Costs of Memory Care

AConcernedSon

I think I know the answer to this question, but there's just a nagging voice in the back of my head saying "Did you explore EVERY possible avenue?" So here I am.

My Dad is doing well in a memory care facility. He gets socialization and good care. He's happy there. My mom is finally relieved after caring for him at home nearly pushed her over the brink. It's all okay now. 

Except the cost. We're just blasting through our savings fast and it's not going to last for much longer. I want to keep my Dad there as long as I can, but I also don't want to bankrupt my own family. 

I know about Medicaid covering skilled nursing. But he's not there yet. 

So just so I can know I asked the question--anyone have suggestions? SOmething I'm missing? Has anyone used a reverse mortgage to fund memory care?
Some kind of grants?
A GoFundMe page (I doubt I ever would, but have seen others do it). 

Is there a stone I didn't turn over? 

King Boo

Do your funds cover the entry requirements for a Memory Care that also has an affiliated skilled nursing facility?

Example:   MC requires 3 years of care; after which they take the resident upon spend down (if nursing home ready) into their nursing home on Medicaid.

This is not feasible for all people, because there may not be such a facility close by with good quality care.  Or perhaps it's not a strategy at all because funds are limited.  

Has your other parent seen a Certified Elder Law Attorney (CELA) www.nelf.org.  This is important for the community spouse  (Your Mom) not to become destitute and to make sure that when LTC through Medicaid is applied for, all your documentation is in correct order.  Apply a day too early, can cost 5 years of care.  

Some states cover MC through Medicaid, others do not, only skilled nursing.  Your elder law attorney will know.

AConcernedSon

Yes we're working with an eldercare lawyer on requirements for Medicaid to skilled nursing down the road. I just hate that that seems to be the only solution. Which I know you all know too well.

eastofbeach

Are you blasting through your dads savings or your own families savings? From what I know, your dads savings would have had to have been low several years before his need of medicare paying for his help, so since he needs help now, it is good you are working with a lawyer, but he may not be able to change the laws in the way medicare works.

So, what would happen if you could no longer pay for this care for your dad if this is coming out of your savings? Wouldn't it seem the state would have to step up and find a place for your dad. It seems they would to me.

They can't just leave him out to dry, so to speak, they have social services for a reason, and they literally can't make you pay this for your dad, and the hospitals etc are great about guilting people and they have to step up and do their jobs. And then, there are waiting lists.

Stop and take a breath and don't put yourself into financial destruction here.

Here is what you say if they say your dad has to leave

"there is no safe place for him to move to"

They cannot do an unsafe discharge, but they will take all of your money before they tell you that.

Really sorry you are having to deal with this instead of being able to be able to take the time to grieve the loss of all this going on. I'm glad your mom is doing better not having to do so much. Take care.

HazeyMae

I just moved my father from Florida in April to an assisted living facility. No way could we afford a facility in Florida. Medicaid waiting list was years long. Dad is destitute. If it wasn't for the pandemic he would be living with either myself or my brother. Neither of us have suitable accommodations. I am working with a local senior agency, who helped me find where he resides. At no cost, because they were paid a finders fee. Anyways, the AL facility lowered the private pay requirement and took him knowing that when his savings ran out all he would have is his SS income. Once a resident always a resident they said. They will even apply for Medicaid on his behalf. Whew! Unfortunately, his situation is advancing, so we may be headed to memory care. So, we will go through the his funds quicker. Again, we lucked out. 

My aunt, who is in late stage alzheimers, is on hospice care. So, depending on what stage your LO is, maybe look into that? 

I wish you well! 

I truly can sympathize with you. 

AConcernedSon

Thanks for the input. It's so hard because I know there are options, but part of it comes down to the quality of the place. I've been to some "nursing homes" that scarred me for life--just not the kind of place I'd want to see him in but maybe I just need to research more and visit more.

AConcernedSon

Thanks. yes, the difference between "assisted living" and "memory care" is huge (2-3 times more) based on what I see here in the Boston area. Thanks for the input, though. In a lot of ways it's just good to know we're not alone--I mean, I know that, but hearing it from you guys helps.

Cynbar

I am also in Massachusetts, and it is true that Medicaid will not pay for memory care, and only infrequently for assisted living ( a few AL facilities do have a few Medicaid beds under the adult foster care program.) I find that the quality of skilled nursing facilities varies widely. Your best bet would be to seek out the best facility in your area, get him on the waitlist and allow enough time that he can go in as private pay. It can make a world of difference in gaining admittance to the most in-demand facilities. Of course, the less desirable ones always have openings and are more open to taking Medicaid patients. Good luck --- it can work out if you do your research and get him into the best place. Few people have the means to afford memory care for an extended period.

PS ---- I just want to add that his present facility cannot just "throw him out on the street." They have to make a safe discharge plan, but it would most likely be to one of the places that always has openings. Your gift to him now is being proactive and keeping control of the planning. 

AConcernedSon

THanks. Yes, his current facility has offered to help with transition and they're great--kept residents safe during COVID, and have great event. That's the hard part. I don't want him to leave.

MN Chickadee

I'm in the midwest and memory care is also three times the cost of AL. I would get to an elder law attorney for planning this move. This can help preserve the most for your mother and use assets to their best ability. The house is her biggest asset, don't do anything without legal advice. Entering a facility that eventually will take Medicaid with some of his funds in tact to private pay for a while will help. Many places will let the person stay if they have been private pay for a while, though it isn't always advertised. MA is a small state packed in the coast, are there any surrounding states where Medicaid covers MC? I'm in MN and it covers some services to keep people out of expensive SNFs like memory care assisted living and some in home care. My mother's "rent" is separated from her care costs in billing, and the Medicaid system pays for the care. Usually a person's retirement income pays the rent portion. Many facilities end up making less money in this arrangement, which is why they may require a person to be private pay for a while before allowing this benevolency. It's a waiver system to the regular Medicaid system. You might expand your search either way. If there is a quality facility that is an hour away that works financially it may be worth the hassle. And keep in mind your goals when evaluating. My mother's place is a bit worn, and it's easy to focus on the vegetative folks who are in stage 7 and would be vegetative no matter where they were. But upon closer evaluation I found a management team that cared, some adies who had been there long term, good food, an amazing activities person. It isn't perfect but it's fine. You don't mention what stage your dad is in but some of the amenities of fancier MC become obsolete with the later stages of Alz. It's so hard, I'm sorry you are faced with these decisions. Unfortunately it seems we never know if we did the right thing, there is always doubt and what ifs. We just do the best we can with the information and resources available.

AConcernedSon

Thanks for the thoughtful reply. I think just hearing from folks, there's no great answer helps with the guilt. I think the next step is researching some other facilities and at least get a sense for what's available, how different they are from pay out of pocket AL MC facilities.