My situation is complicated so in order to keep this from turning into a book, I'm going to be very blunt and just state facts as they are. My mom is in the later stages of unspecified dementia. I'm her sole caregiver and she lives with me in the home that I own with my husband. She is legally married but her husband has been out of the picture for about 15 years. I don't have contact info for him and he likely wouldn't cooperate. He tried to claim her last year on his own taxes, just to give you an idea of the type of person he is. I know this only because we got a letter from the IRS saying we need to check to make sure we meet the criteria to claim her because someone else had tried to. She will not pass Medicaid 5 year lookback until mid June next year. We use her SS to pay for her care and to compensate ourselves for providing it, since I can't work and have to stay home with her. Can we get in trouble for that? Her SS goes into a joint account with me and it was set up before she had dementia. I have POA. She has recently had a sharp decline and this situation is no longer safe for her or for us. She has caused damage to our home, has fallen several times, is awake for days at a time, and impossible to legally contain. Gates don't work. The only methods that would keep her from wandering all night and hurting herself and/or causing flood/fire etc. are not things we can legally or ethically do, like lock her in a room or restrain her. I could go on and on but the point is, I can't do this anymore. She is leaving tomorrow for a 7-14 stay at a neuro psych hospital for evaluation and regulation of her meds. I'm terrified at the thought of her coming home after that. I don't know what to do. Can we refuse to pick her up? Since she lives here, do we need to legally evict her? Would we be in trouble for abandonment or elder abuse if we refuse to pick her up? If we wanted to try to start the medicaid application, what happens when she doesn't pass the lookback and gets a penalty? We can't wait. This isn't safe and I feel like I'm going to have a mental breakdown. I feel violent towards her and I'm worried I may lose control one day. If I tell someone that, can I get in trouble? Will it be taken as a threat against her? It isn't, not at all. I'm being honest. I'm not ok mentally/emotionally anymore and I just can't do this. What am I supposed to do to get her placed somewhere without getting into some kind of legal/criminal issue?
Find the Hospital Social Worker and explain that you can no longer care for your Mom. This is not uncommon to refuse. The Discharge Coordinator might try to convince you to bring Mom home, but stand your ground.
Other writers on this forum will give you more information and their experiences.
Consider resigning your POA and turning her care over to the State of Indiana.
Indiana is a filial obligation state, but I don’t see states bring those laws to bear except in situations where the adult child is flush with funds.
I think you should be speaking with the discharge planners at the psych hospital about "unsafe discharge" and where she should reside next.
Please don't mention feeling violent tendencies toward your mother bc such verbiage can work against you. We here understand and empathize with burn out and compassion fatigue, but not everyone does. Most people don't even understand dementia, never mind the toll it takes on the caregiver!
Ask the attorney about resigning your POA and having the state assume the care for your mother. See if it's legal to do that in Indiana. It's very important to get sound legal advice from a pro now rather than opinions from forum users on the internet. This is way too huge an issue to leave anything to chance....make sure you are armed with all the facts moving forward so you are fully protected.
I hope you can get mom placed at once, and that you'll be able to relax and take your own health and peace of mind back. Sending you a hug and a prayer for a good resolution to all of this chaos. My mother was 95 when she died in Feb from advanced dementia and heart issues. I know the horrible pain of all this, and she wasn't even living with me but in Memory Care Assisted Living. And it still tore me apart having to deal with her every day.
My dad was in the donut hole of to much SS and not getting enough to pay for help or a facility. I was directed to board and care homes and he was able to self pay and have enough left over to pay some bills.
I would get them monthly numbers together for her SS and make a spread sheet showing her share of costs, personal expenses and the small amount left over to pay you for care. This should be done pronto.
Tge 40k only has 6 months to move out of the look back period, for your sanity, just try to do the best you can until then. That's what I would do.
Best of luck finding the best solution for this situation. It is so difficult finding out what we didn't know years ago and dealing with the fallout from that.
Great big warm hug! It will work out and you will be okay.
Its not just the 40k you may have problems with, it will be hard for Medicaid to separate what is hers from yours. Medicaid requires 5 yrs of bank statements. If you had kept her money separate, her bank statement would show the money going in and out. So hope you have kept good records. And u can't pay yourself unless there was an agreement between u and Mom, written would have been the best thing.
If Medicaid questions the 40k there will be a penalty. There is a formula for how long. Either someone pays privately for the penalty period or you care for her during the penalty period.
You may have to take Mom back into your home. If that will be an impossibility, then you may have to allow the State to become Guardian. They will be able to work thru the red tape to get her placed. You will have no say in her care or where she is placed. You maybe able to request a place close by. They will do all the Medicaid work. Maybe requesting certain info from you.
I know, I really have made things look worse but this is how it may go. The reason why an elder lawyer is needed. I think under the circumstances, allowing the State to take over her care may be the best thing. Be aware, her SS will also go to the State to offset the cost of her care.
Its a shame there is not a book of do and don't for Caregivers. Most of what I wrote was learned from this forum. Because of this, I was able to go to Medicaid with information under my belt. I was so lucky that my Mom was a good record keeper. She had at least 5 yrs of bank statements in her file drawer. My Moms lawyer who wrote up her Will and POA told me to get her name off my nephews acct because Medicaid would look at it as hers, until I proved differently. She was 80 at the time. Medicaid was needed at 89.
I am so sorry you are going through all of this.
That she is going into a hospital for care is beyond great as those costs should be covered by Medicare and whatever she has for her secondary health insurance. You want her hospitalized on MediCARE for as long as feasible, as that pushes off her having to deal with filing for LTC Medicaid custodial care in a SNF or NH. Keep your ears open if it should be suggested that she moves out from being a “patient” in a hospital to becoming a “resident” in a skilled nursing care facility aka a NH. Patient in a hospital is MediCARE; resident is private pay, LTC insurance or Medicaid in a facility. You don’t want to trigger her filing for LTC Medicaid till there is a plan as per the new attorney as that 40K gifting will surface.
Im actually concerned abt the old husband…. If they are married, even though estranged:
1. his own financials & details on all property ownership will be needed for mom’s Medicaid filing. Medicaid is “at need” both medically and financially. What he has for income and assets will matter. I’m guessing he will not be at all willing to do this or will do major foot dragging to ever be responsive. Medicaid is very time sensitive so no response in 10-30 days, application closed for noncompliance. If he owns a home, as they are married, it will be subject to however y’all’s State does Medicaid estate recovery. Attorney needs to deal with this and legally segregate them.
AND
2. Hubs could himself file for a capture of some of her monthly income (her SS that goes into that bank account you have access to). They are still married, he is still a spouse. LTC Medicaid has a waiver that spouses can file for, it’s called CSRA or MMNA. Think of it as like old school alimony for the non-NH spouse. It’s $ the community spouse (CS in Medicaid speak) can file to have go to them to enable them to live in their community. Like if mom gets $1500 a mo SS and he can show he needs $1200 of that for his own living in the community costs, he gets $1200 and mom is left with $300 a mo at the most available as a required by Medicaid copay to the NH. NH will not exactly be thrilled to find that an originally anticipated $1500 copay from mom as a new resident is now going to be just $300.
To me, you want the attorney to decisively find a way to cleave off that old estranged hubs from being able to ever have any way or claim to your moms income. Otherwise he’s going to get involved every year when her SS payout changes. & mom will need his updated info every year for her own Medicaid LTC renewal. It will be beyond a buttrash to deal with him on this imo. Again atty need to deal,with this and decisively. Not a DIY.
Ya know “in theory” a NH that has Medicaid beds should not care what the applicants / new resident income & therefore their copay is. But that’s in-my-experience not what happens. My mom had 2 mo income’s and was right below the LTC Medicaid income maximum. NHs I looked at were positively giddy over moms income as it would mean a nice guaranteed $$$ copay. Their gonna be pissed to find they have to deal with a CS who can draw off $$$ every month from a residents income.
Dealing with gifting penalty is sticky. It’s not exactly a $-2-$ match up. It’s more a math problem, a division equation. It gets placed as Day 1 based on the date the Medicaid application is filed (not when the $ moved or the penalty discovered). Each State has its own Medicaid daily room&board reimbursement $ amount paid to a NH. Most do abt $185 room&board day rate. So 40K in a $185 day rate roughly 216 days or 7 months of private pay needed before she could be eligible to file for LTC Medicaid.
The extra difficultly in this is that the facility does NOT have to charge the resident the $185 Medicaid day rate for those 216 days. NH can opt to charge the private pay rate which will be way more than the Medicaid rate. Like way way w…a…y more $$$. If they enter a NH Medicaid Pending then found to be ineligible due to transfer penalty, there will be anywhere from 3-6 or more months of being there and possibly creating a private pay rate bill each & every day.
Thats another reason why ITRR suggestion is really important. You want to get past the lookback before you file. And if you can do it at a lower rate board & care home, it’s way w…a…y more affordable.
Now the Medicaid situation can get tricky due to the gifting. I think prior to Medicaid kicking in, you’d have to spend down 40K prior to it kicking in. But like you mentioned, your Mom doesn’t have any assets and you used the 40k to care for her (perfectly understandable btw).
I know you mentioned you don’t have the funds to consult an elder care attorney. You could talk to some local nursing homes and they may be able to assist you. Simply mention you need a dementia care unit for your mom, but that she has no assets. They can probably hook you up with someone who can help with the paperwork needed. Im sure you’re not the first person who’s been in this situation.
Also try calling your Ombudsman for your State. They can definitely help and serve as a free resource and eldercare assistant. You can totally call them and say you need help and I’m sure they can offer guidance.
Try not to get too freaked out over this - there ARE solutions and a way out that’s good for you AND your Mom.
Hang in there and feel free to keep us posted!
Reasons IMHO are a couple of things that could happen: ward is a legal action. Usually what happens if family or existing POA is not being responsive to hospital/ AL/ NH, the facility contacts APS. APS looks into the situation and if family still unresponsive or unable, then APS will ask a court for an emergency ward of the state action to get done. Court will appoint a temporary guardian (usually from a list of vetted guardian). That new guardian has a lot of legal authority and can go after anyone who appears to have or may have benefitted from or taken advantage of the elder (a vulnerable adult). The OP got $$$ the mom gifted to her & OP is her moms POA. POAs have a required fiduciary duty & that should mean that they do not do anything that could be viewed as “self dealing”. Allowing 40K transferred to you looks like self dealing. It wasn’t self dealing but it’s more that neither mom or OP ever thought mom $ would run out and it was just a lil something mom could do for her daughter & her family…. But it will be a sticky to get a court appointed guardian to easily be accepting of this imo. That 40K is going to mean the guardian will more than likely look in more detail at the moms bank statements which snowballs into having to justify or provide receipts on spends.
Plus Medicaid can ask for documentation on spends. There is someone on this site. dealing with her hubs in her 90’s Auntie and had to justify all checks written over $200….
If the mom still had plenty of $ and could on her own afford a Nh, that $$$ gifted wouldn’t matter. But unfortunately that is so not the case. This mom will need to file for LTC Medicaid and the gifting and it’s transfer penalty will surface. OP really REALLY needs an elder law atty to,run interference on this and the whole hot mess of mom having an estranged husband.
if the gifting wasn’t there, yeah, going ward would definitely be a good idea. As that court appointed guardian can legally deal with the estranged husband.
If you or other family need to be moms cheerleading squad to get her to do what so she can stay in the psych hospital, do that. if she should get all “I’m not doing “fill in the blank” the staff can write her up as non-compliant for care. After a couple of those, MediCARE will stop paying and quickly. Like within 48 hrs. She needs to be engaged & participating in some way.
let us know how it goes. And remember it’s 5 years and 31 days to get beyond the lookback. You don’t want a 1-2 day glitch to become an issue.
When and if your Mother is released from the neuro-psych hospital, her meds should be stabilized, and her behaviors could improve.
If you feel forced to bring her home, (you can refuse), please hire a personal attendant/caregiver for her because at the time you wrote this question you were in no position to be caregiver to her.
You are to be commended for reaching out, and understanding that you could not continue.
Having a plan, and improving the day-to-day (ADL activities of daily living)
will help you. Don't try to be her only caregiver.
Make a note that some people are very sensitive to changes in the environment. A full moon, an eclipse, solar geo-magnetic storms, can all affect a person. That was all happening during the time you posted this question.
Of course, not everything can be blamed on the environment. But look around you when these things occur-even an increase in crazy drivers. It is not magic if you observe these things.
Hoping your Mom and you will be feeling better soon.
However, once someone has become violent towards you, a different plan needs to be put in place. That would be a priority over her marital status or her Medicaid status. In that case, if so, do not be in her presence without supervision, do not bring her to your home. I don't have a plan B or C, but there must be one.
No need to respond at all. Take what can help, ignore the rest.
Check with an attorney and social security to advise her on having her Social Security calculated on her husband's income.
If she has an episode seeing you, do not bring her home.
Call her regular doctor to support you in keeping her there or being placed.
Do not know where you are located, but California has Medi-Cal. Does not have the 'gifting' qualification, but you would need to check.
Call Social Services, or apply online for SNAP/food EBT.
Accept the limited amount even if they only approve you for $15.00/mo.
You will need to supply the stats for the household, you, your husband, and Mom.
Call APS to inspect your home for safety. If she does not have a working toilet-that would count as a safety need, maybe delay her discharge. (but doubt it).
There is always a commode, but not a viable long-term solution.
Avoid circumstances leading up to the urgency to install a DIY toilet overnight by your working husband. I get you are desperate, but panic does not work.
Thus, advice from APS may help.
A Senior Center or Area Agency on Aging may have a handi-worker program to assist with toilet, grab bars, some safety renovations for seniors. This program is free, and has a high income limit for qualifying.
You can't work. How are you able to arrange these things for your Mom?
My guess is you are not, and require a little help.
Sorry, that's all I've got without reading your history-time is an issue for us all.
Seems your help needed has turned to RIGHT NOW.
Maybe other caregivers here can inform you of the "unsafe discharge" options.
You do not know if he got a divorce and she forgot or is uninformed.
State she is divorced, to your knowledge. Don't discuss it or explain.
Just put that out there, stand on your statement. [buying time here].
Then, find out through the courts.
The senior center often has a free attorney. They do not do divorces.
You would have needed to lay the groundwork to apply and receive so many services. Since you posted in January, I have concerns that you are unable to do the necessary paperwork(s) part of your Mom's care needs. (No guilt, it happens).
Can the hospital safely discharge her to a hotel?
If not, discharging her to your home is also an unsafe discharge. imo.
Do you have any knowledgeable friends?
***EDIT***
Proceeds from a home sale, separation and divorce are treated differently when it comes to 'gifting'. She did not receive it as a gift. If the money was spent for her rent and needs while living with you (even 3 years), that can be documented, and was not just 'given away' to you as a gift, right? Where is the money now? (No need to tell me). I feel that you have created legal and tax issues as a concern/fear that will be irrelevant or taken care of without penalties if you see the right CPA and attorney.
Do not let your fears stop you from proceeding.
Have you talked to the discharge planners about sending her to rehab? About releasing her to a facility "Medicaid Pending"?
Start saying u r no longer able to care for her safely.
End of subject nobody business but ur own. Give no reasons just that u can no longet provide her safety. The instition is legally obligated to discharge her to a safe location. Once told ur house is not that they will have to look elsewhere. Be prepared to not having input in elsewhere.
Tmi.. I'm solo live alone.. I tried to kill myself twice.. first time I didn't get close was allowed go home... 2nd time I got closer. Locked up involuntary.
There were as couple of elderly people having their meds adjusted as your mom is. They weremuch better at the end of their time there. Since I live alone and couldn't be left myself, you would be surprised at how many places they have to cubby hole people.. I wouldn't be so worried if I were you. Just just tell them no you can't take care of her safely. Then don't pick her up
I would be seriously tempted to call 911 and get her transported. A facility isn't going to accept this behavior and that's a whole nother headache for you.
The hospital needs to get her stabilized.
Prayers for strength, wisdom and answers for you. Great big warm hug!
I believe they’ll still view a gift as a gift. And it depends on whether you have an understanding bureaucratic/legal person in front of you or not.
In conclusion: I think, they’ll continue to view it as a gift, Medicaid penalty.
I do think the right lawyer is wise of you to consider especially with possible Medicsid placement in 2023. Really hoping for the best outcome for you.
I hope I'm wrong, but I believe that means that Medicaid will look at household income, not just hers in determining Medicaid financial eligibility. Make sure you mention this fact to the lawyer.
I'm so sorry you are in this mess.