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She will be living with my sister. My sister works full time at a very demanding job and cannot afford to quit. When she gets home, she has more job-related work to do, and then must be able to unwind. My mother is a very demanding, harsh woman, and can do very, very little on her own. She has had constant falls, and has been in and out of physical therapy facilities more than she has been in her ALFS (2 ALFs since August 2018) Logistically, the other problem is that my sister is handicapped herself--she has a severe back injury and cannot physically assist Mom. Even if my sister were not injured, Mom complains constantly and berates people unless she is waited on instantly. Right now Mom is in an ALF and it appears they cannot properly meet her needs, so my sister's plan is to get in home care asap. I am just extremely worried that if we cannot get something around the clock, my sister will not be able to get her work done, or rest and rejuvenate in order to keep on getting up in the morning and going to work. I live 2 hours away and go out to see Mom as often as I can, and I will be working soon, out of financial necessity and in order to pay for medical care for the conditions I personally have. My sister and I are both in our 60s and due to our physical handicaps and need to work we cannot be caregivers. I believe Medicaid and related Medicaid waiver programs pay for round the clock care, and we have had so much trouble finding out how it works, even after using an attorney who gladly took our money and then ended up not helping at all with the dilemma we are in. Apparently, there is a 5-year "look back" period. I guess that means that after every last penny of Mom's money is spent on in home care, she'd have to wait 5 years to get in home care? What would we do then, once the well has run dry? She also has VA Health care, and from the agents I have spoken to, she can't get anything from them yet. I've spoken to agents from Elderly Affairs reps. but no one has been able to give us anything solid--besides referring us to ANOTHER attorney to help us figure out how to get medicaid eligibility--and I guess the first thing they ask for is $10,000!! So we are completely lost, and really afraid of what will happen to Mom if she outlives all of her savings!

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Short answer, no there is no affordable in home care. She (and you) likely would be better off in a Nursing home, it likely would cost less per day there than it would 24 hr care at home. Mom can pay them until her money runs out, then go on Medicaid.
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needtowashhair Jan 2020
That's the truth. Every once in a while I hire someone for a 9 hour shift. That 9 hours costs more than a day in a nursing home. And that's with a frugal option.
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Mstrbill is absolutely right. Your mother is the conductor and you and your sister are the orchestra playing, according to Mom, woefully off-key. She cannot behave in Assisted Living so your poor sister is charged with the task of finding what amounts to “bargain home care” for her. What makes you think that if you arrange home care for her she will change and become polite, accommodating and easy to get along with? Ain’t gonna happen. Why should she start behaving now and ruin her rep? You’ve spent a lot of money and time trying to figure this out. Spend the rest of this week telling Mom “this is the way it is, Karen.” You will no longer be the marionettes on the end of her strings. No more attorneys. No more fruitless, frantic research trying to find inexpensive home care. There is no such thing. Seriously. Would you want to do the sorts of things home health care workers do for cheap? I sure wouldn’t. As it is, we don’t pay good health aides nearly what they’re worth, which is their weight in gold.

Mom is no longer to be the little dictator over this small country of hers. She can “harsh” all she wants, but she’s there and she will stay there. You are grown women with lives and responsibilities of your own. Make sure she’s safe and taken care of and if she isn’t happy, she’s free to make her own arrangements.
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cherokeegrrl54 Jan 2020
Absolutely spot on!!!
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Could you get her on some form of medication to tone down her abusive behavior. I am afraid she clearly is her own worse enemy. It isn't easy finding the right caregiver for certain people and it sounds as though she will likely not be able to retain ones with her attitudes and your poor sister doesn't deserve this as you don't but at least you are more capable in life with possibly less injuries. My husband and I are in our 60's and have had a variety of health issues this past year that are ongoing. We are both in chronic pain. I have a mother in AL. I cannot imagine having her in my home and she is not rude or abusive. I hope you find a solution.
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Even if your mother was on Medicaid, Medicaid wouldn’t pay for round the clock caregivers. Not in Florida. They will not pay for 24/7 home care. It is cheaper to place her in a nursing home then pay for round the clock home care.

I think you are misunderstanding the 5 year look back. It doesn’t mean your mom has to wait 5 years after her money is gone before she can get Medicaid. The 5 year lookback means that when your mom applies for Medicaid, Medicaid is going to look back 5 years in to her finances, they are going to look at all her income, her money, her assets that she had during that time and see where it went, how it was spent. If it all went to her livings expenses and health care, she will get Medicaid right Away. But if she gifted large amounts, for example if she sold her home and gave each of her children $50,000, Medicaid is going to deny her and there will be a penalty period of several years before she can get Medicaid. Basically as long as your mom hasn’t given Away tens of thousands of dollars in the last 5 years, or given away any real estate, she should be able to go on Medicaid.

you and your sister need to toughen up and keep your mom in AL. Guess what? She’s going to act out in your sisters home and she’s going to keep falling. Keep her where she is. Neither of you is physically able to care for her. Again no entity is going to provide your mom with round the clock home care. Bring her home and your disabled sister will be providing hands on care and that is wrong. Just wrong. It’s best for all of you if your mom stays in a facility with a team of qualified physically able-bodied people taking care of her
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mgrace45 Jan 2020
Hi, thanks for the reply and what you said makes a great deal of sense. What I failed to mention--and this is a very important piece--the house is my MOM'S house, paid with MOM'S money, not my sister's. My sister has already talked about the plan with Mom, and promised a long time ago to never put Mom in a nursing home--a promise I told her she NEVER should have made. I never made such a promise, and I never would because I have no access to a crystal ball! What's sad is that the house is beautiful and Mom is looking forward to going there. And I don't think my sister will be able to handle it at all. I have expressed concerns many times that I think it would be too much for her (my sister) to handle.Unfortunately, she is one of those people who thinks she's right about everything, and she opens her mouth without thinking, and the damage is done. So I am not even sure there is a way out of this mess, except that I let her go through with her plan (as if I could stop her--she is power of attorney!) and let it all blow up on her--and then Mom ends up in a nursing home when all is said and done. And I did try telling her that putting Mom in a nursing home doesn't have to be an awful thing and it wouldn't make us awful daughters, especially if it's the only way for her to get the level of care she needs. I know it's hard to find a good one, but not impossible.
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What about AL is not meeting mom's needs? It frankly sounds like she needs Nursing Home care.

Call the local Area agency on Aging and get a "needs assessment done. Or ask the AL social worker if she can explain what mom needs, if not AL.

Home care is not the answer here. Geriatric psychiatry might be a way to get her to be a little less agitated and harsh.
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