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I look after my MIL who has Alzheimer's and she was diagnosed 5 years ago. She lives alone currently and has the past 5 years. I know she would qualify financially, information on financial qualifications are all over the internet and easy to find but nothing on whether a person qualifies medically. She used to be adamant that she was NOT going to a home, that people only put somebody in one of those places because they didn't want to fool with them. Well, now she's willing to go and talks about it a lot. Another family member says she wouldn't qualify. She's long had auditory hallucinations and occasional visual hallucinations. The doctor gave her something to help but she refuses to take it because it just knocks her out. She's to the point now where she's scared to stay by herself at night. If there was family available to either stay with her or have her stay with them, then I wouldn't even be posting this, as the arrangements would've already been made. What qualifies a person medically? Where can I find out this information? If she's scared to be alone then she shouldn't be. I just don't know where to start in helping her out of this.

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You need to discuss this with her Doctor. She may need to be evaluated by a Neurologist. Dementia/ALZ is a reason for longterm care.
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I totally understand your befuddlement. I was able to get my mom to go from being in IL to a NH and totally bypassing the AL phase. What we did was to go visit several NH and narrowed it down to a couple. The medical director of the NH also all had their own private practices as gerontologists. Two of them were also affiliated with the Health Science Center that Mom was already going to but not her gerontologist. Mom switched MD to the one affiliated with NH that was the likeliest to have an open bed. It took about 5 mos to get mom’s chart built out to show to be “at need”. Doctors office every 3 -4 weeks with active lab work. The appointment she had a bad H&H and 10% weight loss, he wrote orders for skilled nursing care needed. Got her moved into the NH within 5 weeks post.

MD who are medical director of NH know what needs to be in the chart to show at need for skilled for the assessment that the state caseworker will look at either as an on site review 1-on-1 with your mom or online reading of her health history.

For those living at home or in IL, they usually flat don’t have the fat health chart that say someone recently hospitalized & in rehab would. And these are what most NH admissions come from.... like 70%-80%, you know the scenario....they fall, go to ER, get surgery then discharge to rehab which is at a NH. Then after the first 20/21 days it’s determined they cannot return home do stay in the NH. The paperwork pipeline is in place for a Medicaid review. Plus everybody is happy as Medicare had paid for all till the point that they leave rehab. And rehab had pretty precisely tell you when they are going to stop “progressing “ so you can start finding the paperwork for LTC Medicaid admissions.

But for those with folks still at home or IL going about with dementia (mom had Lewy) kinda ok on ADLs but not at all ok on medication management & realistically not able to live on their own and not exactly solid enough for AL, your just going to have to work with a MD to get her chart to show need for NH level of care. good luck.
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anonymous806474 Nov 2018
When admitted to er they will do an assessment...happened with Dad,then they file papers get admitted to a NH waiting for Medicaid and Ltc..thats it the doctor prescribes patient needs 24 hour care.just had a suupleement in place for daily rate after th 21 days
And 2000 in yr bank account...or caregivers.
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You would need to talk with her doctor. A case worker in a nursing home would also help with the paperwork for Medicaid. There are 2 different types of Medicaid: one for the community and one for institutions. Both are different in what programs are offered but similar in medical requirements. A person is deemed medically necessary if they cannot perform tasks of daily living such as bathing, feeding, toileting or clothing themselves. Each state has their own set of requirements for Medicaid. Here in Texas we use 2-1-1 to find out more info. Hope this helps, good luck.
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anonymous806474 Nov 2018
My Dad was taken to hospital for confusion and a UTI,he was then assessed
and needing 24 hour care,,,that assessment is what you need..then the social workers at the hospital filled the Medicaid paperwork and I wanted dad to go into a NH, he needed the 20 day rehab, but afterwards I needed to pay
a daily rate until the Medicaid went through 2 mos. and taking 10,000 out of his account for a Funeral Trust...you can only have 2000 in your account to qualify for Medicaid...…...he also had 1850.00 per month to pay them from his social security and aid and attendance pension.
frankly it was at 7000 per month not cheap mostly you can only have 2000 in her account and otherwise its a spenddown....also if you have a supplemental it will cover the daily rate....we did not...a good supplemental
not just anyone...I never knew any of this until it was too late.....hindsight
could have brought him home after but then again it took so long to get to
Medicaid from Medicaid pending,,its still expensive look at your mothers
income.
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You would have to apply for it. A caseworker, not a doctor, will make the determination of what she’s eligible for through Medicaid . The programs vary from state to state.
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Take her to a neurologist specializing in AD, if she has not already established a relationship and treatment from one.
Only a medical doctor running tests can diagnose and treat AD, or other dementias. With the assistance of the medical professional, you and the practice can apply for Medicaid for your MIL. Then, you can find a memory care live in facility that accepts Medicaid and can place her in the facility. Get started asap as this process may take months or years. Good Luck.
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I would begin with family doc. My daughter's dr. sent a referral to our local agency and it has changed my life. Because my daughter had taken a walk and gotten lost (911 call and the police and 60 minutes of terror later) we were in contact with the right people. Because she was already on Medicaid it helped so check and see if your LO is eligible for it. A call to the state or local Senior Services. Good Luck and be sure to take time out for yourself. Retired Nurse
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She was diagnosed by a neurologist 5 years ago. I'm thinking he isn't much help at all. I told him how scared she was and he was the one who prescribed Seroquel which she refuses to take. He asked if somebody could stay with her or she could stay with somebody but there's no one available every night. She's getting worse and is starting to get anxiety during the day as well, but hears things at night. She needs to be somewhere so she isn't alone, lonely and scared. I put in a call to her primary doctor but haven't heard back. I'm hoping he'll know which direction to point us in. We do let her sleep on our couch some(only space available)but that won't work long term. She also goes to stay with another family member once, sometimes twice a week.
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She will have to do a spendown when she applies for Medicaid as she only allowed to possess $2K in countable assets.
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