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KeepingStrong Asked August 2017

I may have no choice but to place my elderly mother in a care facility. What are my financial options?

We live in TN. My elderly mother has colon cancer, COPD, and some other physical ailments. Six months ago, she had a violent episode, spent two weeks in a psychiatric unit, and was diagnosed with Paranoid Personality Disorder. From there, I brought her to my home where she remains. I now have Conservatorship. Once I obtained that, I took my mother to a hospital with a senior care unit that specializes in diagnosis and treatment plans for folks with these types of issues. They diagnosed her with early Alzheimer's and she is now on Aricept, anxiety meds, and depression meds. Her behavior is much better! My father will not move in with me and continues to live in their rural home; I have his durable POA. He has hearing problems, memory problems, and I strongly suspect he also has mild dementia. I am an only child, single, with no children. For most of my adult life, I lived three hours away from my parents. I was fortunate enough to have a lucrative job during this time. Two and a half years ago, I left my home and moved back to my home town to care for my parents. I bought a house in our town large enough for the three of us, but have yet to sell my previous home; I do not have a mortgage on either house. I have incurred a lot of expenses due to this move and my mother's recent situation, and can no longer work because I am their sole caregiver. My mother needs 24/7 care and I handle all of my father's affairs, go to medical appointments with him, and do his housework. A stipulation of the conservatorship required me to separate my parent's funds. This resulted in my father not having enough income to cover his expenses. So, I supplement his income by about $1,000 per month. Neither of my parents is aware of this, and I don't want them to ever know. We recently received bad news; my mother's tumor is growing. External radiation is scheduled to commence. She has become ill recently, vomiting regularly. I have been unable to convince her to go to the ER, and will soon resort to having the police escort her in an ambulance. She is not currently violent, but is still very angry and difficult. I believe I may ultimately have no choice but to place her in a care facility. If so, I will have a financial conundrum. She cannot afford it and neither can I. My parents own their home - no mortgage. My mother's income is split from my father's now due to the requirements of the conservatorship. At this point, I cannot afford the cost of a care facility. Are there any options for a person in my situation? I apologize for the long post, but appreciate any advice.

KeepingStrong Aug 2017
Thank you Jamie.

jjariz Aug 2017
Every county in the US has an Area Agency on Aging (although some have a different name). Call them and ask how to be hooked up with a social worker/case manager. S/he should be able to explain options in detail with you.
Blessings,
Jamie

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KeepingStrong Aug 2017
Thank you sue888. That's good to know. It's his family home, and I don't want this to cause him any more stress and sadness than necessary.

sue888 Aug 2017
If you apply for Medicaid they will not make your father leave his home. Do it now because it can be a long process.

GardenArtist Aug 2017
KeepingStrong, I'm sorry to learn that you didn't have a good experience with the home care company, but I do understand that each visit could be somewhat of a "surprise." Not knowing who's coming is exactly what I experienced with a large health care company. Incidentally, it was recommended highly by a close friend, and provided excellent care for her mother several years ago.

I think management changed, its mission changed, and the services changed, and not for the better. Neither of us had any way of knowing that. Now if I can, I try to check out management consistency but it's not that easy.

Good luck; please let us know how this works out. I'm still learning about Palliative Care options.

KeepingStrong Aug 2017
Thank you GardenArtist. That could be a viable option to help with her care. In our small town, we have a hospice that is also the office of home health workers - paid by Medicare. I suspect that would be our palliative care here. I will discuss with her Oncologist. Yes, I agree that research is in order when considering in-home care providers. I used a company for sitters, and never knew what to expect each visit, and never knew who they would send until they arrived. I finally stopped using them when they sent a lady that was just too high-maintenance for my frazzled nerves! Had to straighten up after her, etc. Investigate well. Thanks for your advice.

GardenArtist Aug 2017
KS, with a chronic condition such as COPD and cancer, she probably would qualify for Palliative Care at home. It's not full time care, and it's NOT hospice. I've only learned about it recently. It's paid for by Medicare, so you could keep your mother at home and get some help through Palliative Care.

I don't know how much care she could get, but it's worth investigating. Her oncologist might be the one to script for it.

I've been investigating it and trying to find a good Palliative Care provider in my area. I've found that some companies which provide hospice also provide PC. Among the many questions to ask is whether or not the company has its own staff of professionals or if it uses independent contractors, and if so, when the assignments are made.

I found that some home health care companies and one Palliative Care company make assignments to home care workers the night before the home care visit, and are reluctant to commit to providing the same care workers from one visit to the next.

A family has enough going on with someone who's ill w/o having a revolving door of home care workers. And two out of the 4 who came were unqualified; one was even lazy.

KeepingStrong Aug 2017
Thank you freqflyer for the advice. I have considered applying for Medicaid for my mother, but have been reluctant because I don't want to compromise my father's family home while he is still with us. I'm hoping to find other options before taking that approach. To answer your question, I hire a sitter to stay with my mother when I take my father to the doctor and she usually goes with me when I handle things at their house. Thanks again for your advice.

freqflyer Aug 2017
KeepingStrong, whenever an elder cannot afford to move into a continuing care facility be thankful we have Medicaid [which is different from Medicare]. Have Mom apply and if she is accepted Medicaid will pay for all of her care in a nursing home.

The only thing, Medicaid will place a lien on one half of the equity in the house that she and your Dad own. That is so that Medicaid can be reimbursed for the cost of Mom's care. If there isn't enough equity, don't worry, you will not need to pay the balance.

Gosh you have a lot on your plate with your Mom living with you, and Dad refusing to move from his home. Plus 3 houses to manage [your 2 and your parent's house]. You need to clone yourself. Who takes care of your Mom when you are helping Dad with his appointments and cleaning his house, or do you take her with you?

You need to set some boundaries, or you will crash and burn... then who will take care of your parents???

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