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Spouse is recovering from 4 broken ribs, a severely sprained R hand, can currently stand and walk with walker if attended; he's a fall risk after 9/1 and 9/5 falls. Tenant is 37, male, and has lived with us for 2.5 years. He's always been kind and helpful to carry things if I ask for help because he's strong; he works about 30 hours outside the home weekly, has his own car, and he and Spouse know and like each other.



Currently, he pays $450 for one upstairs bedroom (full house privileges) two doors down from the master bedroom, so he'd be within hearing distance of any call from Spouse for helping to the toilet, etc. I'd forego the rent, the hours would be about 6 hours daily. He hasn't any home health care experience and I've not mentioned the scenario to him. Thanks for any input.

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Pronker, at the risk of sounding harsh, or judgemental, or...something, I think enough is enough.

Your spouse has dementia and was unreasonable even before that diagnosis.

It sounds as if this marriage has been one long road of you being supportive, accommodating and flexible and of him being demanding, belittling and accusatory. To my eye, the man has a personality disorder and while these folks sometimes mellow with age, dementia can cause their self- centeredness to blossom to new heights.

He has a progressive illness that is going to get worse. He is already too large for you to manage at home and he has at least one instance of endangering himself by not comprehending the gravity of the situation (the car thing, remember?)

It seems to me that God or Fate has smiled upon you both and given you the opportunity to have him someplace safe for an extended period of time.

In your shoes, I would be using this time as respite, getting to a lawyer to talk about Medicaid/VA LTC eligibility and YOUR finances, finding a telehealth therapist and taking stock of where the best place for YOU to live for the next 40 years is. You mentioned divorce; I would consult a lawyer about that as well if that's on your mind.

I would not be struggling to figure out ways to cobble together a jury-rigged plan to bring him home with too little help.

Re: leaving your son the house...my parents brought me up with the idea that the "gift" they would leave us was that we wouldn't need to support them in their old age. That's better than a house or legacy of any kind.
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BurntCaregiver Sep 2021
BarbBrooklyn,

If Pronker's household is low-income and on food stamps, they are also on Medicaid.
Medicaid will pay for the husband's homecare aides. They may not pay for 24 hour a day live-in servants, but they will certainly send some homecare.
I've worked for many low-income people on both Medicaid and food stamps. They were receiving up to eight hours a day of home caregiving services. All paid for by Medicaid. Most of them didn't need more than an hour or two of aide care.
Pronker needs to talk to her food stamp caseworker or her husband's. They will set this up for them.
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I am with Barb here. This is the time you get him placed. I have no idea how VA works with their NHs. Does Medicaid get involved?

This is what I would do. Your house is an exempt asset under Medicaid. So is one car. Your monthly income, SS and Pension are not assets. So, you need to look at your assets. If substantial, you need to have them split. Your husbands split would be spent down and then u apply for Medicaid. You will be the Community Spouse and will get enough of your monthly income to pay bills. Maybe all of it if needed. An Eldercare Lawyer should be able to help you.

My GFs parents had 60k in the bank. It was split between them, his going for his care. She stayed in the home and had a car. She seemed to be doing OK.

When DH passes, Medicaid will put a lean on your house to cover the cost of his care. You will be able to continue to live in the house. But if you sell, that lean will need to be satisfied. If you pass, the house will need to be sold to satisfy the lean. A person could also pay the lean and keep the house.

Your profile says DH is 79. I will assume u have not updated his age and I know u have been here a while. So he is now in his 80s? Meaning you are too? I would consider placing him now. The cost and stress of caring for him at home will probably be too much for you. It would for me and I'm 72.
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pronker Sep 2021
Thanks so much for relating the first hand experiences. He is 79 and I am 68.
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I wonder how OP feels not being controlled by her husband since he is not at home right now. Besides his phone calls wanting to go home is it almost a relief not having him there? I imagine it would be. Just something to think about. Can you go back to having him at home now after tasting a little bit of emotional freedom?
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pronker Sep 2021
It's a relief from caring physically for him, that's for sure; the 48 hours he was home between his 9/3 discharge and 9/5 fall #2 was eye opening. Thanks for your input.
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Pronker, one thing stood out in your post:

" Things escalated to "if our situations were reversed, I'd be overjoyed at having you back" ".

My ex (NPD) said stuff like that ALL the time.

In practice, he NEVER had my best interests at heart and immediately became disinterested or feigned illness himself if I had a baby or was ill.

Look, if this has been a mutually supportive marriage of many years, I can see trying to extend yourself to bringing him home with proper paid support (if you all can afford it, which it sounds like you can't--that's another issue entirely).

But if this has been a one way street, with you being endlessly supportive and getting little in return but derision for your efforts, I don't see the points in having these arguments, which are wearing you both out.

"The doctors say this is where you need to be; it's not up to me. If we can't talk about something else, I'll need to leave."

Believe me, I get how painful this is.

((((((hugs)))))))))
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pronker Sep 2021
I'm sorry to read of your ex's dismissal of very important things.

Yes, money has always been a problem..

Thanks for the thoughts and helpful reply - I'll use it, I'm certain, at some point. :) [[]]
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Pronker, he certainly put up a good and long fight until the very end. And you, dear lady, have strategized and pondered and done your very best for him throughout.

I am so sorry for your loss. Be comforted by your good memories and please be gentle with yourself. (((((Hugs)))))).
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pronker Dec 2021
*hugs back* Many thanks for the practical help and the moral support. It's been a trial for him and we've so many memories after 36 years.
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pronker, your tenant already works 30 hours a week at a paying job, do you think he would want to add 42 more hours to his week for no pay? Even if you waive the rent?
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pronker Sep 2021
Thanks for the input - I'm still piecing together what to say to Tenant, if I decide to put it forth. I said earlier he'd no caregiving experience, but I forgot that he'd driven Spouse last year around to various activities such as shopping, totaling about 80 hours' work, for which I paid him. The sitch has changed, though, re Spouse's mobility. Everything's up in the air. I might be making a tempest in a teapot; just today Spouse called and asked what the consequences would be if he just said he's leaving rehab against medical advice. To my knowledge, no more VA coverage; I'm awaiting clarification on the issue. Spouse is desperate and feels his life is at risk if he stays in rehab longer. He's irrational. I would be surprised but not shocked if he just said forget it and signed his discharge. I would not pick him up and would refuse care; he's not safe at home with one old lady, me, to provide care.
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Is ur DH in rehab? Medicare does not guarantee the full 100 days. The therapist has to show that the person is progressing and needs continued therapy. If they hit a plateau, Medicare will ask that the person be discharged to home. If found the person needs 24/7 care you can claim it would be an "unsafe" discharge because you cannot care for him nor do you have the finances to hire private care. This is when u have him placed in LTC. Just the days over 20 may cost you unless u have a very good secondary insurance. My Mom 5 yrs ago paid $150 a day. If she had gone the 100 days, the cost to her would have been 12k.
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pronker Sep 2021
Yes, he's in rehab. His nurse says he's working with the PT who come by to help him stand with his walker; Spouse says he's not working with them and all one does is stand by him to see he doesn't fall. Thanks for your story about your mom and first hand experience with the 100 days.
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Once again, this site has come through with invaluable advice. Many thanks to all who replied.
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I came back from a conference with the care team at Facility to find Spouse on floor, conscious and calling for help. The RN and CNAs came quickly and Hoyered him back into bed; no breaks or bruising says RN, well it takes a while for bruises to appear because they don't just spring to the skin's surface. Bed rails are considered restraints, although an MD can order them. RN pushed his bed to the wall and said she'd get rubber mats on the unprotected side.

Conference had concluded that he "can sit for 30 seconds at edge of bed during PT and then says it's too painful" because of catheter in place and bedsores; said "we can encourage but not force because that would be tortuous even though he's not responding well to PT; he's told us he wants to come home if I can handle his care". Conference concluded "we must plan for discharge to home, or continued placement here for X dollars monthly, or another facility." The X dollars seems doable at this point because of his pension; will need to contact VA to see if this will work.

Today is Youngest's birthday and the fear that his dad might die on that day subsided; the fear arose because of Spouse's sleepiness on three previous visits, really groggy. I believe this was due in part because his TV is a complex thing and the remote hard to figure out, so he lost that stimulation; 10 days ago, he was telling me about various news events and wanting my opinion. Now his original TV is back and he seems uninterested. At my return from the conference, he said "I live here now, don't I" and I said "Yes, until you get stronger."
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Pronker, I am so sorry for your loss.
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pronker Dec 2021
Thanks for the kind words; the support has been phenomenal from family, friends, and this website.
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