What to do if Mom isn't approved for Medicaid for AL?

Ok, well I just found out that if you go that route documenting all these issues, then that might get your parent into memory care and I found out that in some facilities Medicaid is not accepted for memory care. If they get approved by Medicaid for assisted living then they are usually approved when they are set up to receive a level of care, which would be assistance with bathing, dressing, etc. So confusing and mentally exhausting. I just pray it works out for everyone including my mom. I'd hate to move her and she is very happy in AL. She really loves it there.

I felt the need to share what information I have found out so far. I called several places and finally out of frustration tried one more state # and I got a hold of the most helpful informative person in the world! Maybe God is helping me!! First off I reside in NJ. The person I spoke to works for Caregiver Services for the State of NJ. She basically stated that even if mom is still capable of bathing, walking, and good with hygiene, she could still be eligible and approved by Medicaid for assisted living. She explained that I need to make sure the home is reporting all her abnormal behaviors and incidents quarterly and to make sure I get copies. They also recommended finding out exactly what form of dementia she has. I was told by her PCP that she has dementia of the alzheimers type. Is that a correct form?? Any way they also said to have her get a geriatric assessment at one of the hospitals that have geriatric assessment units. She said if I make sure all this is done, then she should be approved. So, I emailed the AL facility to see if they will cooperate with this requirement and am waiting to speak to someone. For example: they need to report any falls, confusion, emotional outbursts, arguments, refusing to take meds or asking for meds when she already took them, what she's like without activities, etc. I hope in some small way, I have helped someone out there who is worried about this as well as this woman from the state made me feel so much better! I couldn't thank her enough!! She is a godsend!!

You could start with the general information number. The last time I took my mom to the ER they sent a rep to me there, so maybe the ER dept? Then there is always the Office of Aging you can contact in your state. I was going by what the rep told me in the hospital so I suppose that there are some AL places that assist you with the Medicaid step. I thought your Mom was in an Independent Living situation. (sorry, maybe read too fast thru) Anyway, here is a link to the type of AL group home you may be able to find in your state, I visited this one and the manager was very helpful with information. baltimoreassistedliving

Thanks Francis! Who would I ask to speak to at the local hospital?? Mom is currently residing in an AL facility. So, you are saying the AL facility usually tries to push through Medicaid? The AL facility my mom is in basically just said they have no control over it and it's not up to them.

Hi Trinity - you may also want to check in with the local hospitals because they are becoming more aware of alz needs and some have reps from AL's to come to the hospital to talk with you or of course give you phone numbers to call. Perhaps you can go ahead and get online and research some AL places and they can guide you. Once you are in one of those, the establishments are able to push thru the Medicaid issue and get their money. There are also now group homes (less expensive) you could research, some will accept your mom with private pay, you could explain the situation, how much she has left, etc,. and some of these homes are set up to receive Medicaid and will not force your parent out.

She is currently taking Aricept which has helped and she sees a neurologist, but not a psychiatrist. Thing is if she isn't living at AL, and if she lived in her own home, she would have episodes again b/c she refuses to be alone. And, if I were to take her into my home, I would have to work, so that won't work and our last aide quit, so AL is the only hope. I wonder what children do if they refuse to take the parent in after their funds are exhausted. What happens to the parent? How would I obtain a copy of the Medicaid laws?

Independent living is for folks with no needs. No medication management, need to be able to be independent for all things. I don't know about new Medicaid laws, I would ask for a copy. There may be regs about needing not to be independent for one or more ADLs. Two years is a long time in the life of a dementia patient.

Has she been seen by a geriatric psychiatrist to see if, on meds, she would be less volatile and paranoid?

I did just call the AL facility and they do not have a Social Worker.

I also asked the Director what happens when a resident exhausts all funds and the family cannot take them in and they didn't really have an answer for me other than that the family usually takes them into their home, which I cannot do.

I thought independent living was sort of the same as AL. What's the difference? My mom needs AL for medication management and she used to fall a lot at home, so it wasn't safe for her to be home by herself. We couldn't keep an aide and my brother was stealing from her, so we had to get her out of the situation and into a safe monitored environment. She can't keep track of her own bills, never knows what day it is, can't keep track of doctor appts, requires medication management as she can't keep track of it, can no longer drive, memory issues, makes up wild stories, etc. I'm not sure they have a social worker at the AL facility, but I did talk to the Director there and they said with the new Medicaid laws, they are not sure if she will be approved just for the reasons I list above, b/c she is still good with bathing, walking, etc.

I guess the thing to look at is what made AL and not an Independent Living facility necessary for your mom. You probably can relieve your anxieties by talking to the social worker at mom's AL. Don't forget, no one can force you to care for your mom.

Hi igloo572...thanks for responding. Mom is on year 3 of the 5 year look back. She is on a waiting list for a Medicaid approved bed at this time. She is currently privately paying and will be on her 2nd year of private pay in January 2016. I am more concerned and worried if she will even qualify medically to stay in AL by Medicaid. We cannot afford to keep her there otherwise and I was just wondering what happens to those who cannot stay in AL due to not being approved by Medicaid and AL being too expensive otherwise. She cannot live with me as her dementia and narcissism are too bad and her dementia makes her lose it if she doesn't have constant attention 24/7 and that is something I alone cannot provide, plus I have to worry about her wondering and getting in strangers cars or letting strangers in the house, it's just too much to handle and I have to work. We had an aide come to help her when she lived in her own house, but the aide would call me all day b/c she too couldn't handle it and eventually quit.

Is your ? more one of there is a worry about something financial in the 5 year lookback that could be a issue - so that there was $ gifted or transferred that will make her ineligible for Medicaid?

OR is your ? more about if she will be one of the ones to get a Medicaid waiver for one of the beds at the AL that are a Medicaid bed? Often for AL, they participate in the waiver but have it such that you private pay for a period of time (like 2 years) and they basically work your way up/pay your way up to getting one of the waiver beds.

Or is it more of worry that mom will qualify medically for being in an AL? For AL that seems to be very flexible (well compared to the providing health history to show the need of skilled nursing care in a NH).

Which is it??? as they are all very different set of concerns.