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Also, it's worth pointing out that people who bother to come on the caregiving board are probably not the type to "dump" their parent just anywhere. Kathryn has described her mother's place as very nice, and others have too.
The person who described a horrible situation where the BIL put the mother in a 4 person home -- that situation may not even have been a regulated facility, and under the radar and scrutiny of laws and regulations and site audits etc.
My mother's nursing home is first-rate. And yes, she is on Medicaid. The caregivers are warm, caring and most have been there for a long time (turnover is so low that they actually do send-offs when people move on --its not common).
My father is over there every day and I am over there as much as I can to visit her and keep an eye on things and address medical things that come up (mom can't communicate so dad or I have to be consulted about things).
The staff has a policy to get people up and out of bed every day unless there is a medical reason not to or the patient refuses to be up. They don't let people languish and they have activities every that are voluntary for the residents.
The staff also takes care and respect for the patient very seriously..in fact one caregiver reported a fellow caregiver who she thought was deficient in her duties.
My father nor I would allow my precious mother to be anywhere less than high standard.
This.
My brother in law and sister in law placed her mom in a beautiful facility. She is on SS and Medicaid. She has her own apartment but her place is every bit as nice as my mom's place - and it's only costing her about half the price! (They are in a large metro area so they probably have more options and more competition.)
I do think they had to put her on a waiting list for a few months but she's in now and we visited her recently and she seemed to be very happily settled in.
Much happier than she was while living in their home and driving everyone (including herself) crazier by the day.
With the new proposed federal budget totally cutting out federal funds for Meals on Wheels, among other cuts to social programs which may affect seniors, "independent living" may become much more difficult.
The rational is that the state and local governments need to pick up the slack in funding, which will be very, very difficult for less affluent areas which are already strapped for funding.
My parents eventually found the MOW meals inedible due to lack of funding in their area, and felt it was not worth the money they were paying. How much will costs go up, I wonder.
This is not a political comment, just saying cuts to this program already has providers indicating the lack of federal money would severely dent their ability to continue the same level of service. Without meals being delivered, it will definitely change the circumstances of some seniors trying to remain in their homes.
I wish "the government" or "the administration" could understand that all these "minor services" add up to so little cost compared to full on nursing home care! Instead, it seems you must be entirely independent and pay for all your own services to stay that way...then the money runs out and you go from that, all the way to completely dependent and insanely expensive nursing home care paid for by Medicaid.
Aren't there studies showing how much more cost efficient it is to support intermediate care services? Or is it just easier to hack this stuff out of the budget? Why does everyone say "hands off" cutting these services or they'll vote whoever out and yet it STILL happens? Why are we not in more control of what our government does with our money? Is there no accountability whatsoever? okay...sorry the rant.
When my husband was first diagnosed with dementia, while he was still thinking clearly and rationally, years before the dementia really impacted his life he vowed that he would never "force our adult children to 'give up their entire lives' to care for him full time." He had seen this happen to relatives in my extended family. he even described it as being "mean and selfish" and not acting the way that a loving parent should act towards their children.
Because we openly and honestly discussed this while we were both of "sound mind" it make me feel so much better about our ongoing plans to place my husband in an assisted living facility since I am not able to care for him any more due to my cancer.
Of course, IMHO, there is a difference between temporary, short time help for a parent in case of accident, injury or a short term crisis but it is the long term, many years, if not several decades long caregiving that we plan to avoid for our children. Our daughter did move home for two years to help and our son is traveling back & forth numerous times from his career & family to help during this difficult time.
I am hoping that all of you, who are currently of "sound mind" are discussing your future plans with your spouses and relatives. And, I hope that you are doing your best to work towards financing those plans, too.
I had been so very, very worried that hubby would end up in a "hell hole" Medicaid paid facility but it is actually a very, top notch place. Our state does not rank assisted living facilities the same way that they rank nursing homes, but I really think that this place is a four or five stars out of five stars. I have friends who can pay the full freight and they have that this is their top choice off facility. I am not sure how hubby got in there. I think it was a combination of them having a vacancy right when we were looking, plus hubby is a pretty easy "patient" both work wise and temperament wise. Plus, it is "off the beaten track". It is on the outskirts of a nearby city, so it is not as convenient as many other facilities. But, for us/me the extra drive is worth it for a much better facility.
PS. Just to clarify, hubby won't be officially moved in for two weeks but I'm pretty sure that everything is all set.
Last edited by germaine2626; 03-18-2017 at 12:49 PM..
Reason: added PS
When my husband was first diagnosed with dementia, while he was still thinking clearly and rationally, years before the dementia really impacted his life he vowed that he would never "force our adult children to 'give up their entire lives' to care for him full time." He had seen this happen to relatives in my extended family. he even described it as being "mean and selfish" and not acting the way that a loving parent should act towards their children.
Because we openly and honestly discussed this while we were both of "sound mind" it make me feel so much better about our ongoing plans to place my husband in an assisted living facility since I am not able to care for him any more due to my cancer.
Of course, IMHO, there is a difference between temporary, short time help for a parent in case of accident, injury or a short term crisis but it is the long term, many years, if not several decades long caregiving that we plan to avoid for our children. Our daughter did move home for two years to help and our son is traveling back & forth numerous times from his career & family to help during this difficult time.
I am hoping that all of you, who are currently of "sound mind" are discussing your future plans with your spouses and relatives. And, I hope that you are doing your best to work towards financing those plans, too.
I had been so very, very worried that hubby would end up in a "hell hole" Medicaid paid facility but it is actually a very, top notch place. Our stare does not rank assisted living facilities the same way that they rank nursing homes, but I really think that this place is a four or five stars out of five stars. I have friends who can pay the full freight and they have that this is their top choice off facility. I am not sure how hubby got in there. I think it was a combination of them having a vacancy right when we were looking, plus hubby is a pretty easy "patient" both work wise and temperament wise. Plus, it is "off the beaten track". It is on the outskirts of a nearby city, so it is not as convenient as many other facilities. But, for us/me the extra drive is worth it for a much better facility.
I think you and your husband were very wise to talk about this and make plans. And I'm so glad that your husband was placed in a good facility! That should help a lot with your peace of mind, as well.
If a person is wealthy and uses paid help, it would especially be thought of as being independent. I wish DH and I were, because nobody in the family is going to do it.
This morning - before 8 am - I had already refilled my mom's prescriptions online, paid some of her bills, scanned legal documents in and written an email attaching them to the probate attorney, and before lunch today I am meeting with my mom's financial advisor about some sort of paperwork, filling out various forms, etc. Then this afternoon my brother and I are meeting the realtor at my mom's apartment to get her to sign the listing agreement for her house. I will have to fill out the extensive Sellers Disclosure Form. Then we're going over to the house to give the realtor the key, be sure it looks good for photos, etc.
Tuesday we took my mom to meet with the judge and the attorney at the probate court. Of course this also involved taking her out to eat and then going to the store for various things she needed.
Sunday we all met at church and then took her out to eat and to get her ubiquitous 4 dozen donut holes. She spilled nearly all the donut holes in the back seat and floorboard of my car, by the way. I got to clean all that up when I got home.
Last week my husband and I drove out of state to meet with appraisers for some property that needs to be sold. This coming week my brother and I are going up there to go through the house and barns to be sure we're not leaving behind something really valuable.
Oh, and also last week, when my husband and I drove six hours in one day, we also loaded up my vehicle with items that needed to be taken out of my mom's house and stored till my other brother can come get them (if he ever does - who knows?). Oh, and we also had to go by the bank and close an account in that town as well.
Next week, after I get back from out of state (again), I will take my mom to the dentist for her teeth cleaning. She is also complaining of swollen ankles and probably needs to go back to her doctor about that - we'll see how those ankles are next week.
Now keep in mind that my mother lives in a senior apartment with all her meals provided. No home maintenance and no laundry and yard work for me to do. So compared to many people on this forum, I've got it really easy.
But you know what - I had a full and interesting and busy life BEFORE the increasing demands of elder care bore down on me, starting about four years ago and reaching a deafening crescendo in October of this past year.
Yes, I always expected to pitch in and help my parents, and inlaws, in their elder years. I never did intend to go without vacations for years, cut a three day business trip short and drive 12 hours straight thru just because an elderly parent couldn't spend the night alone and no other family members would or could come stay with them, or actually have to quit my full time job - which was contributing to our retirement plan - in order to take care of elderly parents and inlaws.
I never did intend to move my parents' household FIVE TIMES IN FIVE YEARS because they kept thinking a new house would make them feel happy and excited again (the final move was to put my dad in the grave and my mom in a senior apartment complex).
I never did intend to finally end up in counseling - $100 a week - in order to relearn how to put my marriage and husband first and my parents' needs and demands further down the list.
I never did intend to have to manage my dad's estate and properties and try to piece together what he owns, the taxes, the various contracts and obligations, etc etc etc without his help - though apparently HE intended for me to do so (would have been nice to have had at least a heads' up on that and preferably a few tutorials).
I don't think either of my parents gave a second thought to what they were expecting from me. My mom still doesn't. A couple of weeks ago when I went by her apartment and was trying to discuss her listing her home (which of course she doesn't want to do, because that severs her last hope of "living independently"), she actually said to me - and she was totally serious - "OK, just to clarify...what exactly is it that you think you do for me?"
Kathryn, why don't you print out that post and the next time she asks what you do for her, you can just hand it to her. Probably ought to make several copies in case she forgets from time to time.
A lot of times Assisted Living is thrown about casually as an option.
Medicaid *in general* will not pay for the Room and Board (i.e. rent and food) portion of an assisted living facility. They might pay for some of the services, if they are medically oriented and would pay for those same services in the person's HOME.
So in order to go to an ALF, the person (or their family) has to be able to pay for it. For many places, that can be $3000+ a month. (Cheaper than a SNF (nursing home in the old language) but not "cheap"). There are many places that require a very expensive buy-in (which may be totally or partially refundable to the patient's family when the patient is no longer living in the ALF)
Selling the family home may provide sufficient costs, or not, depending on worth of home/whether it was paid off/ etc..
Just some additional clarification.
When someone must have services, but has no resources, Medicaid will pay for an ALF. The room might not be private though. In some states, ALFs are required to keep residents when they have exhausted their resources after paying monthly rent for a certain length of time, but their room might be shifted to a non private.
When someone must have services, but has no resources, Medicaid will pay for an ALF. The room might not be private though. In some states, ALFs are required to keep residents when they have exhausted their resources after paying monthly rent for a certain length of time, but their room might be shifted to a non private.
Different states have different laws about this.
Medicare does not pay for an ALF.
Hubby will be going into an advanced level of care assisted living facility soon (CBRF-Community Based Residential Facility) (and hopefully Medicaid will start soon, too). They said that while Medicaid does not pay for room & board, any money that the person has coming in from other sources like SS or a pension goes first to pay the "room & board" part of the bill.
Where he is going, Medicaid will only pay for a studio (450 sq. foot) apartment and not a one bedroom apartment (almost all of their apartments in that place are one bedroom, a few are even two bedroom -for married couples) and once you transition into Memory Care you will need to share a room (OMG, those rooms are so tiny that two twin beds, two small dressers and two night stands will barely fit inside, I'm not even sure that the rooms have a closet).
BTW, in my state there used to be a law (not always followed, but a law) that once you were in an assisted living facility (or nursing home) for two years as a private pay resident if you transferred to Medicaid AND the place had a vacant Medicaid bed they could not kick you out.
As a cost saving measure our governor spearheaded the change to the opposite a few years ago, even if you have been private pay for three years the CBRF/assisted living facility has the absolute right legally to kick you out if you run out of money and need to go on Medicaid. What a kick in the backside for someone who has paid in $144,000 to $216,000 (assuming the costs are $4,000 to $6,000 a month) to a facility and now run out of money.
So please check your states current laws and do not assume that something that was true a couple of years ago is true today.
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