that suggested to do this. Nice & seamless plus easy for record keeping.

Also for those interested, Hangingon61 old posts well are insightful backstory.

I'll try to give additional info based on what happened in our case. Hangingon, I know you're very upset as the process is stressful but try to calm down. Most people (myself included) would not know how this all happens until it becomes an issue in their own family. You seem to be a very bright person, but I worry that you're getting bogged down & are missing the big stuff - like paying Patient Liability.

If NH said her SS would go "directly" to them, they might not have meant that as literally as you took it. If NH was going to deduct directly from mom's bank account, I'd think they would have had to have told you that & you would have needed to authorize. In my case, I believe the word "directly" was also used, but what it meant was that we were to write our Patient Liability amount out to the nursing home within the same month of getting the SS. It was "directly" as in we should not delay writing that check. It was not literally a direct withdrawal from mom's account to the nursing home. At no time did Medicaid or the NH "take" Mom's SS. We have written a timely check each month.

If her bank and utility companies won't talk to you, then who's got POA?

What we were told regarding the house is this: Since Mom was a permanent NH placement with no hope of returning home (ever, ever, ever, never), she was not allowed to keep the house as an asset & it needed to be sold. If there was any delay in selling it, you are correct that the property tax, utilities, emergency repairs, homeowner's insurance, etc would still be coming due. BUT, Medicaid does not care about this at all. Either the house-related bills fall behind and get paid with the proceeds of selling the house OR someone else would need to cover those expenses. We sold the house quickly to avoid the drama. I think her cable bill went to a collection agency, but Mom will never again need good credit - and I know this from working in the industry for years. Don't let anyone pressure YOU into paying HER bills. She's a permanent nursing home resident on Medicaid. She's not going to be cosigning, renting an apartment, or buying anything where her credit would be checked.

I had the same concerns you have about telling Mom she wasn't ever coming home. Mom would rant and rave about there being a conspiracy to put her in a nursing home, etc. But, on some level, ours already knew she could no longer live alone. She would carry on and get emotional to us, but had already told at least one other person (close family friend) that she knew she had to leave. Maybe yours also kind of already knows she can't go home? If you're sure she's clueless about that, then my advice would be to have someone with you when you tell her & let the staff know in advance that this is going to happen in case there's a scene or problems of any kind.

Regarding the house and handing over the deed, they might be talking about a deed-in-lieu. I am really not sure, but Google deed-in-lieu and see if that matches what was said to you.

This is how it worked with my Mom.

First, once the person is in a NH and Medicaid is in their future or they are receiving it, you cannot use their money for anything other than their care. So paying bills with her money is a no no. Mom paid two months privately (used up her money). I applied for Medicaid in May, she started Medicaid in July. At the time she entered the NH "they" started the process to become payee for Moms Pension and SS. So, when Mom passed, it was their problem if SS paid or pulled the money.

Yes Mom had a house. The caseworker chose not to deal with the nephew living there just wanted proof I had the house up for sale. I stopped paying taxes. My nephew pays the utilities out of his SSD check.
I would not pay out of pocket that I couldn't afford to do. There is no guarantee you will ever get it back. If you don't live in the house, then sell it for her care. Speak to admissions or financial and ask if a Medicaid application has been done. I have heard a few people say that the NH helped them with the application and some say the NH gave them the wrong info. Me, I chose to go to Medicaid. I like the one on one with no middle man. Because of previous conversations, I chose to have a lawyer (Medicaid allowed Moms funds to be used) because of the house and someone living in it. I had 60 days from application to find a NH and have all the paperwork to them. If this had not been done, I would have had to start over.

Hope this helps

Oh good lord so I guess I need to go talk to the admissions/administrator tomorrow & find out how/when they are being paid.
I just hope & pray she doesn’t say they’re owed for May.
So if she does, my calculation is that they would want May & June payment:
MAY: $521. (Soc. Sec)
—$30 (allowance).
JUNE: $521 - $30.
Total : $982.00.
Mom only has $ 806.14 in her account as of today so there’s a shortage there of $ 176.00 which I’m embarrassed to say I can’t pay.
What will they do toss my mom out?

They have not sent you any bills? They probably would not toss her out. If payment is late, they would add late and/or interest charges to what is owed. This should be spelled out in the contract, if you have one.

We do get a bill every month, so I'm surprised you didn't get one. Or, maybe you did get one and didn't realize it needed to be acted upon.

I'd say call them Monday and find out what's due for which months and how much. If they are in fact needing you to pay the Patient Liability for May, then it sounds like you can do that with the funds you currently have (based on the figures from your previous post). Once you've paid May, then you're just due for June - right? I always write in the memo portion that the check is for Patient Liability and which month it's for - even thought I'm always current and it should be obvious which month it's for. I'd get on this tomorrow, show good faith, and follow through on what you promise down to every detail. Don't make any promise you can't keep and be very apologetic - even though it doesn't sound like things were explained to you very well from the beginning. I'm sure they've had late payments before, but you can't let it become the rule. Medicaid does not mess around when they're paying out thousands for long term care.

For my mom (2 NH both on Medicaid) she continued to have her monthly incomes (2) continue to be direct deposited to her old bank account that I was signatory on & I wrote a check for the exact copay amount as per the eligibility letter from Medicaid with check sent on 3rd of mo to facility. The first month only for her first NH it was prorated by # of days as she entered in mid month. Prior to first NH mom was in IL in a tiered facility (went from IL to AL to NH & with a hospice wing but was not a buy-in CCRC). For all places, admissions & billing all heavily encouraged that they become the rep payee for her incomes. 1st NH said it was required. It is not required, the NH cannot force your mom to sign off on rep. payee authorization. But if you as DPOA take on the responsibility to pay the Patient Liability you have to do it on time as the late fees & interest cannot be paid from the elders income as Medicaid requires all their $ to go towards their care or their personal needs (like toiletries, clothing). Often family flat find it easier just to let NH get their elders income, close out their bank account and be done with it. But it does not have to be done.

I chose to let moms SS and pension continue to be deposited in her bank, receive a monthly bill from the NH, and pay it out of her bank. I wanted control to make sure everything was being accounted for properly. My GF chose to let her moms checks be turned over to the NH as payee, and so was pretty much happily oblivious to the financial transactions after that. Until the NH tracked her down one day saying the Mom was 6 month in arrears and she owned thousands of dollars. After being thrown into the situation completely unaware of what happened, she discovered that SS thought her Mom had passed away 6 months ago and stopped paying the NH. It took her a long time to get it corrected. It would have been caught immediate if she had been paying the bill herself. So turning the checks over has some advantages, until there’s a screwup. Then not so much.

So hanging, this is just some background so you can better understand what they’re talking about when you meet with the billing office. So you need to find out which payment method you agreed to, and when it kicks in.  And partial months are prorated by exact number of days, so your calculations may be off. Don’t panic. The billing office is used to explaining this stuff all day long, so make sure you understand it when you’re finished.  The ones I’ve dealt with have been very pleasant and helpful.   And try to get those autopays stopped so you have more cash to deal with. 

Hanging - under the terms of the RM it is required to be current on property taxes and all required property insurance (homeowners plus if needed flood, windstorm, earthquake). IF property owner is not current on these then their RM is considered “delinquent” or in “default” of the terms of the contract.

If this happens one would need to “cure” or fix the default by paying taxes or insurance ASAP. Otherwise the RM will go into foreclosure as you’re in default on. When a property goes into foreclosure there will be paperwork in which your ownership is relinquished. Usually for foreclosure it’s done via a “Deed in Lieu”. There’s a bunch of other things that happen with foreclosures, like notices posted in paper, and at the courthouse, eviction letters sent, etc. I wouldn’t worry about those as mom’s moved in a NH so the eviction drama doesn’t matter.

But imo for your mom being in a NH is good as she wants to get her home foreclosed on; she wants to get on with this and not wait a full year of being out of the house for the RM to call in the loan. By her NOT paying her property insurance taxes it places her in default of the RM. it moves up the eventual process of turning back the house to the RM. Let the RM do a foreclosure.... let them deal with property maintenance... utilities, just whatever on the frickin’ house. Make it their monkey do deal with. As RM are sold to old people, lots of these are going to have cognitive issues and be exactly in the predicament that your mom is in, believe me the RM is used to dealing with this and knows what to do to get the property. But they will try to shift some of this onto you to make their legal life easier. You do not have to do anything..... make it their monkey.

House is underwater. There’s is no equity back to mom from any sale of the house. RMs cannot make mom pay for any difference between loan proceeds paid to mom and what it eventually sells for if it’s less (if it’s a HUD backed RM so a HECM). Don’t let the RM buffalo you into you paying or doing anything on the house. It’s their monkey and it’s not a cute lil baby Capuchin monkey but a old Orangutan. Make it their problem. To me dealing with RM is a lot like dealing with a in a NH Medicaid parent keeping their home and knowing family will eventually deal with MERP.... for family you do whatever to have property secure but do not spend time or $ beyond that.

There are free resources on RM you can contact to understand all this better:
National council on Aging 800-510-0301
Neighborhood Works America 888-990-4326
You may need to clearly state that you want the foreclosure done as your trying to move up the inevitable as mom is in a NH and has cancer and dementia. Whomever you speak to is probably way way more used to speaking with families who want desperately  to keep the home. But that’s not your mom’s situation.

And yeah pay mom’s copay for May asap and if there’s a late fee see if it can be waived. Then try to get June paid ASAP or pay a portion of it.

Is there anything at mom’s house that can be sold? Your shortfall is abt $200. I am constantly surprised at the stuff my college kid sells on Craigslist that I had ready to go to VOA & Goodwill or he curb shopped and sold. You may be too overwhelmed to do Craigslist but if you have a younger niece (especially if mom has vintage wardrobe stuff) or nephew or cousins they might could do this for your mom to raise $. 

Igloo572 yes thank you for all that information.
There is no other family to help me.
I’m doing it all by myself & it’s physically very hard because of my arthritis but I just take my Tylenol & do a little every day.

I spoke w/the NH social worker & she said as far as the billing & how they’re getting paid I need to call the business office & speak to her but as far as my mom learning from ME that her house is going to be sold (foreclosed on most likely), bills not paid, etc she’s going to have another psych doctor talk to my mom & explain to her that there’s no likely hood that she can return home & this is what needs to be done w/mom’s house.
I am NOT going to be in my mom’s room when the doctor is there but I will probably go see her later that evening because I know when she hears from the doc she’s going to demand the nurse to call me & tell me to get over there right away because it’s an “emergency.” & mom will want me to answer a whole bunch of questions..
So first off I called the landscaping service & cancelled them..
It’s so sad because they sent 2 invoices so far for spring cleaning & this past months lawn cuttings & little do they know they’re not going to get paid.
Also going to cancel cancel mom’s phone service.
As far as writing a check to pay the nursing home, what’s going to happen there because I’m not able to sign my mom’s checks.
We don’t have a joint account.

Yes the business office is the place to go for the billing questions. It may help to go in person not over the phone. If your mom can still write, couldn't she still sign the checks? Or since you’re POA can’t you sign them “Your Name as POA for your Moms name”? Or have your name added to Moms account? We had that arrangement as “moms name OR my name”. And it made paying things so much easier.

Ok so I received a bill from the NH & Medicaid IS wanting $ from May & June.
$740 each month which is my mom’s SSI:$249
+ S.S. : $521.
Minus $30 each month she keeps.
So grand total came to: $1480.00.
Mom only has $800 in her ckg acc so I wrote the check for $800.
There will always be a deficit or 1 months in arrears going forward which I can do anything about.
So starting July mom only gets her SocSec $521 -$30 so that payment to NH will be $491.
Might be able to catch up at some point but I’m not 100% on that.
So I guess the NH will just have to accept that..
Saw my mom yesterday & she’s still asking me if “the property tax bill came yet”, “did you pay the landscaper?”, “ I want you to bring my checking account statement so I can see what checks cleared”, etc.
I keep changing the subject or telling her fibs..
Don’t know how long I can continue that because she still is unaware the house will be given back to RM co.
As for them, since they made it impossible for me to represent my mom being her POA, I’m not bothering w/them anymore.
I’m assuming the homeowners insurance co (Farmers) will notify them that mom’s policy was canceled ( they accepted my faxed copy of POA) so they canceled it.
Once RM co hears from them, I guess they’ll move forward on what happens next.

NH will charge interest on the past due balance if it is listed in the contract.

Shad250 I understand that will happen, but it won’t ever get paid or be current then since there’s no extra money to pay from.

I’m not dealing w/the RM at all.
So I guess after they calling my mom’s house & see that her phones been disconnected the only other contact is me.
Will they call me, or send a letter to my mom’s house??
We shall see.

So I get a call from the palliative nurse who visited my mom yesterday in he NH & she told me that my mom seemed “more confused” since her visit last month.
My mom told the nurse, “it’s becasue I’m tired & just woke up”.. but the nurse saw her around 12pm & she had already eaten lunch then drifted off to sleep a little bit woke up when the nurse cane.
My mom has been diagnosed w/dementia a few months ago by the NH psychiatrist & she did ask me if my mom was still not getting any treatment for her cancer & I told her she hasn’t.
But she is in very bad pain from her osteoporosis & her spinal degeneration but refuses to take any pain Meds because she says she’s sensitive to side effects..
The ONLY meds she IS taking is the lasix for the swelling in her legs.
The nurse said it’s highly likely that the cancer has metastasized to other parts of mom’s body & is causing the pain.
They did find modules in her brain drying an MRI they took last time she fell & also growths in her lungs bedsides the tumor above her breast.
Both her legs are swollen like an elephant & are rock hard.’she is not walking at all.
Only goes from the bed to the wheelchair, stays up for a few hours, then back to bed to lie down.
The nurse said she would like to administer my mom a pain med, but in the form of a patch.
It is an opioid but very efffective pain reliever (I think she said it was fentinyl)??
& I told her to go ahead with it.
I also agreed to start the hospice because this way my mom will get 2-3 doctor/nursing visits a week to help her instead of just one monthly that’s she’s getting now.
My mom keeps saying “they took my life away from me you know that?”.
I asked her “what do you mean”.
She goes “this place, they’re no doctors here, this isn’t a hospital”..
I said yes, “you have seen a doctor, 2 doctors”,
 but my mom says “they don’t know what they’re doing”.
Up until yesterday my mom has always turned down the hospice.
I’m her poa now so I’m going to ok that.
I also discussed the fact that in order for me to represent my mom to her reverse mortgage bank they wanted a doctors letter stating that my mom can’t make decisions anymore.
I told the nurse that when I spoke to the NH administration, they told me “we can’t do that”, meaning they wouldn’t ask the doctor who diagnosed mom to write that letter.
The palli nurse told me that SHE will approach the doctor herself & get the letter written for me to give to RM.
Once that’s in place, I don’t know what’s gonna happen w/the rm bank since I haven’t notified them that mom is no longer living in the house..
I assume mom’s homeowners insurance company did notify them to tell them mom’s homeowners Insurance was cancelled (i called & cancelled it after giving them Poa info)
so they (RM) may know somethings up now.
Most importantly I asked the nurse how do I approach the subject to my mom that the house is no longer going to be hers & the rm Bank is going to take it.. because as you all may know, I haven’t told my mom yet.
Everyday I go to see her I’m having to lie to her about bills being paid, property taxes, etc & when I tell her that they haven’t been paid because her money is been going to pay the NH she may have a heart attack right there on the spot.
The nurse told me what I should say..
She said tell her..
“ mom you know you have the reverse mortgage on the house right?”...
And my mom will say “yeah”.
I then say, “well, the loan is due now, & they want the house sold to be paid back, so what do you want me to do?”..

The nurse said it’s all about how you phrase the question or information to take the blame off of ME, because I told her my mom is going to BLAME ME for all of this..

I’m glad to get this encouragement from the nurse but I have to disagree w/her as far as when I tell my mom this, the way she says I should..
Nurse says she thinks w/mom’s beginning dementia that she may not remember what she’s told today, tomorrow..
Or just little pieces etc..
I disagree but I sill am
Going to follow her advice when I do tell mom.
But I know my mom is still going to freak.. may even cause her to have a heart attack right there because she still keeps saying “I’m praying to God so much that he makes me well & strong enough so I can leave here & go back home to my own house”..
The NH is planning on a care plan conference for my mom on 7/10 which we do over the phone.
I was thinking maybe I should ask THEM to bring that up during the conference so ALL the nurses will be there w/my mom in case something happens when she hears the news..
What do you all think??

Hi Hangingon, I don’t have too much advice but just want to send a hug. It sounds like the palliative care nurse is giving thoughtful advice. It makes a lot of sense to address it that way. (I’m not sure if the NH nurses would initiate discussion of that topic with your mom, but it doesn’t hurt to ask.) Regardless of who brings it up to her, having the nurse(s) there for extra support and medical attention makes sense. I’m so sorry you even have to tell your mom about this.

I’m also very sorry about her declining health and her pain. You have really stood by her and despite how upset she is, she must know that you love her. I hope you are doing ok.

Hanging, sorry you’re going through this. But instead of wondering how to tell your Mom about the finances and the house, I am going to put it another way... You’re afraid she has a “heart attack” upon hearing the news, you’re already the POA but need confirmation in writing that she can’t make decisions anymore, but will ask her what she wants you to do? Do you think she can give you logical advise? I’m just not seeing the upside of telling her at all. Is there some reason that she has to know? Just a thought.