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Pstracy Asked February 2019

My parents did not plan for long-term care. Now have to rely on Medicaid and the options for care facilities are not pleasant ones. What do I do?

Someone posted that they now know after caregiving how to plan for their future. So true!


Mom suddenly couldn't walk one day and went to short term rehab. She's been there for 7 months without much improvement, she still uses a wheelchair. Their home is not conducive to wheelchair use so she will most likely go into permanent long term care.


Dad has Lewy Body Dementia and had several falls at home. He went to the ER on Christmas day after a fall. He checked out ok but husband insisted he go to long term care. Dad had a hospital stay for 11 days, to find a care facility bed, and has been in a NH where my mom is for about a month. They do not have memory care there so we are trying to find a new NH for him. The hospital made arrangements first for a place we visited and it was awful! They just lost their certification recently. Go figure. We were able to get him in to NH where mom is.


Because mom and dad never planned for long term care, they are on Medicaid. Let alone, it's hard to just find an available Medicaid bed, the places we have seen are less than ideal. My dad is currently in a shared room that is only 10' by 10' ( the minimum state requirement size for a shared room), shares a bathroom with 3 other people (door between two shared rooms for two women and two men), and has a hanging bar for his clothes just 3 feet wide. I can tell this room was originally intended for just one person, but they make more money this way.


He knows we are looking for another place, so it keeps his hopes up. There will be no income from the sale of their home, they had a reverse mortgage, and any profit from the sale will be taken by Medicaid. We still have the home. My husband and I moved from out of state last year to take care of them. We still reside in the home.


I've entertained thoughts of moving dad back home but my husband would divorce me. He did not handle taking care of dad for 6 months very well, and he's even a Paramedic / Firefighter. We cared for dad full time for 6 months. I think my husband was quick to get dad into a NH more so for us and not for dad. I've gone back to work full time and husband will go start again in May. Husband is quick to get rid of my parents' household things and get rid of the house. I'm not so sure I couldn't move dad back in to the house and go back to being his full time caregiver. I really didn't have a hard time with it. But it could destroy my marriage.


Mom is still on the rehab side of the NH and probanly will be for a awhile. Not even sure what to do about options for her in the near future.


And currently don't know what to do between awful options for dad, and my marriage!

needtowashhair Feb 2019
How about a board and care instead of a nursing home? They are generally converted houses. Smaller and more personal than a NH.

Otherwise, have you looked into NH outside the US? Many people don't even think about it. I don't see why not. Many people that haven't traveled have this view of the US and the rest of the world. That being the US is the nicest place on earth and the rest of the world is a dump. Nothing farther can be from the truth. The US is not as nice as many Americans think. Many nursing homes outside the US would put the best US nursing homes to shame.

Nursing homes right across the border in Mexico are close, good and cheap. Cheap enough that their social security might pay for it all. Close enough to the US that they can get back to a US hospital if needed as fast as getting in from the suburbs in many cities. It's worth looking into. Many of the ones along the border are geared towards Americans. So they won't be in a facility as the lone English speakers. Most of the residents are Americans and all the staff speak perfect English. As for that staff, unlike in the US where it's a job that many people get just to pay the bills. Culturally in Mexico, caring for the elderly is a calling and not just a job because the local fast food joint wasn't hiring.
Pstracy Feb 2019
I wouldn't be able to visit them outside the US. Ao not really an option. And they rely now on Medicaid.
NYDaughterInLaw Feb 2019
You and your husband already have moved from out of state to be closer to them, which is more than most people are willing to do. Thank your husband for making that huge compromise and sacrifice. If you want to remain married then your husband is your priority.

After a rather long and tedious search a good friend of mine found a religious group that ran a little nursing home. There were only two dozen residents or so. They accepted Medicaid. The place was simple, clean, and the staff was friendly. She placed her older sister, who had Alzheimer's, with them after the money from the sale of the sister's home was spent and she could no longer afford the "nice nursing home". My friend visited her sister once a week for the five years she lived there.

Good luck with your search. Stay positive and be open to looking at nursing homes that are a little further away but still within driving distance.

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CTTN55 Feb 2019
Please prioritize your marriage!

rocketjcat Feb 2019
Hopefully you find another better facility for your dad soon. The room and accommodations sound worse than a hospital room. Moms NH (on Medicaid) although small is much more pleasant than this so please keep looking.

I don’t know their personal situation but you think Mom and Dad seem to have planned poorly for their old age? Assisted living in my area are about $4k a month even without the additional personal needs they may eventually need. Moms NH is $12k a month. That’s $144k a year. She’s been there going on 3 years so that’s $432k. There’s not a lot of people who can’t afford that and for “normal” people it takes a good income and lots of planning to put that kind of money away. Sometimes those costs are a shock.

gladimhere Feb 2019
My mom did, initially, plan for long term care. She purchased a policy.

Do you see it coming? She then developed dementia, Alzheimer's type, and forgot or decided she would not need it in her Alzheimer's brain. So the policy lapsed, tried to get it reinstated with payment of past premiums. Of course the company would not do it.

If anyone purchases a policy, have a child or someone responsible for making sure the payments are made. Wonder how much the companies make off policies that lapse after years of payment, then forgotten....

JoAnn29 Feb 2019
I think Mom and Dad are where they need to be. Your Dad will go downhill and will need care you won't be able to do. Your husband is ur priority. You have made sure parents are safe, clean, fed and cared for.

rovana Feb 2019
Stick with your marriage.  Works better in the long run. Because even if you moved dad back home, took care of him full-time, lost your marriage, dad would go downhill to the point where you could no longer manage. Then what?   I think it is reasonable for a spouse to not want parents in their home, unless there are absolutely no other options than the streets.
Truth about getting old: "Not pleasant." Even if you have long-term care insurance, you are still likely to need Medicaid in the end.  However, being able to pay a year or two would give you better choices, generally speaking.  Hate to say it but:  we are living too long, with chronic medical issues. Different from the not-so-old days. And nowadays, family members have to work if they possibly can, to provide not just for their old age, but for the here and now.  Europeans may have it better, but they do pay for it in higher taxes.  No easy answers.
Isthisrealyreal Feb 2019
I don't think European countries pay more taxes. They have smaller government agencies and people actually work productively unlike our government employees that do the least amount possible and have no accountability for their actions. When people can't be fired you are asking for a poor work ethic.
SnoopyLove Feb 2019
Also, I think all of us caregivers need to consider our own future care needs, and save as much as we can now, contribute to 401k and IRAs, work as long as we can, protect our own health as much as possible, etc. As Segoline noted, the math just may not work for your parents' situations, but I think all of us younger folks as we assist our parents have to also do what we can to try help things turn out a bit better for us if at all possible.

Sorry that your family is going through this right now!

Isthisrealyreal Feb 2019
When you married you promised to forsake all others for your husband. As hard as that seems, it is unfair to put anyone in the position of caregiver against their will. No one wins in those situations.

Your parents needs will only increase. You can continue to be their advocate and daughter with them in a facility. They will not ever be happy about it but they will adjust. As long as their needs are met, they are safe and cared for you have to let some things go. Does the facility have activities that dad will participate in? His room should be looked at as sleeping quarters and the rest of the facility is now his home. It is hard for everyone but you have to consider what you would do as his and her sole caregiver, no husband, no job, no assets, no resources trying to get Medicaid to pay for everything they need, etc. Please think about the reality of their situation now and future.

Segoline Feb 2019
This is an article you might want to read about LTC price increases.

/www.investmentnews.com/article/20180809/FREE/180809918/genworth-raises-long-term-care-insurance-costs-an-average-58

Segoline Feb 2019
When you say they did not plan, what do you think they neglected to do?

LTC policies are very costly. And the premiums do increase quite a bit. Their daily rate pay may not equal the cost of the daily rate at facility. Many don't pay a dime for 90 days.

I think what many of see today are parents who have outlived their resources, or the value of their resources has not kept up with the escalating cost of care.

Is there a senior resource Center near you which can help you plan? Your state's council on aging is a good resource too.
Pstracy Feb 2019
Thank you for the resource suggestions. To answer your question, my parents thought they would stay in their home until they passed. Their 3,000 sq ft home with stairs to every entrance. They are in a reverse mortgage,theye no other assets (pensions, 401k, etc.), and rely on social security as their only income. Medicaid takes all but $140 a month for their NH bill.

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