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I think you see Title 19 is a benefit for stroke but is is actually Medicaid for people under 65 who have a disability with low income. It is Medicaid under state and federal laws.. Your dad is on Medicare so he is not eligible for title 19. Either way the financial picture is the same. Once on Medicaid the choice will either be a SNF or Medicaid at home with possibly reduction in the number of hours for home care. I would consider expenses now between using a caregiver and putting him in AL now until he spends down.. Unless he is a frugal man with a lot of $$$.
Also many of us here wish we never heard the statement of promising to keep out of a SNF
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GB2112 May 2023
Just to clarify, Title 19/Medicaid can cover folks at any age (there are different sub-programs for different financial and health scenarios), and Medicare doesn’t make you ineligible for Medicaid — in fact Medicaid pays for my (93-year-old) mom’s Medicare premiums. For healthcare (doctor, hospital, etc.) Medicare gets billed first and generally Medicaid picks up the rest (depending on the procedure). She gets her homecare (Personal Care Attendants through an agency) billed directly to Medicaid as well. Currently she’s approved for 8 hours/day of assistance but if her needs change they will pay for more, up to and including live-in care. We are in CT.
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Seems like a lot of harsh comments here that I don’t understand. I completely understand your situation. My dad passed away just a few months ago. He also worried about the cost of care givers etc.. I understand your feelings and they are yours to feel. No one should blame you for feeling them. I also struggled but continued to do what I needed to keep him safe. The role reversal in caring for a parent is hard.
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You are a loving and honest daughter. You want what’s best for him. Please give him time and he will come around when he sees that you are right all along.
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My Dad is cheap - he couldn't Understand why we had help coming in ? Just expected me to do everything . The CNA was being covered by Medicare so he was only spending $67 a Month . I had meals on wheels coming In too and he didnt Like the food So I cooked a lot . I had PT coming in 2 - 4 X a week - The Girls were Up beat and he Liked the exercise and attention . You May want to get a social worker to intervene and Have a chat with him " That he should be Nicer to the Live in caregiver or he needs to go to assisted living . " Sometimes a Outside person with authority gets thru to him or bring Him to the doctors and have that discussion . The VNA has social workers . You can get a VNA Nurse to come In to check on Him too . I find the More help you have there is a Buffer . He Needs to stop Punishing you and the caregiver and get a wake up call . Guilt is a waste of energy - try to meditate instead and release negative feelings .
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Dad is going to be angry no matter what. Tell him you are too old to take care of him and his house plus yourself . If he finds himself with no caregivers willing to work for him , he goes to a care home .
Your local Agency for Aging can help with placement , or if he ends up in the hospital ask to speak to a social worker about placement in a nursing home if he has no caregivers willing to work for him . Don’t let the social worker tell you that you have to take him home. You tell the social worker that it’s an unsafe discharge , there is no one to care for him .
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CM makes a good point, but what he WANTS is for his elderly child to "do" for him and she has decided that she can no longer do that. So she hired a replacement for herself.

You COULD say she's being responsible by doing that (especially with all the stuff we keep hearing about social workers telling "kids" that they can be criminally prosecuted for not caring for their parents, which I think is hogwash) but if dad doesn't want a live in, then one could say "whatever you wish, sir" and let him figure it out for himself.

I just don't think THAT's going to make him any less angry.
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Caregiverstress May 2023
It is hogwash. You can be charged and prosecuted for elder abuse (physical and financial crimes), but you can’t be forced to care for your parent. There are laws on the books in many states that say an adult child is financially responsible for a parent if they can’t take care of themselves, but they are seldom/never enforced.

I had a social worker in CA tell me that by law I had to move back home to care for my father, or move him to me. I told her to go back to social worker school because she clearly doesn’t know her job.
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He likes living alone. Why does he need someone living in? Did he agree to this?
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sp19690 May 2023
He needs someone to cook, clean, shower him and he's a fall risk. OP had been doing it all but just can't anymore. She is after all a senior citizen herself.
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Talk about living too long. Shame the stroke didn't take him out.

Nice that dad wants his elderly child to do everything for him with no consideration about your physical limitations or health issues. The epitome of selfish.

His money will stretch further in a facility which us where he will wind up once the money for 24/7 caregivers runs out.
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Brenda3 May 2023
What a terrible thing to say.
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Oh. The infernal “I promise I’ll never put you in a nursing home” trope. “I promise that no matter what happens, even if I myself should become blind, halt, lame or fed up, even if my husband leaves me, my dog dies, we get evicted and my children become drug addicts - dearest mom and dad and spouse and disabled sibling, I WiLL NEVER REMIT YOU TO THE KINDLY CARE OF PROFESSIONALS WHO CAN CARE FOR YOU SO MUCH BETTER THAN I CAN.

“Furthermore, I promise upon all that matters, like clean water and a healthy planet and shoes that fit, I faithfully promise that I’ll continue to wipe your bottom, clean up your dog’s poop, pretend I don’t mind if you vomit all over me ten times a day and can’t understand anything I say, such as I am exhausted and can’t put new batteries in the remote or haul you for a mammogram tomorrow when you no longer get mammograms because you’ve aged out. Yep (mom, dad or other), I will be your caregiver for the next 20 years until you’re 100 years old, sacrificing every pleasure I ever had in life and the right to sleep at night without your pitifully calling out for your parents, who have been dead for 40 years, and begging me to let you go home.

“And dang it, I love feeling guilty! It goes with the territory along with crying quietly in the shower if I get to take one, which sometimes I don’t because your demands are such that I have no time to myself. If only I could go to a nursing home with 24/7 care where I could rest. Because what if I mattered? What if I hadn’t made that promise? What if I had a hope of outliving you, since at the rate we’re going, I’ll join the 30% of caregivers who drop dead before the ones they’re caring for?”

The Promise. It’s not a Hallmark movie. And no one should ever make it.
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cxmoody May 2023
This. Is. Brilliant, Fawnby.

I’m saving it.
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"This can't be a serious post"

Vent all you want. You just take what you want out of the responses and ignore the rest.

What I think was meant by that phrase was that your Dad is 98 and had a stroke. Not only because of his age but too because of his stroke, the is probably decline in his cognitivity . This makes it hard to reason with Dad. He gets angry with you because your the one that is there. What you may want to try and get across to him is that since he is 98 you are a Senior too. And as such, you just don't have the energy it takes to keep up two households. He needs help and you are not paying for it since he has the money. Its either he pays someone and allows them to help him or he needs to go to an Assisted living. You need to say this sitting down in front of him looking him right in the eye and be firm. Its his decision.

I have never heard Medicaid called Title 19. Learned something new today. 😊
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He's going to be angry no matter what you do.

He's safe, cared for and you don't even need to be in the picture if you don't want to.

With my mom, when she got 'in a mood' which happened now and then, I would simply say "I'm leaving and will come back when you are in better spirits". That always settled her down.

But I had the option of walking away for months and months, if I felt like it.

At 98, every day is a 'gift' so to speak. He doesn't HAVE years. It will feel like it, but when he's gone, you'll be surprised at the emotions that will bubble up.

You are doing and have done the best you can. Don't engage with him in 'fights'...and his CG can handle him as best she can--she can always quit, right? So she's probably used to this dynamic in elderly patients. (I'm using 'her' with the assumption that his CG is a woman. You don't say, so I am making a leap here).

Also, not being related to the stinker at hand makes it a lot easier to cope.

You have done NOTHING over which you should feel guilt!! Pre-grief is probably more like it. You won't likely be able to 'mend' your relationship with your dad. That makes us sad and we feel that way until we work through that grief.
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Right now, he is safe but angry. He may live longer but unhappy till he dies.

Or let him have his way. He may die sooner but happy.

Is he willing to compromise and meet you halfway? Instead of 24/7, maybe just a few hours check in each day?
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It "didn't occur to me" that someone would think this wasn't a serious post. I guess I'll rethink venting before I post anything else.
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PatsyN May 2023
Most of us "got" it. 😻
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Aging is not a pleasant process, but it's not our kids who are to blame.

Has your dad been evaluated for depression?

Strokes often cause cognitive changes and mood swings. Getting him seen by a geriatric psychiatrist would be your next positive step.
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Cc1954 May 2023
Thank you Barb. Good advice and will follow up.
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The other option is Skilled Nursing care which is likely cheaper than 24/7 in home caregivers. Not to mention safer and wiser for all concerned. Making promises about "never" placing an elder in managed care is akin to saying you'd never call 911 to get them medical attention in the hospital for critical care, either. Some medical situations require a team approach that one person cannot properly handle alone, especially if dementia is going on. And if dad is going to be so angry and blustering anyway, why not have him doing so in a safer environment?

At 98, he likely doesn't have "many years left" and you have no reason to feel guilt over anything. Most people don't get to live 98 years of life to begin with, so dad's way ahead of this game, still alive and living at home. He should count his blessings and you should stop visiting so often if all you get to see and hear is blustering!
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"Friends tell me I shouldn’t feel guilty for my choices"

This can't be a serious post.

If your Dad is 98, you OP are 60, 70? Let's say you're 70.

At 70, it never occurred to you, that even though someone at 98 is "trying so hard to prove he can still live alone", they might not be making wise decisions, and therefore you're the one taking wise decisions by hiring care? It never occurred to you that if he's refusing to shower, maybe his mind isn't 100% OK?
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