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Buffalogal Asked October 2022

Moving elderly mother out of rehab and across country; what do I need to plan now and after move?

My mother is 86 and moved to California 30 years ago alone. I live in NY and we haven’t seen each other in 17 years. Until recently she was active, living alone but has developed arthritis and has mobility problems that make some aspects of life difficult (taking out trash, laundry, etc.). She lives in a regular apartment. She fell and fractured her shoulder 3 weeks ago and is in rehab she now wants to move close to me on east coast. I’ve reserved an apartment 2 miles from me that is an adult community. Safe, safety features, clean, etc. I’m struggling bc I’m here and she’s there. She’s also dragging her feet in much of this. Rehab is not giving me a discharge date, saying it’s week by week. If they discharge her, she’ll be alone in apartment until I go out end of November and get her to bring her here. I guess she will need someone to help w/ daily bathing? Cleaning? I can order in meals and she can microwave? What else do I need to consider? If I have no one at home to help her, are they required to keep her there because I have no self-discharge plan? They said if she’s not improving in rehab they’ll send her home but if she can bear weight and improve they’ll keep her there for continued help? Also what do I need to think about in terms of moving her here? I don’t even know what kind of Medicare plan she has? Will I be switching it to a New York State plan? All the costs of different? How do I go about becoming power of attorney so I can do some of these things without her? Right now she’s late even paying her bills (a friend helped her) while she was in rehab so do I need to do that for her? Does she need to initiate that on her own out there? Ideal plan is sell all her stuff, ship personal things, move her here for December 1 right out of rehab, get her a Dr. here and sign her up for Medicare here? Once she gets here, it will be ok, but the next 6 weeks concern me. She is totally sharp mentally (but stubborn) but not between the shoulder and arthritis problem. Thanks in advance for any ideas of where or who to call or some kind of checklist to use. Again, main concern is what if they discharge her before I can go get her to bring her to NY. Sorry for rambling!

Kmjfree Oct 2022
I would slow this down a bit. So many stories on this site start with bad decisions made during a disaster/ panic situations. First question is do you want her to move close to you? Once she moves it will be hard to undo. What is her expectation and yours once she moves? I would start with a short term solution that keeps her in CA and let the dust settle before I moved her. See if her shoulder improves.

CTTN55 Oct 2022
So you haven't seen each other in 17 years and according to your profile, "Mother and I somewhat estranged she now wants to move back to east coast and live close to me."

Why? Does she expect you to become her caregiver? What happens if she refuses to allow help into her apartment?

What are her finances? I hope you aren't expecting to pay for her home help (if she allows it).

"Once she gets here it will be ok"

Are you sure about this? You really must know her capabilities when she is discharged. And then decide how (if?) you are willing to take care of what she will need.

Are you an only child? If not, is/are your sib/sibs also estranged from her?

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SnoopyLove Oct 2022
I am so sorry you and your mother have been estranged. Was she abusive to you when you were a child? Does she have a mental illness (such as narcissistic personality disorder, bipolar, etc.)?

So often on this site we see adult children of abusive or difficult parents moving heaven and earth for someone who wasn’t there for them, trying to finally get the love and approval they were denied as children.

I would run your plan by a counselor or therapist before going any further.
Buffalogal Oct 2022
Hi I had a great childhood but a very old school mom who was tough. Not abusive but stubborn and “ I’m not your friend I’m your mother” she is just very “ it’s my way” and we b we nothing g in common. Plus I’m a daddy’s girl and she resents that even though she left . Anyway- She is a good person but that distance creates barriers. But she’s still my mom.
notgoodenough Oct 2022
You say you haven't seen mom in 17 years. That's a loooonnnnnggg time.

Before you start any sort of move, just HOW certain are you that mom is "totally sharp mentally"? Because if you are completely honest with yourself, and your answer is anything OTHER than 100% certain, you need to take a big "time out" and rethink this plan.

I think if I were in your position, and I could swing it, I would make plans to go out to CA once mom was out of rehab and spend a few weeks with her IN HER HOME to see just how competent she is, how much help she really needs, and whether or not you want to commit to being her caregiver on the East coast.

I imagine you have a valid reason for not seeing your mother in 17 years. I don't need to know why - but YOU need to consider that reason before you commit to this. It seems you're doing this planning in panic mode, and that won't work out well for you OR mom.
Buffalogal Oct 2022
Thx for your thoughtful reply. She’s changed her mind about moving here but I like your idea about me visiting there to assess. And Converstaions will or should be easier in person.
Isthisrealyreal Oct 2022
Buffalogal, welcome!

Encourage mom to work hard at PT. This is how Medicare pays, progress made. However, the average stay is only 20 days and they usually give you 48-72 hours notice. Her being in rehab until the end of November being paid by Medicare is a pretty slim chance.

I would find out what her insurance is and get that sorted out now, it's a process that takes time. If it is an advantage plan, they will cancel her because she lives out of the service area and that will allow her to get supplemental plan and standard Medicare, I highly recommend this route. If she already has that, she probably will be covered by everything but her prescription plan.

You need to find aides that can start helping her in California on short notice. She doesn't need to bathe everyday but, she might need other daily assistance. You want to get this sorted out because of the severe shortage of caregivers.

I would encourage you to get rehab to do a needs assessment. This will help you know what needs to be done, west coast or east coast. She may not be able to live alone and you need to know that asap.

If you are looking at Medicaid, you need to find out what NYS requires to be a legal resident. That would be required for her to get that assistance. It doesn't cross state lines.

Because of her age and injury, you want her doctor in CA to clear her for air travel to NY.

Good luck. The beginning of parental care is overwhelming and we find out how little we know about this.

Oh, contact the area on aging in both locals, they are a gold mine of information on resources.

freqflyer Oct 2022
Buffalogal, moving at any age isn't easy.

First, one will miss all their old time friends.

Next, Mom will need all new doctors, dentist, hairdresser, grocery store, clothing store, the list goes on and on how, and learn how to get to those places.

Next, banking. If Mom has a nationwide bank, no problem. If not, a new bank would be needed with a branch close to Mom's new home.

Next, moving. Since Mom lives in an apartment, the moving companies don't send a half empty truck across county. They will stop to pick up another load. It may take weeks before Mom's furniture arrives.

As for becoming Power of Attorney, only your Mom can appoint a person to do that, and it has to be a legal document. It would be best for your Mom to find an Elder Law Attorney, as there may be other legal documents that your Mom might need.

There is so much to think about. I would think it might be easier on Mom if she continues to live in California, and if she can budget it, move into senior living, be it Independent Living depending on her rehab, or in Assisted Living.

MJ1929 Oct 2022
Don't do anything unless she's given you Power of Attorney, because everyone will stop you in your tracks (banking, Medicare, Social Security, nursing home/apartment folks) without it.

You should have both medical and durable power of attorney. You don't need to activate them right now, but if she can't make decisions or OK whatever you're needing to do, you need to have them ready.
JoAnn29 Oct 2022
Medicare and SS do not recognize POA.
jbramwell Oct 2022
If mom is on assistance and Medicare you need to find out the rules in your state. We moved my Mom from California to Minnesota. She didn’t need it but I found out that she had to live in Minnesota for one year before the state will provide assistance. Also be careful how you spend Mom’s money. Most states have a look back period.
Also from what I understand POA means nothing until mom is deemed incapable of making her own decisions.
I knew nothing about any of this until I had moved my Mom. With the help of this site and a lot of googling I have found out a lot.
just be aware, I feel taking on this has been like a part time job.

JoAnn29 Oct 2022
I think ur jumping the gun here before you have all the information. Mom may rehab well with a broken shoulder. I would also ask the PT about her mobility issues. I would also make the PT aware that you live on the opposite side of the country so u need to investigate options before you can make any plans for Mom. So u need to be kept in the loop about her progress explaining u have been estranged for 17 yrs. Do not allow these people to bully you into making snap decisions they may effect you drasticly till Mom passes. Think "lets get her back in her apt with help" before you consider moving her across country to a place she is no longer familiar with. Your going to be expected to be her entertainmemt.

Medicare pays the first 20 days 100%. The 21st to 100...
50%. This means if its felt Mom needs more therapy passed the 20 days, she will be paying out of pocket for the other 50%. Unless she has a good suppliment. Nothing is guaranteed. Mom can be discharged at any time within those 100 days if she is not progressing or has hit a plateau.

You need to find out what insurance Mom has. The Rehab finance office should be able to help here. Straight Medicare goes from State to State. Supplimentals, unless Medigap, don't. They are written in the State the insurer resides. So if Mom has straight Medicare no problem but unless her supplimental is also written in ur state, she will need another supplimental.

Then there are Medicare Advantages. Medicare contracts out to these companies. They are suppose to cover Part A&B of Medicare and then have some additional advantages. These are networked based meaning you need to use providers they contract with. These are State based again meaning you need to find if they can write policies in your State. If not, Mom needs a new company and has no Medicare till you do. Or, you go back to straight Medicare with a suppliment that provides prescriptions. If prescription plans not provided, Mom needs to pay for a prescription plan.

Medicaid for heath is also State based. So you will need to find out if Mom needs to declare residency in your State to received Medicaid for healthcare.

When you find out what Mom has, call your County Office of Aging and they can help you navigate through all this insurance stuff.

Your other problem is how are you going to get her and her belongings to NY. Maybe she can fly? But who is going to pack up her belongings and move her to NY. I may want to tell her there will be no move if she can't do for herself. I am sure the reason she wants to be near you is for you to be her caregiver. In 17 yrs and at 86yrs old, I doubt Mom has changed. So if ur estranged for the reason she tends to be abusive verbally or will expect you to be at her beck and call...then you may want to leave her where she is with the State taking over her care.

Please, do not make this decision too quickly or because you are being pushed. If Mom is an "unsafe discharge" she can be transferred to a LTC facility or an AL till you research all your options. The SW can also set up in home care for Mom but it will be at Moms expense if she has the money for that, the AL and the LTC. If not, Medicaid may pay for LTC or in home help not an AL. Its the SWs job to make sure Mom is safe. Not much you can do from your position and without a POA also not much you can do.

One step at a time. I would look for options to keep her where she is before moving her across country.
Isthisrealyreal Oct 2022
Supplimental policies are not state specific and follow Medicare wherever you go. Dealt with this with my dad, his prescription plan was the only one that didn't go with him.

Advantage plans started offering plans that go with you last year, however, only for travel and not for permanent moves.
Buffalogal Oct 2022
Thank you all for your insightful, well thought out and helpful answers. My mom has decided for now to stay in California and return to her apartment upon discharge. She said she can do that and will hire in some help. She admitted things were moving g too fast. Like I said- she’s stubborn. There nothing much I can do from here. My concern now ( and I’ll cross that bridge when I get to it) is that the next time something like this happens it will be more difficult o arrange and plan bc she’ll be older and it could be more severe. I think I’ll take someone’s advice on here and note the bullet , go for a visit and have a heart to heart about planning and future realities. This has also taught me a lesson for my own future planning purposes. None of us will be forever young. Thanks again everyone. Be well
Patathome01 Oct 2022
Just a thought: If you do visit your Mom in CA, you may want to stay in a motel so you are not talked into staying at her residence and possibly beyond your original planned timeline.
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