Help With Checking for Dementia
Feeling a little overwhelmed recently. I go every couple of days to check on my in laws (my husband works a demanding job and he’s drowning in everything all at once), but the home isn't taking very good care of them. We keep reminding them they cannot rely on my mil to feed or give my fil his medicine. She can't see well anymore so food will be left on my fil and sugar ants will cover him. She also won't be able to remember if she fed him or not so we can't trust if he was fed or not. Just all around hard situation as it seems to just be getting progressively worse just within the last year. They lost their house last year because my mil forgot to keep paying the mortgage (6mths behind). They've been in the home a year, but my husband is looking into better care possibly through Medicaid for a nursing home. We are aware they need better care, but are trying hard to figure out what to do. They would have to be separated since she’ll more than likely need MC and he’s a paraplegic needing to be fed, etc. She currently doesn't have Medicaid, but my fil does. My husband has POA for finances, but hasn’t had a chance to do DPOA. Any caring & kind advice is very welcome!
Comments
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so sorry about your MIL. Yes she needs to be in memory care immediately and they will need to be separated. Could you find a facility that has both MC & SNF? I would have your husband see an elder care attorney immediately to find out about Medicaid for her. It varies by state. He also needs a Medical POA for each parent.
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Thank you, yes, we’re in the process of looking into it, but my husband is about to get out of a turnaround with his operations job (14 days on 1 day off for 2 months) so I’ve been trying to check in on them every other day or so while he is unable. Unfortunately, I’ve heard some not so good things about those few facilities we have here so I’m not feeling great about it. We’ve been highly disappointed with the care they’re getting at the AL facility. We need to get her approved for disability before trying to get her approved for Medicaid. She should be approved, but if not, we simply don’t have the money to pay out of pocket for MC. The only reason they’ve been able to live in this facility is because both of their social security checks go completely to the home. We’re paying out of pocket for essentials so it’s already becoming hard with finances. My fil should be approved and placed in a nursing home with Medicaid, but not sure how it’ll work out for my mil. I’ll tell my husband about contacting an elder care attorney, but not sure how much that costs. As far as testing goes, what can we ask the doctor to do? PET scan vs MRI? I’ve heard also about a short question test versus long question test.
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I think the short set of questions is just to determine if any additional testing needs to be done. My mom did just fine on the short test, but I insisted on a referral to a neurologist. They did 2 hours of questioning and said she should not drive and was not able to live alone! So I wouldn’t put much into that short test. From there they ordered blood work and a scan of some sort to narrow down the type of dementia. It can take months to get into a neurologist. I would not wait for a diagnosis to get their living situation figured out! I’m no expert, but I’m kind of confused at why your fil would qualify for Medicaid but not your mil. I’m also a bit confused about disability for your mil. How old is she? I guess I think of disability being for a working age person. Does your husband have a durable power of attorney? This is very important. He may run into problems without it. I will attach a link about Medicaid that might be helpful. I will also attach the dbat. If you have looked around at all on this site you have probably already seen it. This is what caregivers use when discussing stages. Most doctors use the 3 stage model. My options for nursing homes were horrible. We live in a rural area. I found something nice, but it’s an hour drive away. I hope something here helps.
https://www.medicaidplanningassistance.org/medicaid-eligibility-income-chart/2 -
You have been given good advice here. I have a few suggestions based on experience with loved ones in memory care facilities: Make sure that there are written orders in their files that they are to be feed every meal. Any other assistance that is needed should be written down in the file to be followed. You can report the facility to a state agency if the neglect continues. Meet with the director of the facility and make your points clear as far as what is expected for care and what will happen if these orders are not followed. Keep notes with dates and times of visits and any issues with care. In my experience, the threat of a report to a state agency was enough to get better care. Take pictures and videos of any evidence of abuse or neglect. Unfortunately, most Medicaid facilities are not good and have this lack of care. Check for bed sores. This is a problem in facilities where care is subpar.
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Yes, my mil’s doctor is already getting us into a neurologist he knows personally here so just waiting on that, but I know it can take time.
The reason I’m doubtful my mil can be approved for Medicaid is because since they were losing the house to foreclosure last year, my husband had to sell the house to pay off the mortgage. They were left with about $50k. He’s been using it for expenses for them and also started using it to pay for funeral costs up front so it’s not difficult later. I had read that Medicaid will look at the previous 5 years so wasn’t sure if that would change anything for her to apply. The money is going quickly with everything so really they have no assets other than a small sum of money left for medical expenses. She’s only 63, turning 64 this summer so that’s when she’ll be eligible to apply. She should be able to get disability because she can’t see at all, before they lost the house she would still drive, which is a miracle she never got into an accident. My husband ended up telling her she can’t drive anymore (they don’t have a car anymore now anyway), but she can also barely walk and has to use a walker. I feel on her eyesight alone, she should be able to get disability. She has withered away the past couple of years, her diabetes has just taken over since she doesn’t take care of herself with what she eats.
He only has Financial POA for now, but is looking to get Medical as well. I’ll share the DBAT, I have been seeing DPOA term on this site but had never heard of either of those before. Thanks for sharing!
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That’s a good idea for written orders, I was actually wondering if they can write it in a file if they have one for them. I wasn’t sure how that all works. I did tell my husband recently, with all the “balls” the facility has been dropping lately, that we should get the director involved so she’s aware of the carelessness and can hold the workers accountable. My in-law’s have a spiral notebook on their kitchen counter that everyone is supposed to be filling out daily for meds, catheter empties, meals given, etc. but many have not been doing it for much of the day so we can never be sure my fil has eaten because we can’t trust my mil’s word because she’ll forget or lie unknowingly. We understand it’s not her fault, but still not trustworthy. So that’s the current situation.
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Does anyone know if it’s dementia related for laughing at inappropriate times? My husband and sil will be trying to have a serious conversation with her about the man she’s seeing (not her husband), etc. and she’ll just get this big smile and laugh about it while continuing to“lie.” I understand the lying isn’t actual lying and confabulation. Just wasn’t sure about the laughing/ smiling part.
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Yes, inappropriate laughing and/or crying are not uncommon behaviors for PWD
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Be very careful spending down in an effort to qualify for Medicaid. In my state there is a 5 year look back. Mom was advised by her lawyer to do a prepaid funeral. I was very worried when I applied for mom. Early on before she was diagnosed she had been taking $400-$600 cash out every week(I paid all her bills). I believe she was giving the money to a dead beat niece. I was so worried it would disqualify her. They had told me large gifts or unexplained large cash withdrawals could disqualify her. We got lucky. If he sees a lawyer about a medical poa, it might be best to ask about how he can safely spend the money down. He might also want to consider a living will, if she is able. From your description it might be too late for her to sign legal documents.
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Yes, my husband has been paying on both his parent’s funerals ahead of time recently. So that’s taking a big chunk. I’m worried about the $8k that he used for them to pay off his little sister’s car. His mom had wrecked it a couple of times and it was in bad shape. My sil couldn’t afford (she’s early 20’s) to get it fixed and then she found out she was pregnant last February so my husband thought it only right for them to pay to get it fixed. He did ask his mom and dad first, which they agreed. Just not sure it’ll pass for Medicaid criteria. He’s also been using it for medical exepenses, which are ongoing especially with her starting the process to get a diagnoses for dementia. So he said there’s not much left, I think maybe $20k or so (started with around $50k), but with paying off the funeral costs, it’ll probably go quickly. He already has POA, but he should definitely find out those things. Thankfully, she’s still in somewhat okay state of mind to where she’ll do whatever my husband asks is needed for their care. So he can still get her to sign things if he sees fit.
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Commonly Used Abbreviations
DH = Dear Husband
DW= Dear Wife, Darling Wife
LO = Loved One
ES = Early Stage
EO = Early Onset
FTD = Frontotemporal Dementia
VD = Vascular Dementia
MC = Memory Care
AL = Assisted Living
POA = Power of Attorney
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