financing 24 hr home care

Barkley

My mother has mid-stage Alzheimer's and is still living in her home which she absolutely refuses to leave.  She's a fall risk, plus she can't see very well, so she needs help with meal preparation.  Adult Protective Services has determined that to stay in her home she needs 24 hour home care, which she can't afford.  Medicaid is useless. Does anyone have any possible solutions for this dilemma?

dayn2nite2

What she wants and doesn't want no longer matters if APS is involved.

If Medicaid in your state will not pay for 24-hour care and you have no family/friends willing to do it, she will probably need to be placed, whether she agrees or not.

Only the very wealthy have enough money to pay for 24-hour care or even care for the majority of the day.

If she has Medicaid, start looking at facilities with Medicaid beds.  I don't know if any facilities are doing tours right now due to the pandemic, but you do not have a infinite amount of time to do this.  If APS is involved (not sure why), and you don't act quickly enough, they will take guardianship of her and place her wherever there is an open bed, which may not be a place you find acceptable.

Priority #1 is finding a facility that accepts Medicaid where you feel they will care for her properly.

Do not discuss whether or not she will be placed with her.  She will have to be if she has no funds for in-home care.

Marta

24 hour care at home is too expensive. Apply for Medicaid so that she can be placed in a facility.

Cynbar

Medicaid doesn't provide 24/7 in home care, that is true. But it is far from useless, it will pay for placement in a facility. I am assuming she has Medicaid and that is why you have found it useless -- if not, apply immediately. But assuming she has it, look around for an acceptable facility that accepts it for payment. She doesn't have a choice at this point, APS has determined her safety is at stake and most people with dementia can't process the risks. When the time comes, you will think of some excuse to get her to the front door of the facility (lots of advice available here, it's a common issue) and then their staff will take over.  Don't even discuss it with her, you can't expect her to agree, it's not going to happen. This is your solution.

PS --- I love your name, I am also a Barkley.

MN Chickadee

Medicaid does not pay for as much for in home help, though some states do provide some. It generally pays for a care facility once her own finances are exhausted. Families who keep their person with dementia (PWD) in their home usually do it by either having lots of money and resources to pay for it, or family members cover much of the care. For example, some people live with the PWD so they can be there at night etc and just hire help for respite time or send the person to adult daycare while they go to work. Adult daycare can be a cheaper way to cover the daytime hours, and in some states Medicaid will pay for it through a waiver program. Each state varies in rules and what they cover so it's hard to make any blanket statements on Medicaid. 

I would recommend getting to an attorney who practices elder law in mom's state. They can best advise how to pay for her care either in home or otherwise based on her unique finances and anything she may qualify for. Applying for long term care medicaid requires adhering to strict rules and timing and an attorney will know the best way. 

And unfortunately what mom wants may not be a factor. Safety and care needs come first. Many of us have to move our LO without their consent or permission for their own safety. We use therapeutic fibs and workarounds to get it done. Don't mess around, if APS gets involved you may have no choice in where she goes.  I would most certainly be researching and choosing facilities that have Medicaid beds as you work on the rest. 

Suzzin

We begged and pleaded, negotiated and flattered, threatened and reasoned but my parents wouldn't move to assisted living, or even a retirement area with support available. "It's too soon", "I know we need to but your dad/mom won't go", "This is my home and I'm not ready to go". For years. And now it's too late, they don't qualify for any of the independent living places and it's unlikely that they could even manage assisted living for long. Every penny they saved through their lives is going to pay for live in "carers" who are little more than sitters. If you can get her moved and settled while she can still maybe make a few friends or memories, it will be so much better for you both as time goes on.

Kaustin1741

We realized my MIL was unable to live alone quickly after my FIL died. She was paying for 24 in home care because family was unable to live with her. It became clear she would run out of funds within a year if something didn't change. Luckily their house was nearly paid off and after 30 years she could sell it and make a good profit. With a lot of resistance from her and really her not understanding what we were trying to do we moved her across the state to live with us.  The four hour drive was rough and she looked at me like I was crazy when I told her this was where she was going to live. We still pay for in home care while we are working and between my husband and I handle the evening hours. That is getting harder and harder, and the prospect of paying for 24 hour care again means running out of money quickly. It sounds like when you run out of funds a medicaid bed at a facility is your only option. My husbands aunt just put her father in a facility. Sadly she took him out to lunch and ran some errands with him while her siblings packed some of his things. Instead of taking him back home she took him to the facility and dropped him off. It sounds mean, but if they don't want to cooperate and APS is going to get involved it sound like there are not a lot of options.