Mom is in an assisted living facility nearby. She is 92 and has moderate dementia. She is on a fixed income and is running through her savings. She must live there two years, use up her savings, before she qualifies for Medicaid. We took over taking care of her meds to save $700 a month. My husband is her go-to person for errands, trips to doctors, change the clocks, pick up meds, get cash for her, etc. She won't use the facility's bus. She's come to rely on him. He's a good guy. I haven't been able to help in some time because of mobility issues.
Recently my issues have worsened and so we are having to move some distance away because there are no ADA apartments nearby. My husband is now busy caring for me. He understandably would like to turn over mom's care to my siblings. So I've reached out to my out of state siblings to take over her care. They want to hire a part-time caregiver though there aren't many in this area plus mom insists she doesn't need anyone. She says she'll rely on her 98 year old boyfriend to take care of pills, drive her to doctors' appointments, etc.
Is it unkind to move her out of state and away from the boyfriend at her age if she refuses a caregiver? And what about the cost which will surely deplete her savings more rapidly? I want to do the kind thing here, but we can't look after her any longer. We're struggling and frankly burned out as it is.
Advice?
Thank you.
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The issues I would mention in regards to moving mom:
1) moving dementia residents can lead to confusion/more decline quicker.
2) if moving out of state, you would start over with state requirements - additional 2 years?
3) can she be "weaned" into using the facility offerings (meds, bus, etc.)
4) removing her from her BF (this may be moot, BF may not have long left!)
Before signing up with mom's facility, I asked about the medications. Her GOOD policy gets 90 day supplies for a pittance. They indicated they had no issue with me handling it, but just after moving in, WITH a 90 day supply already, they ordered her meds via the "usual" place (blister packs presumably.) It was some serious money, and probably only covered one month. WHY did they need to order her meds when she HAD a 3 month supply? I had them return it. We STILL had a remaining balance, and it took several calls to finally be told it was a "restocking" fee. I told them and sent a letter with payment stating it was being paid despite feeling this was not right, but in no way would we pay again as I stipulated with facility, doctor AND the place they were NOT to fill any orders without talking to me. Nothing happened for some time, but when something was ordered again, I had to track it down - we needed to have a "profile" only set up, I believe it was at the facility (they should have done this the first time around!)
One thing that is perplexing is that they charge you - is that for the medication itself or for dispensing it? AL and MC costs should include some care, especially since most/all will not allow medication to be kept by residents, but you would have to check with them or the agreement to see what is covered. Mom is in MC and the monthly fee covers up to 1 hour of personal care and medication dispensing (up to a point.) Can you inquire with them about the need to keep costs down so that mom can stay? Can you provide the meds and they dispense? Although AL/MC places can be often easily "filled", having a guaranteed resident might be preferable to having to find another. See if you can work out something with them.
If you haven't moved yet, several things can be done to alleviate time spent:
1) consolidate trips, even if it means having meds/money before needed.
2) if she has a doctor appt, see #1
3) to get her used to relying on the bus, have hubby go with her ON the bus.
#3 can be done by saying car needs work, he can't use it. BUT, if she has dementia, is it wise that she would travel on the bus alone later? She is likely going to need some kind of assistance from someone.
IF she has only met a few months of the 2 year requirement AND because the dementia will get worse, moving her now will likely be the best option. However as noted this could cost her. How far away are you moving? Could she come for a "visit", to see how well she can transition? Earlier in the dementia path is better than later when considering a move. Would she have a way to stay in touch with her BF (phone, facebook, skype?) What are the requirements/facilities/costs for the state you are moving to? Are the requirements/facilities/costs any better where your siblings live? Each state and each facility will have different offerings/costs. Explore them all carefully and ask a lot of questions!
Although you indicate burnout, if you decide to move mom, could she live with you (or sibling) temporarily, to help stretch out her assets so she can afford the balance of the 2 year (or whatever) requirement in the new state? If she's currently in AL, not MC, it doesn't sound like she needs much "Help" at this point. Having her in your/their home will have it's own issues, but might make the transition easier both logistically and financially. Meanwhile you can explore ALL the options available rather than having to make a quick decision about the new place, if you choose to move her.
It does get tedious repeating things, but as long as this kind of repetition works, it is better than explaining to her over and over that her mother is long gone!!
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Then others will take over, but you will be gone.
Looks like her state works like mine. Some ALs will except Medicaid once the resident has private paid for at least two years. The problem arises though, the ALs only allow a certain % of Medicaid residents. So if they make that quota, Mom may not be able to stay anyway.
The only thing that confuses me is the Medicaid 2 year residency requirement. Is that for the state you would be moving your mom to? If so.....can she afford to self-pay for assisted living for 2 years? Is she already on Medicaid in your state? It’s not clear what you meant by Medicaid and the 2 year requirement so if she needs Medicaid in the next 2 years because she can’t afford to self pay, then moving her would be a problem don’t you think?
I don't think moving her would help. She would still be near you and expecting DH to help. When her money runs out, next step is LTC with Medicaid.