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Scbluheron Asked January 8, 2024

Living in AL that is self-pay. As money is used up, move to AL that will take Medicare?

Hi. Returning poster/lurker. Mom moved into AL in April of last year and has adjusted very well. She misses her house (which I sold to help finance AL) but enjoys the activities and chances to socialize. More than anything she says that she feels safe there and has actually worried about the possibility that I would make her leave. Her positive reactions have been a surprise but she continues to say that she will never stand in her children's way (be a burden).


 


Anyways, I'm a planner and am thinking ahead. Her current AL is private pay only. She has enough money for about 5 years (I understand that fees will increase as time goes on).


 


My question: should I move her as she gets to the 2 year mark for her funds running out (most of the Medicare ALs require 2 years of private pay). Or move her after the funds are completely gone. Either way she will need to move. She likes her current situation so much and the facility provides good care so I will not move her now. Obviously no one knows the future but she is almost 76 and in good physical health so she may very well outlive her funds.


 


Thanks.

lealonnie1 Jan 8, 2024
I had mom in a Memory Care Assisted Living facility that was great. I knew she only had funds to self pay until a certain time. My goal was to keep her in the AL for as long as humanly possible before having to resort to the Medicaid SNF I'd had lined up for her, which was nice enough and well run, but she'd have a roommate. Not good. So I was planning to move mom in the summer of 2022 and she wound up passing in February of 2022. So I didn't have to apply for Medicaid or move her at all. I planned to hold aside 2 months of funds to private pay in the SNF while waiting for Medicaid to be approved.

I'd leave your mom be where she's happy right now and don't rock the boat. 5 years in elder terms is a very long time. Many things can and will change during that time.

strugglinson Jan 8, 2024
I'll second MidKid58 on this part: "I don't have any advice--I just think it's nice to read about an elderly LO who is HAPPY and THRIVING" in an AL!

not sure what the best move is, but its sure nice to hear she is happy and liking it in the current place!

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JoAnn29 Jan 8, 2024
I only have 2 ALs near me. Both take Medicaid after you have private paid at least 2 years. The problem is not being approved for Medicaid its if a Medicaid room is available. ALs only allow a % of residents to be on Medicaid. They would not be able to stay afloat if all residents were on Medicaid. And some ALs make Medicaid residents double up.

To tell you the truth, five years from now Mom may need more care than an AL or MC are willing to give. So she will need Long-term care. So about 3 months before Moms money runs out, you apply for Medicaid.
Scbluheron Jan 8, 2024
Good points Joann. I hadn't considered the availability part (one of the reasons that I like this forum-members point out overlooked details 😀)
Midkid58 Jan 8, 2024
I don't have any advice--I just think it's nice to read about an elderly LO who is HAPPY and THRIVING in a SNF. Really. Most of us are just hamstrung by the demands of our LO's. If I've heard "we can't put MIL in care, she'd die within a week" once, I've heard it a hundred times. (she wouldn't die, she'd just get madder, if that's even possible!)

You are very blessed to have a mom who isn't expecting you to dance attendance.
I'm sure you know that!!

I hope you find that you can keep her in the place she likes as long as possible.
Scbluheron Jan 8, 2024
Yes, I'm definitely blessed. She has her moments when she's not as considerate but they are usually triggered by stress as her brain simply can't handle it anymore. She made it very clear even before the dementia that she didn't want to burden her children and already felt guilty just asking for help with basic things. Most everyone at the AL tells me how sweet she is. She's one of the few residents without mobility issues and has taken her wheelchair bound neighbor under her wing at times. She seems to have gained a sense of purpose at the AL which is fantastic.
97yroldmom Jan 8, 2024
I notice you live in Washington state. Does mom live in Washington state?
Just reading the part about being a long distance caregiver and wanted to be sure as if she lives in a different state, this info would be incorrect.

https://www.medicaidlongtermcare.org/eligibility/washington/

Here is a link for the services available as of 2023 in Washington State for long term care and managed by Medicaid.

You will notice that there are several nuances to each option. Being a planner you might want to visit these different type facilities to see what options your moms remaining assets would best provide for her long term.

In my family 76 is very young. Depends on the type dementia I suppose as to how much care your mom might need. Be sure to ask about total incontinence and bedridden when you ask about long term care and being able to age in place. opposite being a wanderer. Both require more/different care.

I am glad your mom is happy today.

AlvaDeer Jan 8, 2024
Heron,
I personally would move her when the funds run out.
First of all, I think it a mistake to think too far ahead. You just cannot prevent a whole lot of surprises over a ONE YEAR mark let alone a TWO YEAR and heaven forbid a FIVE YEAR. You really can't. She likes her place now. That is great. My bro adjusted well as well and was doing great. Lo and behold, at 85, one year and a bit more into living in his ALF covid hit. No sooner did THAT happen then he got sepsis from a TEENY non healing sore on his shin. And he DIED of it.

You can't predict anything, let alone what mom's condition (or yours) will be as time goes along. The news today is good. Be mindful and stay here at least a year. Reassess your thinking on all of this yearly.

Best to you and best of luck and it is WONDERFUL news that your Mom is adjusting so well.
Geaton777 Jan 8, 2024
Once her funds run out and IF she qualifies for Medicaid, then she will be on waiting lists or be only able to go to county-run Medicaid facilities (ugh).
Geaton777 Jan 8, 2024
First, please understand that you are referring to Medicaid, not Medicare. Medicare doesn't cover any facility care that isn't short-term rehab.

Next, please understand that in most states, Medicaid only covers LTC (long-term care) and NOT AL or MC. So, one has to qualify both medically (as assessed by a doctor, so not your opinion) and then financially. Most states havea a 5-year look-back on the financial app, but not all.

Then, please move her to a facility that accepts Mediacaid recipients. If you don't do this, she might wind up on a waiting list since "insiders" (existing residents) get first dibs on Medicaid beds.

Finally, please know that in most cases a Medicaid bed means a shared room, a roommate.

My advice to you is to consult with a Medicaid Planner for your Mom's current state of residence. You might also want to consider moving her local to you, since long-distance caregiving can be more work and more stressful. Moving someone in poor health a long distance is also expensive (and stressful).

Who is her FPoA? If she doesn't have one, this needs to happen asap. If she does have one... who is it? The FPoA will be the person to decide to move her and to where.
Scbluheron Jan 8, 2024
HI. I'm her MPOA and in charge of her Trust. Thanks for the clarification on Medicare vs Medicaid. I tend to get the terminology mixed up in my head.

When I was looking for an AL we saw one that allows spending down to Medicaid. She would have needed to be at least 2 years of private pay to qualify. That facility, though not unpleasant, was not the right fit for my mom's current cognitive functions.

Moving her near me is still not an option as I am not settled and tend to relocate for my work regularly. I'll see how this next year goes with her dementia decline and reevaluate as needed.

Thanks for the input.

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