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Mom is at home with help. Hours of help getting longer and longer. If she stays in apt until she has only SS, what will become of her? Is there something next? Understanding that it is a gamble to stay at home, paying for help, until money runs out, but I don’t know what to tell her will happen next if she chooses that route. I told her that I will be unable to pay. Trying to convince her that perhaps savings will last longer if she move to AL now, before she can’t because of funds. And if in AL with Medicaid beds, she will be able to get on list from within the community and have better chance, if and when necessary.
She wants to just stay put and see what happens. Well what happens?

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There’s no waitlist for in home care paid for by Medicaid in your state. Waitlists for state paid homecare are actually pretty rare.
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Ckap123 Sep 2019
But Medicaid won’t pay for Fulltime people in home, will it?
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Ckap123, here is what I did in the case of my MIL who only had $693 ss p/mo and was upside down on her house and cc debt, no savings or investment income at all.

(I chose to pay (out of my own pocket) for good, private healthcare for her. This allowed one facility to be able to accept her from a rehab stint directly into their facility as she was alone in her house, had dementia enough so that she wasn't remember to eat, and was a fall risk. )

1) While your mom still has some funds besides ss, research and choose a nice NH. Make sure you ask the question, "Do you accept Medicaid?". If they say no, keep looking. Make sure whichever place you ultimate choose (hopefully together) has a continuum of care (so, AL to MC to Hospice) this way your mom will never need to be uprooted. Don't worry about the cost. A facility that accepts Medicaid cannot kick her out once she is a resident. A Medicaid room means a "shared" room, so she will have a roommate.

2) Get her in as a private pay and then start the Medicaid application. The in-house residences have first dibs on the Medicaid rooms. IF she runs out of money but the facility doesn't have an open Medicaid room, and your mom is in a private room, then she will have to pay the difference in cost between a private a shared room. In our case it was $620 plus phone and cable. We split this between 3 siblings and had to pay it for under a year while she waited for an M room, so it was manageable for us. Medicaid was paying for the room except this amount.

3) Once she is in an M room she will have a social life and the medical attention she needs. My MIL was in 2 different good facilities, both were run by charitable organizations (the Moravian Church and then Presbyterian Homes). Both had excellent care and caring staff. We moved her a second time to be closer to where we live.

My MIL is doing quite well now, going into year 3 of being in LTC. It did take her a while for her mind to accept how things had to be, and it may go like that with your mom as well. But there is no logical reason why you should impoverish yourself because your mom has a romanticized notion of aging in place at home while putting the stress of caregiving onto you. It's not reasonable or fair or wise. From the sounds of it she will eventually need to go into a facility on Medicaid anyway, so why wait for a train wreck? Be preemptive while you are still in control of decisions. Placing her in AL or LTC does not mean you don't love her. It is the only way to solve your problem based on the info you provided. It will take time for the both of you to adjust mentally and emotionally. Wishing you peace in your hearts and courage to make wise decisions for both of your futures!
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mstrbill Sep 2019
Your Mom was fortunate she had children who had the means to pay for her care. Unfortunately many people don't have that luxury. I didn't and it seems OP doesn't have the ability to either. Also, OP's Mom doesn't want to leave home now, but you're right, if she has the money and can get her into private pay facility now and then transition to Medicaid that would be a good option.
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The other possibility when the money runs out if you can't get her in home Medicaid care is you'd have to try to get her into a facility that takes Medicaid pending applications. the problems there are it is very hard to get into a NH by yourself. In other words you can call different facilities but you will be told there is a waitlist most of the time. So it may be best to get on a waitlist now. The problem then would be you have no one to take care of her at home at that point. That scenario is exactly why the only option for some at that point is the ER "dump".
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AlvaDeer Sep 2019
As an old retired RN the "ER Dump" is what I always advise people. I saw people wear themselves and family out with atttempting to place a Senior who had no funds. After all of that, and when completely desperate the Senior came to ER and the Social Workers did their magic, and there was placement. To this day, and I am retired more than 15 years, our system seems to have come up with nothing better than the ER dump. What a sad statement.
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I suppose at the point her savings dry up she would then have to apply for Medicaid but the problems then would be it might take 2-3 months before she is approved and also there might be a wait list for in home Medicaid care. I would look into any Medicaid run in home care program your state has now and see if there is a waitlist. During that time she is waiting for Medicaid approval, if she has a credit card maybe you can still pay the private home health agency with that but the problem there is you won't be able to pay that amount back even when Medicaid is approved (as far as I can tell anyway). Good question, i'm not entirely sure what will happen either, hopefully someone else can add insight.
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