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.
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.
https://portal.ct.gov/DSS/Health-And-Home-Care/Connecticut-Home-Care-Program-for-Elders/Connecticut-Home-Care-Program-for-Elders-CHCPE
I agree that you’ll need to consult an elder law professional familiar with your state program and how it interacts with Medicaid.
I am concerned that even if she qualifies for both, they still won’t cover 98 in home hours a week, but it seems likely that they would cover facility care.
I believe Mstrbill is correct. I found the same thing in MA in my research, at least for the waiver program for care at home. My dad would qualify based on his income but mom is about $300 per month over. I asked well then what happens to mom and the SHINE counselor (they are specialists in Medicare and Medicaid programs for care) and she said nursing home. Outside of state elder services that have the copays (and as you noted not 14 hours of care daily) it has to be private pay or nursing home covered by medicaid. Care at home is out of range for those above the income caps. So mom would have to go to a nursing home with a medicaid bed if her needs were too great for the PACE program. With PACE, where she could get more services, she'd have to change to their doctors as well.
It's all still pretty confusing to me but trying to get more versed in it while I have a "window".
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.
I agree with Barb, see a Medicaid planner or Elder Lawyer who is well versed in Medicaid. I looked it up and doesn't look like they allow a Miller Trust or Qualifying Income Trust. I also could not find an income limit only says has to be less than the cost of the nursing home. Here is the article:
https://www.medicaidplanningassistance.org/medicaid-eligibility-connecticut/
I don't think that you will find any help with paying for 14 hours of in-home care. I think that placement may be necessary. In that event all of mom's income, whatever it is, will go to her care facility once her assets are spent down, and then the combined Federal/State medicaid will take on the rest.
I think that you should see an elder law attorney or a Licensed Social Worker in order to ascertain exact income, exact assets, your state's Medicaid options and help with application to Medicaid. The taxpayer supported programs don't really support in home care in most cases at this stage, though with, an aging population, laws are always changing.
As laws vary greatly according to states you need good guidance here. Paying for it is one (sad) way to spend down.
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.
Plus, no one has a crystal ball and can tell the future. Situations change and we must adapt accordingly.
Discussions about growing old are important to have before we get old. It would avoid so much stress, confusion and headaches.
I have told my children that I don’t want them to be caring for me because I want them to live their own lives. If I need to be in a facility at some point, so be it. I never want them to be stressed like I was with my mom.
To get him on Medicaid I had to spend down his finances to where he was under the $2000 that Medicaid allows someone to have. Once I did that I got him onto Medicaid. With Medicaid his social security all but $50 goes to the nursing home and his pension goes to the nursing home. That $50 is suppose to supply them with some of the special needs they want because the nursing home supplies everything the will need.
I can understand you promised her but there is a time when you have to figure it out if you can take care of her. You need to think of her not her wishes. If you can't then the best place for her is in memory care at a nursing home they really take care of someone there. You can make it out that she has things from her house or bedroom there where its comfortable where they recognize their things that is what we did with my BIL. He has his recliner, his tv, his hats on the wall, and his ottoman. Also he has his bedding there too.
Prayers you find a way
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.
If you have never actually applied, the Medicaid office can only give you information based on the general population without taking all your facts in consideration. You may be denying yourself of valuable benefits when the agency may have approved the application. We missed out on SS and VA benefits because we did not apply as soon as we could have have based on what we "knew" by listening to others experiences.
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.
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
Good luck to you.
Google, "medicaid accepted assisted living near hamden CT."
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!