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Mom is in the independent living section of an AL she chose. She’s been there for a year and now she doesn’t like it so wants to move. She has moderate stage Alzheimer’s and she is beginning to have enough issues that she needs a higher level of care. Her current facility has memory care and as an existing tenant she has priority for getting that level of care over new tenants when she needs it. The place she wants to move to is double the cost of the current facility and that is for the same level of care she currently receives. She has a retirement and social security that more than fund current monthly facility costs. To pay for the new facility she will need to dip into her investments. There is no issue with her doing this because it is her money. However as she needs more and more help with daily living the costs will increase. Her monthly income is too high to qualify for Medicaid or Patriot Angels. If she exhausts her investment income, will I as her Power of Attorney agent be responsible for paying for her care?

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She is no longer able to make executive decisions, this is where your POA comes in to play.

She isn't happy where she is because her brain is broken and changing her perception. She will probably never be happy where she is again, I am sorry for saying that, I have seen this disease to many times to believe otherwise.

I would have a new assessment done and move her to the level of care she needs, keeping in mind that self-pay has more choices. Do either of these facilities accept Medicaid? If not then IMO it would be better to keep her where she has been getting care and move her to the next level required. Or check out facilities that have the levels of care she will need as she progresses that allow self-pay and then accept Medicaid. No reason to not plan for escalating care requirements, it is the one certainty of this awful disease.
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thegoat May 2019
Thank you so much for your response. This is all excellent advice. You confirmed my thought that moving to a new facility will not make her happy because the facility is not the issue.
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Please consult at attorney. Many states have repealed their Filial Responsibility Law but if you are in a state that still has it on the books, you will want sound legal advice. Most states do not currently enforce this law. PA does. And with our elderly population growing and the strain on Medicaid, more states may enforce their law. Talk with an attorney who is familiar with elder laws in your state.
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worriedinCali May 2019
You really ought to mention that if the OP is on a state that enforces filial laws, it will only be enforced if she actually has the money. And in order for filial laws to be enforced, the court has to find that the parent is unable to provide that the parent is unable to provide for their own support AND that the child has the ability to pay.
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No you won’t be financially responsible. Once her assets are gone, she can qualify for long term care Medicaid even if her income is too high.
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thegoat May 2019
Thank you for your response. I did not know about long term Medicaid so I will do my research on that.
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Would a "move" to the Memory Care section of the facility where she is now seem like a "real move" to her? That might placate her desire to move.
As Monica19815 mentioned check with the state where you live to determine if you will be financially responsible. In most states no you would not be responsible. A good Elder law attorney would be the one to consult.
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thegoat May 2019
Thanks for your response. She’s afraid that higher level of care at the current facility equates to a death sentence. Somehow in her mind it would be different at a new facility. Sometimes we forget that assisted living facilities are places where there is a lot of illness and death due to the age and condition of the residents. It’s reality but it doesn’t make it less scary. I’ll get in touch with an elder care attorney to better understand my responsibilities.
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The "fear" of higher level of care might not be realized. She would get the level of care that she would need. Yes they will manage medications for her but is she doing that herself now?
I am sure you could discuss what should be done as well as letting them "back off" for a while to see how she does. Just knowing that there is help there for her if and when she needs it might be all she needs at this time. When my Husband was in day care at a memory care facility then for respite the staff was pretty good about letting the residents set their own pace, at least as far as I could tell.
A "good" facility and a "good" director should take your desire to keep her safe as well as Moms desire to be as independent as possible. Somewhere there is a happy medium.
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Since she is afraid of higher level of care, can you bring an aid in to help her occasionally.

It would be cheaper than a move and give you a different perspective on her reality.

Just a thought, I know how hard it is to balance all the senior items that require attention. This will work out eventually.
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