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PamelaR Asked May 2016

How do you get someone into assisted living when you can't afford it?

Mom won't take her meds. For years, my sister Vanessa and I have had trouble getting Mom, who has heart disease and diabetes, to take her medications. Vanessa lives 500 miles away and I'm taking care of her right now because she had major surgery a few days ago. I knew Mom wouldn't take her meds while I was away, so I hired someone to come in twice a day and see that she took them. Mom resents me going away, so she stopped eating. Now she's in the hospital because her blood sugar is all over the place. Vanessa and I agree that she needs to be in assisted living, but she can't afford it. My sister and I can't afford it for her, either. We applied to the VA for assistance because our stepfather was a WWII vet, but the VA turned us down. I'm going to talk to the County Senior Services, but would appreciate getting any advice you have to offer. How do you get someone into assisted living when you can't afford it?

igloo572 May 2016
The central issue will be just how the state your mom lives in has decided to do their medicaid waivers. Medicaid as originally place into law in the 1960's was for dedicated funding for skilled nursing care in a NH for those financially & medically "at need". Each states administers its Medicaid program uniquely but within overall federal guidelines. Some states use the waiver option to pay for AL, some states do not. Since it's a waiver program, funding can change over time, so some AL will not participate in Medicaid waivers at all or will have just a few beds within the facility that are.

imho One of the reasons why you hear that the AL will take them as Medicaid after 2 years of private pay, is that the AL kinda knows that some of the residents will die or will move to another place closer to son/daughter or will instead need a NH so it's a safe bet that there will be a Medicaid bed or two open a couple of years later.

If you find after visiting 3 or 4 places that you seem to be striking out on AL Medicaid immediately available beds & that can provide the care your mom needs, I'd suggest you approach this differently and look to getting your mom into a NH. Short of mom going into a hospital and discharged to a NH for "rehab", you are going to have to have mom get her health care chart to show the need for skilled nursing care. I'm somewhat surprised that your mom wasn't discharged to a facility after her recent surgery…..was that ever an option? Yiur mom already has some pretty serious diagnosis already, it could be that mom just needs her chart tweaked to show to be "at need". She is going to have some post-srugery follow up MD appointments, I'd ask point blank if any of these docs will write her orders to show she's "at-need" for skilled care. If that doesn't work, all NH have an MD who is the medical director. Most of these also have their own private gerontology practice & they know how a chart need to read to show "need". For my mom, I moved her from IL to NH and bypassed the AL stage, & it took about 5 mos of every 4 - 6 weeks of visits to get the chart history established & the visit where she had a bad H&H labs and 10% weight loss, doc wrote order for skilled. Your mom already has a lot going on in her chart so maybe she could get orders written
sooner.

While you have downtime (lol!) start to look for the documentation required for Medicaid for the financial aspect as well. If an AL takes Medicaid waiver, they should have a list of what's needed. Ditto for NH taking Medicaid. It's going to be quite a few items but totally do-able if mom has been somewhat organized in her financial life and you can put on your best Nancy Drew as well. Good luck and try not to become yourself overwhelmed.

pamstegma May 2016
Assisted Living will help find the financial benefits. Go on some tours. Be sure you have a clear picture of why the VA turned her down. Be sure you know what assets she has and what she did with her money for the last 5 years. VA does a five year look back, same as Medicaid.

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Sunnygirl1 May 2016
Oh, I wanted to add that some states provide funds for those in need who meet the financial requirements. You might also locate a place and ask their Admissions office where to apply. They should be able to point you in the right direction.

Sunnygirl1 May 2016
Different states vary on Assisted Living. NY has something called ALP or Assisted Living Programs. There should be someone with your Counsel on Aging or Social Services agency to help you apply for her to see if she qualifies financially and meets their criteria for need. You can also research ALP in NY locate help or something like that.

I don't know much about the Veterans benefits you have applied for. I know that in NC when I was trying to find my cousin a place in Assisted Living, most of them asked me if she had military background. I'd pursue that further.

cwillie May 2016
Pam, I'm going to reply and bump your post back up to the top of the list. I'm not in the USA, but from reading other questions I know there are some ALs that will accept Medicaid, depending on where you live. It is often recommended that it will be easier to get into these facilities if you can find the funds to private pay for a period before applying.
I have also read of others who were turned down by the VA but ultimately were able to secure funds after reapplying. It helps if you can find someone to walk you through the process.

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