MIL in on ALW priority list. They think she may be looking at early next year to move. Apparently she will be able to choose for a few different homes & her entitlements will cover her for a shared room with 1 other female. she doesn’t get along well with anyone & if she does it’s not long before she alienates them, accuses them of stealing, being loud, rude etc. What are the assisted living homes like over there? At the moment she has a Medi-cal entitlement of shared cost of $1400. She’s definitely not wealthy & neither are we, she only has her social security payments etc coming in She always maintained she was never leaving her home but as she became pretty much wheelchair bound, struggling with doing everyday tasks, forgetting things she said she felt she might have to consider going into AL. What makes our situation challenging is that we live in Australia & she’s always believed we should just sell up & move to USA to take care of her. We can’t do that for a variety of reasons mainly financial & as I’m Australian it creates a whole other set of issues with immigration & at 67 I’m not sure I would get any sort of healthcare there. When we were over there earlier this year we started investigating what where her options for care as she’s not wealthy & her home is a mobile home. A lovely lady at Senior Care Solutions advised us to call APS regarding various issues that had happened which indicated she shouldn’t be living alone. Eventually we did call them after my husband got past that he was betraying her trust. They apparently already had a report on her but of course they wouldn’t tell us who or what it was. The outcome is they recommended she go into Assisted Living which has bumped her up the list considerably. The APS social worker said if she was to increase her insurance by $275 mth she would be completely covered for Medi-cal, whereas at the moment she has share cost entitlements. Its all very confusing to us because even though my husband is American he hasn’t lived there for 23 yrs so isn’t across any if the processes. She wants to sign over her home to Norm but we don’t know what that would mean for her, over here in Australia that has implications financially for the elderly person. We are in the process of getting POA so that we can help her with all her finances because she gets so confused about what she’s paying & being charged. Can anyone tell me with POA does that give Norm authority to check on her bank accounts, increase her health insurance as the social worker suggested, check her phone bill because she said she doesn’t want AT&T but has metro, we don’t know what is going on, is she somehow paying both? It just would make it easier if we could see what’s going out of her account & talk to these companies if something is amiss.The plan is when she gets to the top of the list we will go over to USA, help her move & get her place ready to sell. When her place sells what happens to the money from the sale? Does it go to the home, does it just sit in her account? This is so challenging because she changes her mind all the time about going into assisted living & the worry is we will get over there ready to help her get moved & sorted & she will say no she’s not going. What then?As there is APS involvement does that mean she can be forced to go into AL? I know it probably sounds cold but it costs us best part of $10,000 to go over there each time with airfares, accommodation, car hire etc, we can’t just come back next month & see if she’s willing to move. Would love some advice or thoughts
You should have her mail forwarded or scanned - at least for a month, just to see who is billing her. You should be able to set up online access for all her bills to manage from a distance.
When her home sells, that money will affect her Medi-Cal. She will likely have a share of cost increase until that money is spent down. I don't know how Medi Cal works, but she may even be cut from their benefits until her money is spent paying for her care. Her financial POA will pay the bills to the care home until the money runs out (down to $2000) and she again qualifies for Medicaid assistance. ( Medicaid is the federal funding, administered by states, which may have their own name for it, like Medi-Cal in California, or AHCCCS in Arizona)
You can find a professional Geriatric Care Manager to help you find a suitable placement for MIL. It sounds like it may be too late for Assisted Living, especially if she is on a waiting list. And to answer what the assisted living homes are like over there - I assume California, which has Medi-Cal, there are so many different levels of care homes and some much nicer than others. If you can't be here to check them out, finding someone local to guide you and help facilitate will be invaluable.
You say it is challenging to coordinate her move because she changes her mind. You do Not need to wait for her to make up her mind. It is time for someone else to take charge. Norm (?) should also get healthcare POA, to act as her healthcare proxy. Or someone else who is local. If you are unable or unwilling to act as her healthcare proxy, APS will get a court appointed guardian to act and make decisions on her behalf. She will need to be declared mentally unable to make her own healthcare decisions.
The time is NOW! And I would seriously consider a level of care home which provides more hands-on care than Assisted Living. Or at least a community which offers varying levels of care, so the transition is easier when her needs exceed what assisted living can provide. You don't want to be facing this move conundrum again. Assisted Living is the lightest care level. Skilled Nursing or Memory Care facilities would be the next level. However, most skilled nursing facilities which accept medicaid payment Will Not be as comfortable as Assisted Living! It's typically a much more hospital-like environment. Often with shared rooms.
Oh - and one other piece of advice - Do Not Sign as a responsible party on her care home admissions! You or your husband should NOT be on the hook paying for her care. If he is POA, he can pay the care home from her money, after any insurance, Medicare, or Medi Cal. But He is Not the legal entity responsible for the costs!
Her house can be sold and will fund her AL until she uses that up. If she gifts you any $$$ she will not be eligable for Medicaid and the final boost up for long term care.. So hubby has a choice now to intervene before APS becomes fully involved. You and he already know that it will take a while to close on a home. He will need to visit and seek legal advice soon. See the lawyer for the documents (and it sounds like she might refuse which means you will have to pay for legal fees for guardianship). He will need to take her to a doctor to confirm incompetnce. It takes months to see specialists or her PCP occasionally because this is not an emergency. Her money can reimburse for those legal fees once approved.
When the time comes to sell the home and move her, consider hiring a Geriatric Care Manager local to your MIL who can handle a lot of the research, preparation, and logistics, which will minimize the time you need to spend here when you come for the actual move. You can coordinate by zoom or email.
Your answers to us (and thank you for being so participatory in the Forum) indicate this is not so much a MIL problem as it is a husband problem. You keep telling us that any answers we suggest will not work because of your husband.
This makes sense. I would, then, allow your husband to do what he wishes to do. There is little you can do to change the decisions and action of someone as regards their own flesh and blood.
Your only decision now involve whether you can or cannot continue to live with a husband who is acting in a manner you find disturbing. You are very unlikely to change him.
You may need simply to show him this thread, and to tell him he will have to do as he sees fit; he already knows your feelings in this matter, and YOU will have to do as YOU see fit for your own life and well-being.
I surely do wish you the best of luck. Marriage counseling might be a last ditch effort to mediate some of this.
Im not disturbed by my husband wanting to make sure he can do the best he can under the current circumstances, I’m just concerned & trying to find out what is a really bad idea as against not liking the situation but doing the best for everyone involved that he can accept, but I am disturbed you ended with your “advice” for marriage counselling.
All the best to you.
IMO it will be "best" (the least bad option) for you to allow the county to acquire guardianship of your MIL. The guardian will take care of all her needs, including financial. They will move her to a facility where she will get basic necessary care. They will at some point sell her mobile home and those funds will go to paying for her entitlement (Medicaid/Medi-Cal). DO NOT have her sign the property over to you as this will be seen as gifting and may disqualify or delay her entitlement for custodial housing.
Yes, it will be extremely difficult to manage care for an uncooperative and confused person from the other side of the world, multiple time zones away. You are very correct in thinking you may get to California only to find a person who cannot make a decision, or is maybe even paranoid due to her cognitive impairment.
I was managing care as PoA for 2 very elderly Aunts in FL when I am in MN. Even with the help of local FL relatives, I still found I needed to fly there at least once or twice a year to keep things straight. You will not have an easy time helping your MIL. Please allow someone else to do it.
No where in your post do you actually say the words "dementia" or "memory impairment" but that is exactly what you are describing (been there, done that). As PoA your husband may need a formal diagnosis from your Mom's doctor (good luck getting her to do this) if his PoA is not "durable". His best strategy truly may be to resign his PoA, since him inserting himself just delays his Mom's best solution.
FYI my family went through court-assigned guardianship for my very uncooperative and broke SFIL with progressing Parkinsons and Lewy Body dementia. It was the only, and best, solution for him. We had a positive experience with the guardian, as there were multiple levels of accountabiity with all aspects. They communicated with us as much as the privacy laws allowed, we could call him, visit, bring him gifts, etc. Please consider 3rd party guardianship as a solution for your situation.
Whatever you do, do NOT assume guardianship. If you do that in the USA the court will NEVER let you resign it. POA can be resigned through a court action (in the case of dementia) or through a simple legal letter (in the case of a competent senior) but guardianship is for life and you can't get out of it.
Think carefully about thinking this can be done long distance. I did management of care and POA/Trustee for a brother who was at the one end of California while I was at the other. It was a whole lot of airline travel, and very daunting. I encourage you to know that no matter how good the intentions, the reality and the sheer weight of USA bureaucracy may be a burden that simply cannot be bourn.
Whatever choices you make I wish you the best of luck.
I will also make sure she doesn’t sign the house over to him. I had assumed there would be implications for her in doing that because it’s the same here.
Thanks for your advice.
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