Hello-I have been caregiving for my mom with dementia for 13 years now. She is at a point where she needs Memory Care. She was denied Medicaid. My sisters help on and off on weekends with no consistency. I am told I cannot force their help. Mom's dementia has become a safety issue for herself and my family. She is violent at times with my kids. She is mean to us but very sweet to everyone else. I told my two sisters everyone takes mom for a month giving the other two a two month respite. They refuse. We decided we would pay out of pocket. I did all the necessary paperwork needed by mom's doctor, It took three appointments. I had mom assessed for a facility my sisters found, I sold my big house for a smaller one to insure I could make my share of payment. Then on the day they were supposed to sign her in, they decided neither of them wanted the financial responsibility. So here I am, in a smaller house. Mom is sleeping on a couch living out of a suitcase. I am burned out. Does anyone know anything I can do to get mom the help she needs and deserves, or if there is anything I can do to force my siblings. Thank you
I don't understand the Medicaid system. My understanding is that the person who needs the care must go through all his/her assets down to $2or3,000. Then Medicaid kicks in to pay for the care.
You don't say your age. If you are too old to take care of her, or have health issues, perhaps you should call Adult Protective Services. If nothing else, they will get your lazy sisters involved.
Tell you what, call an attorney pronto. I don't know what state you are in.
Call for attorney recommendations:
National Academy of Elder Law Attorneys
https://www.naela.org/findlawyer
naela@naela.org
NAELA Council of Advanced Practitioners
1577 Spring Hill Rd., Suite 310
Vienna, VA 22182
703-942-5711
I have an excellent attorney in Colorado:
M. Carl Glatstein
Cicoa I think is the initials. In Indiana we call 211 hope they can help you
https://www.ncoa.org/national-institute-of-senior-centers/
https://www.ncoa.org/resources/
https://www.ncoa.org/public-policy-action/long-term-services-and-supports/
I've never looked into it before. Looks like some good info.
Now... if is was a facility that receives no state funding and is fully private...they do not have to take her and many do not want to deal with dementia patients. Have you contacted a social worker with your issues. If you are at the point of mental and physical exhaustion to the point of endangering yourself...this is not any good for anyone. I would contact an elderly care social worker, explain your dilemma and they can send you down the correct path. It might take some time, but they could get you started. Again, with what you have said...there is no way she would be denied.
I'm confused. If she goes into a NH, has no money, and gets less per month in "income" than her NH care would cost, why wouldn't medi____ pay the rest? Did she used to have money and it was spent in ways that do not qualify for the approved "spend down" from getting to having money to not having money? Like if she gave $10k to a friend or relative, that money would delay her being able to get assistance or would have to be paid back, IIRC.
Best of luck. You might want to talk with someone at a local NH to see how they can help you get mom to be their newest resident.
Already Miller Trust has been suggested multiple times and most if not all were followed up with NC (OP/mom's state) doesn't do Miller Trust AND mom has No, read that again N...O... assets, so there is nothing to spend down. Mom's income exceeds the state MEAGER Medicaid limit. As OP posted, too many people use legal means to "protect" their assets and then use Medicaid to pay their way, leaving those with real need SOL.
The secondary problem is that every state has different rules/coverages. It appears that NC Medicaid will cover NH IF you meet the low income requirement, but doesn't cover any kind of AL. Not everyone qualifies for NH (has to be a real need for specialized nursing care - dementia alone doesn't qualify for most if not all cases.) Various State's Medicaid might cover AL, but usually it is limited, there are few places who accept it and some places are probably not where you would want your LO to be!
Please try to skim through the answers before responding.
It sounds like you need a more professional Medicaid advisor.
My 2 sisters and I took turns taking care of mom from 3 months to a year. She passed away at an early age of 58 due to Diabetic complications. She lost her eyesight 5 yrs before passing.
Before we took care of her, She was so independent, hard working, loved all her grandkids. Her diabetes got bad and worse when my dad and her divorced. She was depressed.
My dad remarried and died at 72 due to brain tumor. I helped his second wife with my Dads care.
We never thought of putting our parent's in a nursing home. They took care of us when sleepless nights when we were born.
The ppl that write into this site are seeking answers & help because they have NOT abandoned their parent! Especially those that are dealing w/ parents age 75 + years...it’s harder!
If money for care is the problem..Apply for long term care medical. She will have a share of cost and my have to spend down for monthly care while in the facility. It is difficult to tell your mother where she must go...but you have to do it. To prolong this in your home you and the children will gradually change in your "tolerance" and will handle her out of "frustration" and my progress to anger. When she is in a facility there are Meds. that deal
with anxiety. You can visit daily or....she will know she still has you. You are both dealing with "loss". It is hard but she will adjust and you can have some level of peace in your home and family
Forget about the siblings. There is nothing you can do about them.
Forget about moving Mom to Assisted living/MC. Mom or you can't afford it. (you shouldn't be paying your money anyway unless you were rich enough where it wouldn't affect you or your future or future care).
DO try to get Mom into a skilled nursing facility. IF her Dr. judges she needs or meets that standard of care, Medicaid of LTC Medicaid will cover her, even though she makes too much for regular Medicaid. You will need the support of health care professionals for this. Start with her primary care Dr.
Mom needs to be out of your home ASAP. For her safety and your family's. You can go the take Mom to the hospital route if nothing else is working out for you. You tell them it is unsafe at home, which it is, and you will not be able to care for her. If you don't want to do that, then I would suggest you will need to call an authoritative agency (APS, CPS, Police) to help you.
Now don’t spend your money, spend hers down until she qualifies for Medicaid. You can use her money for someone to care for her to give you a respite or to take her to Bermuda.
Perhaps first see a lawyer ( with her money) to determine the laws of your State. Each State has it’s own laws regarding Medicaid.
Then find a nice place that will accept Medicaid and commit her.
You can visit her once a month, if you like.
And treat yourself to something nice. You deserve it.
Likewise, there is no real "mom money" to pay for a lawyer. OP will have to cover that expense to perhaps get some help in this situation.
Now don’t spend your money, spend hers down until she qualifies for Medicaid. You can use her money for someone to care for her to give you a respite or to take her to Bermuda.
in the meantime, see a lawyer ( with her money) to determine the laws of your State. Each State has it’s own laws regarding Medicaid.
Then find a nice place that will accept Medicaid and commit her.
You can visit her once a month, if you like.
And treat yourself to something nice. You deserve it.
I have only read the first few answers, but as your mother has no assets and only $1400 income, she in NO WAY, should NOT qualify for Medicaid Long Term Care. I work in this field, and although it does vary state to state, basically the income limit is approximately $2000 monthly. If she owned a home or a car, that would not count. But as you said, she has no assets. It may be expensive but seeking help for an elder care attorney could help get the process started more quickly. An alternative is to contact the Area Agency on Aging for your area. Google it. Call them .... they will help you file the paperwork for Medicaid LTC. It needs to be filled out very, very correctly.... and is many times difficult to understand to try to do it on your own. It can take a long time to get onboard and in the meantime, if you need to get your mom out sooner, what Alvadeer posted at the beginning is the BEST and "only" way of getting things done RIGHT NOW.
If you won't think of yourself, then do it for your children. You have given of yourself for a very long time. It is now time for you to have the help of LTC so that you can still have a life, and your mother will receive care. Be strong. Do it now, so you can still live.
Not in NC, at least not on their main web page, however the site is geared more for getting insurance - I poked around but could not get any information as to what the LTC max income was - everything points back to the $1,040 listed. The only thing I could find is that they will "evaluate" your. The 2k you refer to is generally the maximum amount of assets you can have each month - mom has NO assets, no house, nothing but pension and SS.
Given that OP has applied and it was denied based on mom's income, it would appear that the $1,040 listed on the page applies for LTC as well?
National Academy of Elder Law Attorneys
https://www.naela.org/findlawyer
naela@naela.org
NAELA Council of Advanced Practitioners
1577 Spring Hill Rd., Suite 310
Vienna, VA 22182
703-942-5711
naela@naela.org
Personal recommendation in Colorado:
M. Carl Glatstein
Glatstein & O'Brien LLP
I found the following on the North Carolina Medicaid website. Look at what it says for the “medically needy”, which I assume your mother is. Yes, NC Medicaid will pay for a nursing home for your mother. They require you to pay what you can, then they cover the rest. She will get to keep $30.00 per month for personal needs.
I found this information on my first Google search. Have you contacted Medicaid yet? Please let us know. You sounded so desperate.
Income Limitations – The applicant’s income must be less than the cost of care in the facility at the Medicaid rate of pay. Medicaid must approve the level of care requested and the applicant must use part of their income to pay for care services. North Carolina calls this “patient monthly liability.” If single, but not medically needy, the applicant’s monthly income (wages, Social Security benefits, pensions, veteran’s benefits, annuities, SSI payments, IRAs, etc.) must be no higher than 100% the Federal Poverty Rate. If medically needy, however, Medicaid will pay all long term care costs exceeding the applicant’s countable monthly income. Income that is not considered countable includes a personal needs allowance ($30.00/month per individual); health insurance premiums and medical expenses not covered by insurance or other benefits; certain spousal or dependent family members’ allowance; and a home maintenance allowance if the long term care recipient expects to return home within six months, but there is no one living in the home.
Many EC attorneys offer an initial free consult. Try some others - not just a regular attorney, but those who only do elder care. Perhaps there is one out there who could guide you, rather than just telling you what isn't available to you for help.
Referring back to the link I posted, part of the problem is this:
"President Barack Obama’s health care law moved to standardize Medicaid requirements, specifically so any American making up to 133% of the poverty line could qualify. But that provision was challenged and overturned by the Supreme Court. States could expand Medicaid, but they no longer had to. Thirty-three states (plus Washington, D.C.) did; 18 didn’t. And eligibility across states has gotten even more diversified since the Trump administration announced it would allow states to impose work requirements for low-income and needy Americans receiving Medicaid."
Apparently NC is one of those states that suck in that the article says: "The state has not expanded Medicaid to cover all needy adults."
I took a minute to do some lookup out of curiousity. Wow, is NC cheap or what? WHO could live ANYWHERE for $1,005/month??? That was the limit I saw listed in the following (this link lists ALL states, updated 9/2/19, so could be useful to many of you):
For ANYONE:
https://www.policygenius.com/blog/a-state-by-state-guide-to-medicaid/
This provides a lot of information AND includes (as of 9/2/19) requirements by state. Check it out.
For NC, OP's home state:
"Income requirements: For the aged, blind or disabled, or caretakers of someone with those characteristics, your income must be within 100% of the FPL — $1,005 per month for a one-person household,"
How ANYONE believes 1k/month would cover LTC is beyond belief! Even the amount OP's mom has for income is not going to cover LTC. It wouldn't even cover expenses to live under a bridge or in a cardboard box! WHAT are they (government who makes these decisions) thinking and/or what rock do they live under???
P.S. reminder to all - mom has NO assets, so there is no "spend down" AND OP stated Miller Trust is not an option in NC.
My mom was in a very nice facility for $2900/mo. Fortunately, her assets did hold out until she died so we never had to address filing for Medicaid.
Another option, find her a senior apartment, maybe one that accepts HUD payments.
OPs mom brings in $1400 month from SS and a pension. OP has her own children and retirement to think of. Making up the difference is a bad idea.
Also, another comment you made talks about spend down, etc. OP's mom has no assets to spend down - rejection was because mom's income (gross) is over the Medicaid limit in NC.