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POA for 71 y/o mom who’s a widow with mid to late stage dementia who has too much income for Medicaid but not enough money for her home health aide needs (at least 14 hrs per day). She lives in a multi family home owned by her sister in law and only family lives in the home (my aunt and my siblings) I don’t live there I have a family and home of my own. Her assets are dwindling and are below Medicaid requirements but her monthly income is too high for Medicaid. Her care agency is expensive but going rate for CT and she is about to be unable to afford it. Agency on aging approved her for 36 hours of care 3 days a week but she still can’t afford to pay for the other 4 days. She needs 14 hours of care during the day and she gets up multiple times at night. All her kid’s work. We promised we would keep her home per her wishes but we can’t afford it she can’t afford it and we can’t afford nursing homes either. what do we do for the person stuck in the middle of the income bracket not poor enough and not rich enough.

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I’m beginning to think of this kind of family situation as a “false promise”.

When we love someone, we rashly but lovingly promise to assume care responsibilities for which we are totally uninformed and unprepared.

As our dearly loved family member descends into the reality of advancing dementia we slowly (or quickly) come to realize that we are in the fearful embrace of a “promise” which CANNOT FAIRLY BE KEPT, without sacrificing the welfare and resources of those by whom the promise was made.

Then realizing the consequences weeks months or years later, we slather ourselves in “guilt” because of the ambivalence caused by wanting to do the “right” thing, and at the same time meeting responsibilities to ourselves as caregivers AND other family members who are part of our social constellation.

And ALWAYS in this situation, we are confronted by the fact that there is no solution that can yield a “happy ending”.

I have told my children NOT to make their father or me CARE BASED PROMISES.
I DO NOT want them to bear any more emotional burdens than they can REASONABLY AFFORD without being aware of the REAL TIME CONSEQUENCES of care giving.

And I have told them that the promise NOT TO MAKE PROMISES is the only one I expect to be kept.
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Caregiverstress Apr 2023
Wise words. My father has never asked me to move home (opposite coast) and care for him and I have not offered. I know what will happen to my life if I do. If he ever asks, I will tell him I can’t this year and punt it down the road. I know if his body outlives his mind he will be placed in MC. I will never tell him that, but it’s the decision I have made for BOTH of us. I have chosen one that is nice and am looking for others as well. I love my father. I also know that giving up my life in my late 50’s will basically be a very early retirement that I can’t afford and do not want as I become his 24/7 caregiver. Can’t do it, won’t do it. Do I feel guilt sometimes? Of course I do. That’s normal. But kidding myself that I can do it and then watching my life go completely off the rails is IMO a worse fate than the feelings of guilt.
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I am an elder law attorney in Connecticut. I’ve heard this concern before that people are told they are over the income allowance and don’t qualify. Period. It’s heartbreaking to me when I hear that people are not given all of the facts that can help them. There is a program in Connecticut to work around the income problem. It’s a Pooled Trust. Please go to planofct.org and find an attorney on their list near you to contact to get a pooled trust and help get her qualified for the CT Homecare Program for Elders waiver program. It may not pay for the full 14 hours/day but it can help. ~Joan
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mstrbill Apr 2023
Thank you for that Joan. We see that a lot here where people mistakenly believe they or their loved one doesn't qualify or can't qualify for Medicaid. It is heartbreaking and frustrating people are misinformed.
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First of all no one should ever extort the promise from their familiy to "keep me out of a home". It is wrong and the very height of selfishness to ask this. No one should ask this of their children and no one should ever agree to it.
Most of the time families end up having to renege on that promise and there should be no shame or guilt in that. It should never have been asked in the first place.
What a disgusting society we live in when love and loyalty for our elderly family members is judged by how much debt we will take on to keep them out of a "home". Or how much we are willing to neglect our own lives, health, jobs, families, and selves in order to keep them out of the hands of managed care and professional staff in a care facility.
I think it's okay to refuse to make this promise, and if you have it's okay to renege on it.
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Breezy23 Apr 2023
I get what you are saying but it doesn't help or offer a solution to the poster.
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Laws must be changed. Contact your government representatives. That won’t help immediately, but all, and there are many in this situation, need to do this for long term changes to occur. My husband is in a similar bind as his SocSec is over State Medicaid limit. It’s just not fair that those in poverty get home health coverage, but those with a few dollars more, have to deplete all their assets and still won’t qualify for help.
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I had a similar situation with my father n law.He had no assets except a car and he made too much to qualify for Medicaid.He was diagnosed with dementia and he's 88.On faith filed for Medicaid and they accepted him,but they take all his pension and ss check, accept for 60 or 70 dollars. I'm ok with that because I know the memory care facility will take better care of him than I could.Ihope this post gives you some hope.
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S00lin Apr 2023
Except what happens if the SS check and pension is needed to pay the bills, ie utilities etc?
I can't afford to lose this monthly income that covers these bills. My SS check is not enough to cover my Dad's bills plus mine.
I ABSOLUTELY WILL NOT sell/give up my Dad's house and become homeless myself. I am 71 and single.
Medicaid WILL NOT get it!
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Alo, welcome.
Everyone wants to "age at home".

It's a very expensive thing to do and often not the best situation for the elder. Not much socialization and not enough eyes and hands for their care.

You need to see a Medicaid Planner or certified Elder Law attorney in her state. There are ways around the Medicaid income cap if mom is applying for Long Term Care Medicaid.

My mother did very well in a Nursing Home in Connecticut. Mom was private pay but they accepted Medicaid patients.
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If your mom needs 14 hours a day of aide care she really should be in managed care.
No one is turned away from a nursing home. In truth most people cannot afford to cash-pay for one for very long. The cost here in CT usually starts around $10,000 a month or more.
They will take her income and then she goes on Medicaid. Many times the nursing home a person goes to will do the Medicaid application.
It's very sad when a family is forced to make the promise that they will keep an elder at home. No one should ever ask this of their family.
Yes, you will have to renege on that promise. Don't have a moment of guilt about it because it should never have been asked of you.
In Connecticut there are constant advertisements for Hartford Health at Home. They claim to provide live-in care.
They're a huge operation. Give them a call they may be able to help with the Medicaid.
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There has to be an organization that can help. I'm not sure how In Home Supported Health Services IHSS functions regarding income brackets, but perhaps reaching out to them for guidance can help point you in the right direction.

I used to be a CNA in a sanitarium in my younger days. I thought I would never put my mother in one of those places, but if and when the time comes I'll have to weigh out the Pros & Con's.

Fast forward decades later, my mother is in her 80's, and her cognitive functions are dwindling. She makes bad decisions from her emotions (anger). Example giving a 30 day notice for her luxury Independent retirement home apartments.

Which left me scrambling to look for a place for her to rent. I found one with a lot of daily prayers at the last minute but that added anxiety and drama I don't need in my life.

She realizes she made a Big Mistake, she has mentioned it 4 times already. Why the Independent Retirement home didn't reach out to me is a mystery. I am her guarantor for those apartments.

I am her only adult child and family member. I am dealing with my own newly diagnosed health issues. Stress is one thing I don't need. Stress is something she can guarantee to give me.

She's not a kind person to me, nor is she grateful. She is more entitled with a Borderline and Narcissistic personality combined. (Not easy to deal with) It's always been her way or the highway and now that she's aging, it's worse.

She has adult tantrums when she doesn't get her way and pounds her fists on her legs. This frightens me when I'm driving.

She does not take my advice and ends up making more mistakes, I have to clean up again. I'm nowhere near being young but oddly she still sees me as an inexperienced "kid".

If she hears the same advice from a stranger, then that must be "good advice". I'm in a situation where she can't live with my wife and me due to space and cherishing my sanity.

I need to focus on myself and my health right now to get well. I don't feel well all the time, it's ebb and flow but I do my best to help her during this situation almost being homeless.

I believe it was divine intervention that helped, when there were only a few grains of sand left in the hourglass, the apartment I inquired about went from being taken to it falling through and being available again. (unbelievable)

I too felt guilty that I was unable to help move her items physically to a storage unit. My health would not permit it physically, not right now.

I know what it feels like to "feel" guilty but I also know I can't do it all, even if I want to. So I pray and ask for guidance, and things seem to fall into place. I can research and find resources when I am "feeling" good. There's always a way out of a long dark tunnel, keep moving and seeking the answer.

Do what you can with the resources you have (The Internet). If anything you can Research Resources out there and keep reaching out and asking questions. Good luck to all of you in a rough situation with an aging parent/s. Angel from The Bay
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StressedOut99 Apr 2023
So sorry you’re having to deal with this. I can relate as my spouse who is 85 has similar characteristics. I at 73, have worsening health problems myself and am often at ropes end dealing with his. It becomes so complicated because every State is different.
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My advice is to retain an eldercare attorney to help apply for Medicaid. A pooled trust may be the way to go. Don’t give up trying just yet.

Good luck to you.
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You’re understanding as your mom’s health issues worsen - you never should have promised her you’d keep her at home. You didn’t know it wasn’t possible! She didn’t know what a burden that promise would place on you.

Don’t feel guilty that you can’t keep the promise. Most people who make that promise to parents can’t follow through. She needs to be in a facility that can provide the level of care that she requires.
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