Hi, my first time posting. My mom lives in Las Vegas, she's 87, and on oxygen 24/7. She has a friend that took her in before covid due to a collapsed lung and the fact that her condo had stairs. The friend just sort of ended up caring for my mom ever since. Every time I'd call, both of their responses were/are, "we're fine, everything is fine". I finally visited as covid was (I thought) waning. The friend informed me that he needed to return to his hometown as his mother passed during the pandemic quarantine and he needs to take care of things. I live in a different state in a three-story townhouse, so mom cannot live with me. My mom's BMI is below 16.3, she needs to be assisted when walking. Her bathroom habits are appalling -she used rolled up socks instead of adult diapers/pads, which I have purchased for her but she refuses to use. Her (male) friend just washes the socks and doesn't question her as he thinks this will embarrass her. Sadly, she has no money as she's lived in Vegas for over 30 years and, unfortunately, liked to gamble. I can't afford to put her in a home on my (small) pension & social security. I have been told that after a 3-day stay in the hospital she can be release to a SNF and that Medicare will pay for this for the first 3 months? I emailed the only doctor she sees (her lung doctor) and asked his advice. That was a month ago, no response.
These are the things I'm hoping to get some advice on: how to get her admitted to a hospital. Does medicare pick up 3 months? Are Board & Care homes less expensive and how do I go about finding one? (I did find an online company that was supposed to help find a home for mom. I told her mine/mom's circumstances (no $) and she refereed me to a place that'll cost over $4,000 a month. Not very helpful.)
I'd appreciate any advice. Thank you.
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I was in the ER at NYU yesterday (I'm fine) and there was an elderly lady with an awful looking leg wound. She kept putting her dirty stockings back on over it, after the nurses had cleaned it.
When the doctor came in to interview and examine her, she initially refused to talk to him, saying she just need to rest. She finally admitted that she had spent the previous night in a supermarket and on the street, has had some sort of problem with her apartment and must go to Housing Court on 6/21. She only wanted oral antibiotics, not the IV that had been prescribed (she stated, oh I have plenty of (fill in name of med) at home. Lots of it).
She initially wouldn't let the doc examine any part of her except her leg; he managed to wheedle her into a listen to her chest; he found a significant heart murmur and severe congestion in one lung [I just need to cough more"].
Listening to her housing issues, he suggested that he could call the SW department and get some help for her ("Oh, they can't help with Housing Court"). He certainly looked like he was headed in that direction when I left, but here's the thing. Unless your mom is declared incompetent, she can refuse ANY and ALL help that is brought to bear.
In your shoes, I would call APS and report her as vulnerable. And remember, YOUR money doesn't get spent of her care--her SS and Medicaid pay for what she needs.
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For Rehab only, Medicare pays the first 20 days 100%. 21 to 100 50%. The other 50% is paid by the patient or their supplimental insurance partially or fully. The 100 days is not a guarantee. If the patient has hit a plateau Medicare will have them discharged.
With APS, for you not to be involved with Moms care, you will need to allow them to take over her care and the State to become her guardian. This way she will be placed much quicker than you can get her placed. But...you have no say where she is placed or her care.
APS can help you with resources and placement. To have Mom placed in a NH Medicaid can be applied for. Her SS and any pension will be used to offset the cost of her care then Medicaid pays their share. A small amt (in my state $50) goes into a personal needs acct for Mom. Its like an allowance. It can be spent how she wants.
As Alva pointed out your mom has to actually be assessed as needing SNF or LTC as this is the second piece of qualifying for Medicaid.
In order for her doctors to respond to your phone inquiry, first your mom will need to assign you as her Medical Representative. This is a HIPAA form that you request at her pulmonologist's office. She puts your name as her MR and she signs it and hands it in to the receptionist. No notary or lawyer needed. This allows her medical team to legally discuss your mom's health issues with you without her having to be present. All medical info is private, unless a person assigns a MR or MPoA. This is probably why her doctor hasn't returned your call (especially if you aren't your mother's MPoA). The MR permits the exchange of private medical information. The MPoA permits actual decisions to be made on someone's behalf.
If I were in your shoes I would try to visit your mom for 1 or 2 weeks as it will be much easier to get things rolling or in place than via phone. You can take pictures of her living conditions, make appointments with social workers, and have your mom's documents/info on hand when needed (SSN, Medicare card, financial info, etc.) If you get there and your mom is resistant, you may need to consider that she may also have cognitive impairment or memory loss (or any number of other issues that result from personal health neglect). A social worker may be able to get her adult disposable briefs at at discount or free, you can set up Meals on Wheels, and just get her on APS's radar as a vulnerable adult. You have a big learning curve ahead, so you will need to pace yourself and eat the elephant one bite at a time.
Keep coming back to this forum for more guidance as needed. Many here have been there, done that, and then some. I wish you much success in helping improve your mom's situation.
Thank you so much for your response and advice.
Mom needs placement and medical now. The person who was living with her and you yourself should report her to APS as a person in need. Board and Care is less expensive but usually it is a nursing home for those in your mom's indigent status. Please don't spend any of your own money on Mom as the truth is that you will need your funds soon enough.
I am glad you emailed the doctor but soon enough someone is going to want you to be POA (usually a social worker ) if Mom is well enough to give you POA (not suffering dementia). Or temporary guardianship which social workers can do quickly enough.
Certainly ambulance service to hospital for some "made up " breathing difficulty will get you a start on Social Services help but you are in for tough decisions. Managing care for an indigent means getting the records together and applying for medicaid and then finding a facility that will accept it. You would have really to BE THERE. You may be facing a choice of letting APS and Social Services of Nevada to put Mom into state conservatorship though that will take most decisions out of yours and her hands.
I wish you the best. This is a difficult decision that was bound to come. I think you are in for at the very least a trip to assess and then act on this just as soon as the "friend" is not there.
I am really so awfully sorry. You are faced with tough tough decisions. This is something that falls under "not everything can be fixed". That is the dreadful truth. I hope you will update us as you go along. Whatever your choices are you will get an invaluable education, one that can help others by your sticking around the Forum. I want to welcome you and am so sad about the circumstances under which you join here.