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My dad fell twice today because of dizziness. There's no assisted livings in my town that have Medicaid beds and he's not "bad" enough for a nursing home. Even if there was openings, he couldn't go because the facility would take his SS check and leave my mom with next to nothing to live on since the rent is so high. If my dad goes to a facility, my mom will have to go back to a nursing home that also has to accept Medicaid. I'm pressuring our social workers to get a move on with this Medicaid waiver program that pays for in-home health, but it's taking so long. I really truly believe that more home health will prevent a lot of these issues - mainly preventing the drinking that causes the dizziness. I don't know what to do. He refuses a hospital, and I can't make him go either. Just let him keep falling and calling 911 until we get more home health in there??

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Sorry, I don't know your family history but he is going to keep falling even in an AL or NH, what you need to do is work on the cause of the falls and how to deal with them after they have happened. If he is falling because of drinking then that needs to stop - does he understand that the alternative is that you will eventually put him into a facility? Has he had any PT and does he use a walker/rollator to help with his balance?

Once he falls who is picking him up; that is too much for most women to handle without help, some areas allow you to call fire or ems for assistance getting him up without having to transport to the hospital.
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If one spouse is on Medicaid they do not leave the other spouse indigent.
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AJ, do you 3 live together?
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AJ, may I ask, how is your Dad getting the alcohol? And how would a caregiver help Dad not to drink? Would that put the caregiver at a risk if your Dad was adamant about wanting alcohol?

I see from your profile, your parents are in their early 60's, both have issues with alcohol, so young to be going through this.
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i don't know who gets the alcohol but its not the caregivers. My parents never drink in front of caregivers. I talked to him and he said that he leaves his walker by the bathroom door instead of bringing it in with him, and that's where he fell today. i'm really hoping once he goes on Medicaid, goes to the doctor, and gets something for dizziness, and has a frequent presence of a caregiver, this will stop. My parents only drink when caregivers are not there, but if they're there more often this will slow down some.
No i don't live with my parents. I live 6 hours away.
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The dizziness could be from low blood pressure but also could be many other diagnosis. Do they own a BP machine? If so, can he use it?
Falls happen in the blink of an eye & can occur anywhere even with paid CG’s in the room.
Have you checked with the AL you want your dad to go to about the availability of a Medicaid bed? Even with a Medicaid waiver it may take a long time for a bed to be open.
I suggest thinking about a Plan B, in the event your father won’t get admitted to an AL due to Medicaid as the payor.
Be prepared as you are basically watching over both of your parents which can be a handful (as many here would agree).
Good luck! I know it’s hard when you live hours away from them as well.
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AJ,
You are so involved with every detail of your parents care, I was sure you were close by or even in the same house.

At 21, just living on your own is a feat. But managing your own life, plus both your parents affairs, problem solving, in this learn as we go challenge, and do it all from afar, is so impressive!

Now I know it doesn't mean a hill of beans whether some random lady, on a random web site is impressed. And that's so true. I just hope you know you're an amazing daughter, woman and caregiver! 👍💞🌷
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Medicaid will not take your parents assets if only one of them is on medicaid. They will not leave the spouse not on medicaid indigent. The social workers should have told you that. But in my experience, the social workers don't know what they are talking about when it comes to medicaid. You should see a medicaid lawyer for at least a consultation.

As for the dizziness, was it sudden onset? If so, has your dad been evaluated for BPPV? It's common in the elderly and is literally a 5 minute fix. It's easy to evaluate, you can even look for it yourself and then follow up with a health care provider.
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If he falls at home, he will fall at Assisted Living. Try to figure out if he's falling or fainting. Talk to the doctor. Get him to order home physical therapy/occuprational therapy.
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Hi aj,
I agree with the other posters. Medicaid will NOT leave your mother destitute.

Alcohol dehydrates the body. Your dad could be suffering from dehydration then falling from the dizziness it causes. Or, the alcohol could throw his balance off (that's why they stumble) and he falls.

I grew up with 2 alcoholics, so I understand the situation.

I'm sorry to say, your parents are not going to stop drinking just because there are more c/g's in the house. An alcoholic will find a way to get a drink. They are very resourceful.

I'm afraid that you'll probably have to let them make a mess of their lives because you have no power to make them stop drinking, move into a facility, accept caregivers help or anything else.

Unfortunately, your dad may fall and break a bone. He will be in the hospital then in rehab. Maybe he would need long-term care after that. This is IF he has a fracture.

It sounds like they would be better off in Assisted Living/Nursing Home. They would not be allowed to drink there. Your parents would need to be detoxed before moving to prevent going through withdrawal.

It is a very frustrating situation, to watch the demise of your parents and not be able to do anything about it.

Your profile says you have accepted the fact that they are alcoholics and you can distance yourself from their drama. Good, that's a hard lesson to learn. I'd suggest trying to do that.

A lot of times we want to "fix" things but we can't.

I'm sorry. It's such a waste.
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In my area ALs don't except Medicaid until you private pay for two years. Then they have to not have reached the % of Medicaid residents allowed. I doubt if they would take a practicing alcoholic. They are not equipped to deal with someone going thru withdrawal. Your parents need to want to stop and need professional care.
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okay sorry but it's not as simple as receiving professional help for alcoholism in south dakota when you have no money AND you've failed AA before. I hear this all the time and it's just disappointing to hear because it is just not that simple. there's no help for addicts here.
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AJ,
Are you sure dad's not drinking in secret? Like before he came out of the bathroom, he might well have had a bottle hidden in there.


I am a recovering alcoholic, and I had bottles stashed everywhere. Even in the toilet tank. I think the falling IS from drinking. And I believe you are denying the truth. You will run yourself ragged trying to work around it, but in the end, it will come front and center. Alcoholism always reveals itself.

What will you do when it's time to place them? They WILL get withdrawal sickness in a living facility. 

Hey, who knows, maybe then the center will send them for detox and treatment at one of those facilities you claim do not exist. Medicaid does cover addiction treatment.
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Who has told you that there is no Medicaid-covered alcohol treatment in South Dakota?
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The dizziness could be caused by dehydration. Possibly from the alcohol or it could be an electrolyte imbalance.
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Before the Medicaid Long Term Care (formerly waiver) kicks in, does he also have Medicare? Because he has had falls and dizziness, his PCP can order home health through Medicare and he would receive an RN and aides for an initial period of 8 weeks, and then if they would recertify him, that can be extended. That could help until LTC can kick in. Also, was he ever a Veteran? If so, you can check with the VA for benefits.

Ok, so I skimmed the question much too quickly and did not see about the alcohol.  The above still can apply but as someone else said, the aide care may only be a few hours /week.  I was married to an alcoholic in my second marriage.  I would drive him to the AA meeting and wait in the car for him until it was over.  Months later, I found out that he went in the front door and walked to the bar and drank and then came back to the meeting place and out the front door.  And hiding places for the alcohol?  I never knew there could be so many hiding places! Oh, and his daughter told me that when he lived with them, he would call a cab to go to the liquor store and deliver it to him.

I'm sure you really care about your parents, but at such a young age, it is good you moved away.  You must live your own life.  Your parents are still young in their 60's and have made their own choices and you may think you have to help them which is what I thought when I realized that my new husband was alcoholic.  But the day that I had the revelation that by trying to help him, I was essentially trying to "fix" him,  and no one can fix another. I moved away, divorced him, and 15 years later, know that that was the right decision.  Live your life, Young One, and pray for them and do good things in your life, but make it your life, because you are important, too!
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SueC tells it like it is. She paints a sad picture for you, explaining the limitations of what you can do. I am so very sorry. I wish you had more power to fix things. I think we pretty much all wish we had more power. You are a remarkable young woman and obviously a caring one. Take pride in your compassion. Take pride in your independence, in spite of a somewhat dysfunctional upbringing (assuming that alcohol interfered with "normal" family dynamics.)

As a society, we don't have a well-thought out plan and structure for taking care of the huge "baby boomer" stream that is living much longer than previous generations, and therefore experiencing much higher levels of chronic conditions. While your parents aren't in that demographic they are "competing" for resources with this bulge in the aging population. Some social workers are absolutely amazing while others are scarcely mediocre, but none of them can perform miracles and make resources appear where there are none. And as long as we as a society are in a cost-cutting mode, this is not likely to get better.

And while we try, as a society we are not very advanced in how to deal with chemical addictions.

This is a very frustrating situation, and my heart goes out to you. While there are limitations to what you can do to fix things for your parents, please take extra care of yourself! If the frustration gets overwhelming, consider counseling for yourself. If it helps, come here often to vent.
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This was me 7 yrs ago. I lived 5 hrs away from my parents and my dad kept falling in the house. My mother wasn’t telling me every time he fell, but I know she had to get the neighbors involved most of the time to get him off the floor. No way could he get up himself. Finally one day I was visiting and he fell going into the bathroom at midnight. He fell hard and cracked his skull against the tub. Because I was there, I insisted on calling the paramedics. They arrived and took him to the hospital for evaluation. I made sure I spoke to the doctor and the social worker the next day and explained about the amount of times he had been falling and that my mother was not calling for professional assistance. He had bruises all over him and the doctor referred him right away into a nursing home for rehab. After 21 days he came home. He was home for a short time and p/t was coming to the house. But soon after that all ended, my dad was falling again and my mother couldn’t handle him and wouldn’t handle him. He fell again and seriously injured himself and this time he went from the hospital to the nursing home again and he stayed. It was heart-breaking, but I lived too far away to be able to help them more. Everntually I had him transferred down to a NH near me because my mother wasn’t visiting him. My parents never planned for their older years and thought they would live forever in good physical shape. So the planning becomes the children’s job. Many of us are still working and raising families. We have to do the best we can under very difficult circumstances.
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Myownlife hit the nail on the head. My father, uncles, maternal grandmother, were all alcoholics. You cannot stop them from drinking. My grandmother, couldn't drive, she would have had people walking down the street get her booze if that was the only way to get it. By trying to get them to stop drinking, you are just beating your head against a brick wall. He will probably fight you every step of the way if you just try to get him to drink more water.

The best thing you can do for yourself is detach. Go to Al-Anon and get some help. There are all kinds of groups, if one doesn't fit try another. There are women's groups, singles groups, etc. If you were raised in an Alcoholic home, you need to get help anyway, because Alcohol is a family disease, meaning it affects everyone in the family, especially children. I not only went to AA, I got some professional counseling to help me.

Yes, you will probably just let him keep falling and calling 911, because that is all you can do.
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I think it’s easier for the doctor and social worker to sequay a patient into a NH right from the hospital. To try to get someone into a NH from their own home is very difficult.
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If he is a habitual alcoholic, that history could also cause damage to the part of the brain that controls balance. He should have a CT of his brain to confirm this. Sometimes, physical therapy can help.
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It's my experience that board and care facilities don't accept Medicaid. You might consider getting help from an elder law attorney who can help you navigate long term care via Medicaid. In California, a couple can split assets to preserve the assets so the surviving spouse can have something left when the first spouse dies.
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Also, you seem to be the responsible adult in the situation. Increasingly healthcare providers are referring seniors that aren't getting proper care to investigation for elder abuse. You might what to take action, before an investigation.
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Hi AJ,

I know how stressful your current situation can be. I have helped guide people in your situation for several years. There are some home care agencies that do accept Medicaid, they are just few and far between. I live in San Antonio and am in the senior living industry and know of only 4 the will take Medicaid but there are some out there. Another suggestion is a personal care home may be an option. A personal care home or PCH, is a private residences most often within a subdivision that offer personal care services, assistance and supervision to four or more persons. They offer a smaller, more intimate setting, ideal for persons who might not do well with the larger assisted living facilities. They typically provide meals, laundry, housekeeping, medication supervision, assistance with activities of daily living and activity programs at a more cost effective standpoint than a larger Assisted Living Community. There is also more one-on-one attention in a PCH. They are not often advertised and can be hard to find, once you know to search them out you can find them and take a few tours to see if it may be a solution to your situation. I hope this helped a little. Stay strong and make sure you continue to take care of yourself!
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He needs to seek out treatment for the alcohol in some manner, else he will keep being dizzy, IMHO.
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His wife would not be indigent.
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